WO2018091464A1 - Système d'endoprothèse et son utilisation dans le traitement de maladies anévrismales - Google Patents

Système d'endoprothèse et son utilisation dans le traitement de maladies anévrismales Download PDF

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Publication number
WO2018091464A1
WO2018091464A1 PCT/EP2017/079201 EP2017079201W WO2018091464A1 WO 2018091464 A1 WO2018091464 A1 WO 2018091464A1 EP 2017079201 W EP2017079201 W EP 2017079201W WO 2018091464 A1 WO2018091464 A1 WO 2018091464A1
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WO
WIPO (PCT)
Prior art keywords
stent graft
blood vessel
graft body
stentgraftkorper
fenestration
Prior art date
Application number
PCT/EP2017/079201
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German (de)
English (en)
Inventor
Johannes Kalder
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Rheinisch-Westfälische Technische Hochschule (Rwth) Aachen
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Publication of WO2018091464A1 publication Critical patent/WO2018091464A1/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
    • A61F2/02—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
    • A61F2/02—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
    • A61F2002/065—Y-shaped blood vessels
    • A61F2002/067—Y-shaped blood vessels modular
    • 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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0008—Fixation appliances for connecting prostheses to the body
    • A61F2220/0016—Fixation appliances for connecting prostheses to the body with sharp anchoring protrusions, e.g. barbs, pins, spikes

Definitions

  • the present invention relates to a stent graft system or a system consisting of at least two stent grafts, as well as its use in the treatment of aneurysmal diseases, and in particular in the treatment of aortic aneurysms such as thoracoabdominal aortic aneurysms.
  • Aortic aneurysms have been among the most serious diseases of the aorta in humans for a long time and are particularly due to a degeneration of the middle arterial layer, the so-called media, which leads to the widening of the main artery.
  • Another mechanism for aneurysm formation is a tear of the inner aortic wall (aortic dissection) with subsequent dilation of the aorta - also called dissection aneurysm.
  • the cause of this disease may be congenital aortic wall weakness, arteriosclerosis, high blood pressure, peripheral artery disease (PAD), elevated cholesterol, smoking, or even a bacterial infection.
  • An aortic aneurysm is a blood-filled dilation or outgrowth of a part of the aorta, whereby the vascular walls of the aorta can become so weak that ruptures in the aortic wall can occur at normal blood pressure as a result of dilatation or dilatation, sometimes leading to a high mortality rate leads. About 40 out of every 100,000 people suffer from such an aortic aneurysm every year, most often affecting men over the age of 65. An aortic aneurysm is particularly common in the form of an abdominal aortic aneurysm.
  • a thoracoabdominal aortic aneurysm in the form of a dilation of the thoracic and abdominal aorta, occurs at an incidence of 5.9 cases per 100,000 persons per year.
  • An indication for the treatment of TAAA here is if its diameter is more than 6cm or the TAAA grows rapidly with a growth rate of> 5mm / year.
  • 936 TAAA patients were treated surgically in Germany alone, with treatment being performed endovascularly in just over 50%. The share of Endovascular care increased to 70% in Germany in the following two years 2014/2015 and in 2015 to about 75% in the United States.
  • vascular prostheses such as stents or stent grafts
  • a stent is known to be an expanded or dilated vascular or endoprosthesis supporting a luminal wall, such as the aortic inner wall, which in the event of a stenosis may form an undisturbed passage through the affected lumen in the area of the stenosis.
  • a stent may also include a prosthetic graft layer of tissue, coating or the like lining the inside thereof and / or surrounding the outside thereof.
  • a layered stent is generally referred to in the field of endovascular medicine as an endoluminal or endovascular graft, and more particularly as an intraluminal stent graft, or stent graft.
  • vital vascular discharges such as the outlets to the renal arteries in the aorta are covered and thereby closed, side arms or so-called windows can be incorporated into the stent graft, whereby the stent graft is referred to as fenestrated stent graft.
