BRANCHED VESSEL PROSTHESIS

• US 20090264991A1
• Filed: 04/17/2009
• Published: 10/22/2009
• Est. Priority Date: 04/18/2008
• Status: Active Grant

• Current Assignee: Cook Medical Incorporated (Cook Group Incorporated)
• Original Assignee: Cook Incorporated (Cook Group Incorporated)
• Inventors: Chambers, Sean D., Paul, Ram H. JR.
• Granted Patent: US 8,128,686 B2
• Time in Patent Office: Days
• US Class Current: 623/1.350
• CPC Class Codes: A61F 2/2418 Scaffolds therefor, e.g. support stents
• CPC Class Codes: A61F 2/2475 Venous valves
• CPC Class Codes: A61F 2/856 Single tubular stent with a side portal passage
• 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 2/954 for placing stents or stent-grafts in a bifurcation
• 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 2002/075 the stent being loosely attached to the graft material, e.g. by stitching
• CPC Class Codes: A61F 2002/825 having longitudinal struts
• 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 2002/9511 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 2220/005 using adhesives
• CPC Class Codes: A61F 2220/0058 soldered or brazed or welded
• 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 2230/0054 V-shaped

Abstract

The present disclosure describes an implantable branched vessel prosthesis, such as a prosthetic valve, having both a radially expandable annular portion and a laterally extendable branch portion. Methods of delivering the branched vessel prosthesis to a branched body vessel are also provided, as well as delivery systems comprising the branched vessel prosthesis. The branched vessel prostheses are useful, for example, as implantable prosthetic venous valves for treating venous valve insufficiency. The delivery system is configured to deploy independently both the annular portion within a primary vessel and the branch portion within a branch vessel with only one delivery system.

Claims

1. A branched vessel prosthesis comprising:

two longitudinally spaced primary hoop members and at least one primary longitudinal strut coupling the two primary hoop members to define a primary lumen through the primary hoop members about a longitudinal axis, the primary hoop members being movable between a radially compressed configuration and a radially expanded configuration, and

a branch hoop member and at least one flexible member coupling the branch hoop member with at least one of the primary hoop members, the branch hoop member being movable between a first position and a second position, where in the first position the branch hoop member is disposed within the primary lumen and between the primary hoop members in the radially compressed configuration, where in the second position the branch hoop member is disposed outside the primary lumen when the primary hoop members are in the radially expanded configuration, the branch hoop member in the second position defining a branch lumen about a branch axis in communication with the primary lumen.

2. The prosthesis of claim 1, wherein an angle is formed between the longitudinal axis and the branch axis, and the at least one flexible member has a bend configured to conform around said angle.

3. The prosthesis of claim 1, further comprising a graft material, the graft material having a primary portion attached to the primary hoop members and a secondary portion attached to the branch hoop member.

4. The prosthesis of claim 1, further comprising a valve leaflet extending from a base to a free edge, the valve leaflet base being attached to one of the primary hoop members, the free edge being movable within the primary lumen between an open position permitting fluid flow in an antegrade direction through the primary lumen and a closed position inhibiting fluid flow in a retrograde direction opposite the antegrade direction through the primary lumen.

5. The prosthesis of claim 4, where the primary hoop members include a first primary hoop member proximal to a second primary hoop member, the valve leaflet being attached to the first primary hoop member.

6. The prosthesis of claim 4, further comprising a second valve leaflet extending from a base to a free edge, the second valve leaflet base being attached to the branch hoop member, the second valve leaflet free edge movable within the branch lumen between an open position permitting fluid flow in a first direction through the branch lumen and a closed position inhibiting fluid flow in a second direction opposite the first direction through the branch lumen.

7. The prosthesis of claim 1, further comprising a valve leaflet extending from a base to a free edge, the valve leaflet base being attached to branch hoop member, the free edge movable within the branch lumen between an open position permitting fluid flow in a first direction through the branch lumen and a closed position reducing or preventing fluid flow in a second direction opposite the first direction through the branch lumen.

8. The prosthesis of claim 1, wherein the primary hoop members are spaced a longitudinal distance greater than a diameter of the branch hoop member in the second position such that the branch hoop member is positionable between the primary hoop members.

9. The prosthesis of claim 1, wherein the branch hoop member has a length less than a diameter of the primary hoop members in the radially compressed configuration such that the branch hoop member is positionable within the primary lumen when the primary hoop members is in the radially compressed configuration.

10. The prosthesis of claim 1, wherein the length of the branch hoop member is about 25% to 75% the diameter of the primary hoop members in the radially compressed configuration.

