Minimally invasive treatment system for aortic aneurysms

• US 20040117003A1
• Filed: 05/28/2003
• Published: 06/17/2004
• Est. Priority Date: 05/28/2002
• Status: Abandoned Application

• Current Assignee: Cleveland Clinic Foundation
• Original Assignee: Cleveland Clinic Foundation
• Inventors: Jordan, Lisa K., Goodson, Harry B., Ouriel, Kenneth
• Application Number:
  US10/446,472
• Publication Number:
  US 20040117003A1
• Time in Patent Office: Days
• US Class Current: 623/1.35
• 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 2002/061 provided with means for allowing access to secondary lumens
• 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 2002/828 Means for connecting a plurality of stents allowing flexibility of the whole structure
• CPC Class Codes: A61F 2002/8483 Barbs
• CPC Class Codes: A61F 2220/005 using adhesives
• CPC Class Codes: A61F 2220/0075 sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2230/0054 V-shaped
• CPC Class Codes: A61F 2230/0078 hyperboloidal

Abstract

An endoluminal prosthesis (10) comprises a radially expandable tubular segment (12) having a first end (32), a second end (34), a lumen interconnecting the first end (32) and the second end (34). A connection portion (52) defines an opening in the tubular segment (12) in fluid communication with the lumen. The connection portion (52) includes a converging portion (54), an annular diverging portion (56) and an annular neck portion (58) interconnecting the converging portion (52) and the diverging portion (56).

Claims

1. An endoluminal prosthesis comprising:

a radially expandable tubular segment having a first end, a second end, a lumen interconnecting the first end and the second end, and a connection portion defining an opening in the tubular segment in fluid communication with the lumen, the connection portion including a converging portion, an annular diverging portion and an annular neck portion interconnecting the converging portion and the diverging portion.

2. The endoluminal prosthesis of claim 1, wherein the diverging portion comprises an annular member that tapers radially inward to the neck portion.

3. The endoluminal prosthesis of claim 2, wherein the diverging portion is provided in an open configuration by a support member.

4. The endoluminal prosthesis of claim 1 wherein the connection portion has an essentially hourglass shape.

5. The endoluminal prosthesis of claim 1, wherein the first end includes the opening defined by the connection portion and the second end includes a second opening, the opening defined by the connection portion and the second opening being in fluid communication with each other via the lumen.

6. The endoluminal prosthesis of claim 1 being deployed within the vasculature to treat a infrarenal abdominal aortic aneurysm.

7. The endoluminal prosthesis of claim 1 being deployed within the vasculature to treat a suprarenal abdominal aortic aneurysm.

8. The endoluminal prosthesis of claim 5, further comprising a second radially expandable tubular segment, the second segment having a first end, a second end, a lumen interconnecting the first end and the second end, and a second connection portion defining an opening in a mid-portion of the second tubular segment between the first end and the second end of the second segment, the opening in the mid-portion being in fluid communication with the lumen of the second segment, the second connection portion being capable of joining with the first connection portion in situ to form a mechanical junction that allows fluid flow between the first segment and the second segment.

9. The endovascular prosthesis of claim 8, wherein the second connection portion includes a converging portion, an annular diverging portion and an annular neck portion interconnecting the converging portion and the diverging portion.

10. The endoluminal prosthesis of claim 9, wherein the diverging portion of the second segment is perpendicularly offset from the lumen of the second segment to provide the second connection portion with an essentially hourglass shape.

11. The endoluminal prosthesis of claim 9, wherein the first connection portion includes an outer surface and the second connection portion includes an inner surface, the inner surface of the second connection portion engaging the outer surface of the first connection portion when the first connection portion and second connection portion are joined to form the mechanical junction.

12. The endoluminal prosthesis of claim 1, wherein the first segment includes a means for creating a fluid tight seal between the first segment and a wall of a body lumen.

13. The endoluminal prosthesis of claim 12, wherein the means for creating a fluid-tight seal comprises a plurality of substantially radially oriented hooks that extend from the first segment and enter the wall of the lumen in a rotational manner to draw the first segment into close apposition with the wall.

14. The endoluminal prosthesis of claim 13, wherein the first segment includes an anchoring means to inhibit axial motion of the first segment within the lumen.

