WO2016203040A1 - Prothèses vasculaires endoluminales et procédé de déploiement de telles prothèses - Google Patents

Prothèses vasculaires endoluminales et procédé de déploiement de telles prothèses Download PDF

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Publication number
WO2016203040A1
WO2016203040A1 PCT/EP2016/064166 EP2016064166W WO2016203040A1 WO 2016203040 A1 WO2016203040 A1 WO 2016203040A1 EP 2016064166 W EP2016064166 W EP 2016064166W WO 2016203040 A1 WO2016203040 A1 WO 2016203040A1
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Prior art keywords
stent
stent system
proximal
stentgraft
wire
Prior art date
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PCT/EP2016/064166
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English (en)
Inventor
Patrick Berg
Victor Charles BERG
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Benta Pharma Industries
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Priority to EP16738076.5A priority Critical patent/EP3310299A1/fr
Publication of WO2016203040A1 publication Critical patent/WO2016203040A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2/00—Filters 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
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2/07—Stent-grafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2/00—Filters 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
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2/00—Filters 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
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/954—Instruments specially adapted for placement or removal of stents or stent-grafts for placing stents or stent-grafts in a bifurcation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2002/061—Blood vessels provided with means for allowing access to secondary lumens
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2/07—Stent-grafts
    • A61F2002/077—Stent-grafts having means to fill the space between stent-graft and aneurysm wall, e.g. a sleeve
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2/00—Filters 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
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2002/823—Stents, different from stent-grafts, adapted to cover an aneurysm
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0004—Rounded shapes, e.g. with rounded corners
    • A61F2230/0008—Rounded shapes, e.g. with rounded corners elliptical or oval
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0017—Angular shapes
    • A61F2230/0026—Angular shapes trapezoidal
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0073—Quadric-shaped
    • A61F2230/0076—Quadric-shaped ellipsoidal or ovoid
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0037—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in height or in length
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0096—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers
    • A61F2250/0098—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers radio-opaque, e.g. radio-opaque markers

