US20020120327A1 - Endoluminal prostheses and therapies for highly variable body lumens - Google Patents
Endoluminal prostheses and therapies for highly variable body lumens Download PDFInfo
- Publication number
- US20020120327A1 US20020120327A1 US09/942,919 US94291901A US2002120327A1 US 20020120327 A1 US20020120327 A1 US 20020120327A1 US 94291901 A US94291901 A US 94291901A US 2002120327 A1 US2002120327 A1 US 2002120327A1
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- US
- United States
- Prior art keywords
- lumen
- branch
- trunk
- module
- prosthesis
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
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- 0 C1*C2C=*CC2*1 Chemical compound C1*C2C=*CC2*1 0.000 description 1
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- 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
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- A61F2220/0075—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
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- 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
- A61F2250/0039—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 diameter
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- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
- A61F2250/006—Additional features; Implant or prostheses properties not otherwise provided for modular
Definitions
- the present invention relates generally to tubular prostheses, such as grafts, stents, stent-grafts, and the like. More particularly, the present invention provides radially expandable tubular prosthetic structures which are deployable within tortuous body lumens, particularly within branching blood vessels for the treatment of abdominal and other aneurysms.
- Vascular aneurysms are the result of abnormal dilation of a blood vessel, usually resulting from disease and/or genetic predisposition, which can weaken the arterial wall and allow it to expand. While aneurysms can occur in any blood vessel, most occur in the aorta and peripheral arteries, with the majority of aortic aneurysms occurring in the abdominal aorta, usually beginning below the renal arteries and often extending into one or both of the iliac arteries.
- Aortic aneurysms are most commonly treated in open surgical procedures, where the diseased vessel segment is bypassed and repaired with an artificial vascular graft. While considered to be an effective surgical technique, particularly considering the alternative of a usually fatal ruptured abdominal aortic aneurysm, conventional vascular graft surgery suffers from a number of disadvantages.
- the surgical procedure is complex and requires experienced surgeons and well equipped surgical facilities. Even with the best surgeons and equipment, however, patients being treated frequently are elderly and weakened from cardiovascular and other diseases, reducing the number of eligible patients. Even for eligible patients prior to rupture, conventional aneurysm repair has a relatively high morality rate, usually from 2% to 10%. Morbidity related to the conventional surgery includes myocardial infarction, renal failure, impotence, paralysis, and other conditions. Additionally, even with successful surgery, recovery takes several weeks, and often requires a lengthy hospital stay.
- the prosthesis preferably extends axially beyond the weakened portion of the blood vessel to anchor securely in the less diseased vessel wall.
- the prosthetic lumen be substantially sealed against the healthy endolithium.
- the prosthetic lumen should remain open despite physiological movement of the vasculature and environmental stresses, so as to promote the free flow of blood.
- the geometry of the prosthetic lumen at the luminal intersection where the abdominal aorta meets the iliac arteries is of particular importance, as this bifurcation can have a significant impact on the relative blood flows through the two iliac arteries.
- abdominal aortic aneurysms can vary widely from patient to patient. While the aneurysm is often downstream of the renal arteries, as noted above, it may begin in very close proximity to these lateral branching blood vessels, and in some cases will extend up to, above, and along the renals themselves. Additionally, while the aneurysm itself is typically a distension of the vessel wall, the path the prosthesis must follow within the diseased vessel may be fairly convoluted. For example, the abdominal aorta typically defines a significant bend between the renal arteries and the iliac arch when viewed from a lateral position. This aortic bend often remains quite pronounced despite the presence of the distended aneurysm, and complicates the sealing and anchoring of the endoluminal prosthesis adjacent the renal arteries.
- Abdominal aortic aneurysms also appear to have a significant effect on the geometry of the intersection between the abdominal aorta and iliac arteries. Even among healthy patients, there are significant variations in the angles defined by the iliac arteries relative to the aorta, typically being anywhere in the range between 15-45°. The variation in aorta iliac angularity is often much wider in patients seeking therapy for aneurysms. In fact, iliac arteries which branch off from an aorta with a local angle of over 90° have been found in aneurysm patients.
- Known branching endoluminal prostheses are generally formed as tubular, radially expandable stent-grafts. In contrast with the convoluted branchings of diseased body lumens, these stent-graft structures have typically been formed with simplistic cylindrical frames or “stents.” A separate liner or “graft” is typically attached to the frame to prevent blood flow through a ruptured vessel wall. Such liners are often formed from inelastic fabrics to prevent pressure from distending a weakened luminal wall. Typically, these branching structures are primarily supported from immediately below the renal arteries. Patients may not be eligible for these known endovascular aneurysm therapies if this portion of the aorta is weakened by disease.
- the branching stent-graft structures of the prior art have generally comprised uniform structures, in which the smaller iliac branch portions form cylinders which are substantially parallel to the aortic portion when the prosthesis is at rest.
- these straight branching prostheses are intended to deform somewhat to accommodate the branch angles of body lumen systems, the imposition of substantial axial bends on known endovascular stent-grafts tends to cause folding, kinking, or wrinkling which occludes their lumens and degrades their therapeutic value.
- Still another disadvantage of known bifurcated stent-grafts is that even when they are flexed to accommodate varying branch geometry, the prosthetic bifurcation becomes distorted, creating an unbalanced flow to the branches.
- U.S. Pat. No. 5,064,435 describes a self-expanding prosthesis which maintains a stable axial length during radial expansion by anchoring of radial outward flares at each end, and by sliding of an overlapping medial region therebetween.
- U.S. Pat. No. 5,211,658 describes a method and device for endovascular repair of an aneurysm which makes use of separately introduced frame and liner structures.
- a similar method of repairing blood vessels is described in U.S. Pat. No. 5,078,726, in which a locking stent is expanded within a vascular graft which has been positioned within the blood vessel.
- the in situ deployment of an aortic intraluminal prosthesis by a catheter having two inflatable balloons is described in U.S. Pat. No. 5,219,355.
- European patent application publication no. 0 551 179 describes a method for deploying two tubular grafts which extend in parallel from the renals and into the aorta.
- U.S. Pat. No. 5,360,443 describes a bifurcated aortic graft which is secured to the aorta by a plastically deformable frame positioned between the renal arteries and the iliacs.
- Soviet Patent 145-921 describes a bifurcated blood vessel prosthesis having a fastening element which extends past the renal arteries to prevent migration.
- U.S. Pat. No. 4,774,949 describes a catheter having a lumen adapted to access branch arteries.
- U.S. patent application Nos. 4,550,447 and 4,647,416 describe vascular PTFE grafts which include transverse ribs integral with a tube wall, and methods for their production.
- U.S. patent application No. 5,443,499 describes a radially expandable tubular prostheses for intraluminal implantation within children.
- U.S. patent application Nos. 5,229,045 and 5,387,621 describe porous membranes based on unstable polymer solutions which are suitable for vascular prostheses, and methods for their production.
- the present invention provides a branching intraluminal prostheses for use in a branching body lumen system that includes a trunk lumen and first and second branch lumens.
- the prostheses comprises a radially expandable tubular trunk portion having a prosthetic trunk lumen, and radially expandable tubular first and second branch portions with first and second prosthetic branch lumens, respectively.
- a radially expandable tubular lumen separation portion provides fluid communication between the prosthetic trunk lumen and the first and second prosthetic branch lumens.
- the expanded trunk portion is preferably more axially flexible than the lumen separation portion.
- the lumen separation portion benefits from a less axially flexible structure to avoid distortion of the flow balance between the luminal branches when conforming the prosthetic geometry to a torturous body lumen system.
- the present invention therefore provides non-uniform prosthetic structures which are locally optimized to meet these contradictory requirements.
- a trunk sealing cuff is provided opposite the Y-connector to seal between the prosthetic trunk lumen and the trunk lumen of the body lumen system.
- the first and second branch portions are also more axially flexible than the lumen separation portion, and ideally include branch sealing cuffs opposite the lumen separation.
- These sealing cuffs may also benefit from relatively stiff structures, particularly where they help to anchor the prosthesis within the body lumen.
- the resulting prosthetic structure separates the luminal sealing, the axial conforming, and the flow separating functions of the branching prostheses to distinct axial portions of the prosthetic structure, allowing these portions to be still further independently optimized.
- the present invention provides an endoluminal prosthesis comprising first and second prosthesis portions including first and second radially expandable frames defining first and second axes, respectively.
- the frames support tubular liners having lumens.
- a flexible joint between the first and second prosthesis portions provides open fluid communication between the first and second lumens when the first and second axes are at an angle, the flexible joint comprising a self-supporting liner which includes a polymer tube having integral ribs.
- the present invention provides an endoluminal prosthesis comprising a radially expandable tubular liner having a lumen which defines an axis.
- a helical coil supports the liner, the coil defining a plurality of loops which are separated to enhance the axial flexibility of the prosthesis.
- the helical coil elongates during expansion of the liner to avoid unwinding of the coil relative to the liner.
- the coil may be attached at a plurality of attachment points along the length of the coil.
- the coil comprises linked diamond shaped elements, which may expand either resiliently or plastically during deployment.
- the present invention provides an endoluminal prostheses for use in a body lumen, the prostheses comprising a radially expandable tubular frame having an axis.
- the frame includes a plurality of resiliently expandable loops, and also includes a plurality of plastically deformable connector elements extending between adjacent loops to allow the axis to conform to the body lumen.
- the connector elements plastically deform at a predetermined load which is greater than environmental forces imposed on the expanded prostheses by the surrounding body lumen, but which predetermined load is preferably less than or equal to forces imposed on the prostheses during deployment.
- the adjacent loops of the frame are axially separated, and the connector elements combine serpentine structures which extend axially between the adjacent loops.
- connector elements which yieldingly bend, and which remain bent without resiliently straightening in situ will be “plastically deformed” as used herein.
- shape memory alloys or polymers which are deformed in situ such that they will not recover their original shape at body temperatures will be “plastically deformed”, even if they would recover their shape if removed from the patient body and heated beyond a transition temperature.
- At least some of the connector elements are attached to an associated loop of the frame using axially oriented slots, loosely tied sutures, or some other attachment mechanism which allows a limited amount of axial motion without deforming the connector member.
- a structure provides a self-expanding prostheses which conforms to a torturous axial path of a body lumen without imposing resilient straightening forces. This structure is therefore particularly well suited for use in the flexible trunk or branch portions of the branching prosthesis described above.
- the present invention provides a bifurcated endoluminal prosthesis for use within a branching body lumen system having a trunk lumen and first and second branch lumens.
- the trunk lumen will have a larger cross-section than the branch lumens, and the trunk and branch lumens will be in fluid communication at a luminal intersection.
- the prostheses comprises a hub module which is deployable within the body lumen system adjacent the lumenal intersection.
- a trunk module includes a first port which sealingly engages the hub module when radially expanded therein. An end opposing the first port seals radially against the surrounding trunk lumen opposite the hub module.
- a prosthetic trunk lumen is provided between the first port and the sealing end.
- the hub module comprises a tubal wall material which is at least partially self-supporting, wherein a portion of the hub between the trunk lumen port and at least one of the first and second branch ports has an enhanced axial flexibility.
- a radially expandable branch module sealingly engages the deployed first branch port of the hub module, and extends along the first branch lumen of the body lumen system away from the luminal intersection.
- the hub module in certain patients, for example, those having aorta iliac regions which are highly distorted by an aneurism, it may be advantageous to form the hub module as a custom molded tubular expandable body wherein the trunk port and branch ports substantially match the trunk lumen in first and second branch lumens of that particular patient's body lumen system.
- the present invention provides a bifurcated endoluminal prosthesis for use within a branching body lumen system having a trunk lumen and first and second branch lumens.
- the trunk lumen will have a larger cross-section than the branch lumens, and the trunk and branch lumens will be in fluid communication at a luminal intersection.
- the prostheses comprises a branch module having a first branch end which is expandable within the first branch of the body lumen system, and also having a second branch end which is expandable within the second branch of the body lumen system, while a branch lumen extends therebetween.
- a trunk port is located between the first and second branch ends, the trunk port sealingly engageable with a first end of a tubular trunk module.
- a second end of the trunk module seals radially against the surrounding trunk lumen of the body lumen system.
- This branch module is particularly advantageous for use in body lumen systems having relatively sharp trunk/branch angles, particularly for installation across the two iliac arteries in patients having relatively advanced aortic aneurysms.
- the present invention provides a bifurcated endoluminal prosthesis for use within a branching body lumen system having a trunk lumen and first and second branch lumens.
- the trunk lumen will have a larger cross-section than the branch lumens, and the trunk and branch lumens will be in fluid communication at a luminal intersection.
- the prostheses comprises a primary module deployable adjacent the lumenal intersection, and a tubular trunk lumen which is supported at least in part by the primary module when expanded therein.
- this structure allows the prostheses to be supported for adjacent healthy branch lumens, for example, allowing endovascular prosthetic therapies for patient's who have relatively healthy iliac arteries, but who do not have sufficiently healthy aortal wall to substantially support a prostheses from between the renal arteries and the iliacs.
- the primary module comprises a tubular first branch module which supports the trunk module from within the first branch lumen of the body lumen system.
- the present invention provides a bifurcated endoluminal prostheses comprising a radially expandable trunk portion having a trunk lumen and a branch end. Radially expandable first and second branch portions extend from the branch end of the trunk portion, with first and second branch lumens, respectively. The first and second branch lumens are in fluid communication with the trunk lumen of the trunk portion, and at least one of the branch portions is compressible within the trunk portion and extendible from the trunk portion when the prostheses is positioned in situ.
- the at least one extendible branch portion preferably comprises an evertable self-supporting or composite structure. Alternatively, the at least one extendible branch portion may slidingly engage the radially expandable trunk portion so that it can telescope into the deployed position after the trunk portion is positioned.
- the present invention further provides a method for deploying and endoluminal prostheses in a branching body lumen system which includes a trunk lumen and first and second branch lumens.
- the trunk and branch lumens are in fluid communication at a luminal intersection, the trunk lumen being larger in cross-section than the branch lumens.
- the method comprises deploying a primary module within the body lumen system adjacent the luminal intersection so that a trunk portion of the primary module extends along the trunk lumen.
- a trunk module is then expanded within the trunk lumen while an end of the trunk module is within the trunk port of the primary module.
- the primary module engages and supports the trunk module, rather than relying substantially entirely on the trunk lumen of the body lumen system for support.
- the present invention provides a method for deploying an endoluminal protheses in a branching body lumen system which includes a trunk lumen and first and second branch lumens which are in fluid communication at a luminal intersection.
- the method comprises positioning a tubular prosthetic branch module across the luminal intersection from the first branch into the second branch so that a trunk port of the branch prostheses module is adjacent to the luminal intersection.
- the positioned branch module is expanded, and a tubular trunk module is positioned within the trunk lumen of the body lumen system with at least one opening adjacent the luminal intersection.
- the positioned trunk module is expanded, wherein expansion of the ladder of the branch module and the trunk module sealingly engages the branch and trunk modules together.
- the present invention provides a method for deploying an endoluminal prothesis in a branching body lumen system of a patient, the branching lumen system including first, second and third lumens in fluid communication at a luminal intersection.
- the method comprises positioning a first guide wire through the luminal intersection by introducing the first wire in through the first lumen and out the second lumen. A distal end of the first wire is threaded through a distal opening of a second guide wire.
- the prostheses may be positioned by selectively tensioning proximal and distal ends of the first wire, and by selectively tensioning the proximal end of the second wire.
- the threaded first wire is returned through the intersection, and the distal end of the second wire is advanced toward the intersection by tensioning the proximal and distal ends of the first wire.
- the first wire is returned back along the second lumen to the intersection, and then out of the patient through the third lumen, allowing the prosthesis to be precisely positioned by tension from each of the three lumens at the luminal intersection.
- the present invention provides a method for producing an endoluminal prosthesis comprising attaching an axially compressible elongate structure to an elongate liver strip and coiling the strip to form a helix having a plurality of loops.
- the adjacent loops may conveniently be attached to form a tube, thereby allowing continuous and automated production of large numbers of coil-supported prostheses.
- the present invention provides a sealing structure for sealing an end of a tubular endoluminal prosthesis against a plurality of flexible sealing flaps extending from the prosthesis adjacent the end.
- the sealing flaps are resiliently biased to flaps radially outward so as to independently seal against the surrounding lumen.
- the present invention provides an endoluminal prosthesis comprising a tubular liner and a frame supporting the tubular liner.
- the frame defines a plurality of loops having axially oriented apices, at least some of these adjacent apices on adjacent loops being offset to enhance axial flexibility of the prosthesis.
- FIG. 1 is a side view of an exemplary cylindrical vascular stent-graft having axially constant characteristics.
- FIG. 2 is a perspective view of an exemplary delivery catheter for use with the prostheses of the present invention, with a portion of the distal end broken away to disclose a prostheses therein.
- FIGS. 3 A- 3 C illustrate a bifurcated endovascular prosthesis having a relatively rigid expanded Y-connector portion, axially flexible branch and trunk portions, and sealing/anchoring cuffs, according to the principles of the present invention.
- FIG. 4 illustrates a prostheses having two stent-graft portions connected by a flexible joint comprising an integrally ribbed polymer tube.
- FIGS. 5 A- 5 D illustrate an endoluminal prosthetic structure in which a frame is supported by a helical coil of expansible diamond shaped elements, for use in the flexible portions of the prosthesis of FIGS. 3 A- 3 C.
- Fig. 5E illustrates a method for making an endoluminal prosthesis having a helical coil by first attaching the coil material to a strip of liner material, winding the liner strip over a mandrel, and sewing the strip in a helical shape.
- FIGS. 5 F- 5 H illustrates alternative stent-graft sealing structures, according to the principles of the present invention.
- FIGS. 6 A- 6 C illustrate alternative flexible prosthetic structures in which the liner is supported by a plurality of cylindrical segments.
- FIG. 7A illustrates an endoluminal prosthetic structure in which a liner is supported by a plurality of self-expanding loops, and in which serpentine malleable connectors extend between adjacent loops, according to the principles of the present invention.
- FIGS. 7 B- 7 G show alternative connector structures and connector attachment mechanisms for use in the prosthesis of FIG. 7A.
- FIGS. 8 A- 8 F illustrate a method for deploying a self-supporting endoluminal hub module within a luminal intersection, according to the principles of the present invention.
- FIGS. 9 A- 9 B illustrate alternative endoluminal hub modules having flexible portions between their trunk and branch portions.
- FIGS. 10 A- 10 C illustrate a method for positioning guide wires adjacent to a luminal intersection to promote precise positioning of an endoluminal prostheses by selectively tensioning opposed guide wire ends, according to the principles of the present invention.
- Figs. 11 A- 11 C illustrate a method for deploying a branching endoluminal prostheses by first deploying a branch module which extends across the trunk lumen and extending into opposing branch lumens, and by then deploying a trunk module within a trunk port of the branch module, according to the principles of the present invention.
- FIG. 12 illustrates an alternative branching endoluminal prostheses in which a branch module is positioned through a deployed trunk module, according to the principles of the present invention.
- FIG. 13 illustrates an alternative branching inner luminal prostheses in which independent branch modules are deployed within an expanded trunk module.
- FIGS. 14 A- 14 B illustrate a method for deploying a branching endoluminal prostheses in which a spacer module is first deployed to provide support for the trunk module from adjacent to the branch lumens of the body lumen system.
- FIGS. 15 A- 15 B illustrate a method for deploying a branching prostheses in which a tapering primary module is first deployed adjacent a luminal intersection, according to the principles of the present invention.
- FIGS. 16 A- 16 B illustrate a still further alternative method for deploying a branching endoluminal prostheses in which the trunk module is deployed within and supported by a previously deployed branch module, according to the principles of the present invention.
- FIGS. 17 A- 17 D illustrate an alternative branching endoluminal prostheses in which at least one branch portion is compressed within the trunk portion during positioning and deployment.
- FIGS. 18 A- 18 B illustrate alternative branching endoluminal prosthetic structures having reduced compressed frame volumes and adjustable branch lengths, according to the principles of the present invention.
- FIG. 19 illustrates a branching endoluminal prosthesis having a short trunk portion to increase overall axial flexibility, according to the principles of the present invention.
- the present invention provides radially expansible tubular prostheses, particularly grafts, stents, and stent-grafts, which are highly adaptable to varying luminal system geometries.
- the prostheses of the present invention are suitable for a wide variety of therapeutic uses, including stenting of the ureter, urethra, trachea, branchi, esophagus, biliary tract, and the like.
- the present devices and methods will also be useful for the creating of temporary or long term lumens, such as the formation of fistulas.
- the prosthetic structures of the present invention will find their most immediate use as endovascular prostheses for the treatment of diseases of the vasculature, particularly aneurysms, stenoses, and the like, and are especially well suited to the distorted aortal/iliac junction of persons having advanced vascular diseases.
- These prostheses will generally be radially expansible from a narrow diameter configuration to facilitate introduction into the body lumen, typically during surgical cutdown or percutaneous introduction procedures.
- prosthetic structures described hereinbelow will find use in axially uniform cylindrical prostheses, in preassembled bifurcated prostheses, and as prosthetic modules which are suitable for selective assembly either prior to deployment, or in situ.
- Such selective assembly of prosthetic modules to form a customized endoluminal prosthesis is more fully described in co-pending U.S. patent application Ser. Nos. 60/008,254 and 08/538,706 (Attorney Docket Nos. 16380-34 and 16380-38) the full disclosures of which have previously been incorporated herein by reference.
- Prostheses 10 comprises a perforate tubular frame 12 which includes a plurality of independent (non-connected) ring frames 14 .
- the tubular frame 12 supports an inner frame 18 .
- an outer liner is disposed over the ring frames, either inside of inner liner 18 , or in combination therewith.
- the liner is typically sutured to the frame.
- a wide variety of alternative liner/frame attachment mechanisms are available, including adhesive bonding, heat welding, ultrasonic welding, and the like. Where inner and outer liners are used, the ring frames may be sandwiched between the liners and held in place by attaching the liners to each other.
- the prostheses 10 will typically have a length in the range from about 20 mm to 500 mm, preferably from 50 mm to 200 mm, with a relaxed diameter in the range from about 4 mm to 45 mm, preferably being in the range from about 5 mm to 38 mm.
- Alternative stent-graft structures are more fully described in U.S. application Ser. No. 08/538,706 (Attorney Docket No. 16380-38), previously incorporated by reference.
- an exemplary delivery catheter 30 for use with the endoluminal prostheses of the present invention comprises a tubular cover 32 and a shaft 34 .
- Cover 32 has a central lumen 36 extending from a proximal end 38 to a distal end 40 .
- Shaft 34 is slidably received within central lumen 36 and extends proximally of cover 32 .
- a plurality of runners 42 extend distally from shaft 34 .
- Runners 42 line a portion of the inner surface of lumen 36 , and slide within the lumen of the shaft.
- Shaft 34 also has a lumen, in which a core shaft 44 is slidably disposed.
- Core shaft 44 has a guide wire lumen 46 .
- Nosecone 48 is fixed to the distal end of core shaft 44 , and can therefore be manipulated independently of runners 42 .
- Prostheses 10 is radially compressed and restrained within the plurality of runners 42 .
- cover 32 prevents runners 42 from expanding outward.
- Runners 42 are formed from a hard material, and distribute the expansion load of prostheses 10 over the inner surface of central lumen 36 .
- the deploying force is applied proximally against a slider 50 attached to a distal end 38 of cover 30 , while holding a luer fitting 52 at the distal end of shaft 34 , thereby withdrawing the cover proximally from over the prostheses.
- An additional luer adapter 54 at the distal end of core shaft 44 allows the core shaft to be manipulated independently, and to be releasibly secured to the shaft 34 .
- an exemplary branching endovascular protheses 60 comprises a lumen separation portion 62 between a trunk portion 64 and two branch portions 68 .
- Lumen separation portion 62 preferably comprises a relatively rigid structure, having higher column and hoop strength than the remainder of the prostheses.
- the lumen separation portion comprises a flexible liner supported by a resiliently expanding frame.
- the cross-section of the frame adjacent the branches includes discrete lobes which correspond to the first and second branches, and also includes an isthmus therebetween to help prevent an imbalance of flow from the trunk portion to the branch portions.
- Such a lumen separation portion is more fully described in parent application (Attorney Docket No. 16380-003400), also previously incorporated by reference.