  • the publication US 2016/0067033 A1 describes a stent graft whose main part has two openings located at the same height, which are connected to one another via a tubular part made of biocompatible material such that the main part thereof is partially surrounded.
  • the compound has so-called fenestrations, also referred to as fenestration, can be introduced into the side arms for the perfusion of the renal arteries.
  • fenestrations also referred to as fenestration
  • a stent graft for the aortic bifurcation can be taken, which consists of an already bifurcated body and two to connecting legs, wherein at least one of the two legs may have a fenestration.
  • the vital renal arteries are opened up and connected by means of other stents.
  • the small-lumen intercostal arteries or their continuation in the form of small-lumbar lumbar arteries, and the small-lumen Nierenpolarterien be kept open only in a large open surgical operation, since the diameter of the previous endovascular measures with less than 4mm are too small.
  • the diameter of the intercostal arteries increases from cranial to caudal, with the upper intercostal arteries having an average diameter of 1.1 mm on average and the lower intercostal arteries having a diameter of 1.5 mm on average in the lumbai region.
  • the small-lumen vessels such as the intercostal arteries or the lumbar arteries are covered for a long time, but these play an important role in the blood supply to the spinal cord. If less blood enters the spinal cord as a consequence of this long treatment time and the associated lack of blood flow, new vessels are formed over time, which in turn supply the spinal cord gradually better.
  • the present invention provides a stent graft system, preferably a so-called modular stent graft system, for assisting a patient's blood vessel, wherein the blood vessel is preferably the thoracic aorta, the abdominal aorta, the thoracoabdominal aorta, or an iliac vessel ,
  • the stent graft system according to the invention further comprises a first hollow cylindrical stent graft body and at least one second hollow cylindrical stent graft body connectable to the first stent graft body.
  • the second stent graft body In a condition associated with the first stent graft body, the second stent graft body is disposed substantially parallel to and in fluid communication with the first stent graft body, and is in fluid communication therewith, preferably bypass-type fluid communication; Accordingly, it can preferably branch off a fluid flowing through the first stent graft body from the first stent graft body, guide it over a certain distance, and supply it substantially to the first stent graft body again.
  • the second hollow-cylindrical stent graft body in the state connected to the first stent graft body protrudes from the first stent graft body, runs at least partially parallel to it and subsequently re-enters the first stent graft body.
  • the second Stentgraftkorper the stent graft system according to the invention at least one fenestration, also referred to as windowing or simply referred to as windows, which serves for fluid communication of the second stent graft body with at least one blood vessel outlet with a diameter less than 4mm, so a small-lumen blood vessel.
  • Such a small-lumen blood vessel outlet may be a departure of the aorta, such as an intercostal artery or a lumbar artery, or a departure of the lliacalgefäße or renal arteries, the dimension of such a small-lumen blood vessel outlet has a diameter smaller than 4mm; Accordingly, the critical diameter threshold of the previous therapeutic methods in the therapy of a blood vessel and its outlets at a diameter of about 4 mm to settle.
  • fluid is generally understood to mean blood flowing through the blood vessel
  • modular stent graft system is generally understood to mean that the stent graft system consists of several components and thereby brings with it the advantages of a modularized structure, such as for example a flexible selection of the different components.
  • the present invention proposes a combination of a main prosthesis as the first stent graft body, side arm connections of the main prosthesis and fenestrated side prosthesis as the second stent graft body.
  • the fenestration in the parallel-guided prosthesis is placed over at least one mouth of a small aortic outgoing blood vessel outlet, such as a departure in the form of an intercostal artery, a lumbar artery or a departure of the lliacalgefäße, alternatively over adjacent mouths of several small blood vessel exits, and fixed to the aortic wall with a fixation system such as a screw system, an adhesive system, a hooking system, or the like.
