US20010014823A1 - Bifurcated prosthetic graft - Google Patents

Bifurcated prosthetic graft Download PDF

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Publication number
US20010014823A1
US20010014823A1 US09/778,988 US77898801A US2001014823A1 US 20010014823 A1 US20010014823 A1 US 20010014823A1 US 77898801 A US77898801 A US 77898801A US 2001014823 A1 US2001014823 A1 US 2001014823A1
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Prior art keywords
graft
leg
end
component
tubular
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Abandoned
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US09/778,988
Inventor
Thomas Ressemann
Timothy Petrick
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Cordis Corp
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Teramed Corp
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Priority to US09/039,779 priority Critical patent/US6224609B1/en
Application filed by Teramed Corp filed Critical Teramed Corp
Priority to US09/778,988 priority patent/US20010014823A1/en
Publication of US20010014823A1 publication Critical patent/US20010014823A1/en
Assigned to CORDIS CORPORATION reassignment CORDIS CORPORATION MERGER (SEE DOCUMENT FOR DETAILS). Assignors: TERAMED CORPORATION
Application status is Abandoned legal-status Critical

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/04Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06Blood vessels
    • A61F2/07Stent-grafts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/954Instruments specially adapted for placement or removal of stents or stent-grafts for placing stents or stent-grafts in a bifurcation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/962Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
    • A61F2/966Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/04Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06Blood vessels
    • A61F2002/065Y-shaped blood vessels
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/04Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06Blood vessels
    • A61F2/07Stent-grafts
    • A61F2002/075Stent-grafts the stent being loosely attached to the graft material, e.g. by stitching

Abstract

A prosthetic graft for use with a graft system is used to repair the treatment of aortic aneurysms which extend into at least one common iliac artery and do not have a suitable region for seating a stent or other attachment device. The graft is designed to be used in combination with a graft system having legs extending into the common iliac arteries and provides the graft system with a place to securely seat its iliac legs without blocking the internal iliac artery.

