Expandable transluminal graft prosthesis for repair of aneurysm

• US 5,387,235 A
• Filed: 10/21/1992
• Issued: 02/07/1995
• Est. Priority Date: 10/25/1991
• Status: Expired due to Term

• Current Assignee: Cook Incorporated (Cook Group Incorporated)
• Original Assignee: Cook Incorporated (Cook Group Incorporated)
• Inventors: Chuter, Timothy A.
• Primary Examiner(s): Green, Randall L.
• Assistant Examiner(s): Brittingham, Debra
• Application Number:
  US07/959,758
• Time in Patent Office: 839 Days
• Field of Search: 623/1, 623/11, 623/12, 606/191-200, 600/36, 604/96
• US Class Current: 623/1.11
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/115 Staplers for performing anastomosis in a single operation
• CPC Class Codes: A61F 2/06 Blood vessels
• CPC Class Codes: A61F 2/07 Stent-grafts
• CPC Class Codes: A61F 2/848 having means for fixation to the vessel wall, e.g. barbs
• 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 2/954 for placing stents or stent-grafts in a bifurcation
• CPC Class Codes: A61F 2/958 Inflatable balloons for placing stents or stent-grafts
• CPC Class Codes: A61F 2/966 with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
• CPC Class Codes: A61F 2/97 the outer sleeve being splittable
• 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 2002/8486 provided on at least one of the ends
• CPC Class Codes: A61F 2002/9511 the retaining means being filaments or wires
• CPC Class Codes: A61F 2220/0016 with sharp anchoring protrusions, e.g. barbs, pins, spikes
• 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 2250/0007 for adjusting length

Abstract

A transluminal arrangement for positioning a prosthesis assembly at an aneurysm in the bifurcated lumen of the aorta and the common iliac arteries extending therefrom. The prosthesis assembly includes a bifurcated endovascular graft having a main body and ipsilateral and contralateral limbs extending therefrom. The assembly also includes main, ipsilateral, and contralateral spring assemblies each having a compressed state. When released from its compressed state, each spring expands a portion of the graft to substantially conform that portion of the graft to the wall of the bifurcated lumen. The transluminal arrangement comprises an elongated member extending through the main and ipsilateral bores of the graft and includes attachment sutures and an inner catheter extending therethrough for temporarily attaching the main and ipsilateral spring assemblies to the elongated member. An outer sheath contains the attached prosthesis assembly, whereas stent boots consisting of short length sheaths contain the ipsilateral and contralateral spring assemblies. A control limb delivery catheter and attachment sutures maintain the contralateral graft limb and spring assembly in the stent boot for placement in the contralateral iliac artery.

Claims

1. A transluminal arrangement comprising:

main container means containing in a compressed state a main spring assembly of a prosthesis assembly, said prosthesis assembly including a bifurcated endovascular graft having a main body and a first and a second limb extending therefrom, said main body including a main bore extending longitudinally therein and having a cranial orifice, said first limb including a first bore extending longitudinally therein, communicating with said main bore, and having a first caudal orifice, said second limb including a second bore extending longitudinally therein, communicating with said main bore and having a second caudal orifice, said main spring assembly radially expanding said main body of said graft to substantially conform said main body of said graft on an interior wall of a main lumen of a bifurcated lumen when said prosthesis assembly is positioned at a particular position in the bifurcated lumen and said main spring assembly is released from said compressed state, the bifurcated lumen including the main lumen and a first and a second branch lumen communicating with and extending from the main lumen;

first container means separated from said main container means containing in a compressed state a first spring assembly of said prosthesis assembly, said first spring assembly radially expanding said first limb of said graft to substantially conform said first limb of said graft on an interior wall of the first branch lumen of the bifurcated lumen when said prosthesis assembly is positioned at the particular position in the bifurcated lumen and said first spring assembly is released from said compressed state;

retainer means positioned in said main and said first bore of said graft for retaining said prosthesis assembly at the particular position in the bifurcated lumen while said main container means is withdrawn from said prosthesis assembly releasing said main spring assembly from said compressed state.

2. The transluminal arrangement of claim 1 wherein said main container means includes a main sheath having a longitudinal bore and wherein said prosthesis assembly is positioned within said bore of said main sheath.

3. The transluminal arrangement of claim 1 wherein said retainer means comprises an elongated member having a dilator head at a distal end thereof, said head serving to facilitate penetration of said arrangement within the bifurcated lumen and to minimize deleterious blood flow through the bifurcated lumen during positioning of said arrangement.

4. The transluminal arrangement of claim 3 wherein said first container means includes a first sheath having a longitudinal bore and attached around said elongated member caudally from said dilator head and wherein said first spring assembly is positioned in said bore of said first sheath.

5. The transluminal arrangement of claim 1 wherein said retainer means comprises main attachment means for temporarily attaching said main spring assembly to said retainer means when said prosthesis assembly is being positioned at the particular position in the bifurcated lumen.

6. The transluminal arrangement of claim 5 wherein said retainer means comprises first attachment means for temporarily attaching said first spring assembly to said retainer means when said prosthesis assembly is being positioned at the particular position in the bifurcated lumen.

7. The transluminal arrangement of claim 6 wherein said main and said first attachment means comprises contraction means for temporarily pulling respectively said main and said first spring assembly inwardly to said compressed state when said prosthesis assembly is positioned within said main sheath.

8. The transluminal arrangement of claim 6 wherein said main and said first attachment means comprises release means for releasing said prosthesis assembly from said retainer means either during or after removal of at least one of said main and said first sheath.

9. The transluminal arrangement of claim 8 wherein at least one of said main and said first attachment means comprises one or more sutures connected to at least one of said main and said first spring assembly and at one end to inside of said retainer means via apertures therein, and wherein said release means is positioned within said retainer means for releasing said suture from inside said retainer means.