- the perforate frame of lumen separation portion 62 is continuous along its axial length, increasing the column strength of the lumen separation so that the flow separation geometry of the branching inner lumen remains constant regardless of the flexing of the trunk and/or branch portions.
- branch portions 68 The advantageous flexibility of branch portions 68 is shown most clearly in FIG. 3B, in which prostheses 60 is shown deployed within an abdominal aorta A downstream of the renal arteries RA, extending beyond an abdominal aortic aneurism AA, and into the right and left iliac arteries RI, LI.
- Branch portions 68 have relatively high axial flexibility to accommodate the extreme angles between the iliac and abdominal arteries which have been found in patients having such aneurysms.
- Trunk sealing cuff 66 and branch sealing cuffs 70 securely anchor the prostheses against the healthy tissue beyond the aneurism, and also seal the prosthetic lumen against the surrounding endolithium of the body lumen system.
- Trunk sealing cuff 66 will often comprise a polyester such as DacronTM, preferably in an expansible form, ideally as a fabric woven with partially oriented or unoriented polyester fibers in the fill or weave.
- polyester or some other fiber which has been wrapped around a core fiber to allow expansion may be used, or the sealing cuff may comprise a PTFE, silicone, or polyurethane foam to promote sealing between the prosthetic lumen and the surrounding body lumen.
- Exemplary sealing cuff structures are more fully described in co-pending U.S. patent application Ser. Nos. 08/525,989 and 08/538,706, filed Oct. 3, 1995, and Sep. 8, 1995 (Attorney Docket Nos. 16380-30 and -38), the full disclosures of which are incorporated herein by reference.
- trunk portion 64 One particular advantage of the axial flexibility of trunk portion 64 can be understood with reference to the lateral view of the abdominal aorta illustrated in FIG. 3C.
- the aneurysm AA generally distends the abdominal aorta, the specific shape and extent of the aneurysm can vary widely. Even when healthy, the abdominal aorta often angles dorsally just downstream of the renal arteries. The presence of this bend B often persists despite the general distension of the abdominal aorta.
- flexible trunk portion 64 allows the trunk sealing cuff 66 to anchor securely along the axis of the healthy abdominal aorta adjacent the renal arteries, and greatly helps to reduce perimeter leaks around the upstream end of the trunk portion.
- the trunk portion would tend to have a relatively high rigidity and column strength, due to its relatively large cross-section (which must accommodate the combined flow for both iliac arteries).
- the flexible trunk and leg portions will preferably maintain sufficient hoop strength so that their respective lumens remain open throughout a wide range of branch positions, and despite normal physiological movement and environmental stress from the surrounding body lumen.
- the flexible trunk and leg portions will preferable comprise a coiled prosthetic structure or a radially expandable, axially malleable structure as described hereinbelow.
- the flexible trunk and branch portions may comprise an unsupported (or self-supporting) liner.
- jointed prosthesis structure 72 provides axial flexibility and kink resistance, and may therefore find use in the flexible sections of exemplary branching endoluminal prosthesis 60 (see FIG. 3A).
- Jointed prosthesis 72 includes a plurality of stent-graft portions 74 with a joint portion 76 therebetween.
- Stent-graft portions 74 comprise a liner 80 supported by a perforate radially expandable frame 78 .
- joint portion 76 comprises an integrally ribbed polymer tube, as taught by U.S. Pat. Nos. 4,647,416 and 4,550,447, the full disclosures of which are incorporated herein by reference.
- the joint comprises a ribbed PTFE tube which extends continuously to form the liners of the stent-graft portions.
- the framed structure of the stent-graft portion provides the column and hoop strength to support the inner lumen, while the self-supporting joint structure allows the jointed prosthesis to easily adapt to tortuous body lumens. It may be advantageous to provide a series of such liner will preferably include ribs 92 disposed between the adjacent loops 90 of expandable coil 84 .
- a method of fabricating a helical stent-graft 71 will be described with reference to FIG. 5E.
- a series of linked diamond-shaped elements 73 are first attached to a strip of liner material 75 , typically being stitched with a sewing machine.
- the ribbon is then wound over a mandrel 77 of the desired size, and adjacent edges of the ribbon are sewn to each other (or otherwise permanently joined).
- Such a method may be substantially automated and continuous, and is thus particularly beneficial for producing a large number of prostheses.
- the helical stent-graft may optionally be cut to length, but will preferably include a crown stitched stent-ring 79 for sealing and ends against a surrounding lumen when deployed therein.
- a novel feature of helical stent-graft 71 which will have application in a wide range of stent-graft structures is the offsetting of apices 69 .
- Diamond-shaped elements 73 define axially oriented apices 69 at regular intervals along the loops.
- the adjacent apices may optionally be offset from the adjacent apices, each apex ideally being roughly equally spaced from the two adjacent apices as shown.
- this increases axial flexibility by allowing the liner to flex between loops but without substantially decreasing hoop strength.
- the column strength may be selectively and locally increased (and axial flexibility correspondingly decreased) by adjusting the winding of ribbon 75 so that the adjacent apices are substantially aligned.
- aligned apices may be selectively attached to each other, for example, with a lock stitch pattern (as shown in FIG. 5, 4, and more fully explained in co-pending U.S. patent application Ser. No. 08/538,706, filed Oct. 3, 1995 (Attorney Docket No. 16380-003800), previously incorporated herein by reference), to greatly reduce axial flexibility where desired.
- a lock stitch pattern as shown in FIG. 5, 4, and more fully explained in co-pending U.S. patent application Ser. No. 08/538,706, filed Oct. 3, 1995 (Attorney Docket No. 16380-003800), previously incorporated herein by reference
- FIGS. 5 F-G Alternative sealing structures are illustrated in FIGS. 5 F-G.
- liner 81 is split at one end to form a plurality of sealing flaps 83 .
- the sealing flaps are substantially unsupported by the frame.
- the frame adjacent sealing flaps 83 includes axially elongate members which support the sealing flaps, for example, elongate diamonds 85 or fingers 87 .
- These elongate member (or the sealing flaps themselves) are preferably resiliently biased radially outward, typically by heat setting over a tapered mandrel.
- the flaps may fold back along the prosthesis when the prosthesis is compressed for deployment. Regardless, each sealing flap will preferably expand radially outward substantially independently of the other sealing flaps, thereby improving the seal between the end of the prosthesis and a highly irregular body lumen.
- more than one row of overlapping sealing flaps may also be used.
- an alternative flexible prosthetic structure may be fabricated by cutting a cylindrical corrugated polyester graft 96 into a series of cylindrical segments.
- the cylindrical segments may then be used as reinforcing elements by attaching them axially along an expansible tube 100 .
- Suitable expansible tubes may be formed from partially oriented yarn, polypropylene, polyethylene, annealed polyester, PTFE, or the like.
- the reinforcing elements are preferably free to slide over each other as the liner is expanded in situ, and provide some column strength, hoop strength, and kink resistance while also allowing the reinforced lumen to flex axially.
- a plurality of expansible fibers or yarns 102 could be wrapped around the exterior of the corrugated graft segments to hold the structure in a compact profile, and yet still allow expansion.
- outer fibers 102 may be frangible, breaking under a predetermined force to allow the prosthesis to be expanded in situ to the desired size.
- An internally supported flexible structure 104 having similar internal reinforcing elements 106 may optionally avoid the use of the external wrapping yarns.
- Flexible structure 110 comprises a radially expandable liner 112 supported by a plurality of ring frames 114 .
- a series of connector elements 116 extend between adjacent ring frames 114 .
- connector elements 116 may also be used to support the liner 112 .
- the connector elements and ring frames may be independently optimized to tailor the mechanical properties of the prosthesis structure, particularly for use as a flexible trunk or branch position in the branching prosthesis of FIG. 3A.
- flexible prosthetic structure 110 may find use as a stent, or as a cylindrical stent-graft.
- the ring frames comprise resilient self-expanding structures, ideally comprising a super-elastic shape memory alloy such as NitinolTM.
- Connectors 116 preferably comprise a malleable material, ideally including martensitic NitinolTM, stainless steel, cobalt-nickel alloy, titanium, or tantalum.
- the connector elements can provide additional column strength to the prosthetic structure, as well as providing support to the liner between the ring frames.
- such malleable connectors may also provide a structure which will expand resiliently when deployed in situ, and which will conform plastically to an axially tortuous body lumen, such as the blood vessels of the vascular system.
- connector elements 116 comprise serpentine elements which extend axially between adjacent frame loops. Careful selection of the serpentine shape allows tailoring of the bending properties of the prosthesis. Such serpentine connector elements located at the outer portion of an axial bend in the prosthesis will be straightened, while those at the inner portion will decrease in length, optionally maintaining the axial length of the prosthesis at a relatively constant amount. Alternatively, the connector elements may rely primarily (or solely) on either elongation or compression alone, thereby inducing changes in the length of the prosthesis when bent.
- FIGS. 7 B-D illustrate alternative connector element structures.
- a flat connector element 118 may be cut from a flat sheet of the desired malleable material, and optionally includes ends 120 having passages cut therethrough to facilitate attachment of the connector element to the resilient frame structure.
- Such a flat structure has the advantage of not decreasing the internal prosthetic lumen cross-section within a narrow body lumen, and the flat serpentine shapes may be cut from sheet stock using known laser cutting, lithography techniques, or the like.
- a wire connector element 122 having bent loop ends 124 may be formed as a helical coil.
- a bent connector element 126 may be formed from a straight strip of malleable material, as shown in FIG. 7D, and may also include folded ends 128 .
- a wide variety of alternative metallic or polymer connector structures may be suitable. Generally, it will be preferable to make use of materials which are both malleable and biocompatible, as described above.
- FIGS. 7 E-G A variety of alternative attachment mechanisms for coupling the frame structure to the connector elements are shown in FIGS. 7 E-G, and also in FIG. 7A.
- the connector elements may be attached to the frame loops by welding, soldering, adhesive bonding, polymer rivets, suturing, or the like.
- members which extend from a resilient frame and which have been formed to the desired shape and heat treated or otherwise processed to produce the desired malleable properties.
- the mechanism used to attach the resilient frame to the connector elements will also attach the liner to the frame, for example, stitching which extends through passages in both the connector elements and the frame, and then through a woven textile liner.
- An oversized suture loop 130 between a ring frame 14 and passage 120 of flat connector element 118 provides a limited amount of axial motion.
- an axial slot 134 in a slotted frame 132 provides a precisely controlled amount of axial motion of a loop 136 on a wire connector element 138 .
- loop 136 may further be reinforced by suture, wire, adhesive, or the like.
- the end of the connector element may be folded over a ring frame 14 , and optionally adhesively bonded in place, to provide a positive connection.
- connectors 116 compress or elongate plastically under forces typical of those imposed on the prosthesis during deployment.
- the connector elements may advantageously be constructed to avoid deformation from these normal blood and tissue in vivo forces, particularly where a limited amount of axial motion is allowed between connector elements and the ring frames. Therefore, the prosthesis structure can plastically deform during deployment to conform the axis of the prosthesis with the surrounding body lumen, but will thereafter avoid imposing resilient straightening forces against the body lumen.
- a method for assembling in situ an endoluminal prosthesis by first positioning and deploying a hub module will be described with reference to FIGS. 8 A-E.
- a branch access catheter 140 is used to insert guidewires 142 down the aorta A and into the left iliac LI and right iliac RI.
- the branch access catheter 140 preferably comprises a deflecting tip branch access catheter as taught by U.S. Pat. No. 4,774,949, the full disclosure of which is incorporated herein by reference.
- a resilient hub module 144 is advanced over both guidewires 142 while compressed within delivery sheath 146 .
- Hub module 144 preferably comprise an elastic sponge-like microporous silicone, silicone foam, low purometer silicone, polyurethane foam or the like, as more fully described in co-pending U.S. patent application Ser. No. 08/525,989, filed Sep. 8, 1995, (Attorney-Docket No. 16380-003000) the full disclosure of which is incorporated herein by reference.
- Hub module 144 which may be stented or unstented, is deployed over guidewires 142 at the luminal intersection I of the aorta A and left and right iliacs LI, RI, optionally extending along the iliacs beyond the aortic aneurysm AA.
- hub module 144 is deployed by a combination of distally advancing pusher shaft 148 and proximally withdrawing catheter sheath 146 so that a trunk portion 150 of the hub module remains within the aorta, while branch portions 152 extend into each of the iliacs.
- the hub module wall material will preferably be at least in part self-supporting, but may be reinforced adjacent the trunk or branch ports for sealing and to provide sufficient hoop strength to allow prosthetic modules to sealingly engage the hub from within.
- aortic aneurysm AA it may be possible to completely seal off aortic aneurysm AA by positioning a trunk module 154 within trunk port 150 and expanding the trunk module to sealingly engage the hub module and the healthy aorta upstream of the aneurysm, as illustrated in FIG. 8E.
- a four branch hub module 158 similar in structure to hub module 144 , may find use in sealing off the upper end of an aneurysm which extends to or along the renal arteries, optionally making use of a renal branch module 160 similar to branch module 156 described above.
- one or more hubs may be securely attached to (and deployed with) a trunk stent-graft.
- the exemplary microporous silicone can adapt to a range of luminal intersection geometries, it may be advantageous to provide a variety of hub modules having differing angles to accommodate a wider variety of vascular geometries, allowing selection of a suitable hub for each patient. In extreme cases, it may even be preferable to custom mold a hub module for a specific patient's vasculature, preferably based on information provided by fluoroscopy, ultrasound, or some other imaging modality.
- corrugated portions 162 or braided portions 164 between the trunk port 150 and the branch ports 152 may be advantageous to include corrugated portions 162 or braided portions 164 between the trunk port 150 and the branch ports 152 as illustrated in FIGS. 9 A-D.
- Such corrugated structures accommodate compression along the inside of a tight bend radius without kinking, while braided structures are inherently kink resistant when bent.
- Similar enhanced flexibility portions may be used at the junctions of a trifurcation to increase the conformability of an aortal renal hub module, similar to renal hub module 158 shown in FIG. 8F.
- first deploying the hub module adjacent the intersection of the aorta and iliac arteries allows the trunk module to be supported at least in part from the luminal intersection, particularly during deployment.
- a guidewire 166 is introduced from an inferior position and advanced along the right iliac, RI beyond the luminal intersection I, through the aorta A to the subclavian-or carotid artery, where the guidewire is extended out of the patient body.
- Guidewire 166 can then be threaded through a loop 168 in a second guidewire 170 , and the distal end of guidewire 166 be again maneuvered back through the aorta, beyond the luminal intersection I, along one of the iliac arteries, and again extended out of the patient body.
- a proximal end 172 and distal end 174 of guidewire 166 may be selectively tensioned to advance second guidewire 170 down the aorta to the luminal intersection I.
- guidewire 166 may be fed inward and outward through the same iliac to allow loop 168 to be positioned relative to the aortic and one of the two iliac arteries.
- guidewire 166 may be fed inward through, and outward from, alternative iliac arteries.
- tensioning the proximal and distal ends of guidewire 166 and the proximal end of second guidewire 170 precisely positions hoop 168 relative to the luminal intersection I.
- this method provides multiple points of control and access to fine tune endoluminal prosthesis placement, and allows prosthetic modules to be advanced along either end of guidewire 166 or along second guidewire 170 to the precisely positioned loop 168 .
- the iliac arteries may define substantial angles relative to the aorta, particularly on patients having abdominal aortic aneurysms. This often complicates the positioning of a tightly compressed (and therefore relatively stiff) endoluminal prosthesis across the lumenal intersection from the aorta to the iliac arteries.
- Branch module 176 may be advantageous to instead position and deploy a branch module 176 extending across the luminal intersection I from the right iliac to the left iliac, as illustrated in Fig. 11A.
- Branch module 176 will generally include a trunk port 180 which is preferably oriented along the aorta, as shown in Fig. 11B.
- a radiographic marker 178 which provide a visual representation of the expanded module under imaging.
- a balloon catheter 182 may be used to hold branch module 176 in position during deployment of a trunk module 184 into sealing engagement with trunk port 180 .
- branch module 176 may alternatively be deployed through branch ports 186 of a previously deployed primary trunk module 188 . Flow for the two iliacs thus enters the branch module within the lumen of primary trunk module 188 through trunk port 180 .
- a somewhat similar arrangement, which makes use of independent branch modules 190 that sealingly engage an alternative primary trunk module 192 at branch ports 186 is illustrated in FIG. 13.
- a spacer module 192 may first be deployed adjacent the luminal intersection I, preferably with a lower surface 196 in contact with the bifurcation B of the body lumen system. Spacer module 192 is selected so that an upper surface 198 is at the proper distance from the lower surface 196 so that a bifurcated trunk module 194 resting on upper surface 198 is correctly positioned just downstream of the renal arteries. Branch modules may then be positioned through the spacer module and into the branch ports of the bifurcated trunk module to complete the bifurcated prosthesis assembly. Clearly, one or more of the branch portions may optionally be formed integrally with the trunk portion, within the scope of the present invention.
- Tapered primary module 202 includes a wide branch end 204 which is optionally deployed within the luminal intersection so as to be supported by the body lumen bifurcation B.
- the wide branch end 204 facilitates engaging branch modules 208 from widely divergent iliac arteries, and may also help support a trunk lumen sealing module 206 from the bifurcation of the body lumen, as shown in FIG. 15B.
- the present invention also provides supporting in situ endoluminal prosthesis assembly from within the iliac, as illustrated in FIGS. 16 A-B.
- a branch prosthetic module 210 is first deployed within a relatively healthy renal artery.
- One branch port 212 of a bifurcated prosthetic module 214 is then positioned and expanded within branch module 210 .
- a second branch module is then positioned within an alternate branch port of the bifurcated modules 214 , completing the in situ assembly of the bifurcated prosthesis system.
- an extendable leg bifurcated prosthesis 216 may have one or more leg portions 218 disposed within the trunk portion 220 when the prosthesis is radially compressed for positioning and deployment.
- the leg may be everted within the trunk portion, the leg preferably comprising a self-supporting or composite material.
- the leg may slidingly engage the trunk portion and telescope out into position. In either case, disposing the leg within the trunk portion greatly facilitates positioning the prosthesis across the luminal intersection I.
- FIGS. 18 A-B achieve such iliac leg placement flexibility by extending a relatively rigid iliac module through bifurcation modules 232 , 234 , optionally even allowing iliac module 230 to extend in cantilever beyond renal arteries RA. Additionally, by minimizing the length of the trunk lumen portion of the prosthesis, the mass of each module is minimized, facilitating intravascular maneuvering.
- bifurcation module 234 includes a lower support portion 236 having the two-lobed cross-section which is described in co-pending U.S. patent application Ser. No. 08/538,706 (Attorney-Docket No. 16380-003800), previously incorporated herein by reference.
- the relatively narrow mid-section 238 allows axial bending of the assembled prosthesis through the aneurysm to adapt to physiological movement.
- a short trunk branching prosthesis includes a lumen separation portion 242 which is adjacent to a trunk sealing cuff 246 , here shown as a single independent ring frame which is crown stitched to the liner.
- the branch portions 248 will tend to have good axial flexibility due to their significantly smaller diameter than the trunk. Hence, the branch portions may be supported by independently ring-frames.
Abstract
The present invention provides a branching endoluminal prosthesis for use in branching body lumen systems which includes a trunk lumen and first and second branch lumens. The prostheses comprises a radially expandable tubular trunk portion having a prosthetic trunk lumen, and radially expandable tubular first and second branch portions with first and second prosthetic branch lumens, respectively. A radially expandable tubular Y-connector portion provides fluid communication between the prosthetic trunk lumen and the first and second prosthetic branch lumens. Although it is often considered desirable to maximize the column strength of endoluminal prostheses, and although the trunk portion will generally have a larger cross-section than much of the remainder of a branching endoluminal prostheses, the expanded trunk portion is more axially flexible than the expanded Y-connector portion, as insufficient flexibility along the trunk portion may result in leakage between the prosthesis and the trunk lumen of the body lumen system. In contrast, the Y-connector portion benefits form a less axially flexible structure to avoid distortion of the flow balance between the luminal branches.
Description
- This application is a continuation of U.S. patent application Ser. No. 08/615,697, filed Mar. 13, 1996, which is a continuation-in-part of provisional U.S. patent application Ser. No. 60/008,254 (Attorney Docket No. 16380-003400), filed Dec. 1, 1995, the full disclosure of which is incorporate herein by reference.
- 1. Field of the Invention
- The present invention relates generally to tubular prostheses, such as grafts, stents, stent-grafts, and the like. More particularly, the present invention provides radially expandable tubular prosthetic structures which are deployable within tortuous body lumens, particularly within branching blood vessels for the treatment of abdominal and other aneurysms.
- Vascular aneurysms are the result of abnormal dilation of a blood vessel, usually resulting from disease and/or genetic predisposition, which can weaken the arterial wall and allow it to expand. While aneurysms can occur in any blood vessel, most occur in the aorta and peripheral arteries, with the majority of aortic aneurysms occurring in the abdominal aorta, usually beginning below the renal arteries and often extending into one or both of the iliac arteries.
- Aortic aneurysms are most commonly treated in open surgical procedures, where the diseased vessel segment is bypassed and repaired with an artificial vascular graft. While considered to be an effective surgical technique, particularly considering the alternative of a usually fatal ruptured abdominal aortic aneurysm, conventional vascular graft surgery suffers from a number of disadvantages. The surgical procedure is complex and requires experienced surgeons and well equipped surgical facilities. Even with the best surgeons and equipment, however, patients being treated frequently are elderly and weakened from cardiovascular and other diseases, reducing the number of eligible patients. Even for eligible patients prior to rupture, conventional aneurysm repair has a relatively high morality rate, usually from 2% to 10%. Morbidity related to the conventional surgery includes myocardial infarction, renal failure, impotence, paralysis, and other conditions. Additionally, even with successful surgery, recovery takes several weeks, and often requires a lengthy hospital stay.
- In order to overcome some or all of these drawbacks, endovascular prosthesis placement for the treatment of aneurysms has been proposed. Although very promising, many of the proposed methods and apparatus suffer from undesirable limitations. In particular, proper matching of an endovascular prosthesis with the complex and highly variable vascular geometry can be problematic.
- Proper matching of the prosthesis to the proximal neck of the aortic vessel and the branching blood vessels is critical to the treatment of an aneurysm. The prosthesis preferably extends axially beyond the weakened portion of the blood vessel to anchor securely in the less diseased vessel wall. To prevent the leakage of blood through a ruptured aneurysm, and also to prevent the release of thrombus from within the distended aneurysm and into the bloodstream, it is also preferable that the prosthetic lumen be substantially sealed against the healthy endolithium. The prosthetic lumen should remain open despite physiological movement of the vasculature and environmental stresses, so as to promote the free flow of blood. Furthermore, the geometry of the prosthetic lumen at the luminal intersection where the abdominal aorta meets the iliac arteries is of particular importance, as this bifurcation can have a significant impact on the relative blood flows through the two iliac arteries.
- Unfortunately, the size, extent, and specific geometry of abdominal aortic aneurysms can vary widely from patient to patient. While the aneurysm is often downstream of the renal arteries, as noted above, it may begin in very close proximity to these lateral branching blood vessels, and in some cases will extend up to, above, and along the renals themselves. Additionally, while the aneurysm itself is typically a distension of the vessel wall, the path the prosthesis must follow within the diseased vessel may be fairly convoluted. For example, the abdominal aorta typically defines a significant bend between the renal arteries and the iliac arch when viewed from a lateral position. This aortic bend often remains quite pronounced despite the presence of the distended aneurysm, and complicates the sealing and anchoring of the endoluminal prosthesis adjacent the renal arteries.
- Abdominal aortic aneurysms also appear to have a significant effect on the geometry of the intersection between the abdominal aorta and iliac arteries. Even among healthy patients, there are significant variations in the angles defined by the iliac arteries relative to the aorta, typically being anywhere in the range between 15-45°. The variation in aorta iliac angularity is often much wider in patients seeking therapy for aneurysms. In fact, iliac arteries which branch off from an aorta with a local angle of over 90° have been found in aneurysm patients.