  • the present invention provides a hitherto unknown solution of a combination of aortic prosthesis, side arm prosthesis and windows, not only the combination of side arm prosthesis with window and fixation system and the special arrangement of the window of the side arm prosthesis in the aorta far as are not taken from the prior art can.
  • the inventive stent-graft system makes it possible for the first time to include small spinal cord-supplying vessels, such as the intercostal arteries or the lumbar arteries, in the endovascular reconstruction of the aorta and to successfully prevent paraplegia of the patient.
  • small spinal cord-supplying vessels such as the intercostal arteries or the lumbar arteries
  • the fenestration of the second stent graft body is a fenestration facing the wall, or else a window directed towards the aortic wall, and in particular a window directed towards at least one mouth of a small vessel emerging from the aorta, such as the mouth or the exit of an intercostal artery, a Lumbaiarterie or the departure of the lliacalgefäße.
  • the fenestration of the second stent graft body is arranged for anchoring in a wall of the blood vessel surrounding the at least one blood vessel outlet, that is, the aortic wall surrounding the mouth of the blood vessel outlet.
  • the fenestration exhibits structural features, such as an anchoring portion or anchoring margin or the like, for anchoring it to the aortic wall, and thus preferably uniformly connecting the fenestration-surrounding portion of the second stent graft body to the aortic inner wall.
  • the anchoring of the second stent graft body in the wall of the blood vessel surrounding the at least one blood vessel outlet can be effected by fixation, for example by gluing, entanglement, or anchoring with preferably at least one anchoring element, such as an anchoring screw or the like.
  • anchoring screw here is preferably a spiral connecting element for To understand frictional connection of StentgraftShange al and aortic wall in the sense of a helical spring-like component that penetrates both the wall of the second Stentgraftkorpers and the adjoining blood vessel wall and the wall of the second Stentgraftkorpers and the blood vessel wall firmly connected.
  • the second hollow cylindrical Stentgraftkorper is therefore preferably arranged to go through its fenestration with the surrounding at least one blood vessel wall of the blood vessel in abutment.
  • the second stent graft body can be connectable to two side arms of the first stent graft body, which means that the second stent graft body is designed so that it can be connected to the two side arms, preferably with the one side arm cranially and with the caudal to the other side arm.
  • the fenestrated lateral prosthesis is thus connected cranially and caudally to the two lateral arms of the main prosthesis in such a way that it runs at least partially parallel to the main prosthesis after branching off or leaving the main prosthesis on the first lateral arm and also back into the second lateral arm
  • Main prosthesis opens, regardless of the fenestration. Accordingly, a supply of fenestration can be ensured with the fluid flowing through the main prosthesis.
  • the stent graft system according to the invention can be set up such that the fenestration has a stabilizing element for stably keeping open the fenestration of the second stent graft body.
  • the second stent graft of the present invention is preferably an expandable stent graft vehicle that is convertible from a compressed state to an expanded state, that is, an expanding stent graft body
  • the stabilization element serves to stably maintain the fenestration in the expanded state of the second stent graft body. and thus in the expanded state of fenestration.
  • the second stent graft body may consist of a self-expanding material that automatically expands after removal of a retention mechanism, such as in the form of a so-called lock or the like.
  • the stabilizing element here is, for example, an arrangement of wires or wire loops around the fenestration or a wire mesh arranged around the fenestration, or else another additional element such as a stent with a Z-stent structure, a stabilizing ring or the like.
  • connection of the second stent graft body to the first stent graft body is effected by at least one connecting element, preferably an anchoring ring.
  • each end of the second stent graft body, which in the expanded state may have a substantially cylindrical shape, is connected to the corresponding side arm of the first stent graft body by at least one connecting element for a secure fluid connection between the first stent graft body and the second stent graft body produce and maintain.
  • the connecting element may preferably be provided with a marking, such as a gold marker or the like.