15. An endoluminal prosthesis comprising:

a first radially expandable tubular segment that includes a first lumen;

a second radially expandable tubular segment that includes a second lumen; and

a junction connecting the first radially expandable tubular segment and the second radially expandable tubular segment, the junction allowing fluid flow from the first lumen to the second lumen, the junction comprising an annular converging portion, an annular diverging portion and an annular neck portion interconnecting the converging portion and the diverging portion.

16. The endoluminal prosthesis of claim 15 wherein the first segment includes a first connection portion and the second segment includes a second connection portion, the first connection portion engaging the second connection portion to form the junction.

17. The endoluminal prosthesis of claim 16 wherein the first connection portion includes a first converging portion, a first annular diverging portion and a first annular neck portion interconnecting the first converging portion and the first diverging portion and the second connection portion includes a second converging portion, a second annular diverging portion and a second annular neck portion interconnecting the second converging portion and the second diverging portion.

18. The endoluminal prosthesis of claim 17, wherein the first diverging portion includes a first support member that provides the diverging portion in an open configuration and the second diverging portion includes a second support member that provides the second diverging portion in an open configuration.

19. The endoluminal prosthesis of claim 18, wherein the first segment includes a first end and a second end, the first connection portion providing an opening in the first end which is in fluid communication with the first lumen.

20. The endoluminal prosthesis of claim 19, wherein the first diverging portion and first converging portion are tapered radially inward to the first neck portion.

21. The endoluminal prosthesis of claim 20 being deployed within the vasculature to treat a suprarenal abdominal aortic aneurysm.

22. The endoluminal prosthesis of claim 18, wherein the second segment includes a first end, a second end in fluid communication with the first end via the second lumen, and a mid-portion between the first end and the second end, the second connection member defining a side opening in the mid-portion.

23. The endoluminal prosthesis of claim 22, wherein the second diverging portion of the second connection portion comprises an annular member that is tapered radially inward to the second lumen.

24. The endoluminal prosthesis of claim 23 being deployed within the vasculature to treat an infrarenal abdominal aortic aneurysm

25. The endoluminal prosthesis of claim 15, wherein the first segment includes a means for creating a fluid tight seal between the segment and a wall of a body lumen.

26. The endoluminal prosthesis of claim 25, wherein the means for creating a fluid-tight seal comprises a plurality of substantially radially oriented hooks that extend from the first segment and enter the wall of the lumen in a rotational manner to draw the first segment into close apposition to the wall.

27. The endoluminal prosthesis of claim 25, wherein the first segment includes an anchoring means to inhibit axial motion of the first segment within the lumen.

28. An endoluminal prosthesis for treating a suprarenal abdominal aortic aneurysm, the endoluminal prosthesis comprising:

a radially expandable tubular trunk segment having a first end, a second end, a lumen interconnecting the first end and the second end, and at least two connection portions defining openings in a mid-portion of the trunk segment between the first end and the second end of the trunk segment, the openings in the mid-portion being in fluid communication with the lumen of the trunk segment, at least one of the connection portions comprising an annular converging portion, an annular diverging portion and an annular neck portion interconnecting the converging portion and the diverging portion.

29. The endoluminal prosthesis of claim 28, further comprising a radially expandable tubular branch segment, the branch segment having a first end, a second end, a lumen interconnecting the first end and the second end, and a second connection portion, the second connection portion being capable of joining with at least one of the connection portions of the trunk segment in situ to form a mechanical junction that allows fluid flow between the trunk segment and the branch segment.

30. The endoluminal prosthesis of claim 29, wherein the second connection portion includes a converging portion, an annular diverging portion and an annular neck portion interconnecting the converging portion and the diverging portion.

31. The endoluminal prosthesis of claim 30, wherein the first end of the branch segment includes an opening defined by the second connection portion and the second end includes a means for attaching the second end of the branch segment within a branch artery of the aorta.

32. The endoluminal prosthesis of claim 31, wherein the branch artery comprises a renal artery, a superior mesenteric artery, or a celiac artery.

33. The endoluminal prosthesis of claim 28, wherein the trunk segment includes four connection portions defining four openings in the mid-portion of the trunk segment and at least one of the four connection portions comprises an annular converging portion, an annular diverging portion, and an annular neck portion interconnecting the converging portion and the diverging portion.