Description

    FIELD OF THE INVENTION
  • This invention relates to a bifurcated prosthetic graft and a method for deploying the graft at an area of vessel bifurcation. The invention is a bifurcated prosthetic graft for deployment at the bifurcation of the common iliac artery, and in particular, for use with a biluminal graft system for use in repairing abdominal aortic aneurysms. [0001]
  • BACKGROUND OF THE INVENTION
  • Aortic aneurysms represent a significant medical problem for the general population. Aneurysms within the aorta presently affect between two and seven percent of the general population and the rate of incidence appears to be increasing. This form of vascular disease is characterized by a degradation in the arterial wall in which the wall weakens and balloons outward by thinning. If untreated, the aneurysm can rupture resulting in death within a short time. [0002]
  • The traditional treatment for patients with an abdominal aortic aneurysm is surgical repair. This is an extensive operation involving transperitoneal or retroperitoneal dissection of the aorta and replacement of the aneurysm with an artificial artery known as a prosthetic graft. This procedure requires exposure of the aorta through an abdominal incision extending from the lower border from the breast bone down to the pubic bone. The aorta is clamped both above and below the aneurysm so that the aneurysm can be opened and the prosthetic graft of approximately the same size as the aorta can be sutured in place. Blood flow is then re-established through the prosthetic graft. The operation requires a general anesthesia with a breathing tube, extensive intensive care unit monitoring in the immediate post-operative period along with blood transfusions and stomach and bladder tubes. All of this imposes stress on the cardiovascular system. This is a high-risk surgical procedure with well-recognized morbidity and mortality. [0003]
  • More recently, significantly less invasive clinical approaches to aneurysm repair known as endovascular grafting have been proposed. (See, Parodi, J. C., et al. “Transfemoral Intraluminal Graft Implantation for Abdominal Aortic Aneurysms,” 5 Annals of Vascular Surgery, 491 (1991)). Endovascular grafting involves the transluminal placement of a prosthetic arterial graft in the endoluminal position (within the lumen of the artery). By this method, the graft is attached to the internal surface of an arterial wall by means of attachment devices such as expandable stents, one above the aneurysm and a second below the aneurysm. [0004]
  • It is not uncommon for abdominal aortic aneurysms to extend to the aortic bifurcation or even into the common iliac arteries. When the aneurysm extends into the common iliac arteries it is necessary that the graft system used to repair the aneurysm extend into the common iliac arteries past the aneurysm. This requires that there be enough space between the aneurysm and the common iliac bifurcation so that the graft can properly seat. By “seating” it is meant that the graft is somehow fixed to the non-aneurysmal vasculature. However, in a significant number of patients the aneurysm extends into the common iliac arteries on one or both sides such that there is not enough room to seat the graft without at least partially blocking the internal iliac artery. Such a situation occurs in so-called Class D or E aneurysms. The internal iliac artery is a significant vessel which supplies blood to the pelvic region. Blockage of the vessel can result in undesirable consequences for the patient. For this reason, patients in this category are often excluded from the less expensive and less traumatic endovascular repair and must instead undergo the invasive surgical procedure described above. [0005]
  • Therefore, a need exists for an improved prosthetic graft which will allow endoluminal reconstruction of the common, external, and internal iliac bifurcation. The preferred construction will allow a bifurcated or biluminal aortic graft system to be implanted prior to or following the reconstruction of the iliac bifurcation, while maintaining blood flow to the internal iliac arteries. [0006]
  • SUMMARY OF THE INVENTION
  • In one aspect, this invention is a prosthetic graft for placement by a single delivery catheter at the bifurcation of a first vessel into second and third vessels within the vasculature of a patient comprising a first graft conduit having first and second ends and first and second stents, the first stent adapted to secure the first end of the first graft conduit within the lumen of the first vessel, the second stent adapted to secure the second end of the first graft conduit within the lumen of the second vessel; and a second graft conduit attached in fluid communication with the first graft conduit, the second graft conduit having a third stent adapted to secure it within the lumen of the third vessel, the first and second graft conduits being sized and configured to be contained within and delivered by the single delivery catheter. Preferably, the first graft conduit forms a first lumen which contains the first and second stents and the second graft conduit forms a second lumen which contains the third stent. The cross-sectional area of the first end of the first graft conduit may be greater than the cross-sectional area of the second end of the first graft conduit. The first and second graft conduits preferably are configured to expand from a first delivery configuration to a second deployed configuration. The cross-sectional area of the first end of the first graft conduit preferably is at least as great as the cross-sectional area of the prosthetic graft at any localized point along a longitudinal axis of the first graft conduit when in the delivery configuration. [0007]
  • In a second aspect, this invention is a method for placing a prosthetic graft in a vessel of a patient's vascular system. The prosthetic graft has a first tubular graft component and a second tubular graft component in fluid communication with it. The method comprises providing a delivery catheter containing the prosthetic graft in a first delivery configuration, the catheter having an angular control element for adjustably controlling the angle between the first and second tubular graft components; advancing the catheter through the vessel to a desired location; manipulating the angular control element to select a desired angle between the first and second tubular graft components; and deploying the prosthetic graft in the vessel in a second expanded configuration. The angular control element of the catheter may include a wire with a pre-formed angle and the step of manipulating the angular control element to select a desired angle may include advancing or retracting the wire. The first tubular graft component may include a first stent attached thereto and the second tubular graft component may include a second stent attached thereto. Preferably, the method further comprises securing the first and second tubular graft components within the vessel by radially expanding the first and second stents. [0008]
  • In a third aspect, this invention is a prosthetic graft for placement by a single delivery catheter at the bifurcation of a first vessel into second and third vessels within the vasculature of a patient comprising a first graft conduit having first and second ends and including a tubular graft component defining a lumen and at least one stent located within the lumen and attached to the graft component, the stent adapted to secure the first end of the first graft conduit within the lumen of the first vessel and the second end of the first graft conduit within the lumen of the second vessel; and a second graft conduit attached in fluid communication with the first graft conduit, the second graft conduit including a tubular graft component defining a lumen and a stent located within the lumen and attached to the graft component and adapted to secure the second graft component within the lumen of the third vessel, the first and second graft conduits being sized and configured to be contained within and delivered by the single delivery catheter. [0009]
  • In a fourth aspect, this invention is a prosthetic graft for placement by a single delivery catheter at the bifurcation of a first vessel into second and third vessels within the vasculature of a patient comprising: a first leg having first and second leg segments, the first leg segment adapted to be deployed in the lumen of the first vessel, the second leg segment adapted to be deployed in the lumen of the second vessel; and a second leg adapted to be deployed in the lumen of the third vessel, whereby the first and second segments of the first leg and the second leg are adapted to be independently deployable within the lumens of the first, second, and third vessels, the first and second legs being sized and configured to be contained within and delivered by the single delivery catheter. The first leg may include a graft component and at least one stent attached to the graft component and the second leg may include a graft component and a stent attached to the second leg graft component. [0010]
  • In a fifth aspect, this invention is a method of placing a prosthetic graft at the bifurcation of the common iliac artery into the external and internal iliac arteries, the prosthetic graft having a first graft conduit with first and second ends and a second graft conduit attached in fluid communication with the first graft conduit, the method comprising: providing a delivery catheter containing the prosthetic graft in a first delivery configuration; introducing the delivery catheter into a femoral artery on the same side as the common iliac artery bifurcation; advancing the delivery catheter to the common iliac artery bifurcation; and manipulating the delivery catheter to deploy the prosthetic graft in a second expanded configuration such that the first end of the first graft conduit is secured within the lumen of the common iliac artery, the second end of the first graft conduit is secured within the lumen of the external iliac artery and the second graft conduit is secured within the lumen of the internal iliac artery. The delivery catheter may include an angular control element for adjustably controlling the angle between the first and second graft conduits and the method may further include manipulating the angular control element to select a desired angle between the first and second graft conduits. The first graft conduit may include a first stent and the second graft conduit may include a second stent, the first and second stents adapted to expand from a first delivery configuration to a second deployed configuration. The method may further include securing the first end of the first graft conduit within the lumen of the common iliac artery by expanding at least a portion of the first stent to its deployed configuration; the second end of the first graft conduit may be secured within the lumen of the external iliac artery by expanding at least a portion of the first stent to its deployed configuration; and the second graft conduit may be secured within the lumen of the internal iliac artery by expanding the second stent to its deployed configuration. [0011]
  • In a sixth aspect, this invention is a method for repairing an abdominal aneurysm in an aorta which branches into two iliac arteries using a graft system having a first leg which includes first and second ends and a first bifurcated prosthetic graft having a first tubular graft component with first and second ends and a second tubular graft component in fluid communication with the first tubular graft component. The method comprises: providing a delivery system including a first guide wire; advancing the first guide wire through a first iliac artery to a desired location in the aorta above the aneurysm; delivering the first leg over the first guide wire so that the first end of the first leg is above the aneurysm on one side thereof and the second and is on the other side of the aneurysm, the first leg extending across the aneurysm; delivering the first bifurcated prosthetic graft over the first guide wire so that the second tubular graft component is positioned in the internal iliac artery, the first end of the first tubular graft component is positioned in the common iliac artery and the second end of the first graft component is positioned in the external iliac artery; and securing the second end of the first leg to the first end of the first tubular graft component. The first leg may include an aortic stent attached to the first end of the first leg and an iliac stent attached to the second end of the first leg. The first prosthetic graft may include at least one stent attached to the first tubular graft component and a stent attached to the second tubular graft component. The method may further comprise securing the first end of the first leg in the aorta by deploying the aortic stent, securing the second end by deploying the iliac stent and securing the first and second ends of the first tubular graft component by deploying the at least one stent and securing the second tubular graft component by securing the stent attached thereto. Preferably, the first leg is delivered over the first guide wire prior to delivery of the first bifurcated prosthetic graft and the first bifurcated prosthetic graft is delivered over the first guide wire prior to delivery of the first leg. This method may also include providing a first delivery catheter for delivering the first leg and providing a second delivery catheter for delivering the first bifurcated prosthetic graft. The graft system of this method may include a second leg which includes first and second ends and a second bifurcated prosthetic graft having a first tubular graft component with first and second ends and a second tubular graft component in fluid communication with the first tubular graft component; the method then further includes: providing a delivery system including a second guide wire; advancing the second guide wire through the second iliac artery to a desired location in the aorta above the aneurysm; delivering the second leg over the second guide wire so that the first end of the second leg is above the aneurysm and on one side thereof and the second end of the second leg is on the other side of the aneurysm, the second leg extending across the aneurysm; delivering the second bifurcated prosthetic graft over the second guide wire so that the second tubular graft component is positioned in the second internal iliac artery, the first end of the first tubular graft component is positioned in the second common iliac artery and the second graft component is positioned in the second external iliac artery; and securing the second end of the second leg to the first end of the first tubular graft component of the second prosthetic graft. [0012]
  • In a seventh aspect, this invention is a method for repairing an abdominal aneurysm using a graft system having a first leg which includes first and second ends and a first bifurcated prosthetic graft having a first tubular graft component with first and second ends and a second tubular graft component in fluid communication with the first tubular graft component, comprising: advancing the first leg through a first iliac artery into the aorta so that the first end of the first leg is above the aneurysm on one side thereof and the second end is on the other side of the aneurysm, the first leg extending across the aneurysm; after the first leg has been advanced, advancing the first bifurcated prosthetic graft through the same iliac artery so that the second tubular graft component is positioned in the internal iliac artery, the first end of the first tubular graft component is positioned in the common iliac artery and the second end of the first graft component is positioned in the external iliac artery; and securing the second end of the first leg to the first end of the first tubular graft component. The graft system may include a second leg having first and second ends and a second bifurcated prosthetic graft having a first tubular graft component with first and second ends and a second tubular graft component in fluid communication with the first tubular graft component. The method then further comprises: advancing the second leg through the second iliac artery into the aorta so that the first end of the second leg is above the aneurysm on one side thereof and the second end of the second leg is on the other side of the aneurysm, the second leg extending across the aneurysm; and after the second leg has been advanced, advancing the second bifurcated prosthetic graft through the same iliac artery as the second leg so that the second tubular graft component of the second bifurcated prosthetic graft is positioned in the second internal iliac artery, the first end of the first tubular graft component is positioned in the second common iliac artery and the second end of the first graft component is positioned in the second external iliac artery; and securing the second end of the second leg to the first end of the first tubular graft component of the second bifurcated prosthetic graft. [0013]
  • In an eighth aspect, this invention is a graft system for repairing an abdominal aneurysm comprising a first leg having first and second ends, the first end adapted to be secured in the aorta on one side of the aneurysm and the second end adapted to be secured on the other side of the aneurysm; a first bifurcated prosthetic graft having a first tubular graft component with first and second ends and a second tubular graft component attached in fluid communication with the first tubular graft component, the first end of the first tubular graft component adapted to be secured in the common iliac artery, the second end of the first tubular graft component adapted to be secured in the external iliac artery and the second tubular graft component adapted to be secured in the internal iliac artery; a first guide wire sized to fit through a first iliac artery and through the aorta to a location above the aneurysm; a first delivery catheter configured to advance and deliver the first leg across the first guide wire; and a second delivery catheter configured to advance and deliver the first prosthetic graft across the first guide wire. The graft system may include first leg having an aortic stent attached to the first end and an iliac stent attached to the second end. The first bifurcated prosthetic graft may have at least one stent attached to the first tubular graft component and a stent attached to the second tubular graft component. Preferably, the graft system includes: second leg having first and second ends, the first end adapted to be secured in the aorta on one side of the aneurysm and the second end adapted to be secured on the other side of the aneurysm; a second bifurcated prosthetic graft having a first tubular graft component with first and second ends and a second tubular graft component attached in fluid communication with the first tubular graft component, the first end of the first tubular graft component adapted to be secured in the common iliac artery, the second end of the first tubular graft component adapted to be secured in the external iliac artery and the second tubular graft component adapted to be secured in the internal iliac artery; a second guide wire sized to fit through the second iliac artery and through the aorta to a location above the aneurysm; a third delivery catheter configured to advance and deliver the second leg across the second guide wire; and a fourth delivery catheter configured to advance and deliver the second prosthetic graft across the second guide wire. [0014]
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • FIG. 1 is a diagrammatic view of a portion of a human vascular system depicting an abdominal aortic aneurysm extending from below the renal arteries and into the common iliac arteries and showing advancement along a guide wire of a delivery catheter containing the prosthetic graft of the present invention. [0015]
  • FIG. 2 is a view of the aneurysm of FIG. 1 showing injection of radiographic contrast solution at the internal iliac artery and projection of the undeployed internal iliac leg of the prosthetic graft into the internal iliac artery. [0016]
  • FIG. 3 is a view of the aneurysm of FIG. 1 showing deployment of the internal iliac leg of the prosthetic graft. [0017]
  • FIG. 4 is a view of the aneurysm of FIG. 1 showing deployment of the common/external iliac leg of the prosthetic graft. [0018]
  • FIG. 5 is a view of the aneurysm of FIG. 1 showing advancement of the control rod and advancement of the internal iliac sheath into the nose cone. [0019]
  • FIG. 6 is a view of the aneurysm of FIG. 1 after the delivery system has been removed. [0020]
  • FIG. 7 is a view of the aneurysm of FIG. 1 illustrating deployment of a prosthetic graft in both iliac arteries. [0021]
  • FIG. 8 is a view similar to the aneurysm of FIG. 7 showing the prosthetic grafts combined with a biluminal endovascular graft system to repair the aneurysm. [0022]
  • FIG. 9 is a view of the delivery catheter assembly and prosthetic graft. [0023]
  • FIG. 10 is a view of the delivery catheter assembly illustrating the lateral projection of the undeployed internal iliac leg and injection of radiographic contrast solution. [0024]
  • FIG. 11 is a view of the delivery catheter assembly illustrating deployment of the internal iliac leg of the prosthesis. [0025]
  • FIG. 12 is a view of the delivery catheter assembly illustrating expansion of the common/external iliac leg of the prosthesis. [0026]
  • FIG. 13 is a view of the delivery catheter assembly showing movement of the internal iliac sheath into the nose cone. [0027]
  • FIG. 14 is a plan view of the deployed prosthesis. [0028]
  • FIG. 15 is a cross-sectional view of the deployed prosthesis. [0029]
  • FIGS. [0030] 16-20 are cross-sectional views of a second embodiment of the prosthetic graft loaded into a delivery catheter during various stages of the deployment process.
  • FIG. 21 is a cross-sectional view of the second embodiment of the prosthetic graft of the present invention. [0031]
  • DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
  • The present invention is a prosthetic graft for use with a graft system used to repair the treatment of aortic aneurysms which extend into at least one common iliac artery and do not have a suitable region for seating a stent or other attachment device. The graft is designed to be used in combination with a graft system having legs extending into the common iliac arteries and provides the graft system with a place to securely seat its iliac legs without blocking the internal iliac artery. [0032]
  • The terms “distal” and “proximal” as used herein refer only to the delivery catheter of the prosthetic graft, not to the vasculature. The present method contemplates advancement of the delivery catheter in a retrograde manner (i.e., against the flow of blood). Therefore, “proximal” refers to a location closer to the physician and “distal” refers to a location farther from the physician. The vasculature is referred to with respect to the cranial (closer to head) and caudal (closer to feet) directions. Also, as used in this specification, the term “above”, in the context of relative positioning, with respect to the aneurysm, refers to the regional cranial of the aneurysm, for example, within the aorta, whereas “below” refers to the region of the vasculature caudal of the aneurysm, for example, within the common iliac arteries. [0033]