- Known branching endoluminal prostheses are generally formed as tubular, radially expandable stent-grafts. In contrast with the convoluted branchings of diseased body lumens, these stent-graft structures have typically been formed with simplistic cylindrical frames or “stents.” A separate liner or “graft” is typically attached to the frame to prevent blood flow through a ruptured vessel wall. Such liners are often formed from inelastic fabrics to prevent pressure from distending a weakened luminal wall. Typically, these branching structures are primarily supported from immediately below the renal arteries. Patients may not be eligible for these known endovascular aneurysm therapies if this portion of the aorta is weakened by disease.
- The branching stent-graft structures of the prior art have generally comprised uniform structures, in which the smaller iliac branch portions form cylinders which are substantially parallel to the aortic portion when the prosthesis is at rest. Although these straight branching prostheses are intended to deform somewhat to accommodate the branch angles of body lumen systems, the imposition of substantial axial bends on known endovascular stent-grafts tends to cause folding, kinking, or wrinkling which occludes their lumens and degrades their therapeutic value. Still another disadvantage of known bifurcated stent-grafts is that even when they are flexed to accommodate varying branch geometry, the prosthetic bifurcation becomes distorted, creating an unbalanced flow to the branches. To overcome these limitations, it has often been necessary to limit these highly advantageous, minimally invasive endovascular therapies to patients having vascular geometries and abdominal aortic aneurysms which fall within very narrow guidelines.
- For these reasons, it would be desirable to provide improved endoluminal prostheses and methods for their use. It would further be desirable to provide improved branching endoluminal prostheses, and improved methods for placement of such prostheses. It would be particularly desirable to provide endoluminal prostheses (and methods for deploying them) which would accommodate widely varying lumen system geometries, and which would thereby increase the proportion of patients eligible to receive these highly advantageous endoluminal prosthetic therapies for treatment of abdominal aortic aneurysms and other disease conditions of the body lumen systems.
- 2. Description of the Background Art
- Co-pending U.S. patent application Ser. No. 08/538,706 (Attorney-Docket No. 16380-003800), filed Oct. 3, 1995, the full disclosure of which is hereby incorporated by reference, describes modular prostheses and construction methods. Parent Provisional Application (Attorney-Docket No. 16380-003400), previously incorporated herein by reference, describes bifurcated modular prosthetic structures and methods for assembling them in situ.
- U.S. Pat. No. 5,064,435 describes a self-expanding prosthesis which maintains a stable axial length during radial expansion by anchoring of radial outward flares at each end, and by sliding of an overlapping medial region therebetween. U.S. Pat. No. 5,211,658 describes a method and device for endovascular repair of an aneurysm which makes use of separately introduced frame and liner structures. A similar method of repairing blood vessels is described in U.S. Pat. No. 5,078,726, in which a locking stent is expanded within a vascular graft which has been positioned within the blood vessel. The in situ deployment of an aortic intraluminal prosthesis by a catheter having two inflatable balloons is described in U.S. Pat. No. 5,219,355.
- European patent application publication no. 0 551 179 describes a method for deploying two tubular grafts which extend in parallel from the renals and into the aorta. U.S. Pat. No. 5,360,443 describes a bifurcated aortic graft which is secured to the aorta by a plastically deformable frame positioned between the renal arteries and the iliacs. Soviet Patent 145-921 describes a bifurcated blood vessel prosthesis having a fastening element which extends past the renal arteries to prevent migration. U.S. Pat. No. 4,774,949 describes a catheter having a lumen adapted to access branch arteries.
- U.S. patent application Nos. 4,550,447 and 4,647,416 describe vascular PTFE grafts which include transverse ribs integral with a tube wall, and methods for their production. U.S. patent application No. 5,443,499 describes a radially expandable tubular prostheses for intraluminal implantation within children. U.S. patent application Nos. 5,229,045 and 5,387,621 describe porous membranes based on unstable polymer solutions which are suitable for vascular prostheses, and methods for their production.
- In a first aspect, the present invention provides a branching intraluminal prostheses for use in a branching body lumen system that includes a trunk lumen and first and second branch lumens. The prostheses comprises a radially expandable tubular trunk portion having a prosthetic trunk lumen, and radially expandable tubular first and second branch portions with first and second prosthetic branch lumens, respectively. A radially expandable tubular lumen separation portion provides fluid communication between the prosthetic trunk lumen and the first and second prosthetic branch lumens. Surprisingly, the expanded trunk portion is preferably more axially flexible than the lumen separation portion.
- Although it is often considered desirable to maximize the column strength of endoluminal prostheses, and although the trunk portion will generally have a larger cross-section than much of the remainder of a branching endoluminal prostheses, in connection with the present invention it has been found that insufficient flexibility along the trunk portion may result in leakage between a bifurcated prosthesis and the trunk lumen of the body lumen system. Specifically, leaks will be produced between known uniform bifurcated prostheses and the dorsal bend which is typically found immediately downstream of the renal arteries along the abdominal aorta. On the other hand, the lumen separation portion benefits from a less axially flexible structure to avoid distortion of the flow balance between the luminal branches when conforming the prosthetic geometry to a torturous body lumen system. The present invention therefore provides non-uniform prosthetic structures which are locally optimized to meet these contradictory requirements.
- Preferably, a trunk sealing cuff is provided opposite the Y-connector to seal between the prosthetic trunk lumen and the trunk lumen of the body lumen system. Similarly, the first and second branch portions are also more axially flexible than the lumen separation portion, and ideally include branch sealing cuffs opposite the lumen separation. These sealing cuffs may also benefit from relatively stiff structures, particularly where they help to anchor the prosthesis within the body lumen. The resulting prosthetic structure separates the luminal sealing, the axial conforming, and the flow separating functions of the branching prostheses to distinct axial portions of the prosthetic structure, allowing these portions to be still further independently optimized.
- In another aspect, the present invention provides an endoluminal prosthesis comprising first and second prosthesis portions including first and second radially expandable frames defining first and second axes, respectively. The frames support tubular liners having lumens. A flexible joint between the first and second prosthesis portions provides open fluid communication between the first and second lumens when the first and second axes are at an angle, the flexible joint comprising a self-supporting liner which includes a polymer tube having integral ribs.
- In yet another aspect, the present invention provides an endoluminal prosthesis comprising a radially expandable tubular liner having a lumen which defines an axis. A helical coil supports the liner, the coil defining a plurality of loops which are separated to enhance the axial flexibility of the prosthesis. The helical coil elongates during expansion of the liner to avoid unwinding of the coil relative to the liner. Hence, the coil may be attached at a plurality of attachment points along the length of the coil. Preferably, the coil comprises linked diamond shaped elements, which may expand either resiliently or plastically during deployment.
- In yet another aspect, the present invention provides an endoluminal prostheses for use in a body lumen, the prostheses comprising a radially expandable tubular frame having an axis. The frame includes a plurality of resiliently expandable loops, and also includes a plurality of plastically deformable connector elements extending between adjacent loops to allow the axis to conform to the body lumen.
- Preferably, the connector elements plastically deform at a predetermined load which is greater than environmental forces imposed on the expanded prostheses by the surrounding body lumen, but which predetermined load is preferably less than or equal to forces imposed on the prostheses during deployment. Ideally, the adjacent loops of the frame are axially separated, and the connector elements combine serpentine structures which extend axially between the adjacent loops. It should be understood that connector elements which yieldingly bend, and which remain bent without resiliently straightening in situ will be “plastically deformed” as used herein. Hence, shape memory alloys or polymers which are deformed in situ such that they will not recover their original shape at body temperatures will be “plastically deformed”, even if they would recover their shape if removed from the patient body and heated beyond a transition temperature.
- In some embodiments, at least some of the connector elements are attached to an associated loop of the frame using axially oriented slots, loosely tied sutures, or some other attachment mechanism which allows a limited amount of axial motion without deforming the connector member. Advantageously, such a structure provides a self-expanding prostheses which conforms to a torturous axial path of a body lumen without imposing resilient straightening forces. This structure is therefore particularly well suited for use in the flexible trunk or branch portions of the branching prosthesis described above.
- In yet another aspect, the present invention provides a bifurcated endoluminal prosthesis for use within a branching body lumen system having a trunk lumen and first and second branch lumens. The trunk lumen will have a larger cross-section than the branch lumens, and the trunk and branch lumens will be in fluid communication at a luminal intersection. The prostheses comprises a hub module which is deployable within the body lumen system adjacent the lumenal intersection. A trunk module includes a first port which sealingly engages the hub module when radially expanded therein. An end opposing the first port seals radially against the surrounding trunk lumen opposite the hub module. A prosthetic trunk lumen is provided between the first port and the sealing end. Such a structure is particularly advantageous when the trunk lumen of the body lumen system has been weaken by disease adjacent to or beyond the lumenal intersection, as the hub module facilitates sealing at the bifurcation. Preferably, the hub module comprises a tubal wall material which is at least partially self-supporting, wherein a portion of the hub between the trunk lumen port and at least one of the first and second branch ports has an enhanced axial flexibility. Optionally, a radially expandable branch module sealingly engages the deployed first branch port of the hub module, and extends along the first branch lumen of the body lumen system away from the luminal intersection. In certain patients, for example, those having aorta iliac regions which are highly distorted by an aneurism, it may be advantageous to form the hub module as a custom molded tubular expandable body wherein the trunk port and branch ports substantially match the trunk lumen in first and second branch lumens of that particular patient's body lumen system.
- In yet another aspect, the present invention provides a bifurcated endoluminal prosthesis for use within a branching body lumen system having a trunk lumen and first and second branch lumens. The trunk lumen will have a larger cross-section than the branch lumens, and the trunk and branch lumens will be in fluid communication at a luminal intersection. The prostheses comprises a branch module having a first branch end which is expandable within the first branch of the body lumen system, and also having a second branch end which is expandable within the second branch of the body lumen system, while a branch lumen extends therebetween. A trunk port is located between the first and second branch ends, the trunk port sealingly engageable with a first end of a tubular trunk module. A second end of the trunk module seals radially against the surrounding trunk lumen of the body lumen system. This branch module is particularly advantageous for use in body lumen systems having relatively sharp trunk/branch angles, particularly for installation across the two iliac arteries in patients having relatively advanced aortic aneurysms.
- In yet another aspect, the present invention provides a bifurcated endoluminal prosthesis for use within a branching body lumen system having a trunk lumen and first and second branch lumens. The trunk lumen will have a larger cross-section than the branch lumens, and the trunk and branch lumens will be in fluid communication at a luminal intersection. The prostheses comprises a primary module deployable adjacent the lumenal intersection, and a tubular trunk lumen which is supported at least in part by the primary module when expanded therein. Advantageously, this structure allows the prostheses to be supported for adjacent healthy branch lumens, for example, allowing endovascular prosthetic therapies for patient's who have relatively healthy iliac arteries, but who do not have sufficiently healthy aortal wall to substantially support a prostheses from between the renal arteries and the iliacs. Alternatively, the primary module comprises a tubular first branch module which supports the trunk module from within the first branch lumen of the body lumen system.
- In yet another aspect, the present invention provides a bifurcated endoluminal prostheses comprising a radially expandable trunk portion having a trunk lumen and a branch end. Radially expandable first and second branch portions extend from the branch end of the trunk portion, with first and second branch lumens, respectively. The first and second branch lumens are in fluid communication with the trunk lumen of the trunk portion, and at least one of the branch portions is compressible within the trunk portion and extendible from the trunk portion when the prostheses is positioned in situ. The at least one extendible branch portion preferably comprises an evertable self-supporting or composite structure. Alternatively, the at least one extendible branch portion may slidingly engage the radially expandable trunk portion so that it can telescope into the deployed position after the trunk portion is positioned.
- The present invention further provides a method for deploying and endoluminal prostheses in a branching body lumen system which includes a trunk lumen and first and second branch lumens. The trunk and branch lumens are in fluid communication at a luminal intersection, the trunk lumen being larger in cross-section than the branch lumens. The method comprises deploying a primary module within the body lumen system adjacent the luminal intersection so that a trunk portion of the primary module extends along the trunk lumen. A trunk module is then expanded within the trunk lumen while an end of the trunk module is within the trunk port of the primary module. Hence, the primary module engages and supports the trunk module, rather than relying substantially entirely on the trunk lumen of the body lumen system for support.
- In another aspect, the present invention provides a method for deploying an endoluminal protheses in a branching body lumen system which includes a trunk lumen and first and second branch lumens which are in fluid communication at a luminal intersection. The method comprises positioning a tubular prosthetic branch module across the luminal intersection from the first branch into the second branch so that a trunk port of the branch prostheses module is adjacent to the luminal intersection. The positioned branch module is expanded, and a tubular trunk module is positioned within the trunk lumen of the body lumen system with at least one opening adjacent the luminal intersection. The positioned trunk module is expanded, wherein expansion of the ladder of the branch module and the trunk module sealingly engages the branch and trunk modules together.
- In yet another aspect, the present invention provides a method for deploying an endoluminal prothesis in a branching body lumen system of a patient, the branching lumen system including first, second and third lumens in fluid communication at a luminal intersection. The method comprises positioning a first guide wire through the luminal intersection by introducing the first wire in through the first lumen and out the second lumen. A distal end of the first wire is threaded through a distal opening of a second guide wire. The prostheses may be positioned by selectively tensioning proximal and distal ends of the first wire, and by selectively tensioning the proximal end of the second wire. Optionally, the threaded first wire is returned through the intersection, and the distal end of the second wire is advanced toward the intersection by tensioning the proximal and distal ends of the first wire. Ideally, the first wire is returned back along the second lumen to the intersection, and then out of the patient through the third lumen, allowing the prosthesis to be precisely positioned by tension from each of the three lumens at the luminal intersection.
- In yet another aspect, the present invention provides a method for producing an endoluminal prosthesis comprising attaching an axially compressible elongate structure to an elongate liver strip and coiling the strip to form a helix having a plurality of loops. The adjacent loops may conveniently be attached to form a tube, thereby allowing continuous and automated production of large numbers of coil-supported prostheses.
- In a penultimate aspect, the present invention provides a sealing structure for sealing an end of a tubular endoluminal prosthesis against a plurality of flexible sealing flaps extending from the prosthesis adjacent the end. The sealing flaps are resiliently biased to flaps radially outward so as to independently seal against the surrounding lumen.
- In a final aspect, the present invention provides an endoluminal prosthesis comprising a tubular liner and a frame supporting the tubular liner. The frame defines a plurality of loops having axially oriented apices, at least some of these adjacent apices on adjacent loops being offset to enhance axial flexibility of the prosthesis.
- FIG. 1 is a side view of an exemplary cylindrical vascular stent-graft having axially constant characteristics.
- FIG. 2 is a perspective view of an exemplary delivery catheter for use with the prostheses of the present invention, with a portion of the distal end broken away to disclose a prostheses therein.
- FIGS.3A-3C illustrate a bifurcated endovascular prosthesis having a relatively rigid expanded Y-connector portion, axially flexible branch and trunk portions, and sealing/anchoring cuffs, according to the principles of the present invention.
- FIG. 4 illustrates a prostheses having two stent-graft portions connected by a flexible joint comprising an integrally ribbed polymer tube.
- FIGS.5A-5D illustrate an endoluminal prosthetic structure in which a frame is supported by a helical coil of expansible diamond shaped elements, for use in the flexible portions of the prosthesis of FIGS. 3A-3C.
- Fig. 5E illustrates a method for making an endoluminal prosthesis having a helical coil by first attaching the coil material to a strip of liner material, winding the liner strip over a mandrel, and sewing the strip in a helical shape.
- FIGS.5F-5H illustrates alternative stent-graft sealing structures, according to the principles of the present invention.
- FIGS.6A-6C illustrate alternative flexible prosthetic structures in which the liner is supported by a plurality of cylindrical segments.
- FIG. 7A illustrates an endoluminal prosthetic structure in which a liner is supported by a plurality of self-expanding loops, and in which serpentine malleable connectors extend between adjacent loops, according to the principles of the present invention.
- FIGS.7B-7G show alternative connector structures and connector attachment mechanisms for use in the prosthesis of FIG. 7A.
- FIGS.8A-8F illustrate a method for deploying a self-supporting endoluminal hub module within a luminal intersection, according to the principles of the present invention.
- FIGS.9A-9B illustrate alternative endoluminal hub modules having flexible portions between their trunk and branch portions.
- FIGS.10A-10C illustrate a method for positioning guide wires adjacent to a luminal intersection to promote precise positioning of an endoluminal prostheses by selectively tensioning opposed guide wire ends, according to the principles of the present invention.
- Figs.11A-11C illustrate a method for deploying a branching endoluminal prostheses by first deploying a branch module which extends across the trunk lumen and extending into opposing branch lumens, and by then deploying a trunk module within a trunk port of the branch module, according to the principles of the present invention.
- FIG. 12 illustrates an alternative branching endoluminal prostheses in which a branch module is positioned through a deployed trunk module, according to the principles of the present invention.
- FIG. 13 illustrates an alternative branching inner luminal prostheses in which independent branch modules are deployed within an expanded trunk module.
- FIGS.14A-14B illustrate a method for deploying a branching endoluminal prostheses in which a spacer module is first deployed to provide support for the trunk module from adjacent to the branch lumens of the body lumen system.
- FIGS.15A-15B illustrate a method for deploying a branching prostheses in which a tapering primary module is first deployed adjacent a luminal intersection, according to the principles of the present invention.
- FIGS.16A-16B illustrate a still further alternative method for deploying a branching endoluminal prostheses in which the trunk module is deployed within and supported by a previously deployed branch module, according to the principles of the present invention.
- FIGS.17A-17D illustrate an alternative branching endoluminal prostheses in which at least one branch portion is compressed within the trunk portion during positioning and deployment.
- FIGS.18A-18B illustrate alternative branching endoluminal prosthetic structures having reduced compressed frame volumes and adjustable branch lengths, according to the principles of the present invention.
- FIG. 19 illustrates a branching endoluminal prosthesis having a short trunk portion to increase overall axial flexibility, according to the principles of the present invention.
- The present invention provides radially expansible tubular prostheses, particularly grafts, stents, and stent-grafts, which are highly adaptable to varying luminal system geometries. The prostheses of the present invention are suitable for a wide variety of therapeutic uses, including stenting of the ureter, urethra, trachea, branchi, esophagus, biliary tract, and the like. The present devices and methods will also be useful for the creating of temporary or long term lumens, such as the formation of fistulas.
- The prosthetic structures of the present invention will find their most immediate use as endovascular prostheses for the treatment of diseases of the vasculature, particularly aneurysms, stenoses, and the like, and are especially well suited to the distorted aortal/iliac junction of persons having advanced vascular diseases. These prostheses will generally be radially expansible from a narrow diameter configuration to facilitate introduction into the body lumen, typically during surgical cutdown or percutaneous introduction procedures.
- The prosthetic structures described hereinbelow will find use in axially uniform cylindrical prostheses, in preassembled bifurcated prostheses, and as prosthetic modules which are suitable for selective assembly either prior to deployment, or in situ. Such selective assembly of prosthetic modules to form a customized endoluminal prosthesis is more fully described in co-pending U.S. patent application Ser. Nos. 60/008,254 and 08/538,706 (Attorney Docket Nos. 16380-34 and 16380-38) the full disclosures of which have previously been incorporated herein by reference.