34. The endoluminal prosthesis of claim 33, wherein the four connection portions of the trunk segment each include an annular converging portion, an annular diverging portion and an annular neck portion interconnecting the converging portion and the diverging portion.

35. The endoluminal prosthesis of claim 34, further comprising four radially expandable branch segments, each branch segment having a first end, a second end, a lumen interconnecting the first end and the second end, and a second connection portion, the second connection portion of at least one of the branch segments being capable of joining with at least one of the connection portions of the trunk segment in situ to form a mechanical junction that allows fluid flow between the trunk segment and the branch segment.

36. A method of treating an aortic aneurysm, said method comprising the steps of:

deploying a first radially expandable tubular segment, the first segment having a first end, a second end, a lumen interconnecting the first end and the second end, and a first connection portion defining an opening in a mid-portion of the first segment between the first end and the second end, the first connection portion including a converging portion, an annular diverging portion and an annular neck portion interconnecting the converging portion and the diverging portion; and

deploying a second radially expandable tubular segment, the second segment including a distal end, a proximal end, a lumen interconnecting the distal end and the proximal end, and a second connection portion defining an opening in the either end in fluid communication with the lumen, the second connection portion including a converging portion, an annular diverging portion and an annular neck portion interconnecting the converging portion and the diverging portion, the second connection portion and the first connection portion forming an end-to-side junction which allows fluid flow between the first segment and the second segment.

37. A method of treating an infrarenal abdominal aortic aneurysm requiring only unilateral arterial access, said method comprising the steps of:

advancing a guide wire through an arterial access site in the ipsilateral iliac or femoral artery, over the aortic bifurcation and at least partially into the contralateral iliac artery,

advancing over the guide wire a first delivery system containing a first radially expandable tubular segment, the first segment having a first end, a second end, a lumen interconnecting the first end and the second end, and a first connection portion defining an opening in a mid-portion of the first segment between the first end and the second end, the first connection portion including a converging portion, an annular diverging portion and an annular neck portion interconnecting the converging portion and the diverging portion,

deploying the first segment into both iliac arteries, over the aortic bifurcation, such that said the opening is deployed near the apex of the bifurcation or directly into the aorta,

re-positioning the guide wire, or placing a new wire, so that it extends from the arterial access site through the opening in the mid-portion of the first segment and into the aorta,

advancing over the guide wire placed into the aorta a second delivery system containing a second radially expandable tubular segment, the second segment including a distal end, a proximal end, a lumen interconnecting the distal end and the proximal end, and a second connection portion defining an opening in the distal end in fluid communication with the lumen, the second connection portion including a converging portion, an annular diverging portion and an annular neck portion interconnecting the converging portion and the diverging portion, and

deploying the second segment into the aorta such that the second connection portion and the first connection portion form and end-to-side junction that allows fluid flow between the first segment and the second segment.

38. A method of treating an suprarenal abdominal aortic aneurysm requiring only unilateral arterial access, said method comprising the steps of:

deploying a radially expandable tubular trunk segment having a first end, a second end, a lumen interconnecting the first end and the second end, and at least two connection portions defining openings in a mid-portion of the trunk segment between the first end and the second end of the trunk segment, the openings in the mid-portion being in fluid communication with the lumen of the trunk segment, at least one of the connection portions comprising an annular converging portion, an annular diverging portion and an annular neck portion interconnecting the converging portion and the diverging portion; and

deploying a radially expandable tubular branch segment, the branch segment having a first end, a second end, a lumen interconnecting the first end and the second end, and a second connection portion, the second connection portion including a converging portion, an annular diverging portion and an annular neck portion interconnecting the converging portion and the diverging portion, the second connection portion being capable of joining with at least one of the connection portions of the trunk segment in situ to form a mechanical junction that allows fluid flow between the trunk segment and the branch segment.

39. An endovascular prosthesis comprising,

a radially expandable tubular graft layer having a first end, a second end and a lumen extending between the first end and the second end, the first end including a plurality of substantially radially oriented hooks that extend from the graft layer to provide a fluid tight seal between graft layer of the first end and a wall of the vasculature.

