Stent graft and introducer assembly

• US 9,717,611 B2
• Filed: 11/15/2010
• Issued: 08/01/2017
• Est. Priority Date: 11/19/2009
• Status: Active Grant

• Current Assignee: Cook Medical Incorporated (Cook Group Incorporated)
• Original Assignee: Cook Medical Incorporated (Cook Group Incorporated)
• Inventors: Jensen, Kim Moegelvang, Oehlenschlaeger, Bent, Gopalakrishnamurthy, Sharath, Charlebois, Steven J., Dierking, William K., Swift, Richard A., Rasmussen, Erik, Kratzberg, Jarin, Roeder, Blayne A.
• Primary Examiner(s): Sharma, Yashita
• Assistant Examiner(s): PRESTON, REBECCA STRASZHEIM
• Application Number:
  US12/946,238
• Publication Number:
  US 20110125249A1
• Time in Patent Office: 2,451 Days
• Field of Search: 623 111- 113, 623 123
• CPC Class Codes: A61F 2/07 Stent-grafts
• CPC Class Codes: A61F 2/86 Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
• 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 2/9517 handle assemblies therefor
• 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 2/9661 the proximal portion of the stent or stent-graft is released first
• CPC Class Codes: A61F 2002/075 the stent being loosely attached to the graft material, e.g. by stitching
• CPC Class Codes: A61F 2230/0013 Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
• CPC Class Codes: A61F 2230/0078 hyperboloidal

Abstract

A stent graft (40) for treating Type-A dissections in the ascending aorta (22) is provided with a plurality of diameter reducing suture loops (56-60) operable to constrain the stent graft during deployment thereof in a patient'"'"'s aorta. The diameter reducing loops (56-60) allow the stent graft (40) to be partially deployed, in such a manner that its location can be precisely adjusted in the patient'"'"'s lumen. In this manner, the stent graft can be placed just by the coronary arteries (26, 28) with confidence that these will not be blocked. The stent graft (40) is also provided with proximal and distal bare stents (44,52) for anchoring purposes.

Claims

1. A stent graft comprising:

a graft tube provided with proximal and distal ends and first and second expanded configurations,

a plurality of stent rings attached to the graft tube between the proximal and distal ends,

a bare stent extending from the proximal end of the graft tube and designed to flare outwardly relative to the graft tube so as to engage in use a cavity of an aortic sinus of a patient,

an intermediate stent ring having a proximal end and a distal end, the intermediate stent ring located between two other of the plurality of stent rings, and

a mechanically releasable diameter restraining device comprising a first filament and a second filament, wherein the first and second filaments are positioned substantially half-way along the graft tube and at least partially inside the graft tube, and, when the graft tube is in the first expanded configuration, the first filament restrains the proximal end of the intermediate stent ring and the second filament restrains the distal end of the intermediate stent ring, such that in the first expanded configuration a diameter of the stent graft at the intermediate stent ring is less than a diameter of the stent graft at regions immediately proximal and distal the intermediate stent ring, and where stent rings immediately adjacent the intermediate stent ring are not restrained by a diameter restraining device when the graft tube is in the first expanded configuration, and

wherein when the graft tube is in the second expanded configuration the mechanically releasable diameter restraining devices do not restrain any portion of the stent graft.

2. The stent graft of claim 1, wherein the stent graft is provided with a stent section extending from the distal end of the graft tube.

3. The stent graft of claim 1, further comprising a bare stent extending from the distal end of the graft tube.

4. The stent graft of claim 3, wherein the bare stent at the distal end flares outwardly relative to the graft tube.

6. The stent graft of claim 1, further comprising a second mechanically releasable diameter restraining device at the proximal end of the graft tube.

5. The stent graft of 3, wherein each bare stent is formed of an undulating stent structure that has curved or apices.

7. A stent graft comprising:

a graft tube having proximal and distal ends, an intermediate position located approximately halfway between the proximal and distal ends, and first and second expanded configurations,

a plurality of stent rings attached to the graft tube between the proximal and distal ends,

a bare stent extending from the proximal end of the graft tube and designed to flare outwardly relative to the graft tube so as to engage in use a cavity of an aortic sinus of a patient,

a first diameter restraining device comprising a first filament, the first diameter restraining device being located at or proximate the proximal end of the graft tube,

a second diameter restraining device comprising a second filament, the second diameter restraining device located substantially half-way along the graft tube at the intermediate position of the graft tube between the proximal and distal ends of the graft tube, such that when the graft tube is in the first expanded configuration a diameter of the stent graft at the intermediate position of the graft tube is less than a diameter of the stent graft at regions immediately proximal and distal the intermediate position of the graft tube and where, in the first expanded configuration, the regions immediately proximal and distal the intermediate position are not restrained by a diameter restraining device, and

where in the first expanded configuration the proximal end of the graft tube has a diameter less than the region immediately proximal the intermediate position of the graft tube, and wherein when the graft tube is in the second expanded configuration the diameter restraining devices do not restrain any portion of the stent graft.

8. The stent graft of claim 7, further comprising a stent at the distal end of the graft tube wherein at least a portion of the stent at the distal end of the tube extends from the distal end of the graft tube.

9. The stent graft of claim 7, further comprising a bare stent extending from the distal end of the graft tube.

10. The stent graft of claim 9, wherein the bare stent at the distal end flares outwardly relative to the graft tube.

11. The stent graft of claim 7, wherein the bare stent is formed of an undulating stent structure having curved apices.

12. The stent graft of claim 7, wherein the graft tube is in the region of 65 mm in length.

13. The stent graft of claim 7, wherein the bare stent extends from the graft tube by around 10 mm.

14. A stent graft comprising:

a graft tube having a proximal end, a distal ends, a first expanded configuration and a second expanded configuration, the stent graft being of a length such that the graft tube does not block the coronary or brachiocephalic arteries when deployed,

a plurality of stent rings attached to the graft tube between the proximal and distal ends, wherein one of the plurality of stent rings is disposed at an intermediate position along the graft tube between two other of the plurality of stent rings and has proximal and distal ends,

a bare stent extending from the proximal end of the graft tube and designed to flare outwardly relative to the graft tube so as to engage in use a cavity of an aortic sinus of a patient,

a first diameter restraining device comprising a first filament, and a second diameter restraining devices comprising a second filament and a third filament, the first diameter restraining device being located at or proximate the proximal end of the graft tube, the second diameter restraining device located at the intermediate position along the graft tube,

wherein the filaments comprise diameter reducing loops disposed circumferentially around the graft tube, and

wherein when the graft tube is in the first expanded configuration the second filament restrains the proximal end of the stent located at the intermediate position along the graft tube and the third filament restrains the distal ends of the stent located at the intermediate position along the graft tube such that a diameter of the stent graft at the intermediate position along the graft tube is less than a diameter of the stent graft at regions immediately proximal and distal the intermediate positioned along the graft tube and where the regions immediately proximal and distal the intermediate positioned along the graft tube are not restrained by a diameter restraining device, and wherein when the graft tube is in the second expanded configuration the diameter restraining devices do not restrain any portion of the stent graft.

15. A stent graft according to claim 14, wherein the distal end of the graft tube is provided with a stent and a portion of the stent at the distal end-extends from the distal end of the graft tube.

16. The stent graft of claim 14, further comprising a bare stent extending from the distal end of the graft tube.

17. The stent graft of claim 16, wherein the bare stent at the distal end flares outwardly relative to the graft tube.

18. The stent graft of claim 14, wherein the bare stent is formed of an undulating stent structure having curved apices.

19. The stent graft of claim 14, wherein the graft tube is in the region of 65 mm in length.