  • As best seen in FIGS. 14 and 15, the prosthesis includes a common/external iliac leg [0034] 56 and an internal iliac leg 52. Each leg 56 and 52 includes a graft component 57 and 53, and a stent component 59 and 55, respectively. Both legs are generally tubular having a circular cross-section. The common/external iliac leg has an upper portion which is positioned above the junction of the common iliac artery with the internal iliac artery and the lower portion which is positioned in the external iliac artery below the internal iliac artery. The internal iliac leg is attached to and projects from the common/external iliac leg and is positioned within the internal iliac artery. The attachment between the graft and stent is preferably by sutures. The prosthesis is delivered by way of a delivery catheter in a first contracted position. Once properly located the stent components expand radially during deployment so that the legs of the prosthetic graft are secured at the iliac bifurcation in their proper position.
  • The prosthesis is advanced into the iliac artery by means of a catheter. Typically, a guide catheter is introduced into the patient's vasculature via the femoral artery, through an incision made at a location where the vessel is close to the undersurface of the skin. A guide wire is snaked through the vasculature to a point above the aneurysm. The guide wire may be made of stainless steel or the like and is conventionally covered with an inert material (e.g., polytetrafluoroethylene (PTFE)). The guide wire may remain in a fixed position throughout the endoluminal bypass procedure. The catheter of this invention is then guided into the aneurysm along this guide wire and the prosthesis is deployed in the iliac artery. [0035]
  • FIG. 1 shows an aneurysm A in the infrarenal aorta and extending into the common iliac arteries. The infranrenal aorta is that portion of the aorta disposed between the left and right renal arteries RA and the common iliac arteries B which branch left and right. Each common iliac artery branches into internal and external iliac arteries D and C, respectively. External iliac artery C becomes the femoral artery below the inguinal ligament. Internal iliac artery D is also called the hypogastric artery. Delivery catheter [0036] 50 is shown advancing along guide wire 10 to the common iliac bifurcation site of the external and internal iliac arteries C and D.
  • FIG. 9 is a cross-sectional view of the distal portion of delivery catheter assembly [0037] 50 used to introduce and deploy the prosthetic graft. Inner shaft 20 runs the length of delivery catheter assembly 50. Inner shaft 20 defines a central bore, or guide wire lumen, 22, which provides a means for inserting the catheter assembly into a patient along the guide wire (shown as 10 in FIGS. 1 to 7). Inner shaft 20 is fabricated from a suitable polymer, such as HDPE, though other polymers as well as metallic materials may be used. Lumen 22 allows catheter assembly 50 to pass coaxially over a guide wire (such as a 0.035 inch diameter stainless steel guide wire typically used for endovascular procedures in the aorta and iliac arteries).
  • About inner shaft [0038] 20 is mounted main body sheath 64 in slidable engagement with nose cone 60. Main body sheath 64 is fabricated from a biocompatible polymer such as PTFE or from polymer/metal composites. Composite materials may be particularly useful in adding strength and kink resistance to the main body sheath. The prosthetic graft 100 is contained in the compartment formed between inner shaft 20, and the combination of main body sheath 64 and nose cone 60. This compartment also provides a conduit from the proximal to the distal portion of the delivery catheter for passage of cold saline and radiographic contrast solution.
  • Nose cone [0039] 60 is fabricated from a flexible polymeric material or from metallic materials. Nose cone 60 provides a stiffness transition between the relatively flexible guide wire and the stiffer main sheath body 64. The distal tip of the delivery catheter is designed to be more flexible at its distal-most portion and increasingly stiffer proximally. This arrangement will provide a strain-relieving effect, which aids in the tractability of the device in tortuous artery bends.
  • As noted previously, prosthetic graft [0040] 100 includes internal iliac leg 52 and common/external iliac leg 56. Internal iliac leg 52 preferably includes a graft material component 53 and a stent material component 55. Common/external iliac leg 56 preferably includes a graft material component 57 and a stent material component 59. The graft material component of each leg is connected to the stent material component, preferably by sutures.
  • The graft material components may be made of materials which include woven and knitted materials comprising polyester, polytetrafluoroethylene (PTFE), silicones, and urethanes. The materials may be porous or non-porous and may be opaque to X-rays. Preferred materials include polyester fabric, for example, DACRON®, TEFLON®, or other suitable fabric. A preferred fabric for use in the graft component is a 40 denier polyester yarn, having 180 to 250 end yarns per inch and 80 to 120 pick yarns per inch. At this weave density, the graft component is relatively impermeable to blood flow through the wall, but is relatively thin, ranging between 0.08 and 0.12 mm wall thickness. Preferably, the graft components are woven as tubes. [0041]
  • The stent material components are preferably self-expandable and are comprised of a shape memory alloy. Such an alloy can be deformed from an original, heat-stable configuration to a second, heat-unstable configuration. When in the second heat-unstable configuration the application of a desired temperature causes the alloy to revert to an original heat-stable configuration. A particularly preferred shape memory alloy is binary nickel titanium comprising 55.8% Ni by weight. This NiTi alloy undergoes a phase transformation at physiological temperatures. A stent made of this material is deformable when chilled. Thus, at low temperatures, (e.g., below 20° C.), the stent is compressed so it can be delivered to the desired location. The stent is kept at low temperatures by circulating chilled saline solution. The stent expands when the chilled saline is removed and it is exposed to higher temperatures, (e.g., 37° C.). [0042]
  • Preferably, the stent is fabricated from a single piece of alloy tubing. The tubing is laser cut, shape-set by placing the tubing on a mandrel, heat-set to its desired expanded shape and size and electropolished. Electropolishing smoothes the surface of the alloy, which is believed to improve fatigue properties as well as extend the strain-to-fracture and also improves thrombogenicity resistance. Preferably, the shape setting is performed at 550° C. for approximately 20 minutes, followed by aging at 470° C. for 10 minutes. This heat treatment process provides for a stent that has a martensite to austenite transformation temperature range of less than 15 Celsius degrees and an austenite finish temperature (A[0043] f) of slightly less than 37° C.
  • The proximal portion of main body sheath [0044] 64 is connected to a manifold (not shown) which is connected to reservoirs holding radiographic contrast solution and chilled saline. As best seen in FIG. 10, chilled saline and/or radiographic contrast solution 70 flow through main body sheath 64 and out through orifices located at the tip of nose cone 60 and at the tip of internal iliac leg prosthesis 52.
  • Also within main body sheath [0045] 64 are sheath control rod 58 and stent retainer rod 66. The sheath control rod 58 extends from the proximal end to the distal portion of the catheter. The distal portion of the sheath control rod 58 is rigidly attached to sheath control rod slip ring 62. Sheath control rod slip ring 62 has a sliding fit with inner shaft 20. Sheath control rod slip ring 62 is also rigidly affixed to a shorter proximally facing iliac leg sheath control rod 63. Iliac control rod 63 is positioned coaxially within the internal iliac leg 52 of the prosthesis. Sheath control rod 63 is pre-formed to preferentially extend laterally from the axis of the main catheter when unrestrained by nose cone 60. In the completely unrestrained position sheath control rod 63 causes internal iliac leg 56 to assume an angle of between about 45° and 90° with the longitudinal axis of the delivery catheter. Sheath control rod 63 is rigidly attached to internal iliac sheath 61. The retraction of sheath control rod 58 (in a proximal direction) slides internal iliac sheath 61 relative to internal iliac leg 52, thus exposing the internal iliac leg 52. When exposed to body temperature, the stent component of the internal iliac leg 52 expands.
  • Stent retainer rod [0046] 66 is connected to stent retaining slip rings 68 located at the proximal and distal ends of common/external iliac leg 56. Slip rings 68 surround the external/common iliac leg and prevent axial movement of the leg during advancement of the nose cone and inner lumen 20 during the retraction of sheath control rod 58 and/or the retraction of main body sheath 64. Stent retainer rod 66 is preferably made of stainless steel. Preferably, slip rings 68 are made of platinum so they can provide radiopaque markings for angiographic visualization of the prosthesis location. Slip rings 68 maintain a sliding fit with inner shaft 20, which allows relative movement between stent retainer rod 66 and inner shaft 20. The proximal portion of stent retainer rod 66 is attached to a manifold (not shown) that provides the relative anchoring and positioning of the assembly, main body sheath 64, and inner shaft 20.
  • Chilled saline flows through main body sheath [0047] 64, keeping the stent components of both legs cold. Expansion of the stent components 55 and 59 of internal iliac leg 52 and external/common iliac leg 54 by exposing them to body temperature results in fully deploying prosthesis 100.
  • Internal iliac leg sheath [0048] 61 is made from a polymer such as high density polyethylene (HDPE), though other polymers as well as metallic materials may be used. Sheath 61 surrounds internal iliac leg 52 and serves to navigate leg 52 into the internal iliac artery. Sheath 61 preferably has a tapered segment at the distal end that provides an atraumatic surface for navigation into internal iliac artery B. The tip of sheath 61 may also have one or more orifices for the delivery of radiographic contrast solution (such as depicted in FIGS. 3 and 10) and/or chilled saline. Although not shown, the delivery catheter may be provided with separate lumens for the delivery of contrast solution and chilled saline.
  • FIGS. [0049] 9 to 13 show the steps of deploying prosthesis 100 while FIGS. 1-8 show how those steps relate to the introduction, positioning, and deployment of the prosthetic graft to repair an abdominal aortic aneurysm in the vasculature of a human. FIG. 9 is a cross-section of the delivery catheter assembly and prosthetic graft 100 in the fully undeployed configuration which it would be in while the delivery catheter is advanced to the branch of the common and internal iliac arteries as seen in FIG. 1. In FIG. 10, inner shaft 20 and nose cone 60 have been advanced allowing the internal iliac leg 52 to deflect laterally. Radiographic contrast solution 70 is flowing from an orifice at the tip of internal iliac leg 52. The angle of deflection can be controlled by the relative position of nose cone 60 with regards to the sheath control rod 63. The more the nose cone 60 is advanced, the greater the lateral angulation will be. The pre-form in the sheath control rod 63 will determine the maximum unrestrained angle of the extended internal iliac leg 52 and sheath 61. Catheter assembly 50 can be translated and rotated to position internal iliac leg 52 into the internal iliac artery as seen in FIG. 2.
  • In FIG. 11, sheath control rod [0050] 5 8 has been retracted in a proximal direction. This movement advances internal iliac leg sheath 61 off the distal end of internal iliac leg 52. The body temperature causes the stent component 55 of internal iliac leg 52 to expand into the iliac artery as seen in FIG. 3.
  • In FIG. 12, main body sheath [0051] 64 has been retracted and nose cone 60 further advanced, thus exposing the stent component 59 of common/external iliac leg 54 to body temperature. The leg 54 then expands into the common iliac artery. The position of the prosthetic graft 100 is shown in FIG. 4.
  • In FIG. 13, sheath control rod [0052] 58 has been advanced distally until the internal iliac leg sheath 61 is completely inside the common/external iliac leg. This is the position shown in FIG. 5. Once sheath 61 is contained in the common/external iliac leg, the entire catheter assembly can be withdrawn leaving only prosthesis 100 as seen in FIG. 6. Although a particular sequence of deploying the internal iliac leg and the upper (common iliac) and lower (external iliac) portions of the common/external iliac has been shown it will be appreciated that the delivery system allows deployment in any desired sequence.
  • FIGS. 14 and 15 are plan and cross-sectional views of the fully deployed prosthesis [0053] 100. The prosthesis is sized to fit within and sealingly engage the walls of the vessel at the common iliac bifurcation. Preferably, the diameter of the legs of the prosthetic graft are oversized so they are about 2 to 4 mm larger than the diameter of the vessel itself. The longitudinal length of the external/common iliac leg is within the range of about 4 to 12 cm. The longitudinal length of the internal iliac leg is in the range of about 1 to 4 cm. The diameter of the fully deployed external/common iliac leg is about 6 to 18 mm while the diameter of the fully deployed internal iliac leg is about 4 to 8 mm. FIG. 7 shows the prosthetic graft of the present invention deployed in both of the common iliac arteries. The procedure for introducing, positioning, and deploying the second graft are the same as those discussed above except that entry is through the femoral artery on the other side of the patient.
  • FIG. 8 shows the prosthetic grafts [0054] 100 of FIG. 7 connected to the lower or iliac portion of the legs of a biluminal endovascular graft system used to repair the aortic aneurysm. The prosthetic grafts of the present invention could be used in connection with any biluminal graft system which includes separate legs or conduits for each iliac artery. Such a system is disclosed in co-pending patent application entitled “Biluminal Endovascular Graft System”, filed Mar. 16, 1998 as Ser. No. 09/039,776, the disclosure of which is incorporated herein by reference. An advantage of the present invention is that the prosthetic graft of the present invention can be delivered over the same guide wire as the individual legs of the biluminal aortic graft system. A single guide wire introduced through the right femoral artery can be used for delivery of one leg of the biluminal aortic stent and one bifurcated prosthetic graft or a second guide wire introduced through the left femoral artery is used for delivery of the second leg of the biluminal aortic graft and the second prosthetic graft.
  • The biluminal aortic graft system could be deployed either before or after the prosthetic graft [0055] 100. If prosthetic grafts 100 are deployed first, then the iliac legs of the biluminal aortic graft system are deployed into the upper portion of the common/external iliac legs of the prosthetic graft, with a minimum of a 2 cm overlap. This ensures proper attachment and seating of the legs of the aortic graft without blocking the internal iliac arteries. If the biluminal aortic graft is deployed before prosthetic grafts 100 then prosthetic grafts 100 would be deployed into the iliac legs of the aortic graft, with a minimum of a 2 cm overlap. In either case, the graft sizes will be selected to ensure proper attachment and seating of the grafts. The means of attachment of the grafts may include barbs or hooks on the stents of one or both systems (not shown) to ensure a secure attachment.
  • FIG. 21 is a cross-sectional view of a second embodiment of a prosthetic graft [0056] 200 in accordance with the present invention. FIGS. 16-20 are cross-sectional views of the prosthetic graft 200 loaded into a delivery catheter 150 during various stages of the deployment process.
  • As seen in FIG. 21, the prosthesis includes a common/external iliac leg [0057] 156 and an internal iliac leg 152. Leg 156 includes common/external artery graft component 157 and a common iliac artery stent component 159 a and an external iliac artery stent component 159 b. Leg 152 includes a graft component 153 and a stent component 155. The materials which make-up the graft and stent components of prosthetic graft 200 are similar to those described with respect to those used in prosthetic graft 100.
  • By fabricating the common/external iliac leg [0058] 156 from separate stent components which are spaced apart from one another, the internal iliac leg 152 is allowed to be positioned closer to the longitudinal center line of the delivery catheter when collapsed. This configuration results in a reduction in the diameter of the delivery system. The use of separate stents for the common iliac and external iliac arteries also allows flexibility in sizing at each end of the prosthetic graft. Preferably, the longitudinal length of the common/external iliac leg 156 is about 8 to 12 cm. The longitudinal length of the internal iliac leg 152 is about 1 to 4 cm. The diameter of the common iliac portion of the common/external iliac leg 156 is about 12 to 18 mm. The diameter of the external iliac portion of the common/external iliac leg 156 is about 6 to 12 mm.
  • FIG. 16 is a cross-sectional view of the distal portion of delivery catheter assembly [0059] 150 used to introduce and deploy prosthetic graft 200. Inner shaft 120 runs the length of delivery catheter assembly 150. Inner shaft 120 defines a central bore, or guide wire lumen 122 which provides a means for inserting the catheter assembly into a patient along the guide wire. Guide wire lumen 122 allows catheter assembly 50 to pass coaxially over a guide wire.
  • About inner shaft [0060] 120 is mounted main body sheath 164 in slidable engagement with nose cone 160. Prosthetic graft 200 is contained in the compartment formed between inner shaft 120, and the combination of main body sheath 164 and nose cone 160. This compartment also provides a conduit from the proximal to the distal portion of the delivery catheter for passage of cold saline and radiographic contrast solution.
  • As in the previous embodiment, nose cone [0061] 160 provides a stiffness transition between the relatively flexible guide wire and the stiffer main body sheath 164.
  • The proximal portion of main body sheath [0062] 164 is connected to a manifold (not shown) which is connected to reservoirs holding radiographic contrast solution and chilled saline. As in the previous embodiment, chilled saline and/or radiographic contrast solution 70 flows through main body sheath 164 and out through orifices located at the tip of nose cone 160 and at the tip of internal iliac leg prosthesis 152.
  • Also located within main body sheath [0063] 164 are sheath control rod 158 and stent retainer rod 166. The sheath control rod 158 extends from the proximal end to the distal portion of the catheter. The distal portion of the sheath control rod 158 is rigidly attached to sheath control rod slip ring 162. Sheath control rod slip ring 162 has a sliding fit with inner shaft 120. Sheath control rod slip ring is also rigidly affixed to a shorter proximally facing iliac leg control rod 163. Iliac control rod 163 is positioned coaxially within the internal iliac leg 152 of the prosthesis. Iliac control rod 163 is pre-formed to preferentially extend laterally from the axis of the main catheter when unrestrained by nose cone 160. In the completely unrestrained positioned, iliac control rod 163 causes internal iliac leg 156 to assume an angle of between about 45° to 90° with the longitudinal axis of the delivery catheter. A filament sheath 180 is wrapped around internal iliac leg 152. The filament sheath may be fabricated of PTFE suture, however, other metallic and/or polymeric materials may be used. The filament is anchored to prosthetic graft 200 at a point 182 (FIG. 18) and is wrapped around the stent component of the internal iliac leg and attached to iliac control rod 163 at the proximal portion of the leg. The retraction of sheath control rod 158 (in a proximal direction) slides iliac control rod 163 out the end of iliac leg 152 causing the end of iliac control rod 163 to disengage with filament sheath 180, thus allowing the filament sheath to unwind. The wound filament sheath provides a sealing conduit for the application of the chilled saline to leg 152. The filament may be a tightly wound thread or an overlapping ribbon or any other configuration which results in the formation of a substantially closed circuit. Once the filament is removed the body's temperature allows the stent to expand.
  • Stent retainer rod [0064] 166 is connected to stent retainer slip rings 168 located at the proximal and distal ends of stent components 159 a and 159 b. Slip rings 68 prevent axial movement of the leg during advancement of the nose cone and inner lumen 120 during the retraction of sheath control rod 158 and/or the retraction of main body sheath 164. Slip rings 168 maintain a sliding fit with inner shaft 120 which allows relative movement between stent retainer rod 166 and inner shaft 120. The proximal portion of stent retainer rod 166 is attached to a manifold (not shown) that provides the relative anchoring and positioning of the assembly, main body sheath 164, and inner shaft 120.
  • The introduction, positioning, and deployment of prosthetic graft [0065] 200 is similar to that described with respect to prosthetic graft 100. FIG. 16 is a cross-section of the delivery catheter system and prosthetic graft 200 in the fully undeployed configuration it would have while the catheter is advanced to the branch of the common and internal iliac arteries. The position would be similar to that seen in FIG. 1.
  • In FIG. 17, inner shaft [0066] 120 and nose cone 160 have been advanced allowing the internal iliac leg 152 to deflect laterally. Radiographic contrast solution 70 is flowing through internal iliac leg 152 and nose cone 160. The angle of deflection can be controlled by the relative position of nose cone 160 with regards to iliac control rod 163. The more nose cone 160 is advanced, the greater the lateral angulation will be. The pre-form in the internal iliac control rod 163 will determine the maximum unrestrained angle of the extended internal iliac leg 152. Catheter assembly 150 can be translated and rotated to position the internal iliac leg 152 into the internal iliac artery in a manner similar to that illustrated in FIG. 2. When internal iliac leg 152 has been positioned into the internal iliac artery (FIG. 18), sheath control rod 158 is retracted in the proximal direction as shown in FIG. 19. This movement dislodges iliac leg control rod 163 from filament sheath 180. Exposure of iliac leg stent component 155 to body temperature causes it to expand in the same position shown generally in FIG. 3.
  • In FIG. 20, the sheath control rod [0067] 158 is advanced in the distal direction until the control rod 163 is completely inside nose cone 160. The main body sheath 164 has been retracted and nose cone 160 has been further advanced, thus exposing stent components 159 a and 159 b of common/external iliac leg 154 to body temperature. Leg 154 then expands into the common iliac artery such that the position of stent 159 a lies above the junction with the internal iliac artery and stent 159 b lies below the junction with the internal iliac artery. The position of prosthetic graft 200 is similar to that shown in FIG. 4. At this point, delivery catheter 150 is withdrawn through the lumen of common/external iliac leg 156.
  • The prosthetic graft [0068] 200 can be used in the same manner as that described with respect to prosthetic graft 100.

