Thoracic arch stent graft and method of delivery

• US 20080114445A1
• Filed: 10/23/2007
• Published: 05/15/2008
• Est. Priority Date: 10/24/2006
• Status: Active Grant

• Current Assignee: Cook Medical Incorporated (Cook Group Incorporated)
• Original Assignee: Cook Incorporated (Cook Group Incorporated), William A. Cook Australia Pty. Ltd (Cook Group Incorporated)
• Inventors: Van Schie, Gregory, Lawrence-Brown, Michael, Hartley, David, Melsheimer, Jeffry
• Granted Patent: US 8,425,585 B2
• Time in Patent Office: Days
• US Class Current: 623/1.13
• CPC Class Codes: A61F 2/07 Stent-grafts
• CPC Class Codes: A61F 2/885 comprising a coil including a plurality of spiral or helical sections with alternate directions around a central axis
• 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 2002/075 the stent being loosely attached to the graft material, e.g. by stitching
• CPC Class Codes: A61F 2002/826 more than one stent being applied sequentially
• CPC Class Codes: A61F 2002/828 Means for connecting a plurality of stents allowing flexibility of the whole structure

Abstract

A stent arrangement (12) and a stent graft (2) for curved lumens of the body. The stent graft has a tubular body (4) of a graft material, at least a portion of which may be arcuate to define an inner curved side (4b) and an outer curved side (4a) at least when deployed into the curved vessel. The stent graft has a plurality of self expanding stents (10, 12, 13) affixed thereto with a greater distance (11a) between the stents on the outer curved side than on the inner curved side. The stents can be normal, tapered on one or both ends or skewed. When mounted onto a deployment device a twist (152, 154) may be provided in the graft material between adjacent stents to nest the stents.

Claims

1. A stent comprising a wire formed into a plurality of struts and bends between adjacent struts, the struts defining a cylindrical body and the bends at each end defining respective planes transverse to the longitudinal axis of the cylindrical body wherein at least one of the planes is angled with respect to a plane at right angles to the longitudinal axis of the cylindrical body whereby the stent is tapered on one or both ends or is skewed.

2. A stent as in claim 1 wherein the stent is a zig zag stent comprising longer struts and shorter struts.

3. A stent as in claim 1 wherein the wire is stainless steel or a shape memory whereby to form a self expanding stent.

12. A stent graft as in claim 1 wherein the stent graft comprises first, second, third and subsequent stents from its proximal end, the first stent being a tapered stent, the second stent being a normal stent and the third stent being a tapered stent and wherein the tapered stents are mounted to the tubular body with their longer sides on the outer curve of the tubular body.

4. A stent graft for curved lumens of the body, the stent graft comprising a tubular body of a graft material, at least a portion of which is arcuate to define an inner curved side and an outer curved side, the stent graft comprising a plurality of self expanding stents affixed thereto and spaced apart along at least a portion of the tubular body, there being a greater spacing apart between adjacent stents on the outer curved side than on the inner curved side on at least the portion of the tubular body.

5. A stent graft as in claim 4 wherein the stents are zig-zag self expanding stents having a plurality of struts and bends between adjacent struts.

6. A stent graft as in claim 4 wherein at least some of the stents are normal stents comprising a wire formed into a plurality of struts and bends between adjacent struts, the struts defining a cylindrical body and the bends at each end defining respective planes transverse to the longitudinal axis of the cylindrical body with the planes substantially parallel to each other and substantially at right angles to the longitudinal axis of the cylindrical body and at least some of the stents are tapered stents comprising a wire formed into a plurality of struts and bends between adjacent struts, the struts defining a cylindrical body and the bends at each end defining respective planes transverse to the longitudinal axis of the cylindrical body with at least one of the planes being angled with respect to the plane at right angles to the longitudinal axis of the cylindrical body whereby to define a tapered stent having one or two tapered ends.

7. A stent graft as in claim 4 wherein at least some of the stents are tapered to define longer struts and shorter struts and the tapered stents are affixed to the tubular body with the longer struts on the outer curved side and the shorter struts on the inner curved side.