Definitions

  • the present invention relates to endoluminal vascular prostheses and methods of deploying such prostheses. More particularly this invention relates to systems, apparatuses and methods for deploying stents and/or stentgrafts and creating fenestrations in such devices while they are deployed in situ within body lumens, such as blood vessels, to provide additional flow pathways and/or join with other flow-directing or structural devices.
  • An aortic aneurysm is characterized by the dilation of the wall of the aorta. Aortic aneurysms are likely to rupture, especially when the diameter increases, thus posing significant danger to the patient. Rupture of an aneurysm gives only a 20 % chance of survival, so there is a significant emphasis placed on early diagnosis and treatment.
  • Aneurysms of the abdominal and thoracic aorta are a major cause of mortality, especially in the western societies.
  • Stentgrafts are medical devices constructed to reinforce, replace, or bridge a part of a damaged, unhealthy, or diseased blood vessel. The technique has significant limitations and is nor suitable for all patients.
  • a stentgraft at or near an intersection of an artery to be repaired (such as the aorta) with branch vessels (for example the renal arteries, superior mesenteric artery, celiac trunk, brachiocephalic artery, carotid arteries or left subclavian artery etc.) is well recognized.
  • branch vessels for example the renal arteries, superior mesenteric artery, celiac trunk, brachiocephalic artery, carotid arteries or left subclavian artery etc.
  • This technique is easier than the technique for fenestrated
  • chimney grafts in conjunction with polymer-filled endobags which have the ability to conform to adjacent structures may offer advantages over conventional endografts when combined with parallel grafts designed to treat juxtarenal aneurysms (23).
  • the requirements for in vivo fenestration are : obtention of low leak rates, a technique easy to learn and to perform, no wait time using off-the-shelf devices, possibility to treat emergent cases, ostium of target vessels have to be marked easily and
  • ischemia due to temporary occlusion of target vessels has to be prevented and the stentgraft should be flexible enough to deal with a tortuous anatomy. It is the object of the invention to provide a flexible prosthesis with a self- expandable stent allowing blood flow through the struts during cannulation and connection of target vessels with the aortic lumen by the use of stentgrafts. After having connected all the target vessels, the residual lumen between aortic wall and aortic stent is sealed with polymer-filled endobags.
  • the self-expandable stent is cylindrical in shape.
  • An oblique plane cuts the proximal end of the cylinder.
  • the section is an ellipse.
  • the lowest part is meant to be used in an anterior position, below a visceral target vessel, either superior mesenteric artery or celiac trunk for example.
  • the Stent System consists of a closed end, braided self-expanding stent made of Nitinol (nickel-titanium alloy) wire material that is premounted on a delivery system.
  • the over-the-wire (OTW) stent delivery system is compatible with a 0.035" guide wire.
  • the stents contain radiopaque markers at each end and antero-posteriorly allowing to identify the rotation. It also contains a marker at the lowest part of the ellipse. This marker should be placed under the visceral vessel serving as reference.
  • the stent is contained within the outer sheath of the delivery system. Once the distal end of the delivery system reaches the treatment site, the outer sheath of the delivery system is retracted to expose the stent and start its self-expansion.
  • the Vascular Stents are designed to open to a pre-programmed diameter at body temperature.
  • the diameter of the stent is inferior to the diameter of the aorta.
  • the stent remains attached to the catheter allowing minor rotation and height adjustment during implantation.
  • the stent diameter should be chosen according to the diameter of the aortic segment to treat.
  • the difference between aortic and stent diameter should be sufficient to place a parallel graft outside the stent in case of technically difficult access or a target vessel out of reach for an antegrade fenestration. This might occur when the ostium of the target vessel to treat is superposed by the proximal endobag or when the height of the ostium is lower than the portion to fenestrate from the stent system.
  • endobags are fixed on the proximal outer part of the stent. Over these wires, contained endobags can be advanced over the guide wires up to the height of the stent. The endobags are contained in a catheter and released by pulling down the catheter. The endobags are staying connected by small feeder pipes allowing the polymer fill. These endobags are in a longitudinal position at 45°, 135°, 225° and 315°
  • One endobag is attached to the two proximal rings end of the stent following the elliptic shape. This endobag is also connected to a feeder pipe outside the stent allowing polymer fill.
  • the space between aortic wall and stent system around the connected stentgrafts is sealed.
  • the advantage of using endobags not primarily fixed to the stent is to reduce the size of the stent system and to prevent access obstruction to target vessels during cannulation and fenestration.
  • a rhombus is a parallelogram with a 4- sided flat shape with straight sides where all sides have equal length and all opposite sides are parallel and opposite angles are equal.
  • This free space is used to cannulate a target vessel with a guide wire.
  • a stentgraft is advanced over the guide wire into the target vessel.
  • the distal part of the stentgraft is delivered in the proximal part of the target vessel, the proximal part of the stentgraft is delivered in the aortic lumen inside the self-expandable stent.
  • the distance between proximal end of the stentgraft and the rhombus-like wires of the stent is dilated and slightly oversized, preventing a dislocation between stent and connecting stentgraft during manipulations.
  • a technical issue could be to safely cannulate the non-covered stent to create the fenestrations either from the contralateral side or by a subclavian/brachial approach.
  • the fact of matter is, while trying to cannulate the stent with a wire, the wire could go through the struts and jeopardize the procedure.
  • a preloaded contralateral wire will be used and allow to advance an introducer sheath from the contralateral side without any difficulties.
  • the guide wire used to advance the stent system will be catched by a snare catheter from the
  • the distances between the different vessels it is mandatory to calculate the distances between the different vessels to treat so as the angles of ostia of the vessels. If for instance the stent should be placed below the superior mesenteric artery, the lowest part of the vessel and the angle will be the center of a new coordinate system thus giving this point the coordinates (0;0). Thus the lowest part of the elliptic ring will have the coordinates (0;-3) due to the fact that a minimum of 3 mm as safe distance should be respected.