Claims (24)

What is claimed is:
1. A prosthetic graft for placement by a single delivery catheter at the bifurcation of a first vessel into second and third vessels within the vasculature of a patient comprising:
a first graft conduit having first and second ends and first and second stents, the first stent adapted to secure the first end of the first graft conduit within the lumen of the first vessel, the second stent adapted to secure the second end of the first graft conduit within the lumen of the second vessel; and
a second graft conduit attached in fluid communication with the first graft conduit, the second graft conduit having a third stent adapted to secure it within the lumen of the third vessel, the first and second graft conduits being sized and configured to be contained within and delivered by the single delivery catheter.
2. The prosthetic graft of
claim 1
wherein the first graft conduit forms a first lumen and the first and second stents are contained within the first lumen and wherein the second graft conduit forms a second lumen and wherein the third stent is within the second lumen.
3. The prosthetic graft of
claim 1
wherein the cross-sectional area of the first end of the first graft conduit is greater than the cross-sectional area of the second end of the first graft conduit.
4. The prosthetic graft of
claim 1
wherein the first and second graft conduits are configured to expand from a first delivery configuration to a second deployed configuration and wherein the cross-sectional area of the first end of the first graft conduit is at least as great as the cross-sectional area of the prosthetic graft at any localized point along a longitudinal axis of the first graft conduit when in the delivery configuration.
5. A method for placing a prosthetic graft in a vessel of a patient's vascular system, the prosthetic graft having a first tubular graft component and a second tubular graft component in fluid communication with the first tubular graft component, the method comprising:
providing a delivery catheter containing the prosthetic graft in a first delivery configuration, the catheter having an angular control element for adjustably controlling the angle between the first and second tubular graft components;
advancing the catheter through the vessel to a desired location;
manipulating the angular control element to select a desired angle between the first and second tubular graft components; and
deploying the prosthetic graft in the vessel in a second expanded configuration.
6. The method of
claim 5
wherein the angular control element of the catheter includes a wire with a pre-formed angle and wherein the step of manipulating the angular control element to select a desired angle includes advancing or retracting the wire.
7. The method of
claim 5
wherein the first tubular graft component includes a first stent attached thereto and the second tubular graft component includes a second stent attached thereto, the method further comprising securing the first and second tubular graft components within the vessel by radially expanding the first and second stents.
8. A prosthetic graft for placement by a single delivery catheter at the bifurcation of a first vessel into second and third vessels within the vasculature of a patient comprising:
a first graft conduit having first and second ends and including a tubular graft component defining a lumen and at least one stent located within the lumen and attached to the graft component, the stent adapted to secure the first end of the first graft conduit within the lumen of the first vessel and the second end of the first graft conduit within the lumen of the second vessel; and
a second graft conduit attached in fluid communication with the first graft conduit, the second graft conduit including a tubular graft component defining a lumen and a stent located within the lumen and attached to the graft component and adapted to secure the second graft component within the lumen of the third vessel, the first and second graft conduits being sized and configured to be contained within and delivered by the single delivery catheter.
9. A prosthetic graft for placement by a single delivery catheter at the bifurcation of a first vessel into second and third vessels within the vasculature of a patient comprising:
a first leg having first and second leg segments, the first leg segment adapted to be deployed in the lumen of the first vessel, the second leg segment adapted to be deployed in the lumen of the second vessel; and
a second leg adapted to be deployed in the lumen of the third vessel, whereby the first and second segments of the first leg and the second leg are adapted to be independently deployable within the lumens of the first, second, and third vessels, the first and second legs being sized and configured to be contained within and delivered by the single delivery catheter.
10. The prosthetic graft of
claim 9
wherein the first leg includes a graft component and at least one stent attached to the graft component and wherein the second leg includes a graft component and a stent attached to the second leg graft component.
11. A method of placing a prosthetic graft at the bifurcation of the common iliac artery into the external and internal iliac arteries, the prosthetic graft having a first graft conduit with first and second ends and a second graft conduit attached in fluid communication with the first graft conduit, the method comprising:
providing a delivery catheter containing the prosthetic graft in a first delivery configuration;
introducing the delivery catheter into a femoral artery on the same side as the common iliac artery bifurcation;
advancing the delivery catheter to the common iliac artery bifurcation; and
manipulating the delivery catheter to deploy the prosthetic graft in a second expanded configuration such that the first end of the first graft conduit is secured within the lumen of the common iliac artery, the second end of the first graft conduit is secured within the lumen of the external iliac artery and the second graft conduit is secured within the lumen of the internal iliac artery.
12. The method of
claim 11
wherein the delivery catheter includes an angular control element for adjustably controlling the angle between the first and second graft conduits and wherein the method further includes manipulating the angular control element to select a desired angle between the first and second graft conduits.
13. The method of
claim 11
wherein the first graft conduit includes a first stent and the second graft conduit includes a second stent, the first and second stents adapted to expand from a first delivery configuration to a second deployed configuration, the method further including securing the first end of the first graft conduit within the lumen of the common iliac artery by expanding at least a portion of the first stent to its deployed configuration and wherein the second end of the first graft conduit is secured within the lumen of the external iliac artery by expanding at least a portion of the first stent to its deployed configuration and wherein the second graft conduit is secured within the lumen of the internal iliac artery by expanding the second stent to its deployed configuration.
14. A method for repairing an abdominal aneurysm in an aorta which branches into two iliac arteries using a graft system having a first leg which includes first and second ends and a first bifurcated prosthetic graft having a first tubular graft component with first and second ends and a second tubular graft component in fluid communication with the first tubular graft component, the method comprising:
providing a delivery system including a first guide wire;
advancing the first guide wire through a first iliac artery to a desired location in the aorta above the aneurysm;
delivering the first leg over the first guide wire so that the first end of the first leg is above the aneurysm on one side thereof and the second and is on the other side of the aneurysm, the first leg extending across the aneurysm;
delivering the first bifurcated prosthetic graft over the first guide wire so that the second tubular graft component is positioned in the internal iliac artery, the first end of the first tubular graft component is positioned in the common iliac artery and the second end of the first graft component is positioned in the external iliac artery; and
securing the second end of the first leg to the first end of the first tubular graft component.
15. The method of
claim 14
wherein the first leg includes an aortic stent attached to the first end of the first leg and an iliac stent attached to the second end of the first leg and wherein the first prosthetic graft includes at least one stent attached to the first tubular graft component and a stent attached to the second tubular graft component and wherein the method further comprises securing the first end of the first leg in the aorta by deploying the aortic stent, securing the second end by deploying the iliac stent and securing the first and second ends of the first tubular graft component by deploying the at least one stent and securing the second tubular graft component by securing the stent attached thereto.
16. The method of
claim 14
wherein the first leg is delivered over the first guide wire prior to delivery of the first bifurcated prosthetic graft.
17. The method of
claim 14
wherein the first bifurcated prosthetic graft is delivered over the first guide wire prior to delivery of the first leg.
18. The method of
claim 14
further including providing a first delivery catheter for delivering the first leg and providing a second delivery catheter for delivering the first bifurcated prosthetic graft.
19. The method of
claim 14
wherein the graft system includes a second leg which includes first and second ends and a second bifurcated prosthetic graft having a first tubular graft component with first and second ends and a second tubular graft component in fluid communication with the first tubular graft component and wherein the method further includes:
providing a delivery system including a second guide wire;
advancing the second guide wire through the second iliac artery to a desired location in the aorta above the aneurysm;
delivering the second leg over the second guide wire so that the first end of the second leg is above the aneurysm and on one side thereof and the second end of the second leg is on the other side of the aneurysm, the second leg extending across the aneurysm;
delivering the second bifurcated prosthetic graft over the second guide wire so that the second tubular graft component is positioned in the second internal iliac artery, the first end of the first tubular graft component is positioned in the second common iliac artery and the second graft component is positioned in the second external iliac artery; and
securing the second end of the second leg to the first end of the first tubular graft component of the second prosthetic graft.
20. A method for repairing an abdominal aneurysm in an aorta which branches into two iliac arteries using a graft system having a first leg which includes first and second ends and a first bifurcated prosthetic graft having a first tubular graft component with first and second ends and a second tubular graft component in fluid communication with the first tubular graft component, the method comprising:
advancing the first leg through a first iliac artery into the aorta so that the first end of the first leg is above the aneurysm on one side thereof and the second end is on the other side of the aneurysm, the first leg extending across the aneurysm;
after the first leg has been advanced, advancing the first bifurcated prosthetic graft through the same iliac artery so that the second tubular graft component is positioned in the internal iliac artery, the first end of the first tubular graft component is positioned in the common iliac artery and the second end of the first graft component is positioned in the external iliac artery; and
securing the second end of the first leg to the first end of the first tubular graft component.
21. The method of
claim 21
wherein the graft system includes a second leg having first and second ends and a second bifurcated prosthetic graft having a first tubular graft component with first and second ends and a second tubular graft component in fluid communication with the first tubular graft component, the method further comprising:
advancing the second leg through the second iliac artery into the aorta so that the first end of the second leg is above the aneurysm on one side thereof and the second end of the second leg is on the other side of the aneurysm, the second leg extending across the aneurysm; and
after the second leg has been advanced, advancing the second bifurcated prosthetic graft through the same iliac artery as the second leg so that the second tubular graft component of the second bifurcated prosthetic graft is positioned in the second internal iliac artery, the first end of the first tubular graft component is positioned in the second common iliac artery and the second end of the first graft component is positioned in the second external iliac artery; and
securing the second end of the second leg to the first end of the first tubular graft component of the second bifurcated prosthetic graft.
22. A graft system for repairing an abdominal aneurysm in an aorta which branches into two iliac arteries comprising:
a first leg having first and second ends, the first end adapted to be secured in the aorta on one side of the aneurysm and the second end adapted to be secured on the other side of the aneurysm;
a first bifurcated prosthetic graft having a first tubular graft component with first and second ends and a second tubular graft component attached in fluid communication with the first tubular graft component, the first end of the first tubular graft component adapted to be secured in the common iliac artery, the second end of the first tubular graft component adapted to be secured in the external iliac artery and the second tubular graft component adapted to be secured in the internal iliac artery;
a first guide wire sized to fit through a first iliac artery and through the aorta to a location above the aneurysm;
a first delivery catheter configured to advance and deliver the first leg across the first guide wire; and
a second delivery catheter configured to advance and deliver the first prosthetic graft across the first guide wire.
23. The graft system of
claim 22
wherein the first leg includes an aortic stent attached to the first end and an iliac stent attached to the second end and wherein the first bifurcated prosthetic graft has at least one stent attached to the first tubular graft component and a stent attached to the second tubular graft component.
24. The graft system of
claim 22
further including:
a second leg having first and second ends, the first end adapted to be secured in the aorta on one side of the aneurysm and the second end adapted to be secured on the other side of the aneurysm;
a second bifurcated prosthetic graft having a first tubular graft component with first and second ends and a second tubular graft component attached in fluid communication with the first tubular graft component, the first end of the first tubular graft component adapted to be secured in the common iliac artery, the second end of the first tubular graft component adapted to be secured in the external iliac artery and the second tubular graft component adapted to be secured in the internal iliac artery;
a second guide wire sized to fit through the second iliac artery and through the aorta to a location above the aneurysm;
a third delivery catheter configured to advance and deliver the second leg across the second guide wire; and
a fourth delivery catheter configured to advance and deliver the second prosthetic graft across the second guide wire.
US09/778,988 1998-03-16 2001-02-07 Bifurcated prosthetic graft Abandoned US20010014823A1 (en)

