Diaphragm and method for occlusion of the descending thoracic aorta

• US 4,710,192 A
• Filed: 10/17/1986
• Issued: 12/01/1987
• Est. Priority Date: 12/30/1985
• Status: Expired due to Fees

• Current Assignee: Domingo S. Liotta, Holga E. Troncoso De Liotta
• Original Assignee: Domingo S. Liotta, Holga E. Troncoso De Liotta
• Inventors: Liotta, Domingo S., Troncoso De Liotta, Holga E.
• Primary Examiner(s): FRINKS, RONALD
• Application Number:
  US06/919,984
• Time in Patent Office: 410 Days
• Field of Search: 623/1, 623/11, 623/12, 128/325, 128/303 R, 128/334 R, 128/334 C, 128/345
• US Class Current: 606/108
• CPC Class Codes: A61B 17/12 for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord specially adapted for vas deferens or fallopian tubes A61F6/20; materials for ligaturing blood vessels A61L17/00
• CPC Class Codes: A61B 17/12022 Occluding by internal devices, e.g. balloons or releasable wires plugging an opening in the wall of an organ A61B17/0057; occluders for the cervical canal A61F6/146; vas deferens occluders A61F6/20
• CPC Class Codes: A61B 17/12109 in a blood vessel
• CPC Class Codes: A61B 17/12172 having a pre-set deployed three-dimensional shape methods of manufacturing A61B2017/00526
• CPC Class Codes: A61F 2/011 Instruments for their placement or removal
• CPC Class Codes: A61F 2002/018 made from tubes or sheets of material, e.g. by etching or laser-cutting
• CPC Class Codes: A61F 2230/0006 circular
• CPC Class Codes: A61F 2230/0067 conical
• CPC Class Codes: A61F 2230/0093 Umbrella-shaped, e.g. mushroom-shaped

Abstract

A vaulted diaphragm for providing occlusion in a descending thoracic aorta, includes a flexible and substantially circular element, and a plurality of resilient ribs having inner and outer ends supporting the circular element. The inner ends of the ribs are joined together at a hub with the ribs extending radially outwardly therefrom. The ribs are generally positioned on and attached to the circular element with the outer ends of the ribs having protrusions projecting radially beyond the circular element. The ribs have a resilient expansion tendency, such that the diaphragm may be held in a biased folded position during installation and sprung open into a normally vaulted shape upon installation in the aorta, whereby the protrusions are urged radially outwardly by the resilient expansion tendency of the ribs to engage the aorta and hold the diaphragm in position. A surgical procedure for treating an aneurysm in a patient'"'"'s descending thoracic aorta, includes the step of installing an artificial aorta by-pass connecting the patient'"'"'s ascending natural aorta with the patient'"'"'s abdominal aorta end. A temporary graft is installed onto the by-pass and a catheter having a capsule end holding a diaphragm is advanced through the graft. The diaphragm is positioned into a selected site in the aorta, and then released by ejecting it from the capsule and the catheter is withdrawn, with the diaphragm remaining within the aorta to provide an occlusion therein.

Claims

1. A diaphragm for providing occlusion in a descending thoracic aorta, of the type capable of isolating a portion of the aorta affected by an aneurysm, and installed via a surgical treatment in which a permanent arterial by-pass of medically compatible material extending from the ascending aorta to the abdominal aorta is provided, said diaphragm comprising:

a flexible and substantially circular element, said circular element including a cushion rim around the outer periphery thereof, said cushion rim having a thickness substantially greater than said circular element; and

a plurality of resilient ribs having inner and outer ends supporting said circular element, said inner ends of said ribs joined together at a hub with said ribs extending radially outwardly therefrom, said ribs generally positioned on and attached to said circular element with said outer ends of said ribs having protrusions projecting radially beyond said cushion of said circular element, said ribs having a resilient expansion tendency, such that said diaphragm may be held in a biased collapsed position during installation, and sprung open into a normally vaulted shaped upon installation in the aorta, whereby said protrusions are urged radially outwardly by the resilient expansion tendency of said ribs to engage the aorta and hold said diaphragm in position.

2. The diaphragm of claim 1, wherein said ribs are spring-like so that said diaphragm may be collapsed into a retracted umbrella-like assembly.

3. The diaphragm of claim 1, wherein said circular element has a diameter of about 22 to 40 mm.

4. The diaphragm of claim 1, wherein said hub includes a threaded hole engageable by a stylet having a threaded end.

5. The diaphragm of claim 1, wherein said diaphragm includes 8 ribs.

6. The diaphragm of claim 1, wherein said flexible and substantially circular element is made of polyethylene terephthalate fabric.

7. A surgical procedure for treating an aneurysm in a patient'"'"'s descending thoracic aorta, comprising the steps of:

installing an artificial aorta by-pass connecting the patient'"'"'s ascending natural aorta with the patient'"'"'s abdominal aorta end;

installing a temporary graft onto said by-pass; and

advancing a catheter having a capsule end holding a retracted diaphragm through said graft;

positioning said diaphragm into a selected site in said aorta; and

releasing the diaphragm by ejecting it from the capsule thereby allowing said diaphragm to spring open into a vaulted shape and engage the inner walls of aorta all around; and

withdrawing the catheter with the diaphragm remaining within the aorta to provide an occlusion therein.

8. The procedure of claim 7, further comprising the step of viewing the diaphragm using radioscopic or fluoroscopic means, to monitor the position of diaphragm within the patient'"'"'s body.

9. The procedure of claim 7, further comprising the steps of:

engaging a stylet within the catheter onto the diaphragm to hold the diaphragm temporarily in the capsule while the catheter is advanced through the graft and while the diaphragm is moved into position within the aorta; and

ejecting the diaphragm by forcing it out of the capsule by pushing on the stylet and disengaging the stylet from the diaphragm.