11. A branched vessel prosthesis delivery system comprising:

a delivery catheter extending from a proximal end to a distal end about a longitudinal axis, the delivery catheter including an outer sheath enclosing an inner shaft portion, the outer sheath being translatable along the longitudinal axis relative to the inner shaft; and

a branched vessel prosthesis having a support frame comprising two longitudinally spaced primary hoop members and at least one primary longitudinal strut coupling the two primary hoop members to define a primary lumen through the primary hoop members, the primary hoop members being movable between a radially compressed configuration and a radially expanded configuration, and a branch hoop member and at least one flexible member coupling the branch hoop member with at least one of the primary hoop members, the branch hoop member being movable between a first position and a second position, where in the first position the branch hoop member is within the primary lumen and between the primary hoop members in the radially compressed configuration, where in the second position the branch hoop member is outside the primary lumen when the primary hoop members are in the radially expanded configuration, the branch hoop member in the second position defining a branch lumen in communication with the primary lumen,

wherein the outer sheath and the inner shaft portion are configured and oriented such that a retaining region is formed to receive the branched vessel prosthesis with the primary hoop members in the radially compressed configuration and the branch hoop member in the first position.

12. The delivery system of claim 11, where the primary hoop members in the radially compressed configuration is disposed around the inner shaft portion, and the branch hoop member in the second position is disposed between the outer sheath and the inner shaft portion.

13. The delivery system of claim 11, further comprising a tethering device having a wire member extending along the delivery catheter and a grasping member coupled to the wire member and removably attached to the branch hoop member, the tethering device being configured to controllably retain the branch hoop member in the first position independent of the movement of the primary hoop members between the radially compressed configuration and the radially expanded configuration.

14. The delivery system of claim 11, further comprising a trigger wire extending along the delivery catheter and removably attached to the branch hoop member, the trigger wire configured to controllably retain the branch hoop member in the first position independent of the movement of the primary hoop members between the radially compressed configuration and the radially expanded configuration.

15. The delivery system of claim 14, wherein the trigger wire includes a loop removably attached to a distal portion of the branch hoop member, the loop configured to center the distal portion of the branch hoop member into contiguous contact and to urge the distal portion adjacent the inner shaft when the branch hoop member is in the first position.

16. The delivery system of claim 14, wherein the trigger wire is removably attached to a proximal portion of the branch hoop member such that the proximal portion of the branch hoop member is adjacent the inner shaft when the branch hoop member is in the first position.

17. The delivery system of claim 11, where the branched vessel prosthesis further comprises a valve leaflet to regulate fluid flow within the primary lumen, the valve leaflet having a base attached to one of the primary hoop members and a free edge extending into the primary lumen.

18. The delivery system of claim 17, where the branched vessel prosthesis further comprises a second valve leaflet to regulate fluid flow within the branch lumen, the valve leaflet having a base attached to the branch hoop member and a free edge extending into the branch lumen.

20. The method of claim 18, where the point of treatment is a site of a valve within the first body vessel, and the branched vessel prosthesis further comprises a valve leaflet to regulate fluid flow within at least one of the primary and branch lumens, the valve leaflet having a base attached to at least one of the primary and branch hoop members and a free edge extending into at least one the lumens.

19. A method of delivering a branched vessel prosthesis to a point of treatment at a branched vessel site formed from a first body vessel and a second body vessel in fluid communication with the first body vessel, comprising the steps of:

inserting a branched vessel prosthesis in a compressed configuration into said body vessel, the branched vessel prosthesis having a support frame comprising two primary hoop members and at least one primary longitudinal strut coupling the two primary hoop members to define a primary lumen through the primary hoop members, the primary hoop members being in a radially compressed configuration, and a branch hoop member and at least one flexible strut coupling the branch hoop member with at least one of the primary hoop members, the branch hoop member being in a first position where the branch hoop member is within the primary lumen and between the primary hoop members in the radially compressed configuration,

translating the branched vessel prosthesis to said point of treatment at said branched vessel site;

radially expanding the primary hoop members from the radially compressed configuration to a radially expanded configuration to implant the primary hoop members within said first body vessel; and

extending the branch hoop member radially outward from the first position to a second position so that the branch hoop member is positioned within said second body vessel, where in the second position the branch hoop member is outside the primary lumen when the primary hoop members are in the radially expanded configuration and defines a branch lumen in communication with the primary lumen, such that the branched vessel prosthesis is deployed at said point of treatment at said branched vessel site.