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Cited By (44)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1325717A3 (en) * 2002-01-08 2004-01-02 Cordis Corporation Stent graft with branch leg
US6733521B2 (en) 2001-04-11 2004-05-11 Trivascular, Inc. Delivery system and method for endovascular graft
US20060025846A1 (en) * 2004-07-28 2006-02-02 Frederick Feller AAA low profile support structure
US20060074481A1 (en) * 2004-10-04 2006-04-06 Gil Vardi Graft including expandable cuff
US20070179600A1 (en) * 2004-10-04 2007-08-02 Gil Vardi Stent graft including expandable cuff
US7722657B2 (en) 2002-08-23 2010-05-25 William A. Cook Australia Pty. Ltd. Asymmetric stent graft attachment
US7766954B2 (en) 2001-12-20 2010-08-03 Trivascular2, Inc. Advanced endovascular graft
US7803178B2 (en) 2004-01-30 2010-09-28 Trivascular, Inc. Inflatable porous implants and methods for drug delivery
US20100331960A1 (en) * 2009-06-30 2010-12-30 Boston Scientific Scimed, Inc. Endoprosthesis and endoprosthesis delivery system and method
US7862609B2 (en) 2000-11-16 2011-01-04 Cordis Corporation Stent graft having a pleated graft member
US20110208289A1 (en) * 2010-02-25 2011-08-25 Endospan Ltd. Flexible Stent-Grafts
US20110270375A1 (en) * 2003-10-14 2011-11-03 Cook Medical Technologies Llc Introducer for an iliac side branch device
US8221494B2 (en) 2008-02-22 2012-07-17 Endologix, Inc. Apparatus and method of placement of a graft or graft system
US8241346B2 (en) 2001-12-20 2012-08-14 Trivascular, Inc. Endovascular graft and method of delivery
US8317856B2 (en) 2007-03-05 2012-11-27 Endospan Ltd. Multi-component expandable supportive bifurcated endoluminal grafts and methods for using same
US8361136B2 (en) 1998-02-09 2013-01-29 Trivascular, Inc. Endovascular graft
US8486131B2 (en) 2007-12-15 2013-07-16 Endospan Ltd. Extra-vascular wrapping for treating aneurysmatic aorta in conjunction with endovascular stent-graft and methods thereof
US8574287B2 (en) 2011-06-14 2013-11-05 Endospan Ltd. Stents incorporating a plurality of strain-distribution locations
US8858613B2 (en) 2010-09-20 2014-10-14 Altura Medical, Inc. Stent graft delivery systems and associated methods
US8870938B2 (en) 2009-06-23 2014-10-28 Endospan Ltd. Vascular prostheses for treating aneurysms
US8945203B2 (en) 2009-11-30 2015-02-03 Endospan Ltd. Multi-component stent-graft system for implantation in a blood vessel with multiple branches
US8951298B2 (en) 2011-06-21 2015-02-10 Endospan Ltd. Endovascular system with circumferentially-overlapping stent-grafts
US8956397B2 (en) 2009-12-31 2015-02-17 Endospan Ltd. Endovascular flow direction indicator
US8979892B2 (en) 2009-07-09 2015-03-17 Endospan Ltd. Apparatus for closure of a lumen and methods of using the same
US20150157446A1 (en) * 2012-04-12 2015-06-11 Sanford Health Debranching Visceral Stent Graft and Methods for Use
US9101457B2 (en) 2009-12-08 2015-08-11 Endospan Ltd. Endovascular stent-graft system with fenestrated and crossing stent-grafts
US9254209B2 (en) 2011-07-07 2016-02-09 Endospan Ltd. Stent fixation with reduced plastic deformation
US9427339B2 (en) 2011-10-30 2016-08-30 Endospan Ltd. Triple-collar stent-graft
US9468517B2 (en) 2010-02-08 2016-10-18 Endospan Ltd. Thermal energy application for prevention and management of endoleaks in stent-grafts
US9486341B2 (en) 2011-03-02 2016-11-08 Endospan Ltd. Reduced-strain extra-vascular ring for treating aortic aneurysm
US9526638B2 (en) 2011-02-03 2016-12-27 Endospan Ltd. Implantable medical devices constructed of shape memory material
US9572652B2 (en) 2009-12-01 2017-02-21 Altura Medical, Inc. Modular endograft devices and associated systems and methods
US9597204B2 (en) 2011-12-04 2017-03-21 Endospan Ltd. Branched stent-graft system
US9668892B2 (en) 2013-03-11 2017-06-06 Endospan Ltd. Multi-component stent-graft system for aortic dissections
US9737426B2 (en) 2013-03-15 2017-08-22 Altura Medical, Inc. Endograft device delivery systems and associated methods
US9770350B2 (en) 2012-05-15 2017-09-26 Endospan Ltd. Stent-graft with fixation elements that are radially confined for delivery
US9770321B2 (en) 2003-10-14 2017-09-26 Cook Medical Technologies Llc Introducer for a side branch device
US9839510B2 (en) 2011-08-28 2017-12-12 Endospan Ltd. Stent-grafts with post-deployment variable radial displacement
US9855046B2 (en) 2011-02-17 2018-01-02 Endospan Ltd. Vascular bands and delivery systems therefor
US9861466B2 (en) 2012-12-31 2018-01-09 Cook Medical Technologies Llc Endoluminal prosthesis
US9949818B2 (en) 2012-12-14 2018-04-24 Sanford Health Combination double-barreled and debranching stent grafts and methods for use
US9993360B2 (en) 2013-01-08 2018-06-12 Endospan Ltd. Minimization of stent-graft migration during implantation
AU2018201118B2 (en) * 2012-04-12 2019-04-18 Sanford Health Debranching visceral stent graft and methods for use
US10285833B2 (en) 2012-08-10 2019-05-14 Lombard Medical Limited Stent delivery systems and associated methods