  • the ostia of the renal arteries will be projected on the graph giving for x the value for the angle difference between the center of the SMA and the renal arteries.
  • the value for y is the distance between the bottom of the SMA and the top of the renal arteries.
  • the bottom of the celiac axis will have the coordinates (0;0) and all other coordinates will be calculated as described before in this coordinate system.
  • a drawing of the unwrapped cylinder can be done.
  • the ellipse will then have the shape of a sinus curve with period nr and the
  • f(x) a*(l-cos(x/r)), where a is the amplitude ((h2-hl)/2) and x the angle difference of the vessel to treat in relation to the SMA with the coordinates (0;0) and r the radius of the stent.
  • the stent system is released.
  • An existing device to treat infrarenal aortic aneurysms may be attached to the distal part of the stent system, thus completing the procedure.
  • the stent graft system is introduced over a guide wire
  • An introducer sheath is introduced over the preloaded contralateral wire into the stent.
  • the target vessel to fenestrate is cannulated through the struts of the stent with a guide-wire and a diagnostic catheter.
  • a covered stent is introduced into the target vessel
  • a parallel graft may be performed prior to polymer fill outside the stent system in particular cases where a direct fenestration is not possible.
  • Figure 1 shows a perspective view of the over-the-wire
  • FIG. 1 shows a perspective view of the self expandable stent.
  • Figure 3 shows a lateral sketch of the stent.
  • Figure 4 shows the unwrapped cylinder.
  • Figure 5 shows the proximal endobag.
  • Figure 6 shows the lateral endobag.
  • Figure 7 shows the four lateral endobags.
  • Figure 8 and 9 show the fenestration with a stentgraft through the rhombus of the stent.
  • Figure 10 planning of a procedure with projection of the ostia of celiac trunk, superior mesenteric artery, left and right renal artery.
  • Figure 1 shows a perspective view of the over-the-wire (OTW) delivery system, respectively, of a first introducer sheath 4 that glides over a guide wire 1 with a diameter of e.g. 0.035".
  • the first introducer sheath 4 contains a dilator 3.
  • a contralateral wire 2 is attached to the stent system allowing to cannulate the stent system from the contralateral side.
  • the stent 5 is contained within the introducer sheath.
  • Figure 2 shows a perspective view of the self expandable stent 5.
  • the self- expandable stent is cylindrical in shape.
  • An oblique plane cuts the proximal end of the cylinder. As the cutting plane is not
  • the section is an ellipse.
  • Figure 3 shows a lateral sketch of the stent.
  • Figure 4 shows the unwrapped cylinder.
  • Two proximal rings 6 and 7 are fixed to the mesh.
  • the proximal endobag is fixed on the two rings.
  • Four radiopaque markers 8 are fixed on the mesh.
  • the upper marker is fixed on the proximal ring at 0°.
  • Two other markers are fixed on the ventral part of the stent and another marker at 180°. While implanting the stent, the upper marker delivers the information of the height of implantation. The three others deliver the information of rotation of the stent. Under fluoroscopy the three markers should be placed on a line.
  • Figure 5 shows the proximal endobag.
  • This endobag is attached to the two proximal rings end of the stent following the elliptic shape.
  • This endobag is also connected to a feeder pipe outside the stent allowing polymer fill.
  • Figure 6 shows the lateral endobag.
  • a thin guide wire 10 is fixed on the proximal outer part of the stent. Over this wire, a contained endobag 11 can be advanced over the guide wires up to the height of the stent.
  • the endobags are contained in a catheter 12 and released by pulling down the catheter.
  • the endobag is connected by small feeder pipe 13 allowing the polymer fill.
  • the free space between the interwoven nitinol wires 14 has the form of a rhombus.
  • the target vessel is cannulated through this spacel with a guide wire.
  • a stentgraft 15 is advanced over the guide wire into the target vessel.
  • the proximal part of the stentgraft is delivered in the aortic lumen inside the self-expandable stent and is dilated and slightly oversized 16, preventing a dislocation between stent and connecting stentgraft during manipulations.
  • CA Celiac Axis
  • the stent system consists of a closed end, braided self- expanding stent made of Nitinol 5 (nickel-titanium alloy) wire material that is premounted on a delivery system.
  • the over- the-wire (OTW) stent delivery system is compatible with a 0.035" guide wire 1.
  • the stent system has a diameter inferior of the diameter of the aorta.
  • the stent remains attached to the catheter allowing minor rotation and height adjustment during implantation.
  • the stent system further comprises a proximal end cut in an oblique plane antero-posteriorly transforming the section in an ellipse.
  • the stent system further comprises a contralateral preloaded wire 2 allowing cannulation of the stent without difficulties.
  • the stent system further comprises four radiopaque markers 8, allowing height and rotation control.
  • the stent system has two proximal rings 6 and 7 with an elliptic shape.
  • the stent system furthers compries an endobag 9 which is mounted on the two proximal rings.
  • the endobag furthers compries a feeder pipe 13 which allows polymer fill and sealing of the proximal rings.
  • the stent system furthers compries four thin guide wires 10 which are fixed outside the stent system to the proximal rings at 45°, 135°, 225° and 315°.
  • the stent system furthers compries four lateral endobags 11 which are advanced over the guide wires 10 to the proximal end of the stent.
  • Feeder pipes 13 allow polymer fill of the endobags.
  • the free space between the interwoven nitinol wires 14 has the form of a rhombus.
  • Method for fenestrating a stentgraft 5 located in a blood vessel, which branches into a branch vessel comprising the following step: the target vessel is cannulated through the struts of the stent system with a guide wire and a stentgraft is advanced over this guide wire into the target vessel.
  • the method may further comprise the step: the proximal part of the stentgraft 15 is placed inside the mesh of the stent 14 and overdilated 16 to prevent dislocation.
  • the method may further comprise the step: polymer fill of the endobags seals the space between the stent system and the aortic wall around the connecting stentgrafts.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Cardiology (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Pulmonology (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Prostheses (AREA)

