Stent/graft device and method for open surgical placement

• US 8,202,311 B2
• Filed: 07/26/2006
• Issued: 06/19/2012
• Est. Priority Date: 07/27/2005
• Status: Active Grant

• Current Assignee: Cook Medical Incorporated (Cook Group Incorporated)
• Original Assignee: Cook Medical Incorporated (Cook Group Incorporated)
• Inventors: Demetriades, Demetrios, Gingles, Bruce, Hunt, James B., McIntosh, Charles L.
• Primary Examiner(s): Severson, Ryan
• Assistant Examiner(s): CRONIN, ASHLEY L
• Application Number:
  US11/493,076
• Publication Number:
  US 20070027526A1
• Time in Patent Office: 2,155 Days
• Field of Search: 128/898, 606/108, 606152-155, 606/8, 623 111- 116, 623/1.23, 623/1.36, 623/903
• US Class Current: 623/1.13
• CPC Class Codes: A61F 2/064 with special features to facilitate anastomotic coupling anastomosis of natural blood vessels A61B17/11
• 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 2/90 characterised by a net-like or mesh-like structure
• CPC Class Codes: A61F 2/97 the outer sleeve being splittable
• CPC Class Codes: A61F 2002/075 the stent being loosely attached to the graft material, e.g. by stitching
• CPC Class Codes: A61F 2002/8483 Barbs
• CPC Class Codes: Y10S 623/903 Blood vessel

Abstract

A method and a stent/graft device for intraoperative repair of a damaged portion of a body vessel. The stent/graft device has a length at least as long as the length of the damaged portion of the vessel undergoing repair, and is positioned within the vessel such that the device at least spans the length of the damaged vessel portion. The stent/graft device is securely engaged with the vessel at the site of the damage in a manner such that migration of the device in said vessel is inhibited.

Claims

1. A method for open surgical repair of a damaged portion of a body vessel of a patient that has been subjected to a traumatic episode, comprising:

surgically opening an open air pathway from an outer layer of skin to said damaged vessel portion;

positioning a stent/graft device at said surgical opening for insertion through said open air pathway, said stent/graft device having a length at least as long as a length of said damaged vessel portion undergoing repair, said stent/graft device comprising an elongated generally cylindrical stent and a graft material covering at least a portion of said stent, said device being expandable from a compressed condition having a diameter less than a diameter of the vessel to an expanded condition having a diameter at least as large as the diameter of the vessel, said stent/graft device being loaded into a sheath capable of maintaining said stent/graft device in said compressed condition;

inserting said sheath having said stent/graft device loaded therein in said compressed condition into said damaged vessel portion through said open air pathway, such that said device at least spans said damaged vessel portion length; and

removing said sheath from said stent/graft device at said site such that said stent/graft device expands to said expanded condition and engages said vessel, in a manner such that migration of said stent/graft device in said vessel is inhibited.

2. The method of claim 1, wherein said stent/graft device includes an anchoring mechanism for anchoring said device to said vessel and thereby inhibiting said migration.

3. The method of claim 2, wherein said anchoring mechanism comprises barbs provided along at least a portion of an outer circumference of the stent/graft device.

4. The method of claim 3, wherein said sheath includes a mechanism for selectively splitting said sheath for effecting expansion of said device.

5. The method of claim 1, wherein said sheath includes a mechanism for selectively splitting said sheath for effecting expansion of said device.

6. The method of claim 5, wherein said mechanism comprises a pull-tab.

7. The method of claim 6, wherein the pull-tab comprises a string aligned for splitting said sheath upon pulling said string in a first direction.

