Endoluminal prosthesis comprising a valve replacement and at least one fenestration

• US 8,771,336 B2
• Filed: 12/22/2011
• Issued: 07/08/2014
• Est. Priority Date: 08/21/2010
• Status: Active Grant

• Current Assignee: Cook Medical Incorporated (Cook Group Incorporated)
• Original Assignee: Cook Medical Incorporated (Cook Group Incorporated)
• Inventors: Roeder, Blayne A.
• Primary Examiner(s): Sweet, Thomas J
• Assistant Examiner(s): SHIPMON, TIFFANY P
• Application Number:
  US13/335,115
• Publication Number:
  US 20120197382A1
• Time in Patent Office: 929 Days
• Field of Search: 623/1.13, 623/1.35
• US Class Current: 623/1.13
• 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 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 2002/9511 the retaining means being filaments or wires
• CPC Class Codes: A61F 2230/005 Rosette-shaped, e.g. star-shaped
• CPC Class Codes: A61F 2230/0054 V-shaped
• CPC Class Codes: A61F 2230/0067 conical
• CPC Class Codes: A61F 2250/0039 differing in diameter
• CPC Class Codes: A61F 2250/0071 breakable or frangible

Abstract

An endoluminal prosthesis comprises a graft having a tubular body comprising proximal and distal ends, and a valve replacement disposed between the proximal and distal ends of the graft. At least one stent is coupled to the graft and has a contracted delivery state and an expanded state for maintaining patency within a portion of the graft. At least one fenestration is disposed in a sidewall of the graft at a location distal to the valve replacement. In one embodiment, the at least one fenestration is pivotable in any direction away from an axis perpendicular to a longitudinal axis of the prosthesis.

Claims

1. An endoluminal prosthesis comprising:

a graft having a tubular body comprising proximal and distal ends;

a valve replacement disposed between the proximal and distal ends of the graft;

at least one stent coupled to the graft, the at least one stent having a contracted delivery state and an expanded state for maintaining patency within a portion of the graft;

at least one fenestration disposed in a sidewall of the graft at a location distal to the valve replacement;

a first perimeter having a first diameter and surrounding the at least one fenestration;

a band of flexible material attached to and surrounding the first perimeter and having a flexible frame; and

a second perimeter attached to and surrounding the band of flexible material and having a second diameter greater than the first perimeter diameter;

where the band of material has a first diameter substantially the same as the first perimeter diameter and a second diameter substantially the same as the diameter of the second perimeter, and where the diameter of the band of material decreases in a direction away from the surface of the graft from the second perimeter to the first perimeter,

wherein the band of material is configured to independently move between an interior surface of the graft and an exterior surface of the graft, and

wherein the flexible frame extends about a surface of the band from the first perimeter to the second perimeter.

2. The endoluminal prosthesis of claim 1 wherein the at least one fenestration is pivotable in any direction away from an axis perpendicular to a longitudinal axis of the prosthesis.

3. The endoluminal prosthesis of claim 1 wherein the band of material has a concave or convex orientation relative to the surface of the graft.

4. The endoluminal prosthesis of claim 1 wherein first and second fenestrations are disposed in the graft at locations between about 90 and about 270 degrees apart.

5. The endoluminal prosthesis of claim 4 further comprising a first branch vessel prosthesis extending between the first fenestration and a right coronary artery in a deployed state, and a second branch vessel prosthesis extending between the second fenestration and a left coronary artery in the deployed state.

6. The endoluminal prosthesis of claim 1 wherein first and second z-stents are coupled to the graft such that the distal apices of the first stent are aligned with the proximal apices of the second stent, and the at least one fenestration is positioned between a proximal apex of the first stent and a distal apex of the second stent.

7. The endoluminal prosthesis of claim 1 wherein the valve replacement comprises an artificial valve having a tricuspid shape.

8. The endoluminal prosthesis of claim 1 wherein the valve replacement is located at the proximal end of the graft, and one or more barbs extend radially outward from the proximal end of the graft.

9. An endoluminal prosthesis comprising:

a graft having a tubular body comprising proximal and distal ends;

a valve replacement disposed between the proximal and distal ends of the graft;

at least one stent coupled to the graft, the at least one stent having a contracted delivery state and an expanded state for maintaining patency within a portion of the graft;

at least one fenestration disposed in a sidewall of the graft and pivotable in any direction away from an axis perpendicular to a longitudinal axis of the prosthesis;

a first perimeter having a first diameter and surrounding the at least one fenestration;

a band of flexible material attached to and surrounding the first perimeter and having a flexible frame; and

a second perimeter attached to and surrounding the band of flexible material and having a second diameter greater than the first perimeter diameter;

where the band of material has a first diameter substantially the same as the first perimeter diameter and a second diameter substantially the same as the diameter of the second perimeter, and where the diameter of the band of material decreases in a direction away from the surface of the graft from the second perimeter to the first perimeter,

wherein the band of material is configured to independently move between an interior surface of the graft and an exterior surface of the graft, and

wherein the flexible frame extends about a surface of the band from the first perimeter to the second perimeter.

10. The endoluminal prosthesis of claim 9 where the at least one fenestration is disposed at a location distal to the valve replacement.

11. The endoluminal prosthesis of claim 9 wherein the band of material has a concave or convex orientation relative to the surface of the graft.

12. The endoluminal prosthesis of claim 9 wherein first and second fenestrations are disposed in the graft at locations between about 90 and about 270 degrees apart.

13. An endoluminal prosthesis comprising:

a graft having a tubular body comprising proximal and distal ends;

a valve replacement disposed between the proximal and distal ends of the graft;

at least one stent coupled to the graft, the at least one stent having a contracted delivery state and an expanded state for maintaining patency within a portion of the graft;

first and second fenestrations disposed in the graft at locations between about 90 and about 270 degrees apart;

a first branch vessel prosthesis extending between the first fenestration and a right coronary artery in a deployed state, and a second branch vessel prosthesis extending between the second fenestration and a left coronary artery in the deployed state;

a first perimeter having a first diameter and surrounding the first fenestration;

a band of flexible material attached to and surrounding the first perimeter and having a flexible frame; and

a second perimeter attached to and surrounding the band of flexible material and having a second diameter greater than the first perimeter diameter;

where the band of material has a first diameter substantially the same as the first perimeter diameter and a second diameter substantially the same as the diameter of the second perimeter, and where the diameter of the band of material decreases in a direction away from the surface of the graft from the second perimeter to the first perimeter,

wherein the band of material is configured to independently move between an interior surface of the graft and an exterior surface of the graft, and

wherein the flexible frame extends about a surface of the band from the first perimeter to the second perimeter.

14. The endoluminal prosthesis of claim 13 wherein the first and second fenestrations are disposed at a location distal to the valve replacement.

15. The endoluminal prosthesis of claim 13 wherein each of the first and second fenestrations are pivotable in any direction away from an axis perpendicular to a longitudinal axis of the prosthesis.

16. The endoluminal prosthesis of claim 13 wherein the valve replacement comprises an artificial valve having a tricuspid shape.