  • the connecting element can be recognized by the surgeon by means of an imaging procedure, such as fluoroscopy or computed tomography during the procedure of the connection, in order to facilitate the connection of the second stent graft body to the first stent graft body and, on the other hand, a secure connection ensure the two stent graft to the stent graft system.
  • One or more such markers can also be attached to the other components of the stent graft system according to the invention be provided, such as the first and / or the second Stentgraftkorper, the fenestration or the stabilizing element.
  • the stent graft system according to the invention can be set up such that at least the fenestration of the second stent graft body is adapted to the blood vessel anatomy of the patient. Furthermore, not only the fenestration but the entire second stent graft body can be adapted to the patient's blood vessel anatomy. In addition, the entire stent graft system may be adapted to the patient's blood vessel anatomy. In this case, the adaptation preferably takes place on the basis of imaging methods performed on the patient, for example based on data obtained by a radiographic transillumination method, such as computed tomography (CT) or an overlay of angiography and computed tomography, the so-called image Fusion procedure.
  • CT computed tomography
  • image Fusion procedure preferably takes place on the basis of imaging methods performed on the patient, for example based on data obtained by a radiographic transillumination method, such as computed tomography (CT) or an overlay of angiography and computed tomography, the so-called
  • the gold standard for determining the blood vessel anatomy of the patient is thin-layer spiral CT with intravenous administration of iodine-containing contrast agent, wherein the aneurysm can be reconstructed from the generated 3-dimensional data sets and the required stent graft system can be adapted accordingly.
  • an MRI angiography can be performed, which can also be used to determine the blood vessel anatomy of the patient. This makes it possible to adapt the stent-graft system according to the invention as closely as possible to the anatomy of the patient and to enable a successful endovascular procedure, whereby particular attention can be paid to the anatomical conditions of the smaller vessels.
  • the present invention provides a stent graft system for supporting a patient's blood vessel having a first hollow cylindrical stent graft body and at least one second hollow stent graft body connectable to the first stent graft body and substantially parallel to one another in a condition associated with the first stent graft body the first stent graft body is arranged and in fluid communication therewith, wherein the second stent graft body has at least one fenestration, which for fluid communication of the second stent graft body with at least one blood vessel outlet with a diameter smaller than 4mm serves.
  • Preferred developments of this further aspect of the present invention can be taken from the developments described with regard to the stent graft system according to the first aspect of the present invention, which are correspondingly applied here.
  • a stent graft system as described above finds use in the treatment of aneurysmal disorders, particularly in the treatment of aneurysmal disorders of the thoracic, abdominal, thoracoabdominal aorta, or or iliac vessel. Successful use can protect patients from spinal cord injury.
  • FIG. 1 shows a schematic section through part of the aorta with a
  • Aortic aneurysm and a stent graft system according to the preferred embodiment of the present invention in an exploded view, in which, for reasons of clarity, a main prosthesis with two side arms and a fenestrated side prosthesis with fenestration attached to the aortic wall are shown independently of each other; and
  • FIGS. 2a to 2e show a process of introducing the fenestrated lateral prosthesis shown in FIG. 1 into the main prosthesis likewise shown in FIG. 1 and its connection, as well as a connection of the fenestrated lateral prosthesis to a vessel outlet.
  • FIG. 1 shows a stent graft system 1 according to the preferred embodiment of the present invention, which can be seen in a state inserted in an aortic aneurysm 9 present in the aorta.
  • FIG. 1 is a schematic view and does not depict detailed or dimensional imaging.
  • a first stent graft body 1 which may also be referred to as the main prosthesis of the aortic aneurysm 9, is in a non-bonded state with a second stent graft body 12 , which may also be referred to as a fenestrated side prosthesis, is shown, ie in an exploded view, to provide a better illustration of the connection of the second stent graft body 12 to an aortic wall 91.
  • a connection between the first stent graft body 1 1 and the second stent graft body 12 takes place before the connection of the second stent graft body 12 to the aortic wall 91.