40. The endovascular prosthesis of claim 39, wherein the hooks enter the wall of the vasculature in a rotational manner to draw the first end into close apposition to the wall.

41. The endovascular prosthesis of claim 40, wherein the hooks extend in a substantially coplanar configuration that is essentially perpendicular to blood flow through the endovascular prosthesis.

42. The endovascular prosthesis of claim 41, wherein the hooks are deployed in an essentially geometric plane, that is essentially perpendicular to the blood flow within the vasculature.

43. The endovascular prosthesis of claim 39, wherein the hooks include a rough-textured surface to promote a heightened localized biological response.

44. The endovascular prosthesis of claim 39, further comprising an anchoring means for securing the endovascular prosthesis within the vasculature.

45. The endovascular prosthesis of claim 44, wherein the anchoring means secures the endovascular prosthesis within the vasculature by substantially inhibiting axial motion of the endovascular prosthesis relative to the vasculature.

46. The endovascular prosthesis of claim 39 being deployed to treat at least one of a suprarenal abdominal aortic aneurysm and an infrarenal abdominal aortic aneurysm.

47. An endovascular prosthesis comprising,

a radially expandable tubular graft layer having a first end, a second end and a lumen extending along an axis between the first end and the second end, the first end including a plurality of substantially radially oriented hooks, the hooks being curved to enter a wall of a vasculature upon axial rotation of the endovascular prosthesis and draw the first end into close apposition to the wall so as to form a fluid tight seal between the graft layer of the first end and the wall of the vasculature

48. The endovascular prosthesis of claim 47, wherein the hooks extend in a substantially coplanar configuration that is essentially perpendicular to the axis.

49. The endovascular prosthesis of claim 48, wherein the hooks include a rough-textured surface to promote a heightened localized biological response, increase scar tissue formation, and enhance the fixation of the hooks.

50. The endovascular prosthesis of claim 49, further comprising an anchoring means for substantially inhibiting axial motion of the endovascular prosthesis relative to the vasculature.

51. The endovascular prosthesis of claim 50, wherein the anchoring means includes hooks which penetrate the vasculature, the hooks of the anchoring means being deployed at an angle of less than 90 degrees with the direction of blood flow through the endovascular prosthesis.

52. The endovascular prosthesis of claim 47 being deployed to treat at least one of a suprarenal abdominal aortic aneurysm and an infrarenal abdominal aortic aneurysm.

53. An endovascular prosthesis comprising,

a radially expandable tubular graft layer having a first end, a second end and a lumen extending along an axis between the first end and a second end, the first end including an anchoring means for substantially inhibiting axial motion of the endovascular prosthesis relative to the vasculature and a sealing means to provide a fluid tight seal between graft layer of the first end and a wall of the vasculature, the anchoring means and sealing means being separate from one another.

54. The endovascular prosthesis of claim 53, wherein the sealing means comprises a plurality of substantially radially oriented hooks, the hooks being curved to enter a wall of a vasculature upon axial rotation of the endovascular prosthesis and draw the first end into close apposition to the wall so as to form a fluid tight seal between the graft layer of the first end and the wall of the vasculature.

55. The endovascular prosthesis of claim 54, wherein the hooks extend in a substantially coplanar configuration that is essentially perpendicular to blood flow through the endovascular prosthesis.

56. A method of deploying an endovascular prosthesis within a vasculature, the method comprising the steps of:

providing an endovascular prosthesis that includes a radially expandable tubular graft layer having a first end, a second end, a lumen extending between the first end and the second end, and a plurality of substantially radially oriented hooks extending from the first end, the hooks being curved to enter a wall of the vasculature upon axial rotation of the endovascular prosthesis, and

rotationally embedding the substantially radially oriented hooks of the first end into the wall of the vasculature to achieve a fluid-tight seal.

57. A method of forming a fluid tight seal between an endovascular prosthesis and a wall of a vasculature, the method comprising the steps of:

providing an endovascular prosthesis that includes a radially expandable tubular graft layer having a first end, a second end, a lumen extending between the first end and the second end, and a plurality of substantially radially oriented hooks extending from the first end, the hooks being curved to enter a wall of the vasculature upon axial rotation of the endovascular prosthesis, and

rotationally embedding the substantially radially oriented hooks of the first end into the wall of the vasculature.