- An exemplary
cylindrical graft structure 10 is illustrated in FIG. 1.Prostheses 10 comprises a perforatetubular frame 12 which includes a plurality of independent (non-connected) ring frames 14. Thetubular frame 12 supports aninner frame 18. Optionally, an outer liner is disposed over the ring frames, either inside ofinner liner 18, or in combination therewith. - To secure ring frames14 in place, and to secure the liner to the perforate
tubular frame 12, the liner is typically sutured to the frame. A wide variety of alternative liner/frame attachment mechanisms are available, including adhesive bonding, heat welding, ultrasonic welding, and the like. Where inner and outer liners are used, the ring frames may be sandwiched between the liners and held in place by attaching the liners to each other. - The
prostheses 10 will typically have a length in the range from about 20 mm to 500 mm, preferably from 50 mm to 200 mm, with a relaxed diameter in the range from about 4 mm to 45 mm, preferably being in the range from about 5 mm to 38 mm. Alternative stent-graft structures are more fully described in U.S. application Ser. No. 08/538,706 (Attorney Docket No. 16380-38), previously incorporated by reference. - Referring now to FIG. 2, an
exemplary delivery catheter 30 for use with the endoluminal prostheses of the present invention comprises atubular cover 32 and ashaft 34.Cover 32 has acentral lumen 36 extending from aproximal end 38 to adistal end 40.Shaft 34 is slidably received withincentral lumen 36 and extends proximally ofcover 32. A plurality ofrunners 42 extend distally fromshaft 34.Runners 42 line a portion of the inner surface oflumen 36, and slide within the lumen of the shaft.Shaft 34 also has a lumen, in which acore shaft 44 is slidably disposed.Core shaft 44 has aguide wire lumen 46.Nosecone 48 is fixed to the distal end ofcore shaft 44, and can therefore be manipulated independently ofrunners 42. -
Prostheses 10 is radially compressed and restrained within the plurality ofrunners 42. In turn, cover 32 preventsrunners 42 from expanding outward.Runners 42 are formed from a hard material, and distribute the expansion load ofprostheses 10 over the inner surface ofcentral lumen 36. The deploying force is applied proximally against aslider 50 attached to adistal end 38 ofcover 30, while holding a luer fitting 52 at the distal end ofshaft 34, thereby withdrawing the cover proximally from over the prostheses. Anadditional luer adapter 54 at the distal end ofcore shaft 44 allows the core shaft to be manipulated independently, and to be releasibly secured to theshaft 34. Exemplary methods and devices for placement of the prostheses of the present invention are more fully described in co-pending U.S. patent application Ser. No. 08/475,200, filed Jun. 7, 1995 (Attorney Docket No. 16380-001130), the full disclosure of which is incorporated herein by reference. - Referring now to FIGS.3A-3C, an exemplary branching endovascular protheses 60 comprises a
lumen separation portion 62 between atrunk portion 64 and twobranch portions 68.Lumen separation portion 62 preferably comprises a relatively rigid structure, having higher column and hoop strength than the remainder of the prostheses. - In this exemplary embodiment, the lumen separation portion comprises a flexible liner supported by a resiliently expanding frame. The cross-section of the frame adjacent the branches includes discrete lobes which correspond to the first and second branches, and also includes an isthmus therebetween to help prevent an imbalance of flow from the trunk portion to the branch portions. Such a lumen separation portion is more fully described in parent application (Attorney Docket No. 16380-003400), also previously incorporated by reference. Ideally, the perforate frame of
lumen separation portion 62 is continuous along its axial length, increasing the column strength of the lumen separation so that the flow separation geometry of the branching inner lumen remains constant regardless of the flexing of the trunk and/or branch portions. - The advantageous flexibility of
branch portions 68 is shown most clearly in FIG. 3B, in which prostheses 60 is shown deployed within an abdominal aorta A downstream of the renal arteries RA, extending beyond an abdominal aortic aneurism AA, and into the right and left iliac arteries RI, LI.Branch portions 68 have relatively high axial flexibility to accommodate the extreme angles between the iliac and abdominal arteries which have been found in patients having such aneurysms. -
Trunk sealing cuff 66 andbranch sealing cuffs 70 securely anchor the prostheses against the healthy tissue beyond the aneurism, and also seal the prosthetic lumen against the surrounding endolithium of the body lumen system.Trunk sealing cuff 66 will often comprise a polyester such as Dacron™, preferably in an expansible form, ideally as a fabric woven with partially oriented or unoriented polyester fibers in the fill or weave. Alternatively, polyester (or some other fiber) which has been wrapped around a core fiber to allow expansion may be used, or the sealing cuff may comprise a PTFE, silicone, or polyurethane foam to promote sealing between the prosthetic lumen and the surrounding body lumen. Exemplary sealing cuff structures are more fully described in co-pending U.S. patent application Ser. Nos. 08/525,989 and 08/538,706, filed Oct. 3, 1995, and Sep. 8, 1995 (Attorney Docket Nos. 16380-30 and -38), the full disclosures of which are incorporated herein by reference. - One particular advantage of the axial flexibility of
trunk portion 64 can be understood with reference to the lateral view of the abdominal aorta illustrated in FIG. 3C. Although the aneurysm AA generally distends the abdominal aorta, the specific shape and extent of the aneurysm can vary widely. Even when healthy, the abdominal aorta often angles dorsally just downstream of the renal arteries. The presence of this bend B often persists despite the general distension of the abdominal aorta. - Advantageously,
flexible trunk portion 64 allows thetrunk sealing cuff 66 to anchor securely along the axis of the healthy abdominal aorta adjacent the renal arteries, and greatly helps to reduce perimeter leaks around the upstream end of the trunk portion. Those of skill in the art will understand that the trunk portion would tend to have a relatively high rigidity and column strength, due to its relatively large cross-section (which must accommodate the combined flow for both iliac arteries). It should also be understood that the flexible trunk and leg portions will preferably maintain sufficient hoop strength so that their respective lumens remain open throughout a wide range of branch positions, and despite normal physiological movement and environmental stress from the surrounding body lumen. Hence, the flexible trunk and leg portions will preferable comprise a coiled prosthetic structure or a radially expandable, axially malleable structure as described hereinbelow. Alternatively, the flexible trunk and branch portions may comprise an unsupported (or self-supporting) liner. - Referring now to FIG. 4, a
jointed prosthesis structure 72 provides axial flexibility and kink resistance, and may therefore find use in the flexible sections of exemplary branching endoluminal prosthesis 60 (see FIG. 3A).Jointed prosthesis 72 includes a plurality of stent-graft portions 74 with ajoint portion 76 therebetween. Stent-graft portions 74 comprise aliner 80 supported by a perforate radiallyexpandable frame 78. Preferably,joint portion 76 comprises an integrally ribbed polymer tube, as taught by U.S. Pat. Nos. 4,647,416 and 4,550,447, the full disclosures of which are incorporated herein by reference. Ideally, the joint comprises a ribbed PTFE tube which extends continuously to form the liners of the stent-graft portions. - Advantageously, the framed structure of the stent-graft portion provides the column and hoop strength to support the inner lumen, while the self-supporting joint structure allows the jointed prosthesis to easily adapt to tortuous body lumens. It may be advantageous to provide a series of such liner will preferably include
ribs 92 disposed between theadjacent loops 90 ofexpandable coil 84. - A method of fabricating a helical stent-
graft 71 will be described with reference to FIG. 5E. A series of linked diamond-shapedelements 73 are first attached to a strip ofliner material 75, typically being stitched with a sewing machine. The ribbon is then wound over amandrel 77 of the desired size, and adjacent edges of the ribbon are sewn to each other (or otherwise permanently joined). Such a method may be substantially automated and continuous, and is thus particularly beneficial for producing a large number of prostheses. The helical stent-graft may optionally be cut to length, but will preferably include a crown stitched stent-ring 79 for sealing and ends against a surrounding lumen when deployed therein. - A novel feature of helical stent-
graft 71 which will have application in a wide range of stent-graft structures is the offsetting ofapices 69. Diamond-shapedelements 73 define axially orientedapices 69 at regular intervals along the loops. Through proper sizing ofmandrel 77 and monitoring of the loop sewing process, the adjacent apices may optionally be offset from the adjacent apices, each apex ideally being roughly equally spaced from the two adjacent apices as shown. Advantageously, this increases axial flexibility by allowing the liner to flex between loops but without substantially decreasing hoop strength. Conveniently, the column strength may be selectively and locally increased (and axial flexibility correspondingly decreased) by adjusting the winding ofribbon 75 so that the adjacent apices are substantially aligned. In fact, aligned apices may be selectively attached to each other, for example, with a lock stitch pattern (as shown in FIG. 5, 4, and more fully explained in co-pending U.S. patent application Ser. No. 08/538,706, filed Oct. 3, 1995 (Attorney Docket No. 16380-003800), previously incorporated herein by reference), to greatly reduce axial flexibility where desired. Clearly such selective offsetting of apices will be effective with ring frames, zig-zag coils, and a wide range of alternative stent-graft structures, and continuous graft configurations. - Alternative sealing structures are illustrated in FIGS.5F-G. Generally,
liner 81 is split at one end to form a plurality of sealing flaps 83. Optionally, the sealing flaps are substantially unsupported by the frame. Alternatively, the frame adjacent sealing flaps 83 includes axially elongate members which support the sealing flaps, for example,elongate diamonds 85 orfingers 87. These elongate member (or the sealing flaps themselves) are preferably resiliently biased radially outward, typically by heat setting over a tapered mandrel. In some embodiments, the flaps may fold back along the prosthesis when the prosthesis is compressed for deployment. Regardless, each sealing flap will preferably expand radially outward substantially independently of the other sealing flaps, thereby improving the seal between the end of the prosthesis and a highly irregular body lumen. Optionally more than one row of overlapping sealing flaps may also be used. - Referring now to FIGS. 6A and B, an alternative flexible prosthetic structure may be fabricated by cutting a cylindrical
corrugated polyester graft 96 into a series of cylindrical segments. The cylindrical segments may then be used as reinforcing elements by attaching them axially along anexpansible tube 100. Suitable expansible tubes may be formed from partially oriented yarn, polypropylene, polyethylene, annealed polyester, PTFE, or the like. The reinforcing elements are preferably free to slide over each other as the liner is expanded in situ, and provide some column strength, hoop strength, and kink resistance while also allowing the reinforced lumen to flex axially. - Optionally, a plurality of expansible fibers or
yarns 102 could be wrapped around the exterior of the corrugated graft segments to hold the structure in a compact profile, and yet still allow expansion. Alternatively,outer fibers 102 may be frangible, breaking under a predetermined force to allow the prosthesis to be expanded in situ to the desired size. An internally supportedflexible structure 104 having similar internal reinforcingelements 106 may optionally avoid the use of the external wrapping yarns. - A particularly advantageous flexible
prosthetic structure 110 will be described with reference FIGS. 7A-G. Flexible structure 110 comprises a radiallyexpandable liner 112 supported by a plurality of ring frames 114. A series ofconnector elements 116 extend between adjacent ring frames 114. Optionally,connector elements 116 may also be used to support theliner 112. Advantageously, the connector elements and ring frames may be independently optimized to tailor the mechanical properties of the prosthesis structure, particularly for use as a flexible trunk or branch position in the branching prosthesis of FIG. 3A. Alternatively, flexibleprosthetic structure 110 may find use as a stent, or as a cylindrical stent-graft. - Preferably, the ring frames comprise resilient self-expanding structures, ideally comprising a super-elastic shape memory alloy such as Nitinol™.
Connectors 116 preferably comprise a malleable material, ideally including martensitic Nitinol™, stainless steel, cobalt-nickel alloy, titanium, or tantalum. Clearly, the connector elements can provide additional column strength to the prosthetic structure, as well as providing support to the liner between the ring frames. Advantageously, such malleable connectors may also provide a structure which will expand resiliently when deployed in situ, and which will conform plastically to an axially tortuous body lumen, such as the blood vessels of the vascular system. - Preferably,
connector elements 116 comprise serpentine elements which extend axially between adjacent frame loops. Careful selection of the serpentine shape allows tailoring of the bending properties of the prosthesis. Such serpentine connector elements located at the outer portion of an axial bend in the prosthesis will be straightened, while those at the inner portion will decrease in length, optionally maintaining the axial length of the prosthesis at a relatively constant amount. Alternatively, the connector elements may rely primarily (or solely) on either elongation or compression alone, thereby inducing changes in the length of the prosthesis when bent. - FIGS.7B-D illustrate alternative connector element structures. A
flat connector element 118 may be cut from a flat sheet of the desired malleable material, and optionally includes ends 120 having passages cut therethrough to facilitate attachment of the connector element to the resilient frame structure. Such a flat structure has the advantage of not decreasing the internal prosthetic lumen cross-section within a narrow body lumen, and the flat serpentine shapes may be cut from sheet stock using known laser cutting, lithography techniques, or the like. - Alternatively, a
wire connector element 122 having bent loop ends 124 may be formed as a helical coil. In a still further alternative, abent connector element 126 may be formed from a straight strip of malleable material, as shown in FIG. 7D, and may also include folded ends 128. Clearly, a wide variety of alternative metallic or polymer connector structures may be suitable. Generally, it will be preferable to make use of materials which are both malleable and biocompatible, as described above. - A variety of alternative attachment mechanisms for coupling the frame structure to the connector elements are shown in FIGS.7E-G, and also in FIG. 7A. Generally, the connector elements may be attached to the frame loops by welding, soldering, adhesive bonding, polymer rivets, suturing, or the like. In some embodiments, it may be possible to utilize members which extend from a resilient frame, and which have been formed to the desired shape and heat treated or otherwise processed to produce the desired malleable properties. In some embodiments, the mechanism used to attach the resilient frame to the connector elements will also attach the liner to the frame, for example, stitching which extends through passages in both the connector elements and the frame, and then through a woven textile liner.
- It may be desirable to allow some longitudinal motion between the connector elements and their associated frames without deforming the connector elements. An
oversized suture loop 130 between aring frame 14 andpassage 120 offlat connector element 118 provides a limited amount of axial motion. Similarly, anaxial slot 134 in a slottedframe 132 provides a precisely controlled amount of axial motion of aloop 136 on awire connector element 138. Note thatloop 136 may further be reinforced by suture, wire, adhesive, or the like. Alternatively, the end of the connector element may be folded over aring frame 14, and optionally adhesively bonded in place, to provide a positive connection. - Preferably,
connectors 116 compress or elongate plastically under forces typical of those imposed on the prosthesis during deployment. As these forces are typically higher than normal physiological forces, the connector elements may advantageously be constructed to avoid deformation from these normal blood and tissue in vivo forces, particularly where a limited amount of axial motion is allowed between connector elements and the ring frames. Therefore, the prosthesis structure can plastically deform during deployment to conform the axis of the prosthesis with the surrounding body lumen, but will thereafter avoid imposing resilient straightening forces against the body lumen. - A method for assembling in situ an endoluminal prosthesis by first positioning and deploying a hub module will be described with reference to FIGS.8A-E. A
branch access catheter 140 is used to insertguidewires 142 down the aorta A and into the left iliac LI and right iliac RI. Thebranch access catheter 140 preferably comprises a deflecting tip branch access catheter as taught by U.S. Pat. No. 4,774,949, the full disclosure of which is incorporated herein by reference. - A
resilient hub module 144 is advanced over bothguidewires 142 while compressed withindelivery sheath 146.Hub module 144 preferably comprise an elastic sponge-like microporous silicone, silicone foam, low purometer silicone, polyurethane foam or the like, as more fully described in co-pending U.S. patent application Ser. No. 08/525,989, filed Sep. 8, 1995, (Attorney-Docket No. 16380-003000) the full disclosure of which is incorporated herein by reference.Hub module 144, which may be stented or unstented, is deployed overguidewires 142 at the luminal intersection I of the aorta A and left and right iliacs LI, RI, optionally extending along the iliacs beyond the aortic aneurysm AA. Ideally,hub module 144 is deployed by a combination of distally advancingpusher shaft 148 and proximally withdrawingcatheter sheath 146 so that atrunk portion 150 of the hub module remains within the aorta, whilebranch portions 152 extend into each of the iliacs. The hub module wall material will preferably be at least in part self-supporting, but may be reinforced adjacent the trunk or branch ports for sealing and to provide sufficient hoop strength to allow prosthetic modules to sealingly engage the hub from within. - In some embodiments, it may be possible to completely seal off aortic aneurysm AA by positioning a
trunk module 154 withintrunk port 150 and expanding the trunk module to sealingly engage the hub module and the healthy aorta upstream of the aneurysm, as illustrated in FIG. 8E. In other cases, it may be necessary to extend one ormore branch modules 156 along one or both iliac arteries to fully bypass the aneurysm, as illustrated in FIG. 8F. A fourbranch hub module 158, similar in structure tohub module 144, may find use in sealing off the upper end of an aneurysm which extends to or along the renal arteries, optionally making use of arenal branch module 160 similar tobranch module 156 described above. optionally, one or more hubs may be securely attached to (and deployed with) a trunk stent-graft. - Although the exemplary microporous silicone can adapt to a range of luminal intersection geometries, it may be advantageous to provide a variety of hub modules having differing angles to accommodate a wider variety of vascular geometries, allowing selection of a suitable hub for each patient. In extreme cases, it may even be preferable to custom mold a hub module for a specific patient's vasculature, preferably based on information provided by fluoroscopy, ultrasound, or some other imaging modality.
- To increase the ability of the hub module to conform to a variety of vascular geometries, it may be advantageous to include
corrugated portions 162 or braidedportions 164 between thetrunk port 150 and thebranch ports 152 as illustrated in FIGS. 9A-D. Such corrugated structures accommodate compression along the inside of a tight bend radius without kinking, while braided structures are inherently kink resistant when bent. Similar enhanced flexibility portions may be used at the junctions of a trifurcation to increase the conformability of an aortal renal hub module, similar torenal hub module 158 shown in FIG. 8F. Advantageously, first deploying the hub module adjacent the intersection of the aorta and iliac arteries allows the trunk module to be supported at least in part from the luminal intersection, particularly during deployment. - A method for precisely positioning an endoluminal prosthesis using guidewires which pass through the luminal intersection will be described with reference FIGS.10A-C. In the exemplary method, a
guidewire 166 is introduced from an inferior position and advanced along the right iliac, RI beyond the luminal intersection I, through the aorta A to the subclavian-or carotid artery, where the guidewire is extended out of the patient body.Guidewire 166 can then be threaded through aloop 168 in asecond guidewire 170, and the distal end ofguidewire 166 be again maneuvered back through the aorta, beyond the luminal intersection I, along one of the iliac arteries, and again extended out of the patient body. - Advantageously, a
proximal end 172 anddistal end 174 ofguidewire 166 may be selectively tensioned to advancesecond guidewire 170 down the aorta to the luminal intersection I. Optionally, guidewire 166 may be fed inward and outward through the same iliac to allowloop 168 to be positioned relative to the aortic and one of the two iliac arteries. Alternatively, as shown in FIG. 10C, guidewire 166 may be fed inward through, and outward from, alternative iliac arteries. In either case, tensioning the proximal and distal ends ofguidewire 166 and the proximal end ofsecond guidewire 170 precisely positionshoop 168 relative to the luminal intersection I. Hence, this method provides multiple points of control and access to fine tune endoluminal prosthesis placement, and allows prosthetic modules to be advanced along either end ofguidewire 166 or alongsecond guidewire 170 to the precisely positionedloop 168. - As described above, many bifurcated stent-graft systems depend on attachment to a narrow healthy or less diseased zone between the renal arteries and the upstream end of the aneurysm. The length and diameter of this healthy zone can be very difficult to predict, making secure attachment and sealing of the endoluminal prosthesis problematic. As there may be little or no healthy aorta remaining between the aneurysm and the renal arteries to anchor a branching endoluminal prosthesis, it would be advantageous to find alternative support mechanism for branching endoluminal prostheses.
- As was also described above, the iliac arteries may define substantial angles relative to the aorta, particularly on patients having abdominal aortic aneurysms. This often complicates the positioning of a tightly compressed (and therefore relatively stiff) endoluminal prosthesis across the lumenal intersection from the aorta to the iliac arteries.
- For these reasons, it may be advantageous to instead position and deploy a
branch module 176 extending across the luminal intersection I from the right iliac to the left iliac, as illustrated in Fig. 11A.Branch module 176 will generally include atrunk port 180 which is preferably oriented along the aorta, as shown in Fig. 11B. Such orientating of prosthetic modules is aided by aradiographic marker 178 which provide a visual representation of the expanded module under imaging. Optionally, aballoon catheter 182 may be used to holdbranch module 176 in position during deployment of atrunk module 184 into sealing engagement withtrunk port 180. - Referring now to FIG. 12,
branch module 176 may alternatively be deployed throughbranch ports 186 of a previously deployedprimary trunk module 188. Flow for the two iliacs thus enters the branch module within the lumen ofprimary trunk module 188 throughtrunk port 180. A somewhat similar arrangement, which makes use ofindependent branch modules 190 that sealingly engage an alternativeprimary trunk module 192 atbranch ports 186, is illustrated in FIG. 13. - It would be advantageous to provide still further alternative methods for supporting the endoluminal prosthesis assembly, rather than relying substantially on the aorta below the renals. As illustrated in FIGS.14A-B, a
spacer module 192 may first be deployed adjacent the luminal intersection I, preferably with alower surface 196 in contact with the bifurcation B of the body lumen system.Spacer module 192 is selected so that anupper surface 198 is at the proper distance from thelower surface 196 so that abifurcated trunk module 194 resting onupper surface 198 is correctly positioned just downstream of the renal arteries. Branch modules may then be positioned through the spacer module and into the branch ports of the bifurcated trunk module to complete the bifurcated prosthesis assembly. Clearly, one or more of the branch portions may optionally be formed integrally with the trunk portion, within the scope of the present invention. - A still further alternative modular prosthetic assembly will be described with reference to FIGS.15A-B. Tapered
primary module 202 includes awide branch end 204 which is optionally deployed within the luminal intersection so as to be supported by the body lumen bifurcation B. Advantageously, thewide branch end 204 facilitates engagingbranch modules 208 from widely divergent iliac arteries, and may also help support a trunklumen sealing module 206 from the bifurcation of the body lumen, as shown in FIG. 15B. - The present invention also provides supporting in situ endoluminal prosthesis assembly from within the iliac, as illustrated in FIGS.16A-B. In this embodiment, a
branch prosthetic module 210 is first deployed within a relatively healthy renal artery. Onebranch port 212 of a bifurcatedprosthetic module 214 is then positioned and expanded withinbranch module 210. Optionally, a second branch module is then positioned within an alternate branch port of thebifurcated modules 214, completing the in situ assembly of the bifurcated prosthesis system. - It would be desirable to reduce the number of prosthetic module deployment steps required to deploy an endovascular bifurcated prosthesis system. Toward that end, as shown in FIGS.17A-D, an extendable leg
bifurcated prosthesis 216 may have one ormore leg portions 218 disposed within thetrunk portion 220 when the prosthesis is radially compressed for positioning and deployment. Optionally, the leg may be everted within the trunk portion, the leg preferably comprising a self-supporting or composite material. Alternatively, the leg may slidingly engage the trunk portion and telescope out into position. In either case, disposing the leg within the trunk portion greatly facilitates positioning the prosthesis across the luminal intersection I. - The location and extent of aneurysms along the renal arteries varies considerably between patients, and may at times be difficult to accurately measure. It would therefore be advantageous to provide modular structures adaptable to a wide range of iliac leg positions. The prosthetic assemblies of FIGS.18A-B achieve such iliac leg placement flexibility by extending a relatively rigid iliac module through
bifurcation modules iliac module 230 to extend in cantilever beyond renal arteries RA. Additionally, by minimizing the length of the trunk lumen portion of the prosthesis, the mass of each module is minimized, facilitating intravascular maneuvering. - To provide some mutual support between the parallel iliac portions,
bifurcation module 234 includes alower support portion 236 having the two-lobed cross-section which is described in co-pending U.S. patent application Ser. No. 08/538,706 (Attorney-Docket No. 16380-003800), previously incorporated herein by reference. The relativelynarrow mid-section 238 allows axial bending of the assembled prosthesis through the aneurysm to adapt to physiological movement. - Referring finally to FIG. 19, a short trunk branching prosthesis includes a
lumen separation portion 242 which is adjacent to atrunk sealing cuff 246, here shown as a single independent ring frame which is crown stitched to the liner. Advantageously, thebranch portions 248 will tend to have good axial flexibility due to their significantly smaller diameter than the trunk. Hence, the branch portions may be supported by independently ring-frames. - Although the exemplary embodiments have been described in some detail, by way of illustration and example, the scope of the present invention is limited solely by the appended claims.
Claims (59)
1. A branching endoluminal prosthesis for use in a branching body lumen system which includes a trunk lumen and first and second branch lumens, the prosthesis comprising;
a radially expandable tubular trunk portion having a prosthetic trunk lumen;
radially expandable tubular first and second branch portions with first and second prosthetic branch lumens; and
a radially expandable tubular lumen separation portion which provides fluid communication between the prosthetic trunk lumen and the first and second prosthetic branch lumens;
wherein the expanded trunk portion is more axially flexible than the expanded lumen separation portion.
2. A branching endoluminal prosthesis as in claim 1 , wherein the prosthetic trunk lumen and the first and second prosthetic branch lumens adjacent the lumen separation portion define a branch plane, and wherein the trunk portion has greater axial flexibility roughly perpendicular to the branch plane than the lumen separation portion.
3. A branching endoluminal prosthesis as in claim 2 , further comprising a trunk sealing cuff on the trunk portion generally opposite the lumen separation to seal between the prosthetic trunk lumen and the trunk lumen of the body lumen system.
4. A branching endoluminal prosthesis as in claim 3 , wherein the trunk portion is more axially flexible than the trunk sealing cuff.
5. A branching endoluminal prosthesis as in claim 1 , wherein at least a portion of the first and second branch portions are more axially flexible than the lumen separation portion.
6. A branching endoluminal prosthesis as in claim 5 , further comprising branch sealing cuffs on the first and second branch portions generally opposite the lumen separation to seal between the prosthetic branch lumens and the branch lumens of the body lumen system.
7. A branching endoluminal prosthesis as in claim 6 , wherein the branch portions are more axially flexible than the trunk sealing cuffs.
8. A branching endoluminal prosthesis as in claim 1 , wherein at least one of the trunk portion and the first and second branch portions comprises a liner supported by a helical coil defining a plurality of separated loops to enhance axial flexibility, and wherein the helical coil elongates during expansion of the liner to avoid unwinding of the coil relative to the liner.
9. A branching endoluminal prosthesis for use in a branching body lumen system which includes a trunk lumen and first and second branch lumens, the prosthesis comprising;
a radially expandable tubular trunk portion having a prosthetic trunk lumen;
radially expandable tubular first and second branch portions with first and second prosthetic branch lumens;
a radially expandable tubular lumen separation portion between the first and second branch portions and the trunk portion to provide fluid communication between the prosthetic trunk lumen and the first and second prosthetic branch lumens; and
sealing cuffs on the trunk portion and the first and second branch portions generally opposite the lumen separation to seal between the prosthetic lumens and the lumens of the body lumen system;
wherein the expanded branch portions and trunk portion are more axially flexible than the expanded lumen separation portion.
10. An endoluminal prosthesis comprising:
a first prosthesis portion including a first radially expandable frame which defines a first axis, the first frame supporting a first tubular liner having a first lumen;
a second prosthesis portion including a second radially expandable frame which defines a second axis, the second frame supporting a second tubular liner having a second lumen; and
a flexible joint between the first and second prosthesis portions to accommodate angles between the first and second axes, wherein the flexible joint comprises a self supporting polymer tube having integral ribs.
11. An endoluminal prosthesis as in claim 10 , wherein the self-supporting liner comprises a PTFE tube which extends between the first and second liners.
12. An endoluminal prosthesis as in claim 10 , wherein the first and second frames comprise resilient structures.
13. An endoluminal prosthesis as in claim 10 , wherein the first and second portions have substantially higher column strength and hoop strength than the flexible joint.
14. An endoluminal prosthesis comprising:
a first prosthesis portion including a first radially expandable frame which defines a first axis, the first frame supporting a first tubular liner having a first lumen;
a second prosthesis portion including a second radially expandable frame which defines a second axis, the second frame supporting a second tubular liner having a second lumen; and
a flexible joint between the first and second prosthesis portions to accommodate angles between the first and second axes, wherein the flexible joint comprises a tubular joint liner supported by a plurality of reinforcing elements, the reinforcing elements comprising roughly cylindrical segments disposed axially along the joint liner so as to slide relative to each other during radial expansion.
15. An endoluminal prosthesis as in claim 14 , wherein the reinforcing elements comprise corrugated polyester.
16. An endoluminal prosthesis as in claim 14 , wherein the reinforcing elements comprise corrugated PTFE.
17. An endoluminal prosthesis as in claim 14 , wherein the joint liner comprises an expansible material.
18. An endoluminal prosthesis comprising:
a plastically expansible tubular liner having a lumen which defines an axis; and
a helical coil supporting the liner, the coil defining a plurality of loops, wherein the loops are separated to enhance axial flexibility of the prosthesis, and wherein the helical coil elongates during plastic expansion of the liner to avoid unwinding of the coil relative to the liner.