8. A stent graft as in claim 4 wherein at least some of the stents comprising a wire formed into a plurality of struts and bends between adjacent struts, the struts defining a cylindrical body and the bends at each end defining respective planes transverse to the longitudinal axis of the cylindrical body, and wherein at least one of the planes of the bends are at an angle to transverse to the longitudinal axis of the cylindrical body, whereby to define a tapered stent having one or two tapered ends and wherein the tapered stent is mounted to the tubular body with the longer side on the outer curve of the tubular body.

9. A stent graft as in claim 4 wherein the stent graft comprises first, second, third and subsequent stents from its proximal end, the first stent being a skewed stent, the second stent being a normal stent and the third stent being a skewed stent, the skew on the third stent being opposite to that of the first stent.

10. A stent graft as in claim 4 wherein the stent graft comprises first, second, third and subsequent stents from its proximal end, the first, second and third stents being tapered stents and wherein the tapered stents are mounted to the tubular body with their longer sides on the outer curve of the tubular body.

11. A stent graft as in claim 4 wherein the stent graft comprises first, second, third and subsequent stents from its proximal end, the first, second and third stents being tapered stents, the first stent comprising a taper on its distal end, the second stent comprising a taper at both its proximal and distal ends and the third stent comprising a taper on its proximal end and wherein the tapered stents are mounted to the tubular body with their longer sides on the outer curve of the tubular body.

13. A stent graft as in claim 4 wherein the proximal-most stent is inside the tubular body and the remaining stents are on the outside of the tubular body.

14. A stent graft for curved lumens of the body, the stent graft having a tubular body of a graft material, at least a portion of which is arcuate to define an inner curved side and an outer curved side, the stent graft having a plurality of self expanding stents affixed thereto, at least some of the stents being tapered to define longer struts and shorter struts and the tapered stents being affixed to the tubular body with the longer struts on the outer curved side and the shorter struts on the inner curved side, the tapered stents being spaced apart longitudinally on the tubular body whereby the tubular body can be twisted substantially by half a turn between at least some of the adjacent stents when loaded into a deployment device whereby to nest the stents in the deployment device.

15. A stent graft as in claim 14 wherein the tapered stents comprise a plurality of struts and bends between adjacent struts, the struts defining a cylindrical body and the bends at each end defining respective planes transverse to the longitudinal axis of the cylindrical body, and wherein at least one of the planes of the bends are at an angle transverse to the longitudinal axis of the cylindrical body, whereby to define a tapered stent comprising one or two tapered ends and wherein the tapered stent is mounted to the tubular body with the longer side on the outer curve of the tubular body.

16. A stent graft as in claim 14 wherein the tapered stents are fastened to the tubular body at only their proximal or distal ends of the stent or intermediate their ends.

17. A stent graft as in claim 14 wherein the circumferential twisting between adjacent tapered stents is each clockwise or anticlockwise twisting or alternatively clockwise and anticlockwise.

18. A stent graft as in claim 14 wherein each of at least the tapered stents includes a radiopaque marker whereby the relative position of a stent being deployed with respect to a stent already deployed can be determined during deployment.

19. A stent graft as in claim 14 wherein the stents have a marker on their longer sides whereby during deployment the introduction device can be rotated as each stent is released to ensure that each stent and hence the tubular body is correctly placed so that the arcuate portion is in a curved vessel in the desired orientation.

20. A stent graft introduction device in combination with a stent graft, the stent graft comprising a tubular body of a biocompatible graft material and comprising at least a portion nearer the proximal end thereof which is arcuate to define an inner curved side and an outer curved side, the stent graft having a plurality of stents affixed thereto, a first stent at the proximal end being a cylindrical normal self expanding stent, at least the next three stents being tapered stents and the balance of the stents to the distal end of the tubular body being cylindrical normal stents, the tapered stents being mounted to the tubular body such that their longer sides are on the outer curved side of the tubular body, at least the tapered stents having radiopaque markers thereon to facilitate alignment during deployment, the stent graft being retained on the introduction device such that there is a twist in one circumferential direction between the first tapered stent and a second tapered stent and a further twist in the same or the opposite circumferential direction between the second tapered stent and a third tapered stent whereby to nest adjacent stents with each other on the deployment device.