8. The method of claim 1, wherein said stent/graft device includes a coating comprising at least one therapeutic agent.

9. A method for open surgical repair of a damaged portion of a body vessel, comprising:

surgically opening an open air pathway from an outer layer of skin to said damaged vessel portion;

positioning an assembly comprising a sheath and a stent/graft device at said surgical opening for insertion through said open air pathway, said stent/graft device received in said sheath in a compressed condition having a diameter less than a diameter of the vessel, and expandable therefrom to an expanded condition having a diameter at least as large as the diameter of the vessel, said stent/graft device having a length at least as long as the length of said damaged vessel portion undergoing repair, said stent/graft device comprising a plurality of axially spaced stents, and a graft material spanning axially adjacent stents and covering at least a portion of said axially adjacent stents, said assembly including a mechanism for selectively splitting said sheath for effecting expansion of said stents to the expanded condition;

inserting said sheath into said damaged vessel portion through said open air pathway when said stents are in said compressed condition, such that the stent/graft device at least spans said damaged vessel portion; and

splitting said sheath, thereby effecting expansion of said stents to said expanded condition such that said stent/graft device engages said vessel.

10. The method of claim 9, wherein said stent/graft device includes an anchoring mechanism for anchoring said device to said vessel when said device is in the expanded condition.

11. The method of claim 10, wherein said anchoring mechanism comprises barbs provided along at least a portion of an outer circumference of the stent/graft device.

12. The method of claim 9, wherein said plurality of axially spaced stents comprises a pair of stents, said stents spaced such that one of said stents is positioned at each axial end of said stent/graft device.

13. The method of claim 12, wherein a respective sheath is provided for each of said stents, each sheath enclosing a separate one of said stents when said stent is in a compressed condition, each said sheath being selectively removable for effecting expansion of said stent.

14. The method of claim 9, wherein said mechanism for selectively splitting said sheath comprises a pull-tab.

15. The method of claim 14, wherein said pull-tab comprises a string aligned for splitting said sheath upon pulling said string in a first direction.

16. The method of claim 9, wherein the mechanism for selectively splitting the sheath comprises a pair of pull-strings, a first one of said pull-strings being aligned along said sheath to be pulled in a first direction, and a second one of said pull-strings being aligned along said sheath to be pulled in a second direction, opposite from said first direction, whereupon said splitting step comprises pulling each of said pull-strings in said respective direction.

17. A method for open surgical repair of a fragmented portion of a body vessel that has been subjected to a traumatic episode, comprising:

surgically opening an open air pathway from an outer layer of skin to said fragmented vessel portion;

positioning a stent/graft device at said surgical opening for repair, the stent/graft device having a length at least as long as the length of the fragmented vessel portion undergoing repair, the stent/graft device comprising a pair of axially spaced stents, and a graft material spanning the stents, the stents being expandable from a compressed condition having a diameter less than a diameter of the vessel to an expanded condition having a diameter at least as large as the diameter of the vessel, the stent/graft device being loaded into a sheath mechanism, the sheath mechanism including one or more sheath members aligned for maintaining the stents in the compressed condition;

inserting the sheath mechanism having the stent/graft device loaded therein into the fragmented vessel portion through said open air pathway, and aligning the sheath mechanism along the vessel such that the stent/graft device at least spans the fragmented vessel portion; and

removing the sheath mechanism, thereby effecting expansion of the stents to the expanded condition such that the stent/graft device engages the vessel.

18. The method of claim 17, wherein the stent/graft device includes an anchoring mechanism for anchoring the device to the vessel when the device is in the expanded condition.

19. The method of claim 18, wherein the anchoring mechanism comprises at least one anchor member at each axial end thereof.

20. The method of claim 17, wherein the sheath mechanism includes one or more pull-tabs for splitting the sheath for removal thereof.

21. The method of claim 17, wherein said sheath mechanism comprises two sheath members, each of said sheath members includes a pull-string for splitting said sheath member, and wherein said removing step is carried out by pulling each of said pull strings to split the respective sheath members.

22. The method of claim 17, wherein the fragmented portion of the body vessel comprises a portion that has been removed from a remainder of the body vessel, and the inserting step comprises manually placing the sheath mechanism having the stent/graft device loaded therein at a site of the removed vessel portion.