19. An endoluminal prosthesis as in claim 18 , wherein the liner comprises a polymer tube having integral ribbing disposed between the separated loops of the coil.
20. An endoluminal prosthesis as claimed in claim 18 , wherein the coil is attached to the liner at a plurality of attachment points along the length of the coil.
21. An endoluminal prosthesis as claimed in claim 17 , wherein the coil comprises linked diamond-shaped elements.
22. An endoluminal prosthesis as claimed in claim 17 , wherein the liner comprises partially oriented or unoriented polyester fiber, the fiber being circumferentially oriented.
23. An endoluminal prosthesis as claimed in claim 18 , wherein the coil comprises a shape memory alloy or a shape memory polymer.
24. An endoluminal prosthesis for use in a bent body lumen, the prosthesis comprising a radially expandable tubular frame defining an axis, the frame including a plurality of resiliently expandable loops and a plurality of plastically deformable connector elements extending between adjacent loops which allow the axis to plastically conform to the body lumen.
25. An endoluminal prosthesis as in claim 24 , wherein the connector elements plastically deform at a predetermined load which is greater than physiological loads imposed on the deployed prosthesis by the surrounding body lumen.
26. An endoluminal prosthesis as in claim 25 , wherein the predetermined load is less than or equal to loads imposed on the prosthesis during deployment of the prosthesis within the body lumen.
27. An endoluminal prosthesis as in claim 24 , wherein the adjacent loops are axially separated, and wherein the connector elements comprise serpentine structures which extend axially between the adjacent loops.
28. An endoluminal prosthesis as in claim 24 , wherein the loops comprise ring-frames.
29. An endoluminal prosthesis as in claim 28 , further comprising a tubular liner supported by the ring frames and the connector elements.
30. An endoluminal prosthesis as in claim 24 , wherein an attachment mechanism allows a limited axial motion between at least some connector elements and an associated loop without deforming the connector elements.
31. A bifurcated endoluminal prosthesis for use within a branching body lumen system having a trunk lumen and first and second branch lumens, the trunk lumen having a larger cross-section than the branch lumens, the trunk and branch lumens in fluid communication at a lumenal intersection, the prosthesis comprising:
a hub module which is deployable within the body lumen system adjacent the lumenal intersection; and
a tubular trunk module having a first port which sealingly engages the hub module when radially expanded therein, an end opposing the first port which seals radially against the surrounding trunk lumen opposite the hub module, and a trunk lumen therebetween.
32. A bifurcated endoluminal prosthesis as in claim 31 , wherein the hub module includes a trunk lumen port in which the first port of the trunk module is sealingly engageable, and first and second branch lumen ports which are extendable into the first and second branch lumens of the body lumen system so as to promote sealing therewith.
33. A bifurcated endoluminal prosthesis as in claim 32 , wherein a portion of the hub between the trunk lumen port and at least one of the first and second branch ports has enhanced axial flexibility.
34. A bifurcated endoluminal prosthesis as in claim 32 , further comprising a radially expandable branch module having an end which sealingly engages the deployed first branch port and extends along the branch lumen of the body lumen system from the lumenal intersection.
35. A bifurcated endoluminal prosthesis as in claim 31 , wherein the hub module comprises a molded tubular expandable body so that a trunk port and branch ports substantially match the trunk lumen and first and second branch lumens of a particular patient's body lumen system.
36. A bifurcated endoluminal prosthesis for use within a branching body lumen system having a trunk lumen and first and second branch lumens, the trunk lumen having a larger cross-section than the branch lumens, the trunk and branch lumens in fluid communication at a lumenal intersection, the prosthesis comprising:
a branch module having a first branch end which is deployable within the first branch of the body lumen system, a second branch end which is extendable from the first branch end across the lumenal intersection to the second branch of the body lumen system, a prosthetic branch lumen therebetween, and a trunk port between the first and second branch ends; and
a tubular trunk module having a first end which is sealingly engageable to the branch module, a second end opposing the first end which seals radially against the surrounding trunk lumen of the body lumen system, and a prosthetic trunk lumen therebetween.
37. A bifurcated endoluminal prosthesis as claimed in claim 36 , wherein the first end of the trunk module sealingly engages the trunk port of the branch module when deployed therein.
38. A bifurcated endoluminal prosthesis as claimed in claim 37 , wherein the branch and trunk modules engage so as provide a predetermined flow split from the trunk module to the first and second branch ends of the branch module.
39. A bifurcated endoluminal prosthesis as claimed in claim 36 , wherein the trunk lumen has a larger cross-section than the lumen of the branch module adjacent the first or second branch ends.
40. A bifurcated endoluminal prosthesis for use within a branching body lumen system having a trunk lumen and first and second branch lumens, the trunk lumen having a larger cross-section than the branch lumens, the trunk and branch lumens in fluid communication at a lumenal intersection, the prosthesis comprising:
a primary module which is deployable within the body lumen system adjacent the lumenal intersection; and
a tubular trunk module having a first port which is supported at least in part by the deployed primary module when radially expanded therein, an end opposing the first port which seals radially against the surrounding trunk lumen opposite the primary module, and a trunk lumen therebetween.
41. A bifurcated endoluminal prosthesis as in claim 40 , wherein the primary module comprises a spacer having a trunk module support surface and a branch engagement surface, and wherein the trunk module support surface supports the expanded trunk module relative to the branch engagement surface within the body lumen system.
42. A bifurcated endoluminal prosthesis as in claim 40 , wherein the primary module comprises a tapered body which tapers outward from a first end to a second end opposite the trunk module, and further comprising at least one branch module which expands radially to engage a branch port adjacent the second end of the tapered body.
43. A bifurcated endoluminal prosthesis as claimed in claim 40 , wherein the primary module comprises a radially expandable tubular first branch module which supports the trunk module from within the first branch lumen of the body lumen system, wherein the trunk module comprises a bifurcated prosthetic module having a second branch portion disposable adjacent the first port.
44. A bifurcated endoluminal prosthesis comprising:
a radially expandable trunk portion having a trunk lumen and a branch end;
radially expandable first and second branch portions extending from the branch end of the trunk portion, the branch portions having first and second branch lumens, the first and second branch lumens being in fluid communication with the trunk lumen of the trunk portion;
wherein at least one of the branch portions is compressible within the trunk portion, and wherein the at least one branch portion is extendable from the expanded trunk portion in situ.
45. A method for deploying an endoluminal prosthesis in a branching body lumen system which includes a trunk lumen and first and second branch lumens, the trunk lumen and branch lumens in fluid communication at a lumenal intersection, the trunk lumen being larger in cross-section than the first and second branch lumens, the method comprising:
deploying a primary module within the body lumen system adjacent the lumenal intersection so that a trunk port of the primary module extends along the trunk lumen; and
expanding a trunk module within the trunk lumen while an end of the trunk module is within the trunk port of the primary module so that the primary module engages and supports the trunk module from adjacent the lumenal intersection.
46. A method as in claim 45 , wherein the deploying step comprises expanding a tubular hub module so that first and second branch ports extend along the first and second branch lumens of the body lumen system.
47. A methods as in claim 46 , further comprising selecting a hub module which approximately matches a geometry of a particular patients branching body lumen system adjacent the lumenal intersection.
48. A method as in claim 46 , further comprising molding a hub module to match a geometry of a particular patients branching body lumen system adjacent the lumenal intersection.
49. A method as in claim 46 , further comprising expanding a branch module within the first branch port of the hub module.
50. A method for deploying an endoluminal prosthesis in a branching body lumen system which includes a trunk lumen and first and second branch lumens, the trunk lumen and branch lumens in fluid communication at a lumenal intersection, the method comprising:
positioning a tubular prosthetic branch module across the lumenal intersection from the first branch into the second branch, wherein a common lumen port of the branch prosthesis module is adjacent to the lumenal intersection;
expanding the positioned branch module;
positioning a tubular common lumen module within the common lumen of the body lumen system with at least one opening adjacent the lumenal intersection; and
expanding the positioned common lumen module;
wherein expansion of the later of the branch module and the common lumen module sealingly engages the branch and common lumen modules.
51. A method as in claim 50 , further comprising inserting the branch module through first and second openings of the expanded common lumen module.
52. A method as in claim 50 , further comprising inserting the common lumen module into the common lumen port of the expanded branch lumen module.
53. A method as in claim 50 , wherein the common lumen comprises the abdominal aorta, wherein the first and second branch lumens comprise the left and right iliac arteries, and wherein the sealingly engaged prosthetic modules extend upstream and downstream beyond an aneurysm.
54. A method for deploying an endoluminal prosthesis in a branching body lumen system of a patient, the branching lumen system including first, second, and third lumens in fluid communication at a lumenal intersection, the method comprising:
positioning the first wire through the lumenal intersection by introducing the first wire in through the first lumen and out the second lumen;
threading a distal end of the first wire through a distal opening of a second wire; and
selectively tensioning proximal and distal ends of the first wire and the proximal end of the second wire to position the prosthesis adjacent to the intersection.
55. A method as in claim 54 , further comprising:
returning the threaded first wire through the intersection and outside the patient; and
advancing the distal end of the second wire toward the intersection by tensioning the proximal and distal ends of the first wire.
56. A method as in claim 55 , wherein the returning step comprises advancing the threaded first wire back along the second lumen to the intersection and out of the patient through the third lumen.
57. A method for producing an endoluminal prosthesis comprising:
attaching an axially compressible elongate structure to an elongate liner strip;
coiling the liner strip to from a helix having a plurality of loops; and
attaching adjacent loops together so that the liner defines a tube.
58. A sealing structure for sealing an end of a tubular endoluminal prosthesis against a surrounding lumen, that sealing structure comprising a plurality of flexible sealing flaps extending from the prosthesis adjacent the end, the sealing flaps resiliently flaring radially outward to independently seal against the surrounding lumen.
59. An endoluminal prosthesis comprising:
a tubular liner; and
a frame supporting the tubular liner, the frame defining a plurality of loops having axially oriented apices, wherein at least some of the adjacent apices of adjacent loops are offset to enhance axial flexibility of the prosthesis.
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US09/942,919 US20020120327A1 (en) | 1995-12-01 | 2001-08-31 | Endoluminal prostheses and therapies for highly variable body lumens |
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US08/615,697 US5824040A (en) | 1995-12-01 | 1996-03-13 | Endoluminal prostheses and therapies for highly variable body lumens |
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US09/942,919 US20020120327A1 (en) | 1995-12-01 | 2001-08-31 | Endoluminal prostheses and therapies for highly variable body lumens |
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US09/121,226 Division US6283991B1 (en) | 1995-12-01 | 1998-07-22 | Endoluminal prostheses and therapies for highly variable body lumens |
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US09/942,919 Abandoned US20020120327A1 (en) | 1995-12-01 | 2001-08-31 | Endoluminal prostheses and therapies for highly variable body lumens |
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US09/121,226 Expired - Lifetime US6283991B1 (en) | 1995-12-01 | 1998-07-22 | Endoluminal prostheses and therapies for highly variable body lumens |
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Cited By (71)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6676624B2 (en) * | 2001-12-20 | 2004-01-13 | Scimed Life Systems, Inc. | Drainage devices and methods |
US6695877B2 (en) * | 2001-02-26 | 2004-02-24 | Scimed Life Systems | Bifurcated stent |
US20040117003A1 (en) * | 2002-05-28 | 2004-06-17 | The Cleveland Clinic Foundation | Minimally invasive treatment system for aortic aneurysms |
US20040167615A1 (en) * | 2003-02-21 | 2004-08-26 | Scimed Life Systems, Inc | Stent |
US20040176832A1 (en) * | 2002-12-04 | 2004-09-09 | Cook Incorporated | Method and device for treating aortic dissection |
US20040193254A1 (en) * | 2003-01-14 | 2004-09-30 | Greenberg Roy K. | Branched vessel endoluminal device |
US20040215326A1 (en) * | 2003-04-22 | 2004-10-28 | Goodson Harry B. | Single-piece crown stent |
US20040215319A1 (en) * | 2003-04-24 | 2004-10-28 | Humberto Berra | Stent graft tapered spring |
US20050038497A1 (en) * | 2003-08-11 | 2005-02-17 | Scimed Life Systems, Inc. | Deformation medical device without material deformation |
US20050113905A1 (en) * | 2003-10-10 | 2005-05-26 | Greenberg Roy K. | Endoluminal prosthesis with interconnectable modules |
US20050143806A1 (en) * | 1998-01-26 | 2005-06-30 | Phillips Peter W. | Reinforced graft and method of deployment |
US20050288768A1 (en) * | 2004-06-28 | 2005-12-29 | Krzysztof Sowinski | Two-stage stent-graft and method of delivering same |
US20060004455A1 (en) * | 2004-06-09 | 2006-01-05 | Alain Leonard | Methods and apparatuses for bone restoration |
US20060030932A1 (en) * | 2004-08-09 | 2006-02-09 | Kantor John D | Flexible stent |
US20060058869A1 (en) * | 2004-09-14 | 2006-03-16 | Vascular Architects, Inc., A Delaware Corporation | Coiled ladder stent |
US20060089704A1 (en) * | 2004-10-25 | 2006-04-27 | Myles Douglas | Vascular graft and deployment system |
US20060195175A1 (en) * | 2005-02-25 | 2006-08-31 | Abbott Laboratories Vascular Enterprises Limited | Modular vascular prosthesis having axially variable properties and improved flexibility and methods of use |
US20070026132A1 (en) * | 2002-11-15 | 2007-02-01 | Williams Michael S | Endoprostheses and methods of manufacture |
US20070123994A1 (en) * | 2005-11-29 | 2007-05-31 | Ethicon Endo-Surgery, Inc. | Internally Placed Gastric Restriction Device |
EP1795152A2 (en) * | 2005-11-15 | 2007-06-13 | Cordis Corporation | Systems and methods for securing graft material to intraluminal devices |
US20070250154A1 (en) * | 2006-04-19 | 2007-10-25 | William A. Cook Australia Pty Ltd. | Twin bifurcated stent graft |
US20070299495A1 (en) * | 2006-06-23 | 2007-12-27 | Stanislaw Zukowski | Branched stent delivery system |
US7407509B2 (en) | 2003-01-14 | 2008-08-05 | The Cleveland Clinic Foundation | Branched vessel endoluminal device with fenestration |
US20080215129A1 (en) * | 2005-07-25 | 2008-09-04 | Invatec S.R.L. | Endolumenal Prosthesis with Bioresorbable Portions |
EP1996113A2 (en) * | 2006-03-15 | 2008-12-03 | Medinol Ltd. | Hybrid amorphous metal alloy stent |
US20080300668A1 (en) * | 2007-05-30 | 2008-12-04 | Craig Bonsignore | Stent/fiber structural combinations |
US20090005848A1 (en) * | 2005-02-25 | 2009-01-01 | Abbott Laboratories Vascular Enterprises Limited | Modular vascular prosthesis and methods of use |
US20090005760A1 (en) * | 2006-07-31 | 2009-01-01 | Richard George Cartledge | Sealable endovascular implants and methods for their use |
US20090030527A1 (en) * | 2003-06-27 | 2009-01-29 | Zuli Holdings, Ltd. | Amorphous metal alloy medical devices |
US20090043377A1 (en) * | 2003-01-14 | 2009-02-12 | The Cleveland Clinic Foundation | Branched Vessel Endoluminal Device |
WO2008152620A3 (en) * | 2007-06-13 | 2010-02-25 | Edo Kaluski | Bifurcated balloon & stent delivery system |
US7699883B2 (en) | 2004-10-25 | 2010-04-20 | Myles Douglas | Vascular graft and deployment system |
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 |
US20100249898A1 (en) * | 2009-03-24 | 2010-09-30 | Medtronic Vascular, Inc. | Stent Graft |
US20100256741A1 (en) * | 2009-04-07 | 2010-10-07 | William Cook Europe Aps | Modular stent assembly |
US20110093061A1 (en) * | 2007-03-31 | 2011-04-21 | Biotronik Vi Patent Ag | Stent having radially expandable main body |
US7988720B2 (en) | 2006-09-12 | 2011-08-02 | Boston Scientific Scimed, Inc. | Longitudinally flexible expandable stent |
WO2011137215A1 (en) * | 2010-04-29 | 2011-11-03 | Vanderbilt University | Percutaneous collateral bypass |
US8066755B2 (en) | 2007-09-26 | 2011-11-29 | Trivascular, Inc. | System and method of pivoted stent deployment |
US8083789B2 (en) | 2007-11-16 | 2011-12-27 | Trivascular, Inc. | Securement assembly and method for expandable endovascular device |
US8226701B2 (en) | 2007-09-26 | 2012-07-24 | Trivascular, Inc. | Stent and delivery system for deployment thereof |
US8328861B2 (en) | 2007-11-16 | 2012-12-11 | Trivascular, Inc. | Delivery system and method for bifurcated graft |
US8361136B2 (en) | 1998-02-09 | 2013-01-29 | Trivascular, Inc. | Endovascular graft |
US8382821B2 (en) | 1998-12-03 | 2013-02-26 | Medinol Ltd. | Helical hybrid stent |
US20130060322A1 (en) * | 2004-07-21 | 2013-03-07 | Boston Scientific Scimed, Inc. | Expandable framework with overlapping connectors |
US8449597B2 (en) | 1995-03-01 | 2013-05-28 | Boston Scientific Scimed, Inc. | Longitudinally flexible expandable stent |
US8663309B2 (en) | 2007-09-26 | 2014-03-04 | Trivascular, Inc. | Asymmetric stent apparatus and method |
US20140364935A1 (en) * | 2013-06-05 | 2014-12-11 | Abbott Cardiovascular Systems Inc. | Coupled scaffold segments |
US8986386B2 (en) | 2009-03-12 | 2015-03-24 | Vexim Sas | Apparatus for bone restoration of the spine and methods of use |
US8992595B2 (en) | 2012-04-04 | 2015-03-31 | Trivascular, Inc. | Durable stent graft with tapered struts and stable delivery methods and devices |
US9039755B2 (en) | 2003-06-27 | 2015-05-26 | Medinol Ltd. | Helical hybrid stent |
US9155639B2 (en) | 2009-04-22 | 2015-10-13 | Medinol Ltd. | Helical hybrid stent |
US9314352B1 (en) * | 2012-04-17 | 2016-04-19 | W. L. Gore & Associates, Inc. | Endoprosthesis having open flow lumens |
US9408607B2 (en) | 2009-07-02 | 2016-08-09 | Edwards Lifesciences Cardiaq Llc | Surgical implant devices and methods for their manufacture and use |
US9414933B2 (en) | 2011-04-07 | 2016-08-16 | Vexim Sa | Expandable orthopedic device |
US9498363B2 (en) | 2012-04-06 | 2016-11-22 | Trivascular, Inc. | Delivery catheter for endovascular device |
US9566178B2 (en) | 2010-06-24 | 2017-02-14 | Edwards Lifesciences Cardiaq Llc | Actively controllable stent, stent graft, heart valve and method of controlling same |
US9579130B2 (en) | 2008-04-08 | 2017-02-28 | Vexim Sas | Apparatus for restoration of the spine and methods of use thereof |
US9585743B2 (en) | 2006-07-31 | 2017-03-07 | Edwards Lifesciences Cardiaq Llc | Surgical implant devices and methods for their manufacture and use |
US9814611B2 (en) | 2007-07-31 | 2017-11-14 | Edwards Lifesciences Cardiaq Llc | Actively controllable stent, stent graft, heart valve and method of controlling same |
US9827093B2 (en) | 2011-10-21 | 2017-11-28 | Edwards Lifesciences Cardiaq Llc | Actively controllable stent, stent graft, heart valve and method of controlling same |