  • the first stent graft body 1 1 is arranged along a longitudinal axis of the aortic aneurysm 9. It should be noted here that the dimension of the first stent graft body 11 in FIG. 1 is chosen to be small and displaced into the background in order to be able to display the fenestrated lateral prosthesis better.
  • first stent graft body 1 1 On the outside of the first stent graft body 1 1 two side arms 1 1 1 and 1 12 open out of the first Stentgraftkorper 1 1, wherein the first side arm 1 1 1 is provided cranially to the first Stentgraftkorper 1 1, and wherein the second side arm 1 12 caudal is provided on the first Stentgraftkorper 1 1. Both side arms 1 1 1 and 1 12 are aligned with each other to allow later fluid communication through the second stent graft body 12 in a bypass manner.
  • connection (not shown) of the second StentgraftSh 12 with the first Stentgraftkorper 1 1 additionally or alternatively to an already acting radial expansion force, which is exerted by the second Stentgraftkorper 12 on the first Stentgraftkorper 1 1, as described below with reference to Figures 2a to 2e is described in more detail, for example by a fixing element such as an anchoring ring, a hooking element, an adhesive bond or the like.
  • the cranial end of the second Stentgraftkorpers 12 which shows a substantially cylindrical shape in the expanded state, with the corresponding end of the side arm 1 1 1 of the first Stentgraftkorpers 1 1 and the caudal end of the second Stentgraftkorpers 12 with the respective end of the side arm 1 12 of the first Stentgraftkorpers 1 1 are each connected by at least one anchoring ring to establish a secure fluid connection between the first Stentgraftkorper 1 1 and the second Stentgraftkorper 12 and thus with a fenestration 121 of the second Stentgraftkorpers 12 and maintain ,
  • the second Stentgraftkorper 12 is correspondingly connected in the assembled state with the two side arms 1 1 1 and 1 12, as can be seen inter alia Figure 2e, so that in the first Stentgraftkorper 1 1 flowing blood from the first side arm 1 1 1 out, into the second Stentgraftkorper 12 inside, through it and back out of this into the second side arm 1 12 and through this back into the first Stentgraftkorper 1 1 can flow into it.
  • an otherwise occluded blood vessel outlet 92 here the example of an intercostal artery, which represents a departure from the aorta and flows out of this
  • the expanded second Stentgraftkorper 12 the fenestration 121 which cover the mouth of the blood vessel outlet 92 should.
  • the fenestration 121 is adapted to be covered blood vessel outlet 92 with a diameter smaller than 4mm.
  • an edge of the fenestration 121 is fixed at at least two locations 121 1, 1212 by so-called anchor bolts 13 with the aortic wall 91, so that a fluid connection between the second stent graft body 12 and the blood vessel outlet 92 is established.
  • anchor bolts 13 with the aortic wall 91
  • Figure 2e shows the assembled state of the first Stentgraftkorper 1 1 and second Stentgraftkorper 12 to the stent graft system 1, here the fixation of the fenestration 121 at least two locations 121 1, 1212 by so-called anchor bolts 13 with the aortic wall 91 as shown in Figure 1 not yet done.
  • This is done separately in a subsequent, not shown Step, with the result that the composite stent graft system 1 known from FIG. 2e is fixedly connected to the aortic wall 91 as shown in FIG.
  • the first stent graft body 1 1 already shown in FIG. 1 is introduced as the main prosthesis in the aortic aneurysm 9 along the longitudinal axis of the aorta or the aortic aneurysm 9, so that a temporarily free intermediate piece between the cranial first side arm 11 and the caudal second lateral arm 1 12 facing the targeted blood vessel outlet 92, the fenestration 121 is thus placed before the blood vessel outlet 92.
  • a guide wire 2 is inserted cranially into the first Stentgraftkorper 1 1 and by the second side arm 1 12 bridging the free intermediate piece in the first side arm 1 1 1 and thereby back into the first Stentgraftkorper 1 1 passed, as indicated by an arrow in Figure 2b.