10. A transluminal arrangement for positioning a prosthesis assembly at a particular position in a bifurcated lumen, the bifurcated lumen including a main lumen and a first and a second branch lumen communicating with and extending from the main lumen, said prosthesis assembly including a bifurcated endovascular graft having a main body and a first and a second limb extending therefrom, said main body including a main bore extending longitudinally therein and having a cranial orifice, said first limb including a first bore extending longitudinally therein, communicating with said main bore, and having a first caudal orifice, said second limb including a second bore extending longitudinally therein, communicating with said main bore and having a second caudal orifice, said assembly including a main spring assembly, a first spring assembly, and a second spring assembly each having a compressed state, said main spring assembly radially expanding said main body of said graft to substantially conform said main body of said graft on an interior wall of the main lumen when said prosthesis assembly is positioned at a particular position in the bifurcated lumen and said main spring assembly is released from said compressed state, said first spring assembly radially expanding said first limb of said graft to substantially conform said first limb of said graft on an interior wall of the first branch lumen when said prosthesis assembly is positioned at the particular position in the bifurcated lumen and said first spring assembly is released from said compressed state, said second spring assembly radially expanding said second limb of said graft to substantially conform said second limb of said graft on an interior wall of the second branch lumen when said prosthesis assembly is positioned at a particular position in the bifurcated lumen and said second spring assembly is released from said compressed state, said transluminal arrangement comprising:

main container means for containing said main spring assembly in said compressed state;

first container means for containing said first spring assembly in said compressed state;

second container means for containing said second spring assembly in said compressed state;

main retainer means positioned in said main and said first bore of said graft for retaining said prosthesis assembly at the particular position in the bifurcated lumen while said main container means is withdrawn from said prosthesis assembly releasing said main spring assembly from said compressed state;

first retainer means temporarily attached to said first spring assembly for retaining said first spring assembly in said first container means; and

second retainer means temporarily attached to said second spring assembly for retaining said second spring assembly in said second container means.

11. The transluminal arrangement of claim 10 wherein said main container means includes a main sheath with a longitudinal bore and wherein said prosthesis assembly is positioned in said bore of said main sheath.

12. The transluminal arrangement of claim 10 wherein said first container means includes a first sheath with a longitudinal bore and wherein said first spring assembly is positioned in said bore of said first sheath.

13. The transluminal arrangement of claim 10 wherein said second container means includes a second sheath with a longitudinal bore and wherein said second spring assembly is positioned in said second bore of said second sheath.

14. The transluminal arrangement of claim 10 wherein said main retainer means comprises an elongated member having a dilator head at a distal end thereof, main attachment means for temporarily attaching said main spring assembly to said elongated member, and first attachment means for temporarily attaching said first spring assembly to said elongated member.

15. The transluminal arrangement of claim 14 further comprising first release means for releasing at least one of said main and said first attachment means either during or after removal of at least one of said main and said first container means.

16. The transluminal arrangement of claim 15 further comprising second release means temporarily attached to said second spring assembly for releasing said second spring assembly when positioned in the second branch of the bifurcated lumen.

17. A transluminal arrangement for positioning a prosthesis assembly at a particular position in a bifurcated lumen, the bifurcated lumen including a main lumen and a first and a second branch lumen communicating with and extending from the main lumen, said prosthesis assembly including a bifurcated endovascular graft having a main body and a first and a second limb extending therefrom, said main body including a main bore extending longitudinally therein and having a cranial orifice, said first limb including a first bore extending longitudinally therein, communicating with said main bore, and having a first caudal orifice, said second limb including a second bore extending longitudinally therein, communicating with said main bore and having a second caudal orifice, said graft including a main spring assembly, a first spring assembly, and a second spring assembly each having a compressed state, said main spring assembly radially expanding said main body of said graft to substantially conform said main body of said graft on an interior wall of the main lumen when said prosthesis assembly is positioned at a particular position in the bifurcated lumen and said main spring assembly is released from said compressed state, said first spring assembly radially expanding said first limb of said graft to substantially conform said first limb of said graft on an interior wall of the first branch lumen when said prosthesis assembly is positioned at the particular position in the bifurcated lumen and said first spring assembly is released from said compressed state, said second spring assembly radially expanding said second limb of said graft to substantially conform said second limb of said graft on an interior wall of the second branch lumen when said prosthesis assembly is positioned at a particular position in the bifurcated lumen and said second spring assembly is released from said compressed state, said transluminal arrangement comprising:

a main sheath with said prosthesis assembly positioned in a bore of said main sheath;

main container means for containing said main spring assembly in said compressed state;

a first sheath with said first spring assembly positioned in a bore of said first sheath;

first container means for containing said first spring assembly in said compressed state;

a second sheath with said second spring assembly positioned in a bore of said second sheath;

second container means for containing said second spring assembly in said compressed state;

an elongated member positioned in said main and said first bore of said graft;

main attachment means for temporarily attaching said main spring to said elongated member;

first attachment means for temporarily attaching said first spring to said elongated member, said main and said first attachment means for retaining said prosthesis assembly at the particular position in the bifurcated lumen while said main sheath is withdrawn from said prosthesis assembly;

first retainer means temporarily attached to said first spring assembly for retaining said first spring assembly in said first container means;

second retainer means temporarily attached to said second spring assembly for retaining said second spring assembly in said second container means;

first release means for releasing at least one of said main and said first attachment means either during or after removal of at least one of said main and said first sheath; and

second release means temporarily attached to said second spring assembly for releasing said second spring assembly when positioned in the second branch lumen of the bifurcated lumen.