US10159557B2 (en) | 2007-10-04 | 2018-12-25 | Trivascular, Inc. | Modular vascular graft for low profile percutaneous delivery |
US20190274853A1 (en) * | 2018-03-09 | 2019-09-12 | Vesper Medical, Inc. | Implantable stent |
US10512533B1 (en) | 2016-02-23 | 2019-12-24 | W. L. Gore & Associates, Inc. | Branched graft assembly method in vivo |
US10603080B2 (en) | 2013-12-23 | 2020-03-31 | Vexim | Expansible intravertebral implant system with posterior pedicle fixation |
US10702406B2 (en) | 2017-03-29 | 2020-07-07 | Cook Medical Technologies Llc | Prosthesis with flexible stent |
US11096774B2 (en) | 2016-12-09 | 2021-08-24 | Zenflow, Inc. | Systems, devices, and methods for the accurate deployment of an implant in the prostatic urethra |
US20210369440A1 (en) * | 2012-04-12 | 2021-12-02 | Sanford Health | Debranching Visceral Stent Grant and Methods for Use |
WO2023043680A1 (en) * | 2021-09-17 | 2023-03-23 | Boston Scientific Scimed, Inc. | Stent system |
US11890213B2 (en) | 2019-11-19 | 2024-02-06 | Zenflow, Inc. | Systems, devices, and methods for the accurate deployment and imaging of an implant in the prostatic urethra |
Families Citing this family (377)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6051020A (en) | 1994-02-09 | 2000-04-18 | Boston Scientific Technology, Inc. | Bifurcated endoluminal prosthesis |
US5609627A (en) * | 1994-02-09 | 1997-03-11 | Boston Scientific Technology, Inc. | Method for delivering a bifurcated endoluminal prosthesis |
US6039749A (en) | 1994-02-10 | 2000-03-21 | Endovascular Systems, Inc. | Method and apparatus for deploying non-circular stents and graftstent complexes |
DE69518275T3 (en) | 1994-06-08 | 2007-10-18 | CardioVascular Concepts, Inc., Portola Valley | Blood vessel graft |
US6814747B2 (en) | 1995-09-08 | 2004-11-09 | Anthony Walter Anson | Surgical graft/stent system |
GB9518400D0 (en) | 1995-09-08 | 1995-11-08 | Anson Medical Ltd | A surgical graft/stent system |
US6099558A (en) * | 1995-10-10 | 2000-08-08 | Edwards Lifesciences Corp. | Intraluminal grafting of a bifuricated artery |
US6287315B1 (en) * | 1995-10-30 | 2001-09-11 | World Medical Manufacturing Corporation | Apparatus for delivering an endoluminal prosthesis |
US6348066B1 (en) * | 1995-11-07 | 2002-02-19 | Corvita Corporation | Modular endoluminal stent-grafts and methods for their use |
US6991614B2 (en) | 1995-11-07 | 2006-01-31 | Boston Scientific Scimed, Inc. | Ureteral stent for improved patient comfort |
US6929659B2 (en) * | 1995-11-07 | 2005-08-16 | Scimed Life Systems, Inc. | Method of preventing the dislodgment of a stent-graft |
ATE290832T1 (en) * | 1996-01-05 | 2005-04-15 | Medtronic Inc | EXPANDABLE ENDOLUMINAL PROSTHESES |
US6796997B1 (en) | 1996-03-05 | 2004-09-28 | Evysio Medical Devices Ulc | Expandable stent |
WO1997032544A1 (en) | 1996-03-05 | 1997-09-12 | Divysio Solutions Ulc. | Expandable stent and method for delivery of same |
CA2192520A1 (en) | 1996-03-05 | 1997-09-05 | Ian M. Penn | Expandable stent and method for delivery of same |
BE1010183A3 (en) * | 1996-04-25 | 1998-02-03 | Dereume Jean Pierre Georges Em | Luminal endoprosthesis FOR BRANCHING CHANNELS OF A HUMAN OR ANIMAL BODY AND MANUFACTURING METHOD THEREOF. |
FR2748199B1 (en) * | 1996-05-02 | 1998-10-09 | Braun Celsa Sa | TRANSCUTANEOUS SURGICAL ANASTOMOSABLE VASCULAR PROSTHESIS |
US5800514A (en) | 1996-05-24 | 1998-09-01 | Meadox Medicals, Inc. | Shaped woven tubular soft-tissue prostheses and methods of manufacturing |
FR2749160B1 (en) * | 1996-05-28 | 1999-05-21 | Patrice Bergeron | MODULAR BIFURCED VASCULAR PROSTHESIS |
US7238197B2 (en) | 2000-05-30 | 2007-07-03 | Devax, Inc. | Endoprosthesis deployment system for treating vascular bifurcations |
US8728143B2 (en) | 1996-06-06 | 2014-05-20 | Biosensors International Group, Ltd. | Endoprosthesis deployment system for treating vascular bifurcations |
US7686846B2 (en) | 1996-06-06 | 2010-03-30 | Devax, Inc. | Bifurcation stent and method of positioning in a body lumen |
US6666883B1 (en) | 1996-06-06 | 2003-12-23 | Jacques Seguin | Endoprosthesis for vascular bifurcation |
FR2749500B1 (en) * | 1996-06-06 | 1998-11-20 | Jacques Seguin | DEVICE ALLOWING THE TREATMENT OF BODY DUCTS AT THE LEVEL OF A BIFURCATION |
BR9709867A (en) * | 1996-06-20 | 2000-01-11 | Sulzer Vascutek Ltda | Device for retaining a prosthesis in a passage of the body device for fixing a prosthesis on an internal surface of a body passage, prosthetic device, prosthesis and process for fixing a prosthetic device, for repairing a vessel and for inserting a prosthesis in a passage of the body. |
US7341598B2 (en) * | 1999-01-13 | 2008-03-11 | Boston Scientific Scimed, Inc. | Stent with protruding branch portion for bifurcated vessels |
EP1723931B1 (en) | 1996-11-04 | 2012-01-04 | Advanced Stent Technologies, Inc. | Extendible stent apparatus and method for deploying the same |
US6682536B2 (en) | 2000-03-22 | 2004-01-27 | Advanced Stent Technologies, Inc. | Guidewire introducer sheath |
US8211167B2 (en) | 1999-12-06 | 2012-07-03 | Boston Scientific Scimed, Inc. | Method of using a catheter with attached flexible side sheath |
US6692483B2 (en) | 1996-11-04 | 2004-02-17 | Advanced Stent Technologies, Inc. | Catheter with attached flexible side sheath |
US7591846B2 (en) | 1996-11-04 | 2009-09-22 | Boston Scientific Scimed, Inc. | Methods for deploying stents in bifurcations |
US6835203B1 (en) | 1996-11-04 | 2004-12-28 | Advanced Stent Technologies, Inc. | Extendible stent apparatus |
US6325826B1 (en) * | 1998-01-14 | 2001-12-04 | Advanced Stent Technologies, Inc. | Extendible stent apparatus |
US6599316B2 (en) | 1996-11-04 | 2003-07-29 | Advanced Stent Technologies, Inc. | Extendible stent apparatus |
WO1998020810A1 (en) * | 1996-11-12 | 1998-05-22 | Medtronic, Inc. | Flexible, radially expansible luminal prostheses |
US8353948B2 (en) * | 1997-01-24 | 2013-01-15 | Celonova Stent, Inc. | Fracture-resistant helical stent incorporating bistable cells and methods of use |
US6030415A (en) * | 1997-01-29 | 2000-02-29 | Endovascular Technologies, Inc. | Bell-bottom modular stent-graft |
US6302908B1 (en) * | 1997-03-24 | 2001-10-16 | Juan Carlos Parodi | Arterial graft device and method of positioning the same |
EP0884029B1 (en) * | 1997-06-13 | 2004-12-22 | Gary J. Becker | Expandable intraluminal endoprosthesis |
US6070589A (en) | 1997-08-01 | 2000-06-06 | Teramed, Inc. | Methods for deploying bypass graft stents |
US6306164B1 (en) * | 1997-09-05 | 2001-10-23 | C. R. Bard, Inc. | Short body endoprosthesis |
WO1999026559A1 (en) * | 1997-11-25 | 1999-06-03 | Triad Vascular Systems, Inc. | Layered endovascular graft |
US6129754A (en) * | 1997-12-11 | 2000-10-10 | Uni-Cath Inc. | Stent for vessel with branch |
US20050154446A1 (en) * | 1998-01-26 | 2005-07-14 | Peter Phillips | Reinforced graft |
US6395018B1 (en) * | 1998-02-09 | 2002-05-28 | Wilfrido R. Castaneda | Endovascular graft and process for bridging a defect in a main vessel near one of more branch vessels |
US6176864B1 (en) * | 1998-03-09 | 2001-01-23 | Corvascular, Inc. | Anastomosis device and method |
US6129756A (en) * | 1998-03-16 | 2000-10-10 | Teramed, Inc. | Biluminal endovascular graft system |
US6656215B1 (en) | 2000-11-16 | 2003-12-02 | Cordis Corporation | Stent graft having an improved means for attaching a stent to a graft |
US6290731B1 (en) | 1998-03-30 | 2001-09-18 | Cordis Corporation | Aortic graft having a precursor gasket for repairing an abdominal aortic aneurysm |
ATE342014T1 (en) | 1998-06-19 | 2006-11-15 | Endologix Inc | SELF-EXPANDING BRANCHING ENDOVASCULAR PROSTHESIS |
US6461380B1 (en) | 1998-07-28 | 2002-10-08 | Advanced Cardiovascular Systems, Inc. | Stent configuration |
US6238432B1 (en) | 1998-08-25 | 2001-05-29 | Juan Carlos Parodi | Stent graft device for treating abdominal aortic aneurysms |
US6406488B1 (en) * | 1998-08-27 | 2002-06-18 | Heartstent Corporation | Healing transmyocardial implant |
US6849088B2 (en) * | 1998-09-30 | 2005-02-01 | Edwards Lifesciences Corporation | Aorto uni-iliac graft |
US6368345B1 (en) * | 1998-09-30 | 2002-04-09 | Edwards Lifesciences Corporation | Methods and apparatus for intraluminal placement of a bifurcated intraluminal garafat |
AUPQ302999A0 (en) * | 1999-09-23 | 1999-10-21 | Endogad Research Pty Limited | Pre-shaped intraluminal graft |
US6273909B1 (en) * | 1998-10-05 | 2001-08-14 | Teramed Inc. | Endovascular graft system |
US6042597A (en) * | 1998-10-23 | 2000-03-28 | Scimed Life Systems, Inc. | Helical stent design |
US6152937A (en) * | 1998-11-06 | 2000-11-28 | St. Jude Medical Cardiovascular Group, Inc. | Medical graft connector and methods of making and installing same |
US6214036B1 (en) | 1998-11-09 | 2001-04-10 | Cordis Corporation | Stent which is easily recaptured and repositioned within the body |
US6325820B1 (en) | 1998-11-16 | 2001-12-04 | Endotex Interventional Systems, Inc. | Coiled-sheet stent-graft with exo-skeleton |
US6322585B1 (en) | 1998-11-16 | 2001-11-27 | Endotex Interventional Systems, Inc. | Coiled-sheet stent-graft with slidable exo-skeleton |
US20010049554A1 (en) * | 1998-11-18 | 2001-12-06 | Carlos E. Ruiz | Endovascular prosthesis and method of making |
US6187036B1 (en) | 1998-12-11 | 2001-02-13 | Endologix, Inc. | Endoluminal vascular prosthesis |
US6733523B2 (en) * | 1998-12-11 | 2004-05-11 | Endologix, Inc. | Implantable vascular graft |
US6660030B2 (en) | 1998-12-11 | 2003-12-09 | Endologix, Inc. | Bifurcation graft deployment catheter |
JP4189127B2 (en) | 1998-12-11 | 2008-12-03 | エンドロジックス、インク | Intraluminal artificial blood vessels |
US6059824A (en) * | 1998-12-23 | 2000-05-09 | Taheri; Syde A. | Mated main and collateral stent and method for treatment of arterial disease |
US7655030B2 (en) | 2003-07-18 | 2010-02-02 | Boston Scientific Scimed, Inc. | Catheter balloon systems and methods |
US8257425B2 (en) | 1999-01-13 | 2012-09-04 | Boston Scientific Scimed, Inc. | Stent with protruding branch portion for bifurcated vessels |
ATE390902T1 (en) * | 1999-01-22 | 2008-04-15 | Gore Enterprise Holdings Inc | LOW PROFILE STENT AND TRANSPLANT COMBINATION |
US6261316B1 (en) | 1999-03-11 | 2001-07-17 | Endologix, Inc. | Single puncture bifurcation graft deployment system |
US8034100B2 (en) | 1999-03-11 | 2011-10-11 | Endologix, Inc. | Graft deployment system |
US6858034B1 (en) * | 1999-05-20 | 2005-02-22 | Scimed Life Systems, Inc. | Stent delivery system for prevention of kinking, and method of loading and using same |
US6648913B1 (en) | 1999-06-07 | 2003-11-18 | Scimed Life Systems, Inc. | Guidewire-access modular intraluminal prosthesis with connecting section |
US6409754B1 (en) * | 1999-07-02 | 2002-06-25 | Scimed Life Systems, Inc. | Flexible segmented stent |
US6364904B1 (en) * | 1999-07-02 | 2002-04-02 | Scimed Life Systems, Inc. | Helically formed stent/graft assembly |
US6302892B1 (en) * | 1999-08-04 | 2001-10-16 | Percardia, Inc. | Blood flow conduit delivery system and method of use |
WO2001015759A1 (en) * | 1999-09-01 | 2001-03-08 | Bacchus Vascular, Inc. | Methods and apparatus for accessing and treating body lumens |
US6270525B1 (en) * | 1999-09-23 | 2001-08-07 | Cordis Corporation | Precursor stent gasket for receiving bilateral grafts having controlled contralateral guidewire access |
US6689156B1 (en) | 1999-09-23 | 2004-02-10 | Advanced Stent Technologies, Inc. | Stent range transducers and methods of use |
US6849087B1 (en) * | 1999-10-06 | 2005-02-01 | Timothy A. M. Chuter | Device and method for staged implantation of a graft for vascular repair |
AU7997900A (en) | 1999-10-08 | 2001-04-23 | General Hospital Corporation, The | Percutaneous stent graft and method for vascular bypass |
US6383171B1 (en) | 1999-10-12 | 2002-05-07 | Allan Will | Methods and devices for protecting a passageway in a body when advancing devices through the passageway |
GB2355728A (en) | 1999-10-27 | 2001-05-02 | Anson Medical Ltd | Tubular medical implants and methods of manufacture |
US6325823B1 (en) | 1999-10-29 | 2001-12-04 | Revasc Corporation | Endovascular prosthesis accommodating torsional and longitudinal displacements and methods of use |
US6602280B2 (en) | 2000-02-02 | 2003-08-05 | Trivascular, Inc. | Delivery system and method for expandable intracorporeal device |
ATE255860T1 (en) * | 2000-03-03 | 2003-12-15 | Cook Inc | ENDOVASCULAR DEVICE WITH STENT |
EP1132058A1 (en) | 2000-03-06 | 2001-09-12 | Advanced Laser Applications Holding S.A. | Intravascular prothesis |
WO2001074270A2 (en) * | 2000-03-30 | 2001-10-11 | Teramed Corporation | Bifurcated graft and method of delivery |
US6772026B2 (en) * | 2000-04-05 | 2004-08-03 | Therics, Inc. | System and method for rapidly customizing design, manufacture and/or selection of biomedical devices |
US7517352B2 (en) | 2000-04-07 | 2009-04-14 | Bacchus Vascular, Inc. | Devices for percutaneous remote endarterectomy |
US6942691B1 (en) | 2000-04-27 | 2005-09-13 | Timothy A. M. Chuter | Modular bifurcated graft for endovascular aneurysm repair |
US6616689B1 (en) | 2000-05-03 | 2003-09-09 | Advanced Cardiovascular Systems, Inc. | Intravascular stent |
WO2001087184A1 (en) * | 2000-05-16 | 2001-11-22 | Frantzen John J | Radially expandable stent featuring aneurysm covering surface |
US6799637B2 (en) | 2000-10-20 | 2004-10-05 | Schlumberger Technology Corporation | Expandable tubing and method |
US6695833B1 (en) | 2000-09-27 | 2004-02-24 | Nellix, Inc. | Vascular stent-graft apparatus and forming method |
US8870946B1 (en) * | 2000-12-11 | 2014-10-28 | W.L. Gore & Associates, Inc. | Method of deploying a bifurcated side-access intravascular stent graft |
US6645242B1 (en) | 2000-12-11 | 2003-11-11 | Stephen F. Quinn | Bifurcated side-access intravascular stent graft |
US6562022B2 (en) * | 2000-12-13 | 2003-05-13 | Advanced Cardiovascular Systems, Inc. | Catheter with enhanced reinforcement |
US6929660B1 (en) | 2000-12-22 | 2005-08-16 | Advanced Cardiovascular Systems, Inc. | Intravascular stent |
US6565599B1 (en) * | 2000-12-28 | 2003-05-20 | Advanced Cardiovascular Systems, Inc. | Hybrid stent |
NO335594B1 (en) | 2001-01-16 | 2015-01-12 | Halliburton Energy Serv Inc | Expandable devices and methods thereof |
AU2002250189A1 (en) * | 2001-02-26 | 2002-09-12 | Scimed Life Systems, Inc. | Bifurcated stent and delivery system |
US6773456B1 (en) | 2001-03-23 | 2004-08-10 | Endovascular Technologies, Inc. | Adjustable customized endovascular graft |
EP1258230A3 (en) | 2001-03-29 | 2003-12-10 | CardioSafe Ltd | Balloon catheter device |
US7175651B2 (en) * | 2001-07-06 | 2007-02-13 | Andrew Kerr | Stent/graft assembly |
US6761733B2 (en) | 2001-04-11 | 2004-07-13 | Trivascular, Inc. | Delivery system and method for bifurcated endovascular graft |
US20040215322A1 (en) * | 2001-07-06 | 2004-10-28 | Andrew Kerr | Stent/graft assembly |
US6733521B2 (en) | 2001-04-11 | 2004-05-11 | Trivascular, Inc. | Delivery system and method for endovascular graft |
US9937066B2 (en) | 2001-04-11 | 2018-04-10 | Andre Kerr | Stent/graft assembly |
US10105209B2 (en) * | 2001-04-11 | 2018-10-23 | Andrew Kerr | Stent/graft assembly |
US8617231B2 (en) | 2001-05-18 | 2013-12-31 | Boston Scientific Scimed, Inc. | Dual guidewire exchange catheter system |
US6629994B2 (en) * | 2001-06-11 | 2003-10-07 | Advanced Cardiovascular Systems, Inc. | Intravascular stent |
US6939373B2 (en) * | 2003-08-20 | 2005-09-06 | Advanced Cardiovascular Systems, Inc. | Intravascular stent |
JP2004529735A (en) * | 2001-06-18 | 2004-09-30 | イーバ コーポレイション | Prosthetic implants and their use |
US6635083B1 (en) | 2001-06-25 | 2003-10-21 | Advanced Cardiovascular Systems, Inc. | Stent with non-linear links and method of use |
US6749629B1 (en) | 2001-06-27 | 2004-06-15 | Advanced Cardiovascular Systems, Inc. | Stent pattern with figure-eights |
US6675809B2 (en) | 2001-08-27 | 2004-01-13 | Richard S. Stack | Satiation devices and methods |
GB0121980D0 (en) | 2001-09-11 | 2001-10-31 | Cathnet Science Holding As | Expandable stent |
US20030074055A1 (en) * | 2001-10-17 | 2003-04-17 | Haverkost Patrick A. | Method and system for fixation of endoluminal devices |
US20060292206A1 (en) * | 2001-11-26 | 2006-12-28 | Kim Steven W | Devices and methods for treatment of vascular aneurysms |
US7137993B2 (en) | 2001-12-03 | 2006-11-21 | Xtent, Inc. | Apparatus and methods for delivery of multiple distributed stents |
US7147656B2 (en) | 2001-12-03 | 2006-12-12 | Xtent, Inc. | Apparatus and methods for delivery of braided prostheses |
US7309350B2 (en) | 2001-12-03 | 2007-12-18 | Xtent, Inc. | Apparatus and methods for deployment of vascular prostheses |
US7892273B2 (en) | 2001-12-03 | 2011-02-22 | Xtent, Inc. | Custom length stent apparatus |
US7351255B2 (en) | 2001-12-03 | 2008-04-01 | Xtent, Inc. | Stent delivery apparatus and method |
US7270668B2 (en) * | 2001-12-03 | 2007-09-18 | Xtent, Inc. | Apparatus and methods for delivering coiled prostheses |
US7294146B2 (en) | 2001-12-03 | 2007-11-13 | Xtent, Inc. | Apparatus and methods for delivery of variable length stents |
US20030135266A1 (en) * | 2001-12-03 | 2003-07-17 | Xtent, Inc. | Apparatus and methods for delivery of multiple distributed stents |
US7182779B2 (en) | 2001-12-03 | 2007-02-27 | Xtent, Inc. | Apparatus and methods for positioning prostheses for deployment from a catheter |
US8080048B2 (en) | 2001-12-03 | 2011-12-20 | Xtent, Inc. | Stent delivery for bifurcated vessels |
US20040186551A1 (en) | 2003-01-17 | 2004-09-23 | Xtent, Inc. | Multiple independent nested stent structures and methods for their preparation and deployment |
US20100016943A1 (en) | 2001-12-20 | 2010-01-21 | Trivascular2, Inc. | Method of delivering advanced endovascular graft |
US20030135265A1 (en) * | 2002-01-04 | 2003-07-17 | Stinson Jonathan S. | Prostheses implantable in enteral vessels |
US6949121B1 (en) | 2002-02-07 | 2005-09-27 | Sentient Engineering & Technology, Llc | Apparatus and methods for conduits and materials |
US9539121B2 (en) * | 2002-02-07 | 2017-01-10 | Dsm Ip Assets B.V. | Apparatus and methods for conduits and materials |
US7288111B1 (en) * | 2002-03-26 | 2007-10-30 | Thoratec Corporation | Flexible stent and method of making the same |
US6918926B2 (en) * | 2002-04-25 | 2005-07-19 | Medtronic Vascular, Inc. | System for transrenal/intraostial fixation of endovascular prosthesis |
US7887575B2 (en) * | 2002-05-22 | 2011-02-15 | Boston Scientific Scimed, Inc. | Stent with segmented graft |
US6656220B1 (en) | 2002-06-17 | 2003-12-02 | Advanced Cardiovascular Systems, Inc. | Intravascular stent |
US6659313B1 (en) * | 2002-07-24 | 2003-12-09 | Macmurdo Alex | Magnetic tube and delivery apparatus |
WO2004026183A2 (en) | 2002-09-20 | 2004-04-01 | Nellix, Inc. | Stent-graft with positioning anchor |
US20040148016A1 (en) * | 2002-11-07 | 2004-07-29 | Klein Dean A. | Biocompatible medical device coatings |
EP1567087B1 (en) | 2002-11-08 | 2009-04-01 | Jacques Seguin | Endoprosthesis for vascular bifurcation |
US7481821B2 (en) * | 2002-11-12 | 2009-01-27 | Thomas J. Fogarty | Embolization device and a method of using the same |
US6923829B2 (en) | 2002-11-25 | 2005-08-02 | Advanced Bio Prosthetic Surfaces, Ltd. | Implantable expandable medical devices having regions of differential mechanical properties and methods of making same |
US20040260382A1 (en) | 2003-02-12 | 2004-12-23 | Fogarty Thomas J. | Intravascular implants and methods of using the same |
US20080051866A1 (en) * | 2003-02-26 | 2008-02-28 | Chao Chin Chen | Drug delivery devices and methods |
US7220274B1 (en) | 2003-03-21 | 2007-05-22 | Quinn Stephen F | Intravascular stent grafts and methods for deploying the same |
GB0309616D0 (en) | 2003-04-28 | 2003-06-04 | Angiomed Gmbh & Co | Loading and delivery of self-expanding stents |
US7074194B2 (en) * | 2003-05-19 | 2006-07-11 | Ischemia Technologies, Inc. | Apparatus and method for risk stratification of patients with chest pain of suspected cardiac origin |
US7241308B2 (en) | 2003-06-09 | 2007-07-10 | Xtent, Inc. | Stent deployment systems and methods |
US7247986B2 (en) * | 2003-06-10 | 2007-07-24 | Samsung Sdi. Co., Ltd. | Organic electro luminescent display and method for fabricating the same |
US20050015110A1 (en) * | 2003-07-18 | 2005-01-20 | Fogarty Thomas J. | Embolization device and a method of using the same |
US6840569B1 (en) * | 2003-07-22 | 2005-01-11 | Arthur Donald Leigh | Caravan |
US8157850B2 (en) * | 2003-07-29 | 2012-04-17 | Boston Scientific Scimed, Inc. | Device and method for loading a luminal graft for endoluminal delivery |
US8298280B2 (en) | 2003-08-21 | 2012-10-30 | Boston Scientific Scimed, Inc. | Stent with protruding branch portion for bifurcated vessels |
US20070198078A1 (en) | 2003-09-03 | 2007-08-23 | Bolton Medical, Inc. | Delivery system and method for self-centering a Proximal end of 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 |
US11259945B2 (en) | 2003-09-03 | 2022-03-01 | Bolton Medical, Inc. | Dual capture device for stent graft delivery system and method for capturing a stent graft |
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 |
US11596537B2 (en) | 2003-09-03 | 2023-03-07 | Bolton Medical, Inc. | Delivery system and method for self-centering a proximal end of a stent graft |
WO2005032340A2 (en) * | 2003-09-29 | 2005-04-14 | Secant Medical, Llc | Integral support stent graft assembly |