  • the second stent graft body 12 is also guided in a compressed state over the guide wire 2 cranially through the first stent graft body 1 1 to the free intermediate piece opposite the targeted blood vessel outlet 92, that the cranial end of the second stent graft body 12 is within the first Side arm 1 1 1 and the caudal end of the second Stentgraft stresses 12 within the second side arm 1 12 is arranged.
  • the fenestration 121 is not necessarily recognizable.
  • the compressed second Stentgraftkorper 12 may also be held in a (not shown) envelope in the compressed state, such as a so-called lock or the like.
  • it may also be a known balloon-expanding Stentgraftkorper 12, or even a fully self-expanding Stentgraftkorper 12, which is without wrapping of a compressed state in an expanding state, for example by an activation mechanism or the like.
  • the sheath of the second stent graft body 12, if present, must be removed over the guidewire 2 prior to expansion, whereby the second stent graft body 12 is progressively released and may gradually expand.
  • the second stent graft body 12 is designed such that not only the fenestration 121 of the second stent graft body 12 is adapted to the illustrated blood vessel anatomy of the patient, but the entire second stent graft body 12 is adapted to it. This can be seen in that the second stent graft body 12 expands with the fenestration 121, in particular in the direction of the blood vessel outlet 92.
  • An adaptation or structural preprogramming of the second stent graft body 12 takes place, for example, on the basis of the results of a computed tomography (CT) of the patient, or on the basis of the results of an overlay from angiography and computer tomography, the so-called image fusion method.
  • CT computed tomography
  • the fenestration 121 is located directly above the blood vessel outlet 92, so that a blood supply thereof by means of the stent graft system 1 can be ensured.
  • the second stent graft body 12 In order to improve stability of the stent graft system 1, the second stent graft body 12 must are still fixed to the aortic wall 91, as previously described with reference to Figure 1.
  • the guide wire 2 is already removed from the stent graft system 1 in order to enable or facilitate the anchoring of the fenestration 121 to the aortic wall 91. While in FIGS.
  • the dimension of the first stent graft body 1 1 has been selected small and displaced into the background in order better to depict the fenestrated side prosthesis, the dimension of the first stent graft body 1 1 in FIG. 2 e is chosen to be larger in order to gain a better understanding to provide the connection between the first stent graft body 1 1 and the second stent graft body 12.

Abstract

L'invention concerne un système d'endoprothèse (1) pour soutenir un vaisseau sanguin d'un patient, qui présente un premier corps (11) cylindrique creux d'endoprothèse et au moins un deuxième corps (12) cylindrique creux d'endoprothèse, qui peut être relié au premier corps (11) d'endoprothèse et qui est disposé, dans un état relié au premier corps (11) d'endoprothèse, de manière essentiellement parallèle par rapport au premier corps (11) d'endoprothèse et en communication fluidique avec celui-ci. À cette fin, le deuxième corps (12) d'endoprothèse présente au moins une fenestration (121), qui sert à la communication fluidique du deuxième corps (12) d'endoprothèse avec au moins une sortie (92) de vaisseau sanguin présentant un diamètre inférieur à 4 mm. En outre, selon l'invention, le système d'endoprothèse (1) est utilisé dans le traitement de maladies anévrismales, en particulier de l'aorte thoracique, abdominale, thoraco-abdominale ou d'un vaisseau iliaque.
PCT/EP2017/079201 2016-11-15 2017-11-14 Système d'endoprothèse et son utilisation dans le traitement de maladies anévrismales WO2018091464A1 (fr)

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DE102016013616.2 2016-11-15
DE102016013616.2A DE102016013616A1 (de) 2016-11-15 2016-11-15 Stentgraftsystem und dessen Verwendung in der Behandlung von aneurysmatischen Erkrankungen

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