Device and method for aortic branched vessel repair

• US 9,592,112 B2
• Filed: 03/07/2013
• Issued: 03/14/2017
• Est. Priority Date: 11/16/2011
• Status: Active Grant

• Current Assignee: Bolton Medical, Inc. (Terumo Corporation)
• Original Assignee: Bolton Medical, Inc. (Terumo Corporation)
• Inventors: Arbefeuille, Samuel, Christian, Fletcher, Manguno, Joseph A. Jr., Canning, John C.
• Primary Examiner(s): Rodjom, Katherine
• Application Number:
  US13/788,724
• Publication Number:
  US 20130184806A1
• Time in Patent Office: 1,468 Days
• Field of Search: 623/1.11, 623/1.13, 623/1.15, 623/1.35
• US Class Current: 1/1
• 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 2/954 for placing stents or stent-grafts in a bifurcation
• 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 2002/061 provided with means for allowing access to secondary lumens
• 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 2002/821 Ostial stents
• CPC Class Codes: A61F 2002/9505 having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument
• CPC Class Codes: A61F 2002/9665 with additional retaining means
• 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 2250/0098 radio-opaque, e.g. radio-opaque markers

Abstract

An aortic graft assembly includes a tubular component that defines a wall aperture having a proximal end that extends perpendicular to a major longitudinal axis of the tubular aortic component, and a tunnel graft connected to the wall of the tubular aortic component and extending from the wall aperture toward a proximal end of the tubular aortic component. The method for delivery of the aortic graft assembly includes delivering the aortic graft assembly through the wall aperture and into interferring relation with the tunnel graft.

Claims

1. An aortic graft assembly, comprising:

a) a tubular aortic component that defines a tunnel lumen and includes a proximal end and a distal end connected by a wall of the tubular aortic component, the wall defining a wall aperture that is between the proximal and distal ends, the wall aperture having a proximal end and a distal end, the proximal end of the wall aperture including an arch that lies in a first plane extending perpendicular to a major longitudinal axis of the tubular aortic component when viewed orthogonally to the major longitudinal axis;

b) a tunnel graft connected to the wall of the tubular aortic component and extending from the wall aperture and within the tunnel lumen of the tubular aortic component toward the proximal end of the tubular aortic component, the tunnel graft having a proximal end and a distal end, and defining a tunnel graft lumen that extends between the distal end and the proximal end of the tunnel graft lumen, the distal end being at the wall aperture of the tubular aortic component, and wherein the length of the proximal end of the wall aperture in the first plane is greater than the diameter of the tunnel graft lumen in a second plane extending orthogonally to the major longitudinal axis at a point proximal to the proximal end of the wall aperture;

c) a proximal stent that supports the proximal end of the tubular aortic component; and

d) a distal stent that supports the distal end of the tubular aortic component.

2. The aortic graft assembly of claim 1, further including a clasping stent at the proximal end of the tubular aortic component, the clasping stent including at least two exposed proximal apices proximate to the proximal end of tubular component.

3. The aortic graft assembly of claim 2, wherein the clasping stent is attached to an interior wall of the tubular aortic component.

4. The aortic graft assembly of claim 3, wherein the tubular aortic component includes a centerline that bisects the wall aperture and two of the exposed proximal apices of the clasping stent are adjacent to the centerline, whereby collapse of the unattached apices will cause at least partial collapse of the tubular aortic component at the clasping stent.

5. The aortic graft assembly of claim 2, further including a crown stent between the clasping stent and the proximal end of the tubular aortic component.

6. The aortic graft assembly of claim 5, wherein the crown stent includes proximal and distal apices connected by struts.

7. The aortic graft assembly of claim 6, wherein the proximal apices of the crown stent are blunted relative to the distal apices of the crown stent.

8. The aortic graft assembly of claim 7, wherein the clasping and crown stents are nested with each other.

9. The aortic graft assembly of claim 8, wherein the crown stent is attached to an interior surface of the tubular aortic component.

10. The aortic graft assembly of claim 1, further including at least one stent between the proximal and distal stents wherein at least a portion of said stent includes alternating proximal and distal apices connected by struts.