US7553324B2 (en) | 2003-10-14 | 2009-06-30 | Xtent, Inc. | Fixed stent delivery devices and methods |
US7344557B2 (en) | 2003-11-12 | 2008-03-18 | Advanced Stent Technologies, Inc. | Catheter balloon systems and methods |
WO2005058202A1 (en) * | 2003-12-17 | 2005-06-30 | Cook Incorporated | Interconnected leg extensions for an endoluminal prostehsis |
US7326236B2 (en) | 2003-12-23 | 2008-02-05 | Xtent, Inc. | Devices and methods for controlling and indicating the length of an interventional element |
US7195644B2 (en) * | 2004-03-02 | 2007-03-27 | Joint Synergy, Llc | Ball and dual socket joint |
US8007528B2 (en) | 2004-03-17 | 2011-08-30 | Boston Scientific Scimed, Inc. | Bifurcated stent |
US7323006B2 (en) | 2004-03-30 | 2008-01-29 | Xtent, Inc. | Rapid exchange interventional devices and methods |
US7674284B2 (en) | 2004-03-31 | 2010-03-09 | Cook Incorporated | Endoluminal graft |
US20050267559A1 (en) * | 2004-05-11 | 2005-12-01 | De Oliveira Daniel D | Cuffed grafts for vascular anastomosis |
EP2419048A4 (en) | 2004-05-25 | 2014-04-09 | Covidien Lp | Vascular stenting for aneurysms |
US20060206200A1 (en) | 2004-05-25 | 2006-09-14 | Chestnut Medical Technologies, Inc. | Flexible vascular occluding device |
EP1750619B1 (en) | 2004-05-25 | 2013-07-24 | Covidien LP | Flexible vascular occluding device |
US8628564B2 (en) | 2004-05-25 | 2014-01-14 | Covidien Lp | Methods and apparatus for luminal stenting |
EP1753369B1 (en) | 2004-06-08 | 2013-05-29 | Advanced Stent Technologies, Inc. | Stent with protruding branch portion for bifurcated vessels |
US20050276914A1 (en) * | 2004-06-15 | 2005-12-15 | Liu Ming-Dah | Method for manufacturing light guide plate mold cores |
US8317859B2 (en) | 2004-06-28 | 2012-11-27 | J.W. Medical Systems Ltd. | Devices and methods for controlling expandable prostheses during deployment |
US20050288766A1 (en) | 2004-06-28 | 2005-12-29 | Xtent, Inc. | Devices and methods for controlling expandable prostheses during deployment |
US8048145B2 (en) | 2004-07-22 | 2011-11-01 | Endologix, Inc. | Graft systems having filling structures supported by scaffolds and methods for their use |
WO2006012567A2 (en) | 2004-07-22 | 2006-02-02 | Nellix, Inc. | Methods and systems for endovascular aneurysm treatment |
ATE448752T1 (en) * | 2004-07-28 | 2009-12-15 | Cordis Corp | BIFURCATION PROSTHESIS FOR REPAIR OF AN ABDOMINAL AORTIC ANEURYSM |
CA2580859C (en) * | 2004-09-21 | 2012-12-04 | William A. Cook Australia Pty. Ltd. | Stent graft connection arrangement |
AU2005289812B2 (en) * | 2004-09-22 | 2010-09-16 | Cook Incorporated | Stent graft with integral side arm |
EP1793766B3 (en) | 2004-09-28 | 2012-07-04 | William A. Cook Australia Pty. Ltd. | Device for treating aortic dissection |
US8221397B2 (en) | 2004-10-15 | 2012-07-17 | Baxano, Inc. | Devices and methods for tissue modification |
US8257356B2 (en) | 2004-10-15 | 2012-09-04 | Baxano, Inc. | Guidewire exchange systems to treat spinal stenosis |
US7555343B2 (en) | 2004-10-15 | 2009-06-30 | Baxano, Inc. | Devices and methods for selective surgical removal of tissue |
US7738969B2 (en) | 2004-10-15 | 2010-06-15 | Baxano, Inc. | Devices and methods for selective surgical removal of tissue |
US9247952B2 (en) | 2004-10-15 | 2016-02-02 | Amendia, Inc. | Devices and methods for tissue access |
US7887538B2 (en) | 2005-10-15 | 2011-02-15 | Baxano, Inc. | Methods and apparatus for tissue modification |
US8430881B2 (en) | 2004-10-15 | 2013-04-30 | Baxano, Inc. | Mechanical tissue modification devices and methods |
US7918849B2 (en) | 2004-10-15 | 2011-04-05 | Baxano, Inc. | Devices and methods for tissue access |
US7578819B2 (en) | 2005-05-16 | 2009-08-25 | Baxano, Inc. | Spinal access and neural localization |
US9101386B2 (en) | 2004-10-15 | 2015-08-11 | Amendia, Inc. | Devices and methods for treating tissue |
US7857813B2 (en) | 2006-08-29 | 2010-12-28 | Baxano, Inc. | Tissue access guidewire system and method |
US20100331883A1 (en) | 2004-10-15 | 2010-12-30 | Schmitz Gregory P | Access and tissue modification systems and methods |
US20110190772A1 (en) | 2004-10-15 | 2011-08-04 | Vahid Saadat | Powered tissue modification devices and methods |
US8048080B2 (en) | 2004-10-15 | 2011-11-01 | Baxano, Inc. | Flexible tissue rasp |
US8617163B2 (en) | 2004-10-15 | 2013-12-31 | Baxano Surgical, Inc. | Methods, systems and devices for carpal tunnel release |
US7938830B2 (en) | 2004-10-15 | 2011-05-10 | Baxano, Inc. | Powered tissue modification devices and methods |
US8062300B2 (en) | 2006-05-04 | 2011-11-22 | Baxano, Inc. | Tissue removal with at least partially flexible devices |
US9427340B2 (en) | 2004-12-14 | 2016-08-30 | Boston Scientific Scimed, Inc. | Stent with protruding branch portion for bifurcated vessels |
US7857843B2 (en) * | 2004-12-31 | 2010-12-28 | Boston Scientific Scimed, Inc. | Differentially expanded vascular graft |
US7806922B2 (en) * | 2004-12-31 | 2010-10-05 | Boston Scientific Scimed, Inc. | Sintered ring supported vascular graft |
KR100614654B1 (en) * | 2005-01-04 | 2006-08-22 | 삼성전자주식회사 | RF transmitter for efficiently compensating output power variation due to temperature and process |
US7833263B2 (en) * | 2005-04-01 | 2010-11-16 | Boston Scientific Scimed, Inc. | Hybrid vascular graft reinforcement |
US20060222596A1 (en) | 2005-04-01 | 2006-10-05 | Trivascular, Inc. | Non-degradable, low swelling, water soluble radiopaque hydrogel polymer |
US7402168B2 (en) | 2005-04-11 | 2008-07-22 | Xtent, Inc. | Custom-length stent delivery system with independently operable expansion elements |
JP5070373B2 (en) | 2005-04-28 | 2012-11-14 | エンドーロジックス インコーポレイテッド | Graft system having a filling structure supported by a framework and method of use thereof |
US20060247760A1 (en) | 2005-04-29 | 2006-11-02 | Medtronic Vascular, Inc. | Methods and apparatus for treatment of aneurysms adjacent branch arteries |
US8317855B2 (en) | 2005-05-26 | 2012-11-27 | Boston Scientific Scimed, Inc. | Crimpable and expandable side branch cell |
US8480728B2 (en) | 2005-05-26 | 2013-07-09 | Boston Scientific Scimed, Inc. | Stent side branch deployment initiation geometry |
US20060276883A1 (en) * | 2005-06-01 | 2006-12-07 | Cook Incorporated | Tapered and distally stented elephant trunk stent graft |
US20080109058A1 (en) * | 2005-06-01 | 2008-05-08 | Cook Incorporated | Intraoperative Anastomosis Method |
US20060282149A1 (en) | 2005-06-08 | 2006-12-14 | Xtent, Inc., A Delaware Corporation | Apparatus and methods for deployment of multiple custom-length prostheses (II) |
US7938851B2 (en) | 2005-06-08 | 2011-05-10 | Xtent, Inc. | Devices and methods for operating and controlling interventional apparatus |
JP2009500121A (en) | 2005-07-07 | 2009-01-08 | ネリックス・インコーポレーテッド | System and method for treatment of an intraluminal aneurysm |
CA2829353C (en) * | 2005-07-27 | 2016-03-15 | Cook Medical Technologies Llc | Stent/graft device and method for open surgical placement |
US20070050015A1 (en) | 2005-08-25 | 2007-03-01 | Scimed Life Systems, Inc. | Endoluminal prosthesis adapted to deployment in a distorted branched body lumen and method of deploying the same |
US8038706B2 (en) | 2005-09-08 | 2011-10-18 | Boston Scientific Scimed, Inc. | Crown stent assembly |
US7731741B2 (en) | 2005-09-08 | 2010-06-08 | Boston Scientific Scimed, Inc. | Inflatable bifurcation stent |
US8043366B2 (en) | 2005-09-08 | 2011-10-25 | Boston Scientific Scimed, Inc. | Overlapping stent |
US20070061003A1 (en) * | 2005-09-15 | 2007-03-15 | Cappella, Inc. | Segmented ostial protection device |
US8366712B2 (en) | 2005-10-15 | 2013-02-05 | Baxano, Inc. | Multiple pathways for spinal nerve root decompression from a single access point |
US8092456B2 (en) | 2005-10-15 | 2012-01-10 | Baxano, Inc. | Multiple pathways for spinal nerve root decompression from a single access point |
US8062298B2 (en) | 2005-10-15 | 2011-11-22 | Baxano, Inc. | Flexible tissue removal devices and methods |
US20070100431A1 (en) * | 2005-11-03 | 2007-05-03 | Craig Bonsignore | Intraluminal medical device with strain concentrating bridge |
US8163002B2 (en) * | 2005-11-14 | 2012-04-24 | Vascular Devices Llc | Self-sealing vascular graft |
US20070112418A1 (en) | 2005-11-14 | 2007-05-17 | Boston Scientific Scimed, Inc. | Stent with spiral side-branch support designs |
US8343211B2 (en) | 2005-12-14 | 2013-01-01 | Boston Scientific Scimed, Inc. | Connectors for bifurcated stent |
US8435284B2 (en) | 2005-12-14 | 2013-05-07 | Boston Scientific Scimed, Inc. | Telescoping bifurcated stent |
US7540881B2 (en) * | 2005-12-22 | 2009-06-02 | Boston Scientific Scimed, Inc. | Bifurcation stent pattern |
US20070162109A1 (en) * | 2006-01-11 | 2007-07-12 | Luis Davila | Intraluminal stent graft |
US8821561B2 (en) | 2006-02-22 | 2014-09-02 | Boston Scientific Scimed, Inc. | Marker arrangement for bifurcation catheter |
WO2007100556A1 (en) | 2006-02-22 | 2007-09-07 | Ev3 Inc. | Embolic protection systems having radiopaque filter mesh |
US7833264B2 (en) | 2006-03-06 | 2010-11-16 | Boston Scientific Scimed, Inc. | Bifurcated stent |
US8298278B2 (en) | 2006-03-07 | 2012-10-30 | Boston Scientific Scimed, Inc. | Bifurcated stent with improvement securement |
CA2646885A1 (en) | 2006-03-20 | 2007-09-27 | Xtent, Inc. | Apparatus and methods for deployment of linked prosthetic segments |
US7678141B2 (en) * | 2006-04-18 | 2010-03-16 | Medtronic Vascular, Inc. | Stent graft having a flexible, articulable, and axially compressible branch graft |
US7790273B2 (en) * | 2006-05-24 | 2010-09-07 | Nellix, Inc. | Material for creating multi-layered films and methods for making the same |
US7872068B2 (en) * | 2006-05-30 | 2011-01-18 | Incept Llc | Materials formable in situ within a medical device |
US9259336B2 (en) * | 2006-06-06 | 2016-02-16 | Cook Medical Technologies Llc | Stent with a crush-resistant zone |
US7922758B2 (en) | 2006-06-23 | 2011-04-12 | Boston Scientific Scimed, Inc. | Nesting twisting hinge points in a bifurcated petal geometry |
GB0617219D0 (en) | 2006-08-31 | 2006-10-11 | Barts & London Nhs Trust | Blood vessel prosthesis and delivery apparatus |
US8216267B2 (en) | 2006-09-12 | 2012-07-10 | Boston Scientific Scimed, Inc. | Multilayer balloon for bifurcated stent delivery and methods of making and using the same |
US8778009B2 (en) * | 2006-10-06 | 2014-07-15 | Abbott Cardiovascular Systems Inc. | Intravascular stent |
US7951191B2 (en) * | 2006-10-10 | 2011-05-31 | Boston Scientific Scimed, Inc. | Bifurcated stent with entire circumferential petal |
US8206429B2 (en) | 2006-11-02 | 2012-06-26 | Boston Scientific Scimed, Inc. | Adjustable bifurcation catheter incorporating electroactive polymer and methods of making and using the same |
US7842082B2 (en) * | 2006-11-16 | 2010-11-30 | Boston Scientific Scimed, Inc. | Bifurcated stent |
US9044311B2 (en) * | 2006-11-30 | 2015-06-02 | Cook Medical Technologies Llc | Aortic graft device |
US8523931B2 (en) | 2007-01-12 | 2013-09-03 | Endologix, Inc. | Dual concentric guidewire and methods of bifurcated graft deployment |
US7959668B2 (en) * | 2007-01-16 | 2011-06-14 | Boston Scientific Scimed, Inc. | Bifurcated stent |
US20080199510A1 (en) | 2007-02-20 | 2008-08-21 | Xtent, Inc. | Thermo-mechanically controlled implants and methods of use |
CN101715329B (en) | 2007-03-05 | 2012-11-14 | 恩多斯潘有限公司 | Multi-component expandable supportive bifurcated endoluminal grafts and methods for using same |
US8623070B2 (en) | 2007-03-08 | 2014-01-07 | Thomas O. Bales | Tapered helical stent and method for manufacturing the stent |
US8486132B2 (en) | 2007-03-22 | 2013-07-16 | J.W. Medical Systems Ltd. | Devices and methods for controlling expandable prostheses during deployment |
US8118861B2 (en) | 2007-03-28 | 2012-02-21 | Boston Scientific Scimed, Inc. | Bifurcation stent and balloon assemblies |
US8647376B2 (en) | 2007-03-30 | 2014-02-11 | Boston Scientific Scimed, Inc. | Balloon fold design for deployment of bifurcated stent petal architecture |
US20080294235A1 (en) * | 2007-05-24 | 2008-11-27 | Inverthis Ltd. | Bypass graft device and delivery system and method |
US9427343B2 (en) | 2007-06-22 | 2016-08-30 | David L. Bogert | Locked segments pushable stent-graft |
US10154917B2 (en) * | 2007-06-22 | 2018-12-18 | C. R. Bard, Inc. | Helical and segmented stent-graft |
US8486134B2 (en) | 2007-08-01 | 2013-07-16 | Boston Scientific Scimed, Inc. | Bifurcation treatment system and methods |
US9237959B2 (en) * | 2007-08-17 | 2016-01-19 | Cook Medical Technologies Llc | Stent and barb |
WO2009032363A1 (en) | 2007-09-06 | 2009-03-12 | Baxano, Inc. | Method, system and apparatus for neural localization |
US7959669B2 (en) * | 2007-09-12 | 2011-06-14 | Boston Scientific Scimed, Inc. | Bifurcated stent with open ended side branch support |
BRPI0819215A2 (en) | 2007-10-26 | 2015-05-05 | Cook Critical Care Inc | Vascular conductor and delivery system for open surgical placement |
WO2009064353A1 (en) * | 2007-11-13 | 2009-05-22 | Cook Incorporated | Intraluminal bypass prosthesis |
US7833266B2 (en) | 2007-11-28 | 2010-11-16 | Boston Scientific Scimed, Inc. | Bifurcated stent with drug wells for specific ostial, carina, and side branch treatment |
US8192436B2 (en) | 2007-12-07 | 2012-06-05 | Baxano, Inc. | Tissue modification devices |
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 |
US7722661B2 (en) * | 2007-12-19 | 2010-05-25 | Boston Scientific Scimed, Inc. | Stent |
US8277501B2 (en) * | 2007-12-21 | 2012-10-02 | Boston Scientific Scimed, Inc. | Bi-stable bifurcated stent petal geometry |
CA2711176C (en) * | 2007-12-26 | 2015-09-15 | Medical Engineering And Development Institute, Inc. | Stent and method of making a stent |
US8021413B2 (en) | 2007-12-27 | 2011-09-20 | Cook Medical Technologies Llc | Low profile medical device |
WO2009088953A2 (en) | 2007-12-31 | 2009-07-16 | Boston Scientific Scimed Inc. | Bifurcation stent delivery system and methods |
US7862538B2 (en) * | 2008-02-04 | 2011-01-04 | Incept Llc | Surgical delivery system for medical sealant |
WO2009105699A1 (en) | 2008-02-22 | 2009-08-27 | Endologix, Inc. | Design and method of placement of a graft or graft system |
GB0803302D0 (en) * | 2008-02-22 | 2008-04-02 | Barts & London Nhs Trust | Blood vessel prosthesis and delivery apparatus |
US9101503B2 (en) | 2008-03-06 | 2015-08-11 | J.W. Medical Systems Ltd. | Apparatus having variable strut length and methods of use |
US20090240318A1 (en) * | 2008-03-19 | 2009-09-24 | Boston Scientific Scimed, Inc. | Stent expansion column, strut and connector slit design |
US8236040B2 (en) | 2008-04-11 | 2012-08-07 | Endologix, Inc. | Bifurcated graft deployment systems and methods |
WO2009132141A1 (en) * | 2008-04-22 | 2009-10-29 | Coherex Medical, Inc. | Device, system and method for aneurysm embolization |
AU2009240419A1 (en) | 2008-04-25 | 2009-10-29 | Nellix, Inc. | Stent graft delivery system |
US8932340B2 (en) * | 2008-05-29 | 2015-01-13 | Boston Scientific Scimed, Inc. | Bifurcated stent and delivery system |
US8377108B2 (en) | 2008-06-02 | 2013-02-19 | Boston Scientific Scimed, Inc. | Staggered two balloon bifurcation catheter assembly and methods |
US20090319029A1 (en) * | 2008-06-04 | 2009-12-24 | Nellix, Inc. | Docking apparatus and methods of use |
JP2011522615A (en) | 2008-06-04 | 2011-08-04 | ネリックス・インコーポレーテッド | Sealing device and method of use |
WO2009149410A1 (en) | 2008-06-05 | 2009-12-10 | Boston Scientific Scimed, Inc. | Deflatable bifurcated device |
EP2299945B1 (en) | 2008-06-05 | 2016-03-23 | Boston Scientific Scimed, Inc. | Balloon bifurcated lumen treatment |
AU2009269146B2 (en) | 2008-06-30 | 2013-05-16 | Bolton Medical, Inc. | Abdominal aortic aneurysms: systems and methods of use |
US8409206B2 (en) | 2008-07-01 | 2013-04-02 | Baxano, Inc. | Tissue modification devices and methods |
EP2520320B1 (en) | 2008-07-01 | 2016-11-02 | Endologix, Inc. | Catheter system |
US9314253B2 (en) | 2008-07-01 | 2016-04-19 | Amendia, Inc. | Tissue modification devices and methods |
US8398641B2 (en) | 2008-07-01 | 2013-03-19 | Baxano, Inc. | Tissue modification devices and methods |
CA2730732A1 (en) | 2008-07-14 | 2010-01-21 | Baxano, Inc. | Tissue modification devices |
US20100063578A1 (en) * | 2008-09-05 | 2010-03-11 | Aga Medical Corporation | Bifurcated medical device for treating a target site and associated method |
GB0816965D0 (en) * | 2008-09-16 | 2008-10-22 | Angiomed Ag | Stent device adhesively bonded to a stent device pusher |
AU2009296415B2 (en) | 2008-09-25 | 2015-11-19 | Advanced Bifurcation Systems Inc. | Partially crimped stent |
US8828071B2 (en) | 2008-09-25 | 2014-09-09 | Advanced Bifurcation Systems, Inc. | Methods and systems for ostial stenting of a bifurcation |
US11298252B2 (en) | 2008-09-25 | 2022-04-12 | Advanced Bifurcation Systems Inc. | Stent alignment during treatment of a bifurcation |
US8821562B2 (en) | 2008-09-25 | 2014-09-02 | Advanced Bifurcation Systems, Inc. | Partially crimped stent |
GB0901496D0 (en) | 2009-01-29 | 2009-03-11 | Angiomed Ag | Delivery device for delivering a stent device |
US8409606B2 (en) | 2009-02-12 | 2013-04-02 | Incept, Llc | Drug delivery through hydrogel plugs |
JP5582619B2 (en) | 2009-03-13 | 2014-09-03 | バクサノ,インク. | Flexible nerve position determination device |
BRPI1012599A2 (en) | 2009-03-13 | 2016-03-22 | Bolton Medical Inc | system and method for placing an endoluminal prosthesis in a surgical site |
US9173760B2 (en) * | 2009-04-03 | 2015-11-03 | Metamodix, Inc. | Delivery devices and methods for gastrointestinal implants |
EP2429452B1 (en) | 2009-04-28 | 2020-01-15 | Endologix, Inc. | Endoluminal prosthesis system |
US9579103B2 (en) | 2009-05-01 | 2017-02-28 | Endologix, Inc. | Percutaneous method and device to treat dissections |
US10772717B2 (en) | 2009-05-01 | 2020-09-15 | Endologix, Inc. | Percutaneous method and device to treat dissections |
US20100292777A1 (en) * | 2009-05-13 | 2010-11-18 | Boston Scientific Scimed, Inc. | Stent |
GB0909319D0 (en) | 2009-05-29 | 2009-07-15 | Angiomed Ag | Transluminal delivery system |
EP2445444B1 (en) | 2009-06-23 | 2018-09-26 | Endospan Ltd. | Vascular prostheses for treating aneurysms |
US8394102B2 (en) | 2009-06-25 | 2013-03-12 | Baxano, Inc. | Surgical tools for treatment of spinal stenosis |
CA2767596C (en) | 2009-07-09 | 2015-11-24 | Endospan Ltd. | Apparatus for closure of a lumen and methods of using the same |
WO2011008989A2 (en) | 2009-07-15 | 2011-01-20 | Endologix, Inc. | Stent graft |
US8118856B2 (en) | 2009-07-27 | 2012-02-21 | Endologix, Inc. | Stent graft |
WO2011064782A2 (en) | 2009-11-30 | 2011-06-03 | Endospan Ltd. | Multi-component stent-graft system for implantation in a blood vessel with multiple branches |
WO2011070576A1 (en) | 2009-12-08 | 2011-06-16 | Endospan Ltd. | Endovascular stent-graft system with fenestrated and crossing stent-grafts |
US20110276078A1 (en) | 2009-12-30 | 2011-11-10 | Nellix, Inc. | Filling structure for a graft system and methods of use |
CA2785953C (en) | 2009-12-31 | 2016-02-16 | Endospan Ltd. | Endovascular flow direction indicator |
CA2789304C (en) | 2010-02-08 | 2018-01-02 | Endospan Ltd. | Thermal energy application for prevention and management of endoleaks in stent-grafts |
CN103037815B (en) | 2010-03-24 | 2015-05-13 | 高级分支系统股份有限公司 | Methods and systems for treating a bifurcation with provisional side branch stenting |
AU2011232361B2 (en) | 2010-03-24 | 2015-05-28 | Advanced Bifurcation Systems Inc. | Stent alignment during treatment of a bifurcation |
WO2011119884A1 (en) | 2010-03-24 | 2011-09-29 | Advanced Bifurcation Systems, Inc | System and methods for treating a bifurcation |
US8961501B2 (en) | 2010-09-17 | 2015-02-24 | Incept, Llc | Method for applying flowable hydrogels to a cornea |
EP2635241B1 (en) | 2010-11-02 | 2019-02-20 | Endologix, Inc. | Apparatus for placement of a graft or graft system |
WO2012068298A1 (en) | 2010-11-17 | 2012-05-24 | Endologix, Inc. | Devices and methods to treat vascular dissections |
US8801768B2 (en) | 2011-01-21 | 2014-08-12 | Endologix, Inc. | Graft systems having semi-permeable filling structures and methods for their use |
US9526638B2 (en) | 2011-02-03 | 2016-12-27 | Endospan Ltd. | Implantable medical devices constructed of shape memory material |
EP2672932B1 (en) | 2011-02-08 | 2018-09-19 | Advanced Bifurcation Systems, Inc. | System for treating a bifurcation with a fully crimped stent |
CA2826760A1 (en) | 2011-02-08 | 2012-08-16 | Advanced Bifurcation Systems, Inc. | Multi-stent and multi-balloon apparatus for treating bifurcations and methods of use |
US9855046B2 (en) | 2011-02-17 | 2018-01-02 | Endospan Ltd. | Vascular bands and delivery systems therefor |
CN105232195B (en) | 2011-03-01 | 2018-06-08 | 恩朵罗杰克斯股份有限公司 | Delivery catheter system |
WO2012117395A1 (en) | 2011-03-02 | 2012-09-07 | Endospan Ltd. | Reduced-strain extra- vascular ring for treating aortic aneurysm |
EP2693980B1 (en) | 2011-04-06 | 2022-07-13 | Endologix LLC | System for endovascular aneurysm treatment |
US8622934B2 (en) * | 2011-04-25 | 2014-01-07 | Medtronic Vascular, Inc. | Guidewire with two flexible end portions and method of accessing a branch vessel therewith |
US8574287B2 (en) | 2011-06-14 | 2013-11-05 | Endospan Ltd. | Stents incorporating a plurality of strain-distribution locations |
