BLOOD VESSEL PROSTHESIS AND DELIVERY APPARATUS

• US 20110166644A1
• Filed: 02/23/2009
• Published: 07/07/2011
• Est. Priority Date: 02/22/2008
• Status: Active Grant

• Current Assignee: Barts and The London NHS Trust
• Original Assignee: Barts and The Londhon NHS Trust
• Inventors: Keeble, Thomas, Rothman, Martin
• Granted Patent: US 9,439,758 B2
• Time in Patent Office: Days
• US Class Current: 623/1.24
• CPC Class Codes: A61F 2/07 Stent-grafts
• CPC Class Codes: A61F 2/2409 Support rings therefor, e.g. for connecting valves to tissue annuloplasty rings A61F2/2442
• CPC Class Codes: A61F 2/2412 with soft flexible valve members, e.g. tissue valves shaped like natural valves check valves with flexible valve members in general F16K15/14
• CPC Class Codes: A61F 2/2418 Scaffolds therefor, e.g. support stents
• CPC Class Codes: A61F 2/2427 Devices for manipulating or deploying heart valves during implantation
• CPC Class Codes: A61F 2/2442 Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
• CPC Class Codes: A61F 2/82 Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents stent-grafts for tubular structures of the body other than blood vessels A61F2/04; stent-grafts for blood vessels A61F2/07; instruments specially adapted for placement or removal of stents or stent-grafts A61F2/95; for closing wounds, or holding wounds closed A61B17/04 - A61B17/115; dilators A61M29/00
• CPC Class Codes: A61F 2/856 Single tubular stent with a side portal passage
• 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 2/915 with bands having a meander structure, adjacent bands being connected to each other
• CPC Class Codes: A61F 2/95 Instruments specially adapted for placement or removal of stents or stent-grafts
• CPC Class Codes: A61F 2/954 for placing stents or stent-grafts in a bifurcation
• CPC Class Codes: A61F 2002/061 provided with means for allowing access to secondary lumens
• CPC Class Codes: A61F 2002/075 the stent being loosely attached to the graft material, e.g. by stitching
• CPC Class Codes: A61F 2002/821 Ostial stents
• CPC Class Codes: A61F 2002/825 having longitudinal struts
• CPC Class Codes: A61F 2002/9583 Means for holding the stent on the balloon, e.g. using protrusions, adhesives or an outer sleeve
• CPC Class Codes: A61F 2230/0013 Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
• CPC Class Codes: A61F 2230/0054 V-shaped
• CPC Class Codes: A61F 2230/0069 cylindrical
• CPC Class Codes: A61F 2250/0069 : Sealing means

Abstract

A prosthesis for locating at a branch region of a blood vessel. The prosthesis comprises a main conduit (10) having a tubular portion (11) with first and second ends (12,13), and at least one projecting portion (14,15,16) projecting from the first end of the tubular portion. One or more branch conduits (17,18) are connected to, and extend from the projecting portions or the tubular portion at a position adjacent the projecting portions. Portions of the prosthesis to which the branch conduits are attached may be more flexible and/or elastic than other portions of the prosthesis.

Claims

1. A prosthesis for locating at a branch region of a blood vessel, the prosthesis comprising:

a main conduit having a tubular portion with first and second ends, and a first projecting portion projecting from the first end of the tubular portion, and

a first branch conduit, wherein the first branch conduit is connected to, and extends from;

the first projecting portion;

or

the tubular portion at a position adjacent the first projecting portion.

2. The prosthesis according to claim 1, comprising a second projecting portion projecting from the first end of the tubular portion, and a second branch conduit connected to, and extending from:

the second projecting portion;

or

the tubular portion at a position adjacent the second projecting portion.

3. The prosthesis according to claim 1, wherein the branch conduits are connected to, and extend from, the projecting portions.

4. The prosthesis according to claim 1, wherein the branch conduits are connected to, and extend from, the tubular portion.

5. The prosthesis according to claim 1, arranged for deploying at the branch region of the aortic root, where the aorta meets the right and left coronary arteries, the main conduit and the branch conduits being for locating in the aorta, and the coronary arteries, respectively, whereupon the projecting portions project into the bowl-shaped cavities of the leaflets of the aortic valve.

6. The prosthesis according to claim 1, wherein the projecting portions extend from a rim or annular region extending around the circumference of the tubular portion, at the first end of the tubular portion.

7. The prosthesis according to claim 6, wherein each projecting portion extends from less than half of the circumference of the rim or annular region.

8. The prosthesis according to claim 6, wherein each projecting portion extends from less than one third of the circumference the rim or annular region.

9. The prosthesis according to claim 1, wherein each projecting portion is a lobe.

10. The prosthesis according to claim 1, wherein one or more of the projecting portion s extend in a direction which is angled from the elongation direction of the tubular portion.

11. The prosthesis according to claim 1, wherein one or more of the projecting portions extend in the same direction as the elongation direction of the tubular portion.

