DEVICES AND METHODS FOR TREATMENT OF THE AORTIC ARCH

• US 20140316514A1
• Filed: 02/25/2014
• Published: 10/23/2014
• Est. Priority Date: 03/13/2013
• Status: Active Grant

• Current Assignee: W. L. Gore & Associates (W.L. Gore & Associates)
• Original Assignee: W. L. Gore & Associates (W.L. Gore & Associates)
• Inventors: Zukowski, Stanislaw L.
• Granted Patent: US 9,402,751 B2
• Time in Patent Office: Days
• US Class Current: 623/1.35
• CPC Class Codes: A61F 2/07 Stent-grafts
• CPC Class Codes: A61F 2/856 Single tubular stent with a side portal passage
• CPC Class Codes: A61F 2002/061 provided with means for allowing access to secondary lumens
• CPC Class Codes: A61F 2250/0039 differing in diameter
• CPC Class Codes: A61F 2250/006 modular
• CPC Class Codes: A61F 2250/0065 telescopic

Abstract

The present disclosure includes an endoprosthesis comprising a descending stent-graft, an ascending stent-graft, and/or a side-branch stent-graft. In various embodiments, an ascending stent-graft is capable of being coupled to a descending stent-graft, and/or a descending stent-graft can comprise a fenestration capable of being coupled to a side-branch stent-graft. In addition, in various embodiments, a descending and/or ascending stent-graft can comprise a reduced diameter portion that, when implanted within an aortic arch, recedes from a luminal surface of the aortic arch to allow a side-branch stent-graft to be maneuvered within the aortic arch.

Claims

1. An endoprosthetic assembly for treating a main vessel and at least one branch vessel extending from the main vessel, the endoprosthetic assembly comprising:

a first expandable device and a second expandable device, each having a generally tubular shaped wall comprising a trunk portion configured for engaging the main vessel;

reduced diameter portions of each of the first and second devices having reduced diameters relative to their respective trunk portions, the first and second devices being configured to engage each other telescopically; and

at least one branch for treating the at least one branch vessel and extending through a fenestration in one of the reduced diameter portions.

2. The endoprosthetic assembly as in claim 1 including a second branch through a second fenestration formed in the reduced diameter portion of the other of the first and second expandable devices.

3. The endoprosthetic assembly as in claim 2 including a third branch through a third fenestration formed in the reduced diameter portion of one of the first and second expandable devices.

4. The endoprosthetic assembly as in claim 1 including visually distinct radiopaque or echogenic markers on each of the first and second expandable devices.

5. The endoprosthetic assembly as in claim 1, wherein at least one reduced diameter portions is concentrically offset from a trunk portion to which it is coupled.

6. An endoprosthesis comprising:

a descending stent-graft;

an ascending stent-graft; and

a side-branch stent-graft.

7. The endoprosthesis of claim 6, wherein the ascending stent-graft is capable of being coupled to the descending stent-graft.

8. The endoprosthesis of claim 6, wherein the descending stent-graft comprises a fenestration capable of being coupled to the side-branch stent-graft.

9. The endoprosthesis of claim 6, wherein the descending stent-graft comprises two fenestrations, a first fenestration capable of being coupled to the side-branch stent-graft and a second fenestration capable of being coupled to another side-branch stent-graft.

10. The endoprosthesis of claim 6, wherein the ascending stent-graft comprises a fenestration capable of being coupled to the side-branch stent-graft.

11. The endoprosthesis of claim 6, wherein the descending stent-graft comprises a reduced diameter portion that, when implanted within an aortic arch, recedes from a luminal surface of the aortic arch to allow the side-branch stent-graft to be maneuvered within the aortic arch.

12. The endoprosthesis of claim 6, wherein the ascending stent-graft comprises a reduced diameter portion that, when implanted within an aortic arch, recedes from a luminal surface of the aortic arch to allow the side-branch stent-graft to be maneuvered within the aortic arch.

13. The endoprosthesis of claim 6, wherein each of the ascending and descending stent-grafts comprises a trunk portion and a reduced diameter portion, the reduced diameter portion coupled to the trunk portion and concentrically offset from the trunk portion.

14. The endoprosthesis of claim 13, wherein the reduced diameter portions of each of the ascending and descending stent-grafts comprises a plurality of alternating first and second stent-rings, wherein the first stent-rings have a first diameter and the second stent-rings have a second diameter different than the first diameter.

15. A method comprising:

deploying a descending stent-graft within a descending portion of an aortic arch;

deploying an ascending stent-graft within an ascending portion of the aortic arch;

deploying a side-branch stent-graft through a fenestration in one of the ascending stent-graft and the descending stent-graft.

16. The method of claim 15, wherein the ascending stent-graft couples to the descending stent-graft during deployment.

17. The method of claim 15, further comprising maneuvering the side-branch stent-graft within the aortic arch between the fenestration and an ostium of a side-branch artery.

18. The method of claim 15, further comprising deploying two side-branch stent-grafts through two fenestrations in the descending stent-graft and a single side-branch stent-graft through a fenestration in the ascending stent-graft.

19. The method of claim 15, further comprising precannulating a side-branch artery with a guidewire prior to the deploying the descending stent-graft, wherein the guidewire abuts a luminal surface of the side-branch artery to facilitate deployment of the descending stent-graft.

20. The method of claim 15, further comprising precannulating the aortic arch with two guidewires prior to the deploying the descending stent-graft.

21. The method of claim 15, further comprising loading the ascending stent-graft on a guidewire such that a trunk portion of the ascending-stent-graft is located distal to a reduced diameter portion of the ascending stent-graft.

22. The method of claim 15, further comprising imaging one of the descending stent-graft, the ascending stent-graft and the side-branch stent-graft by way of a radiopaque marker.

23. The method of claim 20, wherein the two guidewires extend through common entry into a femoral artery.

24. The method of claim 15, wherein a flow through at least one side-branch stent-graft is retrograde relative to a main vessel flow.

25. The method of claim 15, further comprising deploying a balloon in one of the two side-branch stent-grafts.

26. The method of claim 15, the descending stent-graft comprising a trunk portion and a reduced diameter portion, the reduced diameter portion concentrically offset from the trunk portion.

27. The method of claim 15, the ascending stent-graft comprising a trunk portion and a reduced diameter portion, the reduced diameter portion concentrically offset from the trunk portion.

29. The endoprosthetic device of claim 22, further comprising at least one side-branch stent-graft for treating the at least one branch vessel and extending through a fenestration in one of the first main body device and the second main body device.

28. An endoprosthetic assembly for treating a main vessel and at least one branch vessel extending from the main vessel, the endoprosthetic device comprising:

a first main expandable device having a generally tubular shaped wall comprising a trunk portion configured for engaging the main vessel and a reduced diameter portion having a reduced diameter relative to the trunk portion, the reduced diameter portion concentrically offset from the trunk portion, the reduced diameter portion extending tangentially from the trunk portion, and the reduced diameter portion having at least one fenestration opposite a portion that abuts the trunk portion; and

a second main expandable device having a generally tubular shaped wall comprising a trunk portion configured for engaging the main vessel and a reduced diameter portion having a reduced diameter relative to the trunk portion, the reduced diameter portion concentrically offset from the trunk portion, the reduced diameter portion extending tangentially from the trunk portion, and the reduced diameter portion having at least two fenestrations opposite a portion that abuts the trunk portion.