EP2579811B1 (en) | 2011-06-21 | 2016-03-16 | 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 |
WO2013030818A2 (en) | 2011-08-28 | 2013-03-07 | Endospan Ltd. | Stent-grafts with post-deployment variable axial and radial displacement |
US9427339B2 (en) | 2011-10-30 | 2016-08-30 | Endospan Ltd. | Triple-collar stent-graft |
WO2013084235A2 (en) | 2011-12-04 | 2013-06-13 | Endospan Ltd. | Branched stent-graft system |
US20130197657A1 (en) * | 2011-12-08 | 2013-08-01 | Diana Anca | Central airway stent |
ES2618221T3 (en) | 2012-04-12 | 2017-06-21 | Bolton Medical Inc. | Vascular prosthesis administration device and method of use |
US9770350B2 (en) | 2012-05-15 | 2017-09-26 | Endospan Ltd. | Stent-graft with fixation elements that are radially confined for delivery |
US9308107B2 (en) * | 2012-08-27 | 2016-04-12 | Cook Medical Technologies Llc | Endoluminal prosthesis and delivery device |
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 |
US10092391B2 (en) | 2012-12-26 | 2018-10-09 | The Cleveland Clinic Foundation | Endoluminal prosthesis having modular branches and methods of deployment |
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 |
US9157174B2 (en) | 2013-02-05 | 2015-10-13 | Covidien Lp | Vascular device for aneurysm treatment and providing blood flow into a perforator vessel |
US9668892B2 (en) | 2013-03-11 | 2017-06-06 | Endospan Ltd. | Multi-component stent-graft system for aortic dissections |
JP6533776B2 (en) | 2013-03-14 | 2019-06-19 | エンドーロジックス インコーポレイテッド | System for treating an aneurysm in a patient's body and method of operating the same |
US9439751B2 (en) | 2013-03-15 | 2016-09-13 | Bolton Medical, Inc. | Hemostasis valve and delivery systems |
AU2013207592B1 (en) * | 2013-07-11 | 2013-11-14 | Cook Medical Technologies Llc | An iliac stent graft |
US10105245B2 (en) * | 2013-08-23 | 2018-10-23 | Cook Medical Technologies Llc | Stent graft assembly for treating branched vessels |
US10603197B2 (en) | 2013-11-19 | 2020-03-31 | Endospan Ltd. | Stent system with radial-expansion locking |
US20150196417A1 (en) * | 2014-01-15 | 2015-07-16 | Terumo Kabushiki Kaisha | Bypass device, support frame for bypass device, and method |
BR112017012425A2 (en) | 2014-12-18 | 2018-01-02 | Endospan Ltd | endovascular stent graft with fatigue resistant lateral tube |
US10610347B2 (en) * | 2015-03-19 | 2020-04-07 | The Secant Group, Llc | Textile engineered prosthetics, bioreactors, and methods of manufacturing textile engineered prosthetics |
US11129737B2 (en) | 2015-06-30 | 2021-09-28 | Endologix Llc | Locking assembly for coupling guidewire to delivery system |
US9622897B1 (en) | 2016-03-03 | 2017-04-18 | Metamodix, Inc. | Pyloric anchors and methods for intestinal bypass sleeves |
JP7044374B2 (en) | 2016-05-19 | 2022-03-30 | メタモディクス インコーポレイテッド | Extraction device |
US10821009B2 (en) * | 2016-05-26 | 2020-11-03 | Swiss Capital—Engineering AG | Vascular medical device, system and method |
US9848906B1 (en) | 2017-06-20 | 2017-12-26 | Joe Michael Eskridge | Stent retriever having an expandable fragment guard |
US10238513B2 (en) | 2017-07-19 | 2019-03-26 | Abbott Cardiovascular Systems Inc. | Intravascular stent |
CA3133857A1 (en) | 2019-03-20 | 2020-09-24 | inQB8 Medical Technologies, LLC | Aortic dissection implant |
USD950730S1 (en) * | 2019-12-09 | 2022-05-03 | Lifenet Health | Medical implant device |
US11324583B1 (en) | 2021-07-06 | 2022-05-10 | Archo Medical LTDA | Multi-lumen stent-graft and related surgical methods |
Family Cites Families (79)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3945052A (en) * | 1972-05-01 | 1976-03-23 | Meadox Medicals, Inc. | Synthetic vascular graft and method for manufacturing the same |
US4130904A (en) * | 1977-06-06 | 1978-12-26 | Thermo Electron Corporation | Prosthetic blood conduit |
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 |
US4774949A (en) * | 1983-06-14 | 1988-10-04 | Fogarty Thomas J | Deflector guiding catheter |
US4647416A (en) * | 1983-08-03 | 1987-03-03 | Shiley Incorporated | Method of preparing a vascular graft prosthesis |
US4550447A (en) * | 1983-08-03 | 1985-11-05 | Shiley Incorporated | Vascular graft prosthesis |
US5104399A (en) | 1986-12-10 | 1992-04-14 | Endovascular Technologies, Inc. | Artificial graft and implantation method |
US4728328A (en) * | 1984-10-19 | 1988-03-01 | Research Corporation | Cuffed tubular organic prostheses |
US4718907A (en) | 1985-06-20 | 1988-01-12 | Atrium Medical Corporation | Vascular prosthesis having fluorinated coating with varying F/C ratio |
JPH0763489B2 (en) * | 1986-10-31 | 1995-07-12 | 宇部興産株式会社 | Medical tube |
SU1457921A1 (en) * | 1987-03-10 | 1989-02-15 | Харьковский научно-исследовательский институт общей и неотложной хирургии | Self-fixing prosthesis of blood vessel |
US4820298A (en) * | 1987-11-20 | 1989-04-11 | Leveen Eric G | Internal vascular prosthesis |
US5019090A (en) * | 1988-09-01 | 1991-05-28 | Corvita Corporation | Radially expandable endoprosthesis and the like |
US5226913A (en) * | 1988-09-01 | 1993-07-13 | Corvita Corporation | Method of making a radially expandable prosthesis |
US5078726A (en) * | 1989-02-01 | 1992-01-07 | Kreamer Jeffry W | Graft stent and method of repairing blood vessels |
US5163958A (en) * | 1989-02-02 | 1992-11-17 | Cordis Corporation | Carbon coated tubular endoprosthesis |
CA2026604A1 (en) * | 1989-10-02 | 1991-04-03 | Rodney G. Wolff | Articulated stent |
US5035706A (en) * | 1989-10-17 | 1991-07-30 | Cook Incorporated | Percutaneous stent and method for retrieval thereof |
JPH067843B2 (en) | 1990-02-15 | 1994-02-02 | 寛治 井上 | Artificial blood vessel with frame |
US5123917A (en) * | 1990-04-27 | 1992-06-23 | Lee Peter Y | Expandable intraluminal vascular graft |
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 |
US5064435A (en) * | 1990-06-28 | 1991-11-12 | Schneider (Usa) Inc. | Self-expanding prosthesis having stable axial length |
US5122154A (en) * | 1990-08-15 | 1992-06-16 | Rhodes Valentine J | Endovascular bypass graft |
AR246020A1 (en) * | 1990-10-03 | 1994-03-30 | Hector Daniel Barone Juan Carl | A ball device for implanting an intraluminous aortic prosthesis, for repairing aneurysms. |
DE9116881U1 (en) * | 1990-10-09 | 1994-07-07 | Cook Inc | Percutaneous stent |
DE69116130T2 (en) * | 1990-10-18 | 1996-05-15 | Ho Young Song | SELF-EXPANDING, ENDOVASCULAR DILATATOR |
US5282847A (en) * | 1991-02-28 | 1994-02-01 | Medtronic, Inc. | Prosthetic vascular grafts with a pleated structure |
CA2065634C (en) * | 1991-04-11 | 1997-06-03 | Alec A. Piplani | Endovascular graft having bifurcation and apparatus and method for deploying the same |
US5628783A (en) * | 1991-04-11 | 1997-05-13 | Endovascular Technologies, Inc. | Bifurcated multicapsule intraluminal grafting system and method |
FR2678508B1 (en) * | 1991-07-04 | 1998-01-30 | Celsa Lg | DEVICE FOR REINFORCING VESSELS OF THE HUMAN BODY. |
US5229045A (en) * | 1991-09-18 | 1993-07-20 | Kontron Instruments Inc. | Process for making porous membranes |
US5151105A (en) | 1991-10-07 | 1992-09-29 | Kwan Gett Clifford | Collapsible vessel sleeve implant |
US5366504A (en) * | 1992-05-20 | 1994-11-22 | Boston Scientific Corporation | Tubular medical prosthesis |
US5456713A (en) * | 1991-10-25 | 1995-10-10 | Cook Incorporated | Expandable transluminal graft prosthesis for repairs of aneurysm and method for implanting |
US5211658A (en) * | 1991-11-05 | 1993-05-18 | New England Deaconess Hospital Corporation | Method and device for performing endovascular repair of aneurysms |
US5316023A (en) * | 1992-01-08 | 1994-05-31 | Expandable Grafts Partnership | Method for bilateral intra-aortic bypass |
US5507767A (en) * | 1992-01-15 | 1996-04-16 | Cook Incorporated | Spiral stent |
US5405377A (en) * | 1992-02-21 | 1995-04-11 | Endotech Ltd. | Intraluminal stent |
US5282823A (en) * | 1992-03-19 | 1994-02-01 | Medtronic, Inc. | Intravascular radially expandable stent |
US5370683A (en) * | 1992-03-25 | 1994-12-06 | Cook Incorporated | Vascular stent |
US5354308A (en) * | 1992-05-01 | 1994-10-11 | Beth Israel Hospital Association | Metal wire stent |
EP0637947B1 (en) * | 1993-01-14 | 2001-12-19 | Meadox Medicals, Inc. | Radially expandable tubular prosthesis |
FR2706764B1 (en) * | 1993-06-24 | 1995-08-04 | Synthelabo | |
US5425765A (en) * | 1993-06-25 | 1995-06-20 | Tiefenbrun; Jonathan | Surgical bypass method |
US5735892A (en) * | 1993-08-18 | 1998-04-07 | W. L. Gore & Associates, Inc. | Intraluminal stent graft |
ES2217270T3 (en) | 1993-09-30 | 2004-11-01 | Endogad Research Pty Limited | ENDOLUMINAL GRAFT. |
WO1995009586A1 (en) * | 1993-10-01 | 1995-04-13 | Emory University | Self-expanding intraluminal composite prosthesis |
US5609624A (en) * | 1993-10-08 | 1997-03-11 | Impra, Inc. | Reinforced vascular graft and method of making same |
US5632772A (en) * | 1993-10-21 | 1997-05-27 | Corvita Corporation | Expandable supportive branched endoluminal grafts |
US5723004A (en) * | 1993-10-21 | 1998-03-03 | Corvita Corporation | Expandable supportive endoluminal grafts |
US5545220A (en) * | 1993-11-04 | 1996-08-13 | Lipomatrix Incorporated | Implantable prosthesis with open cell textured surface and method for forming same |
DE69419877T2 (en) | 1993-11-04 | 1999-12-16 | Bard Inc C R | Fixed vascular prosthesis |
DE9319267U1 (en) * | 1993-12-15 | 1994-02-24 | Vorwerk Dierk Dr | Aortic endoprosthesis |
FR2714815B1 (en) * | 1994-01-10 | 1996-03-08 | Microfil Ind Sa | Elastic prosthesis to widen a duct, in particular a blood vessel. |
US5476506A (en) * | 1994-02-08 | 1995-12-19 | Ethicon, Inc. | Bi-directional crimped graft |
US5609627A (en) | 1994-02-09 | 1997-03-11 | Boston Scientific Technology, Inc. | Method for delivering a bifurcated endoluminal prosthesis |
US5507769A (en) * | 1994-10-18 | 1996-04-16 | Stentco, Inc. | Method and apparatus for forming an endoluminal bifurcated graft |
AU1752195A (en) * | 1994-03-04 | 1995-09-18 | Universite De Montreal | Endovascular hepatic prostheses |
US5733303A (en) * | 1994-03-17 | 1998-03-31 | Medinol Ltd. | Flexible expandable stent |
EP0997115B1 (en) * | 1994-04-01 | 2003-10-29 | Prograft Medical, Inc. | Self-expandable stent and stent-graft and method of preparing them |
JP3647456B2 (en) * | 1994-04-29 | 2005-05-11 | ボストン・サイエンティフィック・コーポレーション | Medical artificial stent and method for producing the same |
ES2199993T3 (en) * | 1994-06-13 | 2004-03-01 | Endomed, Inc. | EXPANSIBLE ENDOVASCULAR GRAFT AND METHOD FOR FORMATION. |
ATE296140T1 (en) * | 1994-06-27 | 2005-06-15 | Bard Peripheral Vascular Inc | RADIALLY EXPANDABLE POLYTETRAFLUORETHYLENE AND EXPANDABLE ENDOVASCULAR STENTS MOLDED THEREFROM |
EP0689805B1 (en) * | 1994-06-27 | 2003-05-28 | Corvita Corporation | Bistable luminal graft endoprostheses |
US5556426A (en) * | 1994-08-02 | 1996-09-17 | Meadox Medicals, Inc. | PTFE implantable tubular prostheses with external coil support |
US5653743A (en) * | 1994-09-09 | 1997-08-05 | Martin; Eric C. | Hypogastric artery bifurcation graft and method of implantation |
US5545210A (en) * | 1994-09-22 | 1996-08-13 | Advanced Coronary Technology, Inc. | Method of implanting a permanent shape memory alloy stent |
NL9500094A (en) * | 1995-01-19 | 1996-09-02 | Industrial Res Bv | Y-shaped stent and method of deployment. |
NL9500095A (en) | 1995-01-19 | 1996-09-02 | Industrial Res Bv | Expandable carrier balloon for a stent assembly. |
US5755770A (en) * | 1995-01-31 | 1998-05-26 | Boston Scientific Corporatiion | Endovascular aortic graft |
US5662675A (en) * | 1995-02-24 | 1997-09-02 | Intervascular, Inc. | Delivery catheter assembly |
US5617878A (en) * | 1996-05-31 | 1997-04-08 | Taheri; Syde A. | Stent and method for treatment of aortic occlusive disease |
US5676697A (en) * | 1996-07-29 | 1997-10-14 | Cardiovascular Dynamics, Inc. | Two-piece, bifurcated intraluminal graft for repair of aneurysm |
US5843166A (en) * | 1997-01-17 | 1998-12-01 | Meadox Medicals, Inc. | Composite graft-stent having pockets for accomodating movement |
US5851232A (en) * | 1997-03-15 | 1998-12-22 | Lois; William A. | Venous stent |
US5980565A (en) * | 1997-10-20 | 1999-11-09 | Iowa-India Investments Company Limited | Sandwich stent |
US6168619B1 (en) * | 1998-10-16 | 2001-01-02 | Quanam Medical Corporation | Intravascular stent having a coaxial polymer member and end sleeves |
-
1996
- 1996-03-13 US US08/615,697 patent/US5824040A/en not_active Expired - Lifetime
-
1998
- 1998-07-22 US US09/121,226 patent/US6283991B1/en not_active Expired - Lifetime
-
2001
- 2001-08-31 US US09/942,919 patent/US20020120327A1/en not_active Abandoned
Cited By (140)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8449597B2 (en) | 1995-03-01 | 2013-05-28 | Boston Scientific Scimed, Inc. | Longitudinally flexible expandable stent |
US8728147B2 (en) | 1995-03-01 | 2014-05-20 | Boston Scientific Limited | Longitudinally flexible expandable stent |
US20050143806A1 (en) * | 1998-01-26 | 2005-06-30 | Phillips Peter W. | Reinforced graft and method of deployment |
US10548750B2 (en) | 1998-02-09 | 2020-02-04 | Trivascular, Inc. | Endovascular graft |
US8801769B2 (en) | 1998-02-09 | 2014-08-12 | Trivascular, Inc. | Endovascular graft |
US9867727B2 (en) | 1998-02-09 | 2018-01-16 | Trivascular, Inc. | Endovascular graft |
US8361136B2 (en) | 1998-02-09 | 2013-01-29 | Trivascular, Inc. | Endovascular graft |
US8382821B2 (en) | 1998-12-03 | 2013-02-26 | Medinol Ltd. | Helical hybrid stent |
US6695877B2 (en) * | 2001-02-26 | 2004-02-24 | Scimed Life Systems | Bifurcated stent |
US7766954B2 (en) | 2001-12-20 | 2010-08-03 | Trivascular2, Inc. | Advanced endovascular graft |
US6676624B2 (en) * | 2001-12-20 | 2004-01-13 | Scimed Life Systems, Inc. | Drainage devices and methods |
US20040117003A1 (en) * | 2002-05-28 | 2004-06-17 | The Cleveland Clinic Foundation | Minimally invasive treatment system for aortic aneurysms |
US7704276B2 (en) * | 2002-11-15 | 2010-04-27 | Synecor, Llc | Endoprostheses and methods of manufacture |
US20070026132A1 (en) * | 2002-11-15 | 2007-02-01 | Williams Michael S | Endoprostheses and methods of manufacture |
US9408731B2 (en) * | 2002-12-04 | 2016-08-09 | Cook Medical Technologies Llc | Method and device for treating aortic dissection |
US20040176832A1 (en) * | 2002-12-04 | 2004-09-09 | Cook Incorporated | Method and device for treating aortic dissection |
US9125733B2 (en) | 2003-01-14 | 2015-09-08 | The Cleveland Clinic Foundation | Branched vessel endoluminal device |
US10631972B2 (en) | 2003-01-14 | 2020-04-28 | The Cleveland Clinic Foundation | Branched vessel endoluminal device |
US9943400B2 (en) | 2003-01-14 | 2018-04-17 | The Cleveland Clinic Foundation | Branched vessel endoluminal device |
US20090043377A1 (en) * | 2003-01-14 | 2009-02-12 | The Cleveland Clinic Foundation | Branched Vessel Endoluminal Device |
US7105020B2 (en) | 2003-01-14 | 2006-09-12 | The Cleveland Clinic Foundation | Branched vessel endoluminal device |
US7407509B2 (en) | 2003-01-14 | 2008-08-05 | The Cleveland Clinic Foundation | Branched vessel endoluminal device with fenestration |
US20040193254A1 (en) * | 2003-01-14 | 2004-09-30 | Greenberg Roy K. | Branched vessel endoluminal device |
WO2004075790A1 (en) * | 2003-02-21 | 2004-09-10 | Boston Scientific Limited | Stent |
US7179286B2 (en) | 2003-02-21 | 2007-02-20 | Boston Scientific Scimed, Inc. | Stent with stepped connectors |
US20040167615A1 (en) * | 2003-02-21 | 2004-08-26 | Scimed Life Systems, Inc | Stent |
US20040215326A1 (en) * | 2003-04-22 | 2004-10-28 | Goodson Harry B. | Single-piece crown stent |
US6945992B2 (en) * | 2003-04-22 | 2005-09-20 | Medtronic Vascular, Inc. | Single-piece crown stent |
US20040215319A1 (en) * | 2003-04-24 | 2004-10-28 | Humberto Berra | Stent graft tapered spring |
US7279003B2 (en) | 2003-04-24 | 2007-10-09 | Medtronic Vascular, Inc. | Stent graft tapered spring |
US20070299503A1 (en) * | 2003-04-24 | 2007-12-27 | Medtronic Vascular, Inc. | Stent Graft Tapered Spring |
US7846195B2 (en) | 2003-04-24 | 2010-12-07 | Medtronic Vascular, Inc. | Stent graft tapered spring |
EP1472990A1 (en) * | 2003-04-24 | 2004-11-03 | Medtronic Vascular, Inc. | Stent graft tapered spring |
US7887584B2 (en) | 2003-06-27 | 2011-02-15 | Zuli Holdings, Ltd. | Amorphous metal alloy medical devices |
US20090062823A1 (en) * | 2003-06-27 | 2009-03-05 | Zuli Holdings, Ltd. | Amorphous metal alloy medical devices |
US10363152B2 (en) | 2003-06-27 | 2019-07-30 | Medinol Ltd. | Helical hybrid stent |
US9039755B2 (en) | 2003-06-27 | 2015-05-26 | Medinol Ltd. | Helical hybrid stent |
US20090030527A1 (en) * | 2003-06-27 | 2009-01-29 | Zuli Holdings, Ltd. | Amorphous metal alloy medical devices |
US9456910B2 (en) | 2003-06-27 | 2016-10-04 | Medinol Ltd. | Helical hybrid stent |
US20090054977A1 (en) * | 2003-06-27 | 2009-02-26 | Zuli Holdings, Ltd. | Amorphous metal alloy medical devices |
US9603731B2 (en) | 2003-06-27 | 2017-03-28 | Medinol Ltd. | Helical hybrid stent |
US7955387B2 (en) | 2003-06-27 | 2011-06-07 | Zuli Holdings, Ltd. | Amorphous metal alloy medical devices |
US9956320B2 (en) | 2003-06-27 | 2018-05-01 | Zuli Holdings Ltd. | Amorphous metal alloy medical devices |
US8496703B2 (en) | 2003-06-27 | 2013-07-30 | Zuli Holdings Ltd. | Amorphous metal alloy medical devices |
US20110202076A1 (en) * | 2003-06-27 | 2011-08-18 | Zuli Holdings, Ltd. | Amorphous metal alloy medical devices |
US20050038497A1 (en) * | 2003-08-11 | 2005-02-17 | Scimed Life Systems, Inc. | Deformation medical device without material deformation |
US20050113905A1 (en) * | 2003-10-10 | 2005-05-26 | Greenberg Roy K. | Endoluminal prosthesis with interconnectable modules |
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 |
US9408707B2 (en) | 2004-06-09 | 2016-08-09 | Vexim Sa | Methods and apparatuses for bone restoration |
US20110046739A1 (en) * | 2004-06-09 | 2011-02-24 | Vexim | Methods and Apparatuses for Bone Restoration |
US20060004455A1 (en) * | 2004-06-09 | 2006-01-05 | Alain Leonard | Methods and apparatuses for bone restoration |
US11752004B2 (en) | 2004-06-09 | 2023-09-12 | Stryker European Operations Limited | Systems and implants for bone restoration |
US7846206B2 (en) | 2004-06-09 | 2010-12-07 | Vexim Sas | Methods and apparatuses for bone restoration |
US10813771B2 (en) | 2004-06-09 | 2020-10-27 | Vexim | Methods and apparatuses for bone restoration |
US10098751B2 (en) | 2004-06-09 | 2018-10-16 | Vexim | Methods and apparatuses for bone restoration |
US7955373B2 (en) * | 2004-06-28 | 2011-06-07 | Boston Scientific Scimed, Inc. | Two-stage stent-graft and method of delivering same |
US20050288768A1 (en) * | 2004-06-28 | 2005-12-29 | Krzysztof Sowinski | Two-stage stent-graft and method of delivering same |
US20130060322A1 (en) * | 2004-07-21 | 2013-03-07 | Boston Scientific Scimed, Inc. | Expandable framework with overlapping connectors |
US8685079B2 (en) * | 2004-07-21 | 2014-04-01 | Boston Scientific Scimed, Inc. | Expandable framework with overlapping connectors |
US20060030932A1 (en) * | 2004-08-09 | 2006-02-09 | Kantor John D | Flexible stent |
US7323008B2 (en) * | 2004-08-09 | 2008-01-29 | Medtronic Vascular, Inc. | Flexible stent |
US20060058869A1 (en) * | 2004-09-14 | 2006-03-16 | Vascular Architects, Inc., A Delaware Corporation | Coiled ladder stent |
US20060089704A1 (en) * | 2004-10-25 | 2006-04-27 | Myles Douglas | Vascular graft and deployment system |
US7699883B2 (en) | 2004-10-25 | 2010-04-20 | Myles Douglas | Vascular graft and deployment system |
US8002818B2 (en) * | 2005-02-25 | 2011-08-23 | Abbott Laboratories Vascular Enterprises Limited | Modular vascular prosthesis having axially variable properties and improved flexibility and methods of use |
US20060195175A1 (en) * | 2005-02-25 | 2006-08-31 | Abbott Laboratories Vascular Enterprises Limited | Modular vascular prosthesis having axially variable properties and improved flexibility and methods of use |
US8025694B2 (en) | 2005-02-25 | 2011-09-27 | Abbott Laboratories Vascular Enterprises Limited | Modular vascular prosthesis and methods of use |
US8603154B2 (en) | 2005-02-25 | 2013-12-10 | Abbott Laboratories Vascular Enterprises Limited | Modular vascular prosthesis and methods of use |
US20090005848A1 (en) * | 2005-02-25 | 2009-01-01 | Abbott Laboratories Vascular Enterprises Limited | Modular vascular prosthesis and methods of use |
US20080215129A1 (en) * | 2005-07-25 | 2008-09-04 | Invatec S.R.L. | Endolumenal Prosthesis with Bioresorbable Portions |
US8870940B2 (en) * | 2005-07-25 | 2014-10-28 | Medtronic, Inc. | Endolumenal prosthesis |
EP1795152A2 (en) * | 2005-11-15 | 2007-06-13 | Cordis Corporation | Systems and methods for securing graft material to intraluminal devices |
EP1795152A3 (en) * | 2005-11-15 | 2009-07-15 | Cordis Corporation | Systems and methods for securing graft material to intraluminal devices |
US20070123994A1 (en) * | 2005-11-29 | 2007-05-31 | Ethicon Endo-Surgery, Inc. | Internally Placed Gastric Restriction Device |
EP1790313A3 (en) * | 2005-11-29 | 2007-07-18 | Ethicon Endo-Surgery, Inc. | Internally placed gastric restriction device |
EP1996113A4 (en) * | 2006-03-15 | 2010-04-14 | Medinol Ltd | Hybrid amorphous metal alloy stent |
EP1996113A2 (en) * | 2006-03-15 | 2008-12-03 | Medinol Ltd. | Hybrