Modular stent graft assembly and use thereof

• US 20020198587A1
• Filed: 03/22/2002
• Published: 12/26/2002
• Est. Priority Date: 03/28/2001
• Status: Active Grant

• Current Assignee: Cook Medical Technologies, LLC (Cook Group Incorporated)
• Original Assignee: Cook Incorporated (Cook Group Incorporated)
• Inventors: Mead, Jason A., Greenberg, Roy K.
• Granted Patent: US 7,160,318 B2
• Time in Patent Office: Days
• US Class Current: 623/1.13
• 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 2/95 Instruments specially adapted for placement or removal of stents or stent-grafts
• CPC Class Codes: A61F 2002/065 Y-shaped blood vessels
• CPC Class Codes: A61F 2002/067 modular
• CPC Class Codes: A61F 2002/075 the stent being loosely attached to the graft material, e.g. by stitching
• CPC Class Codes: A61F 2002/9511 the retaining means being filaments or wires
• CPC Class Codes: A61F 2230/0054 V-shaped
• CPC Class Codes: A61F 2230/0067 conical
• CPC Class Codes: A61F 2250/0039 differing in diameter

Abstract

A modular stent graft assembly (10) for repairing a ruptured abdominal aorta aneurysm (90) and having an aortic section tubular graft (12) and an iliac section tubular graft (14). The aortic section graft has a proximal attachment stent (32) thereon for suprarenal attachment of the assembly (10) to the aorta. A proximal end portion (50) of the iliac section graft (14) underlies the distal end portion (28) of the aortic graft (12) and presses outwardly thereagainst forming a a friction fit, at a telescoping region (64). The assembly (10) can be selected from an inventory (300) containing a set of delivery systems (100) of four size aortic section grafts (12) and a set of delivery systems (200) of four size iliac section grafts (14), that together accommodate a large majority of aneurysm sizes, and delivery systems (250) containing four standard sizes of occluders (80).

Claims

1. A modular stent graft assembly for repairing a ruptured or symptomatic aneurysm comprising;

an aortic section including a first tubular graft having a proximal end portion and a distal end portion, said distal end portion having a first constant diameter for a first predetermined length, said proximal end portion having a second diameter greater than said first constant diameter and sized for leakproof engagement against an aortic artery, said aortic section also including a first plurality of stents attached along said first tubular graft; and

an iliac section including a second tubular graft including a distal end portion having a third diameter sized for leakproof engagement against an iliac artery, said second tubular graft also including a proximal end portion having a fourth constant diameter for a second predetermined length and approximating said first constant diameter of said distal end portion of said aortic section, said iliac section also including a second plurality of stents attached along said second tubular graft, whereby when said aortic and iliac sections are positioned in an aortic artery and an iliac artery, respectively, said proximal end portion of said iliac section and said distal end portion of said aortic section overlap at least a minimum length and engage each other when positioned one within another for said at least minimum length.

2. The modular stent graft assembly of claim 1, wherein said aortic section is selected from a set of aortic sections each having a proximal end portion with a second diameter different from the second diameter of any other proximal end portion of the aortic sections in the set and greater than said first constant diameter of the distal end portion of said aortic section.

3. The modular stent graft assembly of claim 2, wherein the second diameter of the proximal end portion of the first tubular graft is in a range of 22 to 34 mm.

4. The modular stent graft assembly of claim 3, wherein said first and said fourth constant diameter are approximately 12 mm.

5. The modular stent graft assembly of claim 2, wherein said iliac section is selected from a set of iliac sections each having a distal end portion with a third diameter different from the third diameter of any other distal end portion of the iliac sections in the set and at least equal to said fourth constant diameter of the proximal end portion of said iliac section.

6. The modular stent graft assembly of claim 5, wherein the third diameter of the distal end portion of the second tubular graft is in a range of 12 to 24 mm.

7. The modular stent graft assembly of claim 1, wherein said first tubular graft has a tapered transition portion between said proximal end portion and said distal end portion and wherein said tapered transition portion has not more than two stents from said first plurality of stents attached therealong.

8. The modular stent graft assembly of claim 7, wherein said first predetermined length of said distal end portion of said first tubular graft is in a range of 60 to 70 mm.

9. The modular stent graft assembly of claim 1, wherein said first tubular graft has a total length in a range of 108 to 127 mm.

10. The modular stent graft assembly of claim 9, wherein said second tubular graft has a total length in a range of 94 to 110 mm.

11. The modular stent graft assembly of claim 1, wherein said second tubular graft has a tapered transition portion between said distal end portion and said proximal end portion and wherein said tapered transition portion has not more than two stents from said second plurality of stents attached therealong.

12. The modular stent graft assembly of claim 11, wherein said second predetermined length is in a range of 56 to 73 mm.

13. The modular stent graft assembly of claim 1, wherein said assembly further comprises a bypass graft for interconnecting the contralateral and ipsilateral iliac arteries.

14. The modular stent graft assembly of claim 1, wherein said assembly further comprises an occluder including a tubular graft and at least one stent, said graft having a constant diameter in a range of 14 to 24 mm.

15. The modular stent graft assembly of claim 1, wherein said aortic section includes an attachment stent attached to a proximal end of said first tubular graft and extending proximally therefrom.

16. The modular stent graft assembly of claim 1, wherein said first and said second plurality of stents are attached to said first and said second tubular grafts, respectively, with first and second sets of predetermined spacings or gaps longitudinally therebetween, respectively.

17. The modular stent graft assembly of claim 1, wherein said at least minimum length where said aortic and said iliac sections overlap includes at least two or more stents from each of said first and second plurality of stents.

20. The method according to claim 19 also including the step of inserting an occluder in the other iliac artery.

18. A modular stent graft assembly for repairing a ruptured or symptomatic aneurysm in an aortic artery, said assembly comprising an aortic section including a first tubular graft having a proximal end portion and a distal end portion, said distal end portion having a first constant diameter for a first predetermined length, said proximal end portion having a second diameter greater than said first constant diameter and sized for leakproof engagement within an aortic artery, said aortic section also having a first plurality of stents attached along said first tubular graft;

an iliac section including a second tubular graft including a distal end portion having a third diameter sized for leakproof engagement within an aortic artery, said first section also having a first plurality of stents attached along said first tubular graft;

an iliac section including a second tubular graft including a distal end portion having a third diameter sized for leakproof engagement against an iliac artery, said second tubular graft also including a proximal end portion having a fourth constant diameter for a second predetermined length and approximating said first constant diameter of said distal end portion of said first section, said iliac section also having a second plurality of stents attached along said second tubular graft, whereby when said aortic and iliac sections are positioned in an aortic artery and iliac artery, respectively, said proximal end portion of said iliac section and said distal end portion of said first section overlap at least a minimum length and engage each other when positioned one within another for said at least minimum length, and an occluder for the other iliac artery whereby the flow of blood to both iliac arteries can be maintained by a bypass graft between the two iliac arteries.

19. A method of repairing a ruptured or symptomatic aneurysm in an aortic artery by a modular stent graft assembly comprising the steps of:

inserting in the aortic artery an aortic section of the assembly including a first tubular graft having a proximal end portion and a distal end portion, said distal end portion having a first constant diameter for a first predetermined length, said proximal end portion having a second diameter greater than said first constant diameter and sized for leakproof engagement against an aortic artery, said aortic section also including a first plurality of stents attached along said first tubular graft; and

inserting in an iliac artery and into said aortic section an iliac section of the assembly including a second tubular graft including a distal end portion having a third diameter sized for leakproof engagement against an iliac artery, said second tubular graft also including a proximal end portion having a second constant diameter for a second predetermined length and approximating said first constant diameter of said distal end portion of said aortic section, said iliac section also including a second pluality of stents attached along said second tubular graft, whereby when said aortic and iliac sections are positioned in an aortic artery and an iliac artery, respectively, said proximal end portion of said iliac section and said distal end portion of said aortic section overlap at least a minimum length and engage each other when positioned one within another for said at least minimum length.