Abstract

La présente invention concerne des prothèses vasculaires endoluminales et des procédés de déploiement de telles prothèses. Plus particulièrement, l'invention concerne des systèmes, des appareils et des procédés pour déployer des endoprothèses et/ou greffons d'endoprothèse et créer des fenestrations dans de tels dispositifs lorsqu'ils sont déployés in situ dans des lumières corporelles, tels que des vaisseaux sanguins, pour fournir des passages d'écoulement supplémentaires et/ou se raccorder à d'autres dispositifs structurels ou de direction d'écoulement. La présente invention vise à fournir un dispositif endovasculaire souple implanté dans l'aorte avec une endoprothèse auto-extensible permettant une circulation sanguine à travers les entretoises pendant l'implantation et pendant la canulation et le raccordement de vaisseaux cibles avec la lumière aortique à l'aide de greffons d'endoprothèse. Après le raccordement de tous les vaisseaux cibles, la lumière résiduelle entre une paroi aortique et une endoprothèse aortique est scellée avec des endo-sacs remplis de polymère.
PCT/EP2016/064166 2015-06-18 2016-06-20 Prothèses vasculaires endoluminales et procédé de déploiement de telles prothèses WO2016203040A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP16738076.5A EP3310299A1 (fr) 2015-06-18 2016-06-20 Prothèses vasculaires endoluminales et procédé de déploiement de telles prothèses

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US201562181224P 2015-06-18 2015-06-18
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CN110123501A (zh) * 2018-02-08 2019-08-16 柯惠有限合伙公司 血管可扩张装置
WO2020146621A1 (fr) * 2019-01-09 2020-07-16 Osf Healthcare System Prothèse endovasculaire
US10888414B2 (en) 2019-03-20 2021-01-12 inQB8 Medical Technologies, LLC Aortic dissection implant

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Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN110123501A (zh) * 2018-02-08 2019-08-16 柯惠有限合伙公司 血管可扩张装置
CN110123501B (zh) * 2018-02-08 2022-01-28 柯惠有限合伙公司 血管可扩张装置
WO2020146621A1 (fr) * 2019-01-09 2020-07-16 Osf Healthcare System Prothèse endovasculaire
US10888414B2 (en) 2019-03-20 2021-01-12 inQB8 Medical Technologies, LLC Aortic dissection implant

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