Fenestration devices, systems, and methods

• US 10,596,352 B2
• Filed: 12/28/2016
• Issued: 03/24/2020
• Est. Priority Date: 11/16/2010
• Status: Active Grant

• Current Assignee: W. L. Gore & Associates (W.L. Gore & Associates)
• Original Assignee: W. L. Gore & Associates (W.L. Gore & Associates)
• Inventors: Cully, Edward H.
• Primary Examiner(s): Orkin, Alexander J
• Application Number:
  US15/392,199
• Publication Number:
  US 20170216565A1
• Time in Patent Office: 1,182 Days
• CPC Class Codes: A61B 1/00082 Balloons
• CPC Class Codes: A61B 1/00085 Baskets
• CPC Class Codes: A61B 1/00154 using guiding arrangements for insertion
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61F 2/07 Stent-grafts
• CPC Class Codes: A61F 2/89 the wire-like elements comprising two or more adjacent rings flexibly connected by separate members
• CPC Class Codes: A61F 2/958 Inflatable balloons for placing stents or stent-grafts
• CPC Class Codes: A61F 2002/061 provided with means for allowing access to secondary lumens
• CPC Class Codes: A61F 2250/0007 for adjusting length
• CPC Class Codes: A61M 2025/1045 for treating bifurcations, e.g. balloons in y-configuration, separate balloons or special features of the catheter for treating bifurcations
• CPC Class Codes: A61M 25/0108 using radio-opaque or ultrasound markers
• CPC Class Codes: A61M 25/0662 Guide tubes

Abstract

The present disclosure provides methods and apparatuses for guiding an endovascular tool, such as a puncturing tool or an angioscope, in a radial direction, such as toward or through the sidewall of a vessel, stent, or stent graft, using elongate members and specialized catheters. The present disclosure provides methods and apparatuses for locating branch vessels from within a grafted main vessel while maintaining continuous blood flow to the branch vessel. Another aspect of the present disclosure involves a reverse cannulation system, particularly useful for stenting the abdominal aorta proximate the renal arteries and stenting the renal artery.

Claims

1. A guide device deployable through a vessel comprising:

an expandable member including a plurality of slats, each of which is movable between a collapsed position and an outwardly extending, expanded position, at least one of the slats including an inner surface, an outer surface, and an aperture extending between and through the inner surface and the outer surface and the aperture being located on the slat that permits an endovascular tool to pass from a guide tube through the aperture;

the guide tube having a distal tip operatively coupled to the expandable member;

a first elongate member comprising a first lumen; and

a second elongate member comprising a second lumen, wherein the expandable member extends between a first end connected to the first elongate member and an opposite second end connected to the second elongate member, such that the expandable member expands outwardly in response to longitudinal displacement of the second elongate member relative to the first elongate member, wherein the longitudinal displacement of the second elongate member is configured to apply a compression or a tension force to the expandable member and is configured to result in a radial expansion of the expandable member.

2. The guide device of claim 1, wherein the expandable member moves in response to selective actuation of the expandable member between the collapsed and expanded positions.

3. The guide device of claim 1, wherein the guide tube is flexible and is configured to bend as the expandable member outwardly bends in response to corresponding longitudinal displacement of the second elongate member relative to the first elongate member.

4. The guide device of claim 1, wherein the expandable member has a discontinuous structure to allow perfusion of fluid therethrough when in an expanded position.

5. The guide device of claim 1, wherein the expandable member is configured to permit perfusion of fluid around the guide device when the expandable member is in the collapsed configuration and to permit perfusion between the plurality of slats of the expandable member when the expandable member is in the expanded positions.

6. The guide device of claim 1, wherein the radial expansion of the expandable member is substantially radially symmetrical.

7. The guide device of claim 1, wherein the expandable member comprises nitinol.

8. The guide device of claim 1, wherein the expandable member is adjustable across a range of expanded position diameters.

9. The guide device of claim 1, wherein the distal tip comprises a radiopaque material.

10. The guide device of claim 1, wherein at least a portion of the first elongate member, the second elongate member, and the guide tube are coaxial along their lengths.