Families Citing this family (84)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7641685B2 (en) * 1996-05-03 2010-01-05 Medinol Ltd. System and method for delivering a bifurcated stent
US6887268B2 (en) * 1998-03-30 2005-05-03 Cordis Corporation Extension prosthesis for an arterial repair
US8034100B2 (en) * 1999-03-11 2011-10-11 Endologix, Inc. Graft deployment system
US6602280B2 (en) * 2000-02-02 2003-08-05 Trivascular, Inc. Delivery system and method for expandable intracorporeal device
US20040204701A1 (en) * 2000-10-18 2004-10-14 Brian Cox Mechanism for the deployment of endovascular implants
DE60225240T2 (en) 2001-01-19 2009-04-30 Boston Scientific Ltd., Saint Michael Apparatus for introducing a branching prosthesis
EP1258230A3 (en) 2001-03-29 2003-12-10 CardioSafe Ltd Balloon catheter device
US20040138734A1 (en) * 2001-04-11 2004-07-15 Trivascular, Inc. Delivery system and method for bifurcated graft
US6761733B2 (en) * 2001-04-11 2004-07-13 Trivascular, Inc. Delivery system and method for bifurcated endovascular graft
US6752825B2 (en) 2001-10-02 2004-06-22 Scimed Life Systems, Inc Nested stent apparatus
CA2705569C (en) * 2002-03-07 2014-07-08 Cordis Corporation Iliac bifurcation balloon catheter
US7585301B2 (en) * 2002-06-12 2009-09-08 Howmedica Osteonics Corp. Modular hip inserter/positioner
US6733489B2 (en) 2002-09-26 2004-05-11 Angiodynamics, Inc. Vascular orientation marker for determining the orientation of a blood vessel
US6994721B2 (en) * 2002-10-21 2006-02-07 Israel Henry M Stent assembly
US6849084B2 (en) * 2002-12-31 2005-02-01 Intek Technology L.L.C. Stent delivery system
US7169177B2 (en) * 2003-01-15 2007-01-30 Boston Scientific Scimed, Inc. Bifurcated stent
US8500792B2 (en) 2003-09-03 2013-08-06 Bolton Medical, Inc. Dual capture device for stent graft delivery system and method for capturing a stent graft
US7763063B2 (en) 2003-09-03 2010-07-27 Bolton Medical, Inc. Self-aligning stent graft delivery system, kit, and method
US8292943B2 (en) 2003-09-03 2012-10-23 Bolton Medical, Inc. Stent graft with longitudinal support member
US20080264102A1 (en) 2004-02-23 2008-10-30 Bolton Medical, Inc. Sheath Capture Device for Stent Graft Delivery System and Method for Operating Same
US9198786B2 (en) 2003-09-03 2015-12-01 Bolton Medical, Inc. Lumen repair device with capture structure
US8628564B2 (en) 2004-05-25 2014-01-14 Covidien Lp Methods and apparatus for luminal stenting
US10004618B2 (en) 2004-05-25 2018-06-26 Covidien Lp Methods and apparatus for luminal stenting
US20060206200A1 (en) 2004-05-25 2006-09-14 Chestnut Medical Technologies, Inc. Flexible vascular occluding device
US8617234B2 (en) 2004-05-25 2013-12-31 Covidien Lp Flexible vascular occluding device
AU2005247490B2 (en) 2004-05-25 2011-05-19 Covidien Lp Flexible vascular occluding device
US8287583B2 (en) 2005-01-10 2012-10-16 Taheri Laduca Llc Apparatus and method for deploying an implantable device within the body
US20060155366A1 (en) * 2005-01-10 2006-07-13 Laduca Robert Apparatus and method for deploying an implantable device within the body
US8128680B2 (en) 2005-01-10 2012-03-06 Taheri Laduca Llc Apparatus and method for deploying an implantable device within the body
EP1890642A1 (en) * 2005-03-30 2008-02-27 University of Limerick A vascular graft
US8961516B2 (en) 2005-05-18 2015-02-24 Sonoma Orthopedic Products, Inc. Straight intramedullary fracture fixation devices and methods
US8287541B2 (en) 2005-05-18 2012-10-16 Sonoma Orthopedic Products, Inc. Fracture fixation device, tools and methods
CN101208053A (en) 2005-05-18 2008-06-25 索诺玛整形外科产品公司 Minimally invasive actuable bone fixation devices, system and method of using the same
US9060820B2 (en) 2005-05-18 2015-06-23 Sonoma Orthopedic Products, Inc. Segmented intramedullary fracture fixation devices and methods
CA2604081C (en) 2005-05-25 2013-11-26 Chestnut Medical Technologies, Inc. System and method for delivering and deploying a self-expanding device within a vessel
US8273101B2 (en) 2005-05-25 2012-09-25 Tyco Healthcare Group Lp System and method for delivering and deploying an occluding device within a vessel
US8267985B2 (en) 2005-05-25 2012-09-18 Tyco Healthcare Group Lp System and method for delivering and deploying an occluding device within a vessel
US8157851B2 (en) 2005-06-08 2012-04-17 Xtent, Inc. Apparatus and methods for deployment of multiple custom-length prostheses
US8043366B2 (en) 2005-09-08 2011-10-25 Boston Scientific Scimed, Inc. Overlapping stent
DE602006012087D1 (en) * 2005-11-16 2010-03-18 Cook Inc Introducer for an implantable device
US8152833B2 (en) 2006-02-22 2012-04-10 Tyco Healthcare Group Lp Embolic protection systems having radiopaque filter mesh
WO2008064346A2 (en) 2006-11-22 2008-05-29 Sonoma Orthopedic Products, Inc. Fracture fixation device, tools and methods
JP5662683B2 (en) 2007-02-09 2015-02-04 タヘリ ラドュカ エルエルシー Apparatus and method for deploying an implantable device in the body
US8226701B2 (en) 2007-09-26 2012-07-24 Trivascular, Inc. Stent and delivery system for deployment thereof
US8066755B2 (en) 2007-09-26 2011-11-29 Trivascular, Inc. System and method of pivoted stent deployment
US8663309B2 (en) 2007-09-26 2014-03-04 Trivascular, Inc. Asymmetric stent apparatus and method
CN101917929A (en) 2007-10-04 2010-12-15 特里瓦斯库拉尔公司 Modular vascular graft for low profile percutaneous delivery
US8328861B2 (en) 2007-11-16 2012-12-11 Trivascular, Inc. Delivery system and method for bifurcated graft
US8083789B2 (en) 2007-11-16 2011-12-27 Trivascular, Inc. Securement assembly and method for expandable endovascular device
EP2234562B1 (en) 2007-12-21 2019-02-27 MicroVention, Inc. A system and method of detecting implant detachment
EP2231030B1 (en) 2007-12-21 2019-02-27 MicroVention, Inc. System and method for locating detachment zone of a detachable implant
US9675482B2 (en) 2008-05-13 2017-06-13 Covidien Lp Braid implant delivery systems
CN107961098A (en) 2008-06-30 2018-04-27 波顿医疗公司 Abdominal aortic aneurysms: systems and methods of use
US20100010519A1 (en) * 2008-07-09 2010-01-14 Joshua Stopek Anastomosis Sheath And Method Of Use
US8137308B2 (en) * 2008-09-16 2012-03-20 Biosense Webster, Inc. Catheter with adjustable deflection sensitivity
AU2009296243A1 (en) 2008-09-26 2010-04-01 Sonoma Orthopedic Products, Inc. Bone fixation device, tools and methods
US10046141B2 (en) * 2008-12-30 2018-08-14 Biosense Webster, Inc. Deflectable sheath introducer
BRPI1012599A2 (en) 2009-03-13 2016-03-22 Bolton Medical Inc system and method for the placement of an endoluminal prosthesis in a surgical site
US20100274276A1 (en) * 2009-04-22 2010-10-28 Ricky Chow Aneurysm treatment system, device and method
US8945202B2 (en) 2009-04-28 2015-02-03 Endologix, Inc. Fenestrated prosthesis
CA2779616A1 (en) * 2009-11-03 2011-05-12 Large Bore Closure, L.L.C. Closure device
US8419743B2 (en) * 2010-03-05 2013-04-16 Biomet Manufacturing Corp. Assembly tool for modular implants and associated method
US8679130B2 (en) 2010-03-05 2014-03-25 Biomet Manufacturing, Llc Guide assembly for lateral implants and associated methods
US8460393B2 (en) * 2010-03-05 2013-06-11 Biomet Manufacturing Corp. Modular lateral hip augments
US8221432B2 (en) 2010-03-05 2012-07-17 Biomet Manufacturing Corp. Method and apparatus for implanting a modular femoral hip
US8333807B2 (en) * 2010-03-05 2012-12-18 Biomet Manufacturing Corp. Method and apparatus for trialing and implanting a modular femoral hip
US8529569B2 (en) 2010-03-05 2013-09-10 Biomet Manufacturing, Llc Method and apparatus for preparing a proximal femur
US8992595B2 (en) 2012-04-04 2015-03-31 Trivascular, Inc. Durable stent graft with tapered struts and stable delivery methods and devices
US9498363B2 (en) 2012-04-06 2016-11-22 Trivascular, Inc. Delivery catheter for endovascular device
JP6238959B2 (en) 2012-04-12 2017-11-29 ボルトン メディカル インコーポレイテッド Vascular prosthesis delivery device and methods of use
US9155647B2 (en) 2012-07-18 2015-10-13 Covidien Lp Methods and apparatus for luminal stenting
US9301831B2 (en) 2012-10-30 2016-04-05 Covidien Lp Methods for attaining a predetermined porosity of a vascular device
US9452070B2 (en) 2012-10-31 2016-09-27 Covidien Lp Methods and systems for increasing a density of a region of a vascular device
US9943427B2 (en) 2012-11-06 2018-04-17 Covidien Lp Shaped occluding devices and methods of using the same
GB201222854D0 (en) 2012-12-18 2013-01-30 Vascutek Ltd Graft with Leg
GB201222852D0 (en) 2012-12-18 2013-01-30 Vascutek Ltd Modular Fenestrated Assembly
US10039657B2 (en) * 2012-12-21 2018-08-07 CARDINAL HEALTH SWITZERLAND 515 GmbH Cannulation guiding device for bifurcated stent and method of use
US9157174B2 (en) 2013-02-05 2015-10-13 Covidien Lp Vascular device for aneurysm treatment and providing blood flow into a perforator vessel
US9439793B2 (en) * 2013-03-12 2016-09-13 Cook Medical Technologies Llc Extension for iliac branch delivery device and methods of using the same
US10130501B2 (en) 2013-03-12 2018-11-20 Cook Medical Technologies Llc Delivery device with an extension sheath and methods of using the same
US9439751B2 (en) 2013-03-15 2016-09-13 Bolton Medical, Inc. Hemostasis valve and delivery systems
US9770278B2 (en) 2014-01-17 2017-09-26 Arthrex, Inc. Dual tip guide wire
US9814499B2 (en) 2014-09-30 2017-11-14 Arthrex, Inc. Intramedullary fracture fixation devices and methods
US9956101B2 (en) 2014-12-04 2018-05-01 Trivascular, Inc. Internal iliac preservation devices and methods

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5387235A (en) * 1991-10-25 1995-02-07 Cook Incorporated Expandable transluminal graft prosthesis for repair of aneurysm
US5653743A (en) * 1994-09-09 1997-08-05 Martin; Eric C. Hypogastric artery bifurcation graft and method of implantation
US6004347A (en) * 1993-04-22 1999-12-21 C. R. Bard, Inc. Non-migrating vascular prosthesis and minimally invasive placement system therefor
US6152956A (en) * 1997-01-28 2000-11-28 Pierce; George E. Prosthesis for endovascular repair of abdominal aortic aneurysms

Family Cites Families (52)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3657744A (en) 1970-05-08 1972-04-25 Univ Minnesota Method for fixing prosthetic implants in a living body
US4140126A (en) 1977-02-18 1979-02-20 Choudhury M Hasan Method for performing aneurysm repair
SE445884B (en) 1982-04-30 1986-07-28 Medinvent Sa A device for implantation of a tubular prosthesis
US4512338A (en) 1983-01-25 1985-04-23 Balko Alexander B Process for restoring patency to body vessels
US4503569A (en) 1983-03-03 1985-03-12 Dotter Charles T Transluminally placed expandable graft prosthesis
US4665906A (en) 1983-10-14 1987-05-19 Raychem Corporation Medical devices incorporating sim alloy elements
US5190546A (en) 1983-10-14 1993-03-02 Raychem Corporation Medical devices incorporating SIM alloy elements
US5067957A (en) 1983-10-14 1991-11-26 Raychem Corporation Method of inserting medical devices incorporating SIM alloy elements
US5275622A (en) 1983-12-09 1994-01-04 Harrison Medical Technologies, Inc. Endovascular grafting apparatus, system and method and devices for use therewith
US4787899A (en) 1983-12-09 1988-11-29 Lazarus Harrison M Intraluminal graft device, system and method
US5693083A (en) 1983-12-09 1997-12-02 Endovascular Technologies, Inc. Thoracic graft and delivery catheter
US5104399A (en) 1986-12-10 1992-04-14 Endovascular Technologies, Inc. Artificial graft and implantation method
US4617932A (en) 1984-04-25 1986-10-21 Elliot Kornberg Device and method for performing an intraluminal abdominal aortic aneurysm repair
US4577631A (en) * 1984-11-16 1986-03-25 Kreamer Jeffry W Aneurysm repair apparatus and method
US4733665C2 (en) 1985-11-07 2002-01-29 Expandable Grafts Partnership Expandable intraluminal graft and method and apparatus for implanting an expandable intraluminal graft
US4878906A (en) 1986-03-25 1989-11-07 Servetus Partnership Endoprosthesis for repairing a damaged vessel
US5078726A (en) 1989-02-01 1992-01-07 Kreamer Jeffry W Graft stent and method of repairing blood vessels
US4994071A (en) 1989-05-22 1991-02-19 Cordis Corporation Bifurcating stent apparatus and method
US5578071A (en) 1990-06-11 1996-11-26 Parodi; Juan C. Aortic graft
US5360443A (en) 1990-06-11 1994-11-01 Barone Hector D Aortic graft for repairing an abdominal aortic aneurysm
US5122154A (en) 1990-08-15 1992-06-16 Rhodes Valentine J Endovascular bypass graft
US5354309A (en) 1991-10-11 1994-10-11 Angiomed Ag Apparatus for widening a stenosis in a body cavity
US5824044A (en) 1994-05-12 1998-10-20 Endovascular Technologies, Inc. Bifurcated multicapsule intraluminal grafting system
CA2065634C (en) 1991-04-11 1997-06-03 Alec A. Piplani Endovascular graft having bifurcation and apparatus and method for deploying the same
EP0539237A1 (en) * 1991-10-25 1993-04-28 Cook Incorporated Expandable transluminal graft prosthesis for repair of aneurysm and method for implanting
US5693084A (en) 1991-10-25 1997-12-02 Cook Incorporated Expandable transluminal graft prosthesis for repair of aneurysm
US5456713A (en) * 1991-10-25 1995-10-10 Cook Incorporated Expandable transluminal graft prosthesis for repairs of aneurysm and method for implanting
US5316023A (en) 1992-01-08 1994-05-31 Expandable Grafts Partnership Method for bilateral intra-aortic bypass
US5540712A (en) 1992-05-01 1996-07-30 Nitinol Medical Technologies, Inc. Stent and method and apparatus for forming and delivering the same
US5405378A (en) 1992-05-20 1995-04-11 Strecker; Ernst P. Device with a prosthesis implantable in the body of a patient
US5290295A (en) * 1992-07-15 1994-03-01 Querals & Fine, Inc. Insertion tool for an intraluminal graft procedure
BR9405622A (en) 1993-09-30 1999-09-08 Endogad Res Pty Ltd intraluminal graft
US5545209A (en) * 1993-09-30 1996-08-13 Texas Petrodet, Inc. Controlled deployment of a medical device
US5855598A (en) 1993-10-21 1999-01-05 Corvita Corporation Expandable supportive branched endoluminal grafts
US5723004A (en) 1993-10-21 1998-03-03 Corvita Corporation Expandable supportive endoluminal grafts
US5609627A (en) 1994-02-09 1997-03-11 Boston Scientific Technology, Inc. Method for delivering a bifurcated endoluminal prosthesis
US5443477A (en) 1994-02-10 1995-08-22 Stentco, Inc. Apparatus and method for deployment of radially expandable stents by a mechanical linkage
US6039749A (en) * 1994-02-10 2000-03-21 Endovascular Systems, Inc. Method and apparatus for deploying non-circular stents and graftstent complexes
US5591196A (en) 1994-02-10 1997-01-07 Endovascular Systems, Inc. Method for deployment of radially expandable stents
US5456694A (en) 1994-05-13 1995-10-10 Stentco, Inc. Device for delivering and deploying intraluminal devices
US5397355A (en) 1994-07-19 1995-03-14 Stentco, Inc. Intraluminal stent
US5507769A (en) 1994-10-18 1996-04-16 Stentco, Inc. Method and apparatus for forming an endoluminal bifurcated graft
EP0723786A1 (en) * 1995-01-30 1996-07-31 Cardiovascular Concepts, Inc. Lesion measurement catheter and method
US5683449A (en) 1995-02-24 1997-11-04 Marcade; Jean Paul Modular bifurcated intraluminal grafts and methods for delivering and assembling same
US5591228A (en) 1995-05-09 1997-01-07 Edoga; John K. Methods for treating abdominal aortic aneurysms
US5713948A (en) * 1995-07-19 1998-02-03 Uflacker; Renan Adjustable and retrievable graft and graft delivery system for stent-graft system
US6099558A (en) 1995-10-10 2000-08-08 Edwards Lifesciences Corp. Intraluminal grafting of a bifuricated artery
US5749848A (en) * 1995-11-13 1998-05-12 Cardiovascular Imaging Systems, Inc. Catheter system having imaging, balloon angioplasty, and stent deployment capabilities, and method of use for guided stent deployment
US5669925A (en) * 1996-02-06 1997-09-23 Saunders; Michael R. Soft tissue graft introducer
US5755773A (en) 1996-06-04 1998-05-26 Medtronic, Inc. Endoluminal prosthetic bifurcation shunt
US5755778A (en) 1996-10-16 1998-05-26 Nitinol Medical Technologies, Inc. Anastomosis device
US6129756A (en) * 1998-03-16 2000-10-10 Teramed, Inc. Biluminal endovascular graft system

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5387235A (en) * 1991-10-25 1995-02-07 Cook Incorporated Expandable transluminal graft prosthesis for repair of aneurysm
US6004347A (en) * 1993-04-22 1999-12-21 C. R. Bard, Inc. Non-migrating vascular prosthesis and minimally invasive placement system therefor
US5653743A (en) * 1994-09-09 1997-08-05 Martin; Eric C. Hypogastric artery bifurcation graft and method of implantation
US6152956A (en) * 1997-01-28 2000-11-28 Pierce; George E. Prosthesis for endovascular repair of abdominal aortic aneurysms

Cited By (70)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8801769B2 (en) 1998-02-09 2014-08-12 Trivascular, Inc. Endovascular graft
US8361136B2 (en) 1998-02-09 2013-01-29 Trivascular, Inc. Endovascular graft
US9867727B2 (en) 1998-02-09 2018-01-16 Trivascular, Inc. Endovascular graft
US7862609B2 (en) 2000-11-16 2011-01-04 Cordis Corporation Stent graft having a pleated graft member
US6733521B2 (en) 2001-04-11 2004-05-11 Trivascular, Inc. Delivery system and method for endovascular graft
US8241346B2 (en) 2001-12-20 2012-08-14 Trivascular, Inc. Endovascular graft and method of delivery
US7766954B2 (en) 2001-12-20 2010-08-03 Trivascular2, Inc. Advanced endovascular graft
US8864814B2 (en) 2001-12-20 2014-10-21 Trivascular, Inc. Method of delivering advanced endovascular graft and system
EP1325717A3 (en) * 2002-01-08 2004-01-02 Cordis Corporation Stent graft with branch leg
US7722657B2 (en) 2002-08-23 2010-05-25 William A. Cook Australia Pty. Ltd. Asymmetric stent graft attachment
US9808365B2 (en) 2003-10-14 2017-11-07 Cook Medical Technologies Llc Introducer for an iliac side branch device
US9603734B2 (en) 2003-10-14 2017-03-28 Cook Medical Technologies Llc Introducer for an iliac side branch device
US10201414B2 (en) * 2003-10-14 2019-02-12 Cook Medical Technologies Llc Introducer for a side branch device
US9782284B2 (en) 2003-10-14 2017-10-10 Cook Medical Technologies Llc Introducer for an iliac side branch device
US9788982B2 (en) 2003-10-14 2017-10-17 Cook Medical Technologies Llc Introducer for an iliac side branch device
US20180008396A1 (en) * 2003-10-14 2018-01-11 Cook Medical Technologies Llc Introducer for a side branch device
US10166095B2 (en) 2003-10-14 2019-01-01 Cook Medical Technologies Llc Introducer for a side branch device
US9770321B2 (en) 2003-10-14 2017-09-26 Cook Medical Technologies Llc Introducer for a side branch device
US20110270375A1 (en) * 2003-10-14 2011-11-03 Cook Medical Technologies Llc Introducer for an iliac side branch device
US7803178B2 (en) 2004-01-30 2010-09-28 Trivascular, Inc. Inflatable porous implants and methods for drug delivery
US8267989B2 (en) 2004-01-30 2012-09-18 Trivascular, Inc. Inflatable porous implants and methods for drug delivery
US20060025846A1 (en) * 2004-07-28 2006-02-02 Frederick Feller AAA low profile support structure
US7344562B2 (en) * 2004-07-28 2008-03-18 Cordis Corporation AAA low profile support structure
US20070179600A1 (en) * 2004-10-04 2007-08-02 Gil Vardi Stent graft including expandable cuff
US20060074481A1 (en) * 2004-10-04 2006-04-06 Gil Vardi Graft including expandable cuff
US8709068B2 (en) 2007-03-05 2014-04-29 Endospan Ltd. Multi-component bifurcated stent-graft systems
US8317856B2 (en) 2007-03-05 2012-11-27 Endospan Ltd. Multi-component expandable supportive bifurcated endoluminal grafts and methods for using same
US20110093058A1 (en) * 2007-03-12 2011-04-21 Gil Vardi Graft including expandable materials
US8486131B2 (en) 2007-12-15 2013-07-16 Endospan Ltd. Extra-vascular wrapping for treating aneurysmatic aorta in conjunction with endovascular stent-graft and methods thereof
US9149381B2 (en) 2008-02-22 2015-10-06 Endologix, Inc. Apparatus and method of placement of a graft or graft system
US8672989B2 (en) 2008-02-22 2014-03-18 Endologix, Inc. Apparatus and method of placement of a graft or graft system
US8221494B2 (en) 2008-02-22 2012-07-17 Endologix, Inc. Apparatus and method of placement of a graft or graft system
US10245166B2 (en) 2008-02-22 2019-04-02 Endologix, Inc. Apparatus and method of placement of a graft or graft system
US8870938B2 (en) 2009-06-23 2014-10-28 Endospan Ltd. Vascular prostheses for treating aneurysms
US9918825B2 (en) 2009-06-23 2018-03-20 Endospan Ltd. Vascular prosthesis for treating aneurysms
US20100331960A1 (en) * 2009-06-30 2010-12-30 Boston Scientific Scimed, Inc. Endoprosthesis and endoprosthesis delivery system and method
US8979892B2 (en) 2009-07-09 2015-03-17 Endospan Ltd. Apparatus for closure of a lumen and methods of using the same
US8945203B2 (en) 2009-11-30 2015-02-03 Endospan Ltd. Multi-component stent-graft system for implantation in a blood vessel with multiple branches
US10201413B2 (en) 2009-11-30 2019-02-12 Endospan Ltd. Multi-component stent-graft system for implantation in a blood vessel with multiple branches
US9572652B2 (en) 2009-12-01 2017-02-21 Altura Medical, Inc. Modular endograft devices and associated systems and methods
US9101457B2 (en) 2009-12-08 2015-08-11 Endospan Ltd. Endovascular stent-graft system with fenestrated and crossing stent-grafts
US8956397B2 (en) 2009-12-31 2015-02-17 Endospan Ltd. Endovascular flow direction indicator
US9468517B2 (en) 2010-02-08 2016-10-18 Endospan Ltd. Thermal energy application for prevention and management of endoleaks in stent-grafts
US20110208289A1 (en) * 2010-02-25 2011-08-25 Endospan Ltd. Flexible Stent-Grafts
US8858613B2 (en) 2010-09-20 2014-10-14 Altura Medical, Inc. Stent graft delivery systems and associated methods
US9526638B2 (en) 2011-02-03 2016-12-27 Endospan Ltd. Implantable medical devices constructed of shape memory material
US9855046B2 (en) 2011-02-17 2018-01-02 Endospan Ltd. Vascular bands and delivery systems therefor
US9486341B2 (en) 2011-03-02 2016-11-08 Endospan Ltd. Reduced-strain extra-vascular ring for treating aortic aneurysm
US8574287B2 (en) 2011-06-14 2013-11-05 Endospan Ltd. Stents incorporating a plurality of strain-distribution locations
US8951298B2 (en) 2011-06-21 2015-02-10 Endospan Ltd. Endovascular system with circumferentially-overlapping stent-grafts
US9254209B2 (en) 2011-07-07 2016-02-09 Endospan Ltd. Stent fixation with reduced plastic deformation
US9839510B2 (en) 2011-08-28 2017-12-12 Endospan Ltd. Stent-grafts with post-deployment variable radial displacement
US9427339B2 (en) 2011-10-30 2016-08-30 Endospan Ltd. Triple-collar stent-graft
US9597204B2 (en) 2011-12-04 2017-03-21 Endospan Ltd. Branched stent-graft system
US9393102B2 (en) 2012-04-12 2016-07-19 Sanford Health Debranching great vessel stent graft and methods for use
US20160367353A1 (en) * 2012-04-12 2016-12-22 Sanford Health Debranching Visceral Stent Graft and Methods for Use
US9393101B2 (en) 2012-04-12 2016-07-19 Sanford Health Visceral double-barreled main body stent graft and methods for use
US9370413B2 (en) 2012-04-12 2016-06-21 Sanford Health Combination double-barreled and debranching stent graft and methods for use
US9283068B2 (en) * 2012-04-12 2016-03-15 Sanford Health Debranching visceral stent graft and methods for use
AU2018201118B2 (en) * 2012-04-12 2019-04-18 Sanford Health Debranching visceral stent graft and methods for use
US9427308B2 (en) * 2012-04-12 2016-08-30 Sanford Health Debranching visceral stent graft and methods for use
US20150157447A1 (en) * 2012-04-12 2015-06-11 Sanford Health Debranching Visceral Stent Graft and Methods for Use
US20150157446A1 (en) * 2012-04-12 2015-06-11 Sanford Health Debranching Visceral Stent Graft and Methods for Use
US9770350B2 (en) 2012-05-15 2017-09-26 Endospan Ltd. Stent-graft with fixation elements that are radially confined for delivery
US10285833B2 (en) 2012-08-10 2019-05-14 Lombard Medical Limited Stent delivery systems and associated methods
US9949818B2 (en) 2012-12-14 2018-04-24 Sanford Health Combination double-barreled and debranching stent grafts and methods for use
US9861466B2 (en) 2012-12-31 2018-01-09 Cook Medical Technologies Llc Endoluminal prosthesis
US9993360B2 (en) 2013-01-08 2018-06-12 Endospan Ltd. Minimization of stent-graft migration during implantation
US9668892B2 (en) 2013-03-11 2017-06-06 Endospan Ltd. Multi-component stent-graft system for aortic dissections
US9737426B2 (en) 2013-03-15 2017-08-22 Altura Medical, Inc. Endograft device delivery systems and associated methods

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ES2358570T3 (en) 2011-05-11
US6224609B1 (en) 2001-05-01
DK1063945T3 (en) 2011-05-02
DE69943181D1 (en) 2011-03-24
EP1063945B1 (en) 2011-02-09
AT497738T (en) 2011-02-15
WO1999047078A1 (en) 1999-09-23
EP1063945A4 (en) 2008-10-22
EP1063945A1 (en) 2001-01-03

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