Bloused Stent-Graft and Fenestration Method

• US 20090240316A1
• Filed: 03/20/2008
• Published: 09/24/2009
• Est. Priority Date: 03/20/2008
• Status: Active Grant

• Current Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Original Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Inventors: Bruszewski, Walter
• Granted Patent: US 8,100,960 B2
• Time in Patent Office: Days
• US Class Current: 623/1.130
• 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 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 2230/0013 Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped

Abstract

A method includes deploying a bloused stent-graft into a main vessel such that a bloused section of the bloused stent-graft covers a branch vessel emanating from the main vessel. The bloused section includes loose graft cloth. A pressure differential between the main vessel and the branch vessel causes the bloused section to be forced into an ostium of the branch vessel creating a pocket aligned with the branch vessel. A distal tip of a puncture device is located in the pocket and thus aligned with the branch vessel. An outward force is applied to the puncture device to cause the distal tip of the puncture device to fenestrate the bloused section thus creating a collateral opening in the bloused section precisely aligned with the branch vessel.

Claims

1. A bloused stent-graft comprising:

a proximal section having a first diameter;

a distal section having a second diameter; and

a bloused section attached to and between said proximal section and said distal section, said bloused section comprising loose graft cloth, said bloused section extending outward from said proximal section and said distal section.

2. The bloused stent-graft of claim 1 wherein said proximal section comprises a proximal end and a distal end, said distal end being attached to a proximal end of said bloused section by a first attachment means.

3. The bloused stent-graft of claim 2 wherein said attachment means comprises stitching.

4. The bloused stent-graft of claim 2 wherein a distal end of said bloused section is attached to a proximal end of said distal section by a second attachment means.

5. The bloused stent-graft of claim 4 wherein said second attachment means comprises stitching.

6. The bloused stent-graft of claim 1 wherein said bloused stent-graft defines a main lumen extending generally parallel to a longitudinal axis of said bloused stent-graft and between a proximal main opening and a distal main opening of said bloused stent graft.

7. The bloused stent-graft of claim 1 wherein said bloused section has a non-uniform diameter.

8. The bloused stent-graft of claim 7 wherein said bloused section has said first diameter at a proximal end of said bloused section and has said second diameter at a distal end of said bloused section, said bloused section increasing in diameter from said proximal end and said distal end.

9. The bloused stent-graft of claim 8 wherein said proximal section comprises a first cylindrical piece of graft material having said first diameter, said distal section comprises a second cylindrical piece of graft material having said second diameter, and said bloused section comprising a third cylindrical piece of graft material having a third diameter greater than said first diameter and said second diameter, wherein ends of said third cylindrical piece of graft material are attached to said proximal section and said distal section to form said bloused section.

10. The bloused stent-graft of claim 8 wherein said bloused section balloons outward from said proximal section and said distal section.

11. The bloused stent-graft of claim 8 wherein said loose graft cloth is slack and said proximal section and said distal section are taut.

12. The bloused stent-graft of claim 1 wherein said bloused section comprises radiopaque ink.

13. The bloused stent-graft of claim 1 further comprising at least one stent ring.

14. The bloused stent-graft of claim 13 wherein said at least one stent ring comprises:

a first stent ring attached to said proximal section; and

a second stent ring attached to said distal section.

15. The bloused stent-graft of claim 1 further comprising a collateral opening in said bloused section.

16. A method comprising:

deploying a bloused stent-graft into a main vessel such that a bloused section of said bloused stent-graft covers a first branch vessel emanating from said main vessel, said bloused stent-graft comprising;

a proximal section;

a distal section; and

said bloused section attached to and between said proximal section and said distal section, said bloused section comprising loose graft cloth,

wherein a pressure differential between said main vessel and said first branch vessel causes said bloused section to be forced into an ostium of said first branch vessel creating a pocket aligned with said first branch vessel; and

locating a distal tip of a puncture device in said pocket.

17. The method of claim 16 wherein said pocket is defined by a portion of said bloused section extending into said first branch vessel.

18. The method of claim 16 wherein said pocket comprises an apex, said bloused section tapering radially outward from a vessel wall of said main vessel to said apex.

19. The method of claim 16 wherein said puncture device is oriented radially relative to a longitudinal axis of said bloused stent-graft within said pocket.

20. The method of claim 16 wherein said distal tip of said puncture device contacts an apex of said pocket.

21. The method of claim 16 wherein said puncture device comprises a radiopaque marker and wherein said bloused section comprises radiopaque ink facilitating visualization of alignment of said puncture device within said pocket.

22. The method of claim 16 wherein said puncture device comprises a guide catheter being fluoroscopically visible and wherein said bloused section comprises radiopaque ink facilitating visualization of alignment of said guide catheter within said pocket.

23. The method of claim 22, wherein said guide catheter is a steerable guide catheter.

24. The method of claim 16 wherein said locating a distal tip of a puncture device in said pocket comprises applying an outward radial force on said puncture device to cause said puncture device to slide down a taper of said pocket to an apex of said pocket.

25. The method of claim 22 wherein said locating a distal tip of a puncture device in said pocket comprises applying an outward radial force on said guide catheter to cause said guide catheter to slide down a taper of said pocket to an apex of said pocket.

26. The method of claim 16 further comprising applying outward force on said puncture device to cause said distal tip of said puncture device to fenestrate said bloused section in alignment with said first branch vessel.

27. The method of claim 22, wherein a puncture device catheter is contained within said guide catheter and further comprising applying outward force on said puncture device catheter to cause said distal tip of said puncture device to fenestrate said bloused section in alignment with said first branch vessel.

28. The method of claim 26 wherein said fenestration of said bloused section comprises creating a collateral opening in said bloused section, said collateral opening being aligned with said first branch vessel.

29. The method of claim 28 wherein said first branch vessel is perfused through said collateral opening.

30. The method of claim 28 wherein said bloused section follows a contour of an ostium of said first branch vessel forming a branch graft extending into said first branch vessel.

31. A method comprising:

deploying a bloused stent-graft into a main vessel such that a bloused section of said bloused stent-graft covers a first branch vessel and a second branch vessel emanating from said main vessel, said bloused stent-graft comprising;

a proximal section;

a distal section; and

said bloused section attached to and between said proximal section and said distal section, said bloused section comprising loose graft cloth,

wherein said bloused section is forced into a first ostium of said first branch vessel creating a first pocket aligned with said first branch vessel and wherein said bloused section is forced into a second ostium of said second branch vessel creating a second pocket aligned with said second branch vessel; and

locating a distal tip of a puncture device in said first pocket;

applying outward force on said puncture device to cause said distal tip of said puncture device to fenestrate said bloused section creating a first collateral opening in alignment with said first branch vessel;

locating said distal tip of said puncture device in said second pocket; and

applying outward force on said puncture device to cause said distal tip of said puncture device to fenestrate said bloused section creating a second collateral opening in alignment with said second branch vessel.