Multiple Branch Tubular Prosthesis and Methods

• US 20070208256A1
• Filed: 03/03/2006
• Published: 09/06/2007
• Est. Priority Date: 03/03/2006
• Status: Abandoned Application

• Current Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Original Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Inventors: Marilla, Brennan
• Application Number:
  US11/276,512
• Publication Number:
  US 20070208256A1
• Time in Patent Office: Days
• US Class Current: 600/467
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 5/02007 Evaluating blood vessel condition, e.g. elasticity, compliance
• CPC Class Codes: A61B 8/0833 involving detecting or locating foreign bodies or organic structures
• CPC Class Codes: A61B 8/0841 for locating instruments
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61F 2/07 Stent-grafts
• 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 2002/061 provided with means for allowing access to secondary lumens
• CPC Class Codes: A61F 2002/065 Y-shaped blood vessels
• CPC Class Codes: A61F 2250/0071 breakable or frangible

Abstract

A tubular prosthesis having an opening formed in a side wall thereof is positioned in a first passageway in a human body with the opening facing and providing fluid flow to a first branch passageway that branches from the first passageway. A portion of the prosthesis that is in the vicinity of the juncture between the first passageway a second branch passageway is located and a second opening is formed in the located portion of the prosthesis so that the second opening faces the second branch passageway. In another embodiment, a tubular prosthesis is endovascularly delivered and positioned in a first passageway in a human body in the vicinity of a second passageway that branches from the first passageway. An imaging device, which is positioned in the prosthesis, locates the juncture between the first passageway and the second passageway after which a piercing member is advanced from the imaging device to a portion of the prosthesis adjacent to the juncture to form an opening in that portion of the prosthesis.

Claims

1. A method of forming an opening in a tubular prosthesis in vivo comprising:

endovascularly positioning a tubular prosthesis in a first passageway in a human body in the vicinity of a second passageway that branches from the first passageway;

positioning an imaging device in the prosthesis and locating the juncture between the first passageway and the second passageway therewith;

extending a piercing member from the imaging device to a portion of the prosthesis adjacent to the juncture; and

forming an opening in the portion with the piercing member into the second passageway.

2. The method of claim 1 including advancing a guidewire from the piercing member into the second passageway.

3. The method of claim 2 including enlarging the opening.

4. The method of claim 3 wherein a balloon catheter is advanced over the guidewire and into the opening and expanded to enlarge the opening.

5. The method of claim 4 wherein the balloon catheter is withdrawn and a secondary tubular prosthesis advanced over the guidewire and positioned in the opening and second passageway.

6. The method of claim 3 wherein a secondary tubular prosthesis is advanced over the guidewire and positioned in the opening and second passageway.

7. The method of claim 6 wherein the guidewire is withdrawn.

16. The method of claim 1 wherein the tubular prosthesis comprises a graft.

17. The method of claim 1 wherein the tubular prosthesis comprises a stent-graft.

8. The method of claim wherein the tubular prosthesis has a preformed opening formed in a side wall thereof and the tubular prosthesis is positioned in a first passageway in a human body with the opening facing and providing fluid flow to a first branch passageway that branches form the first passageway wherein a secondary tubular prosthesis is delivered over the guide device and positioned in the first passageway with the preformed opening facing and providing fluid flow to a third passageway that branches from the first passageway.

9. The method of claim 8 wherein the first passageway is an artery.

10. The method of claim 9 wherein the first passageway is the aorta.

11. The method of claim 10 wherein the second and third passageways are renal arteries.

12. The method of claim 11 wherein the tubular prosthesis comprises a graft.

13. The method of claim 11 wherein the tubular prosthesis comprises a stent-graft.

14. The method of claim 9 wherein the tubular prosthesis comprises a graft.

15. The method of claim 9 wherein the tubular prosthesis comprises a stent-graft.

18. A method of placing tubular prosthesis in a passageway in a human body comprising:

endovascularly positioning a tubular prosthesis, which has a preformed opening formed in a side wall thereof, in a first passageway in a human body in the vicinity of second and third passageways that branch from the first passageway so that the preformed opening faces and provides fluid flow to the second passageway;

positioning an imaging device in the prosthesis and locating the juncture between the first passageway and the third passageway therewith;

extending a piercing member from the imaging device to a portion of the prosthesis adjacent to the juncture; and

forming an opening in the portion with the piercing member.

19. The method of claim 18 wherein an expandable balloon is placed near the imaging device and expanded to force the piercing member through the prosthesis portion.

20. The method of claim 18 further including advancing a guidewire from the piercing member into the third passageway and withdrawing the imaging device.

21. The method of claim 20 wherein a balloon catheter having a balloon is advanced over the guidewire and the balloon into the portion opening and expanded to enlarge that opening.

22. The method of claim 21 wherein the balloon catheter is deflated and withdrawn and a secondary tubular prosthesis advanced over the guidewire and positioned in the opening and third passageway.

23. The method of claim 27 wherein another secondary tubular prosthesis is positioned in the preformed opening and second passageway.

24. The method of claim 18 wherein the first passageway is an artery.

25. The method of claim 18 wherein the first passageway is the aorta.

26. The method of claim 25 wherein the second and third passageways are renal arteries.

27. The method of claim 18 wherein the tubular prosthesis comprises a graft.

28. The method of claim 18 wherein the tubular prosthesis comprises a stent-graft.

29. A system for placing a prosthesis in the vicinity of a branch vessel comprising:

a tubular prosthesis adapted to be endovascularly delivered through a vessel in a human body; and

an imaging catheter adapted to be positioned in the tubular prosthesis and detect a branch vessel that branches from said vessel in which it is placed, said imaging catheter having a piercing member that is extendable therefrom and adapted to form an opening in the tubular prosthesis in the vicinity of the detected branch vessel.

30. The system of claim 29 wherein said imaging catheter includes a guidewire that is extendable from said piercing member.

31. The system of claim 29 wherein said tubular prosthesis has a tubular side wall and said side wall has an opening formed therein.

32. The system of claim 31 wherein said tubular prosthesis comprises a graft.

33. The system of claim 31 wherein said tubular prosthesis comprises a stent-graft.

34. The system of claim 29 wherein said tubular prosthesis comprises a graft.

35. The system of claim 29 wherein said tubular prosthesis comprises a stent-graft.

36. The system of claim 29 further including a tubular branch vessel prosthesis adapted for endovascular delivery to a branch vessel that branches from said vessel.