11. The aortic graft assembly of claim 1, further including at least two support-wire sutures within the tubular aortic component at the proximal end of the tubular aortic component, wherein the at least two support-wire sutures facilitate releaseable constraint of the aortic graft assembly in a delivery device by engagement with at least one supporting wire of the delivery device.

12. The aortic graft assembly of claim 11, wherein at least one of the support-wire sutures are at an inferior portion within the tubular aortic component.

13. The aortic graft assembly of claim 12, wherein the support-wire sutures are distal to proximal apices of the clasping stent.

14. The aortic graft assembly of claim 13, wherein the support-wire sutures are separated by at least one distal apex of the proximal clasping stent.

15. The aortic graft assembly of claim 1, wherein the length of the proximal end of the wall aperture transverse to a major longitudinal axis of the tubular aortic component is equal to or less than one-half the circumference of the tubular aortic component.

16. The aortic graft assembly of claim 15, wherein the length of the proximal end of the wall aperture is about 6 mm, about 8 mm, about 10 mm, about 12 mm or about 14 mm.

17. The aortic graft assembly of claim 15, wherein a longitudinal length of the wall aperture is equal to or less than about 90 mm.

18. An aortic graft assembly, comprising:

a) a tubular aortic component that defines a tunnel lumen and includes a proximal end and a distal end connected by a wall of the tubular aortic component, the wall defining a wall aperture that is between the proximal and distal ends, the wall aperture having a proximal end and a distal end, the proximal end of the wall aperture including an arch that lies in a first plane extending perpendicular to a major longitudinal axis of the tubular aortic component when viewed orthogonally to the major longitudinal axis;

b) a tunnel graft connected to the wall of the tubular aortic component and extending from the wall aperture and within the tunnel lumen of the tubular aortic component toward the proximal end of the tubular aortic component, the tunnel graft having a proximal end and a distal end, and defining a tunnel graft lumen that extends between the distal end and the proximal end of the tunnel graft lumen, the distal end being at the wall aperture of the tubular aortic component, and wherein the length of the proximal end of the wall aperture in the first plane is greater than the diameter of the tunnel graft lumen in a second plane extending orthogonally to the major longitudinal axis at a point proximal to the proximal end of the wall aperture;

c) a proximal stent that supports the proximal end of the tubular aortic component;

d) a distal stent that supports the distal end of the tubular aortic component;

e) a clasping stent at the proximal end of the tubular aortic component proximal to the proximal stent, the clasping stent including at least two exposed proximal apices proximate to the proximal end of tubular component and attached to an interior wall of the tubular aortic component; and

f) a crown stent between the clasping stent and the proximal end of the tubular aortic component, the crown stent attached to an interior surface of the tubular aortic component.

19. An aortic graft assembly, comprising:

a) a tubular aortic component that defines a tunnel lumen and includes a proximal end and a distal end connected by a wall of the tubular aortic component, the wall defining a wall aperture that is between the proximal and distal ends, the wall aperture having a proximal end and a distal end, the proximal end of the wall aperture including an arch that lies lying in a first plane extending perpendicular to a major longitudinal axis of the tubular aortic component when viewed orthogonally to the major longitudinal axis;

b) a tunnel graft connected to the wall of the tubular aortic component and extending from the wall aperture and within the tunnel lumen of the tubular aortic component toward the proximal end of the tubular aortic component, the tunnel graft having a proximal end and a distal end, and defining a tunnel graft lumen that extends between the distal end and the proximal end of the tunnel graft lumen, the distal end being at the wall aperture of the tubular aortic component, and wherein the length of the proximal end of the wall aperture in the first plane is greater than the diameter of the tunnel graft lumen in a second plane extending orthogonally to the major longitudinal axis at a point proximal to the proximal end of the wall aperture;

c) a proximal stent that abuts the proximal end of the wall aperture;

d) a distal stent that supports the distal end of the tubular aortic component;

e) an abutting distal stent that includes at least one proximal apex that abuts the distal end of the wall aperture;

f) a clasping stent at the proximal end of the tubular aortic component proximal to the proximal stent, the clasping stent including at least two exposed proximal apices proximate to the proximal end of tubular component, the clasping stent attached to an interior wall of the tubular aortic component; and

g) a crown stent between the clasping stent and the proximal end of the tubular aortic component, the crown stent attached to an interior surface of the tubular aortic component.