12. The prosthesis according to claim 1, any one of the preceding claims, wherein the main conduit comprises one or more z-stents for supporting walls of the main conduit.

13. The prosthesis according to claim 12, wherein one of the z-stents is provided adjacent the first end of the tubular portion and defines outer edges of the projecting portions.

14. The prosthesis according to claim 1, further comprising a prosthetic valve.

15. The prosthesis according to claim 14, wherein the valve comprises three valve leaflets, side edges of each valve leaflet releasably engaging side edges of the adjacent valve leaflets to form in three radially extending ridges.

16. The prosthesis according to claim 15, wherein the side edges have commissural points connected to the tubular portion, adjacent the first end of the tubular portion, and between regions at which the projecting portions project from the first end of the tubular portion.

17. The prosthesis according to claim 1, comprising a circumferential sealing element on the outer side of the tubular portion.

18. The prosthesis according to claim 1, wherein at least one of the branch conduits connects to a wall section of the projecting portion that is flexible and/or elastic.

19. The prosthesis of claim 18, wherein the wall section is more flexible and/or elastic than walls of the tubular portion.

20. The prosthesis of claim 19, wherein the wall section is annular.

21. The prosthesis according to claim 18, wherein the wall section has a different thickness, weave and/or chemical properties to walls of the tubular portion.

22. The prosthesis of claim 18, wherein the main conduit comprises wall scaffolding, and the wall section receives less support from the scaffolding than the walls of the tubular portion.

23. The prosthesis according to claim 1, wherein the prosthesis can be moved between a contracted and an expanded state.

24. The prosthesis according to claim 23, wherein the prosthesis is arranged such that, when the prosthesis is placed in a contracted state, walls of the projecting portions envelop the branch conduits connected or adjacent thereto.

38. The prosthesis according to claim 1, comprising a scaffold that supports wall material of the tubular portion, the scaffold including two or more wire rings and linking scaffold members that link adjacent wire rings, the linking members being arranged towards one side of the prosthesis and not on an opposite side.

25. A prosthesis for locating at a branch region of a blood vessel, the prosthesis comprising:

a main conduit having walls extending between first and second ends of the main conduit, and

one or more branch conduits;

wherein the walls of the main conduit comprise a first section and a second section, the second section being more flexible than the first section, more elastic than the first section, or a combination thereof, and

wherein the one or more branch conduits are connected to, and extend from the second section.

26. The prosthesis of claim 25, wherein the second section comprises wall material of lower thickness, different weave, different chemical properties, or combinations thereof, to wall material of the first section.

27. The prosthesis of claim 25, wherein the main conduit comprises wall scaffolding, and the second section receives less support from the scaffolding than the first section.

28. The prosthesis of claim 27, wherein the scaffolding is provided by one or more z-stents integral to the walls.

29. The prosthesis of claim 25, wherein the first and second sections are first and second circumferential wall sections respectively.

30. The prosthesis of claim 29, comprising a third circumferential wall section, the second circumferential wall section being more flexible and/or elastic than the first and third circumferential wall sections.

31. A prosthesis for locating at the branch region of the aortic root where the aorta meets the right and left coronary arteries, the prosthesis comprising

a main conduit for locating in the aorta, the main conduit having first and second ends, the first end being for locating in the aortic root upstream of the second end, and

a first branch conduit connected to the main conduit at a position located between the first and second ends of the main conduit, the first branch conduit being for locating in one of the left and right coronary arteries, and

a prosthetic aortic valve,

wherein the distance between the connection position of the first branch conduit with the main conduit and the first end of the main conduit is such that, when the first branch conduit is located in one of the left and right coronary arteries, the first end of the main conduit extends in the aortic root to a position at which it presses against the aortic valve, maintaining the aortic valve in an open position.

32. The prosthesis according to claim 31, comprising a second branch conduit connected to the main conduit, for locating in the other of the left and right coronary arteries.

33. The prosthesis of claim 31, wherein the distance between the connection position of the first branch conduit with the main conduit and the first end of the main conduit is between 1 cm and 2 cm.

34. A catheter apparatus for delivering a prosthesis to a branch region of a blood vessel, the prosthesis comprising a main conduit and one or more branch conduits, the catheter apparatus comprising:

a core catheter having a distal end and a proximal end;

a push element provided at the distal end of the core catheter for engaging and pushing the prosthesis, and

one or more push actuators for pushing the one or more branch conduits of the prosthesis,

wherein the actuators are slidably mounted to the push element.

35. The apparatus of claim 34, wherein the push element comprises lateral regions that extend in a direction substantially perpendicular to the elongation direction of the core.

36. The apparatus of claim 35, wherein the actuators are slidably mounted within bores provided in the lateral regions of the push element.

37. The apparatus of claim 34, comprising a reinforced liner sleeve for locating over the core catheter, push element and the prosthesis during delivery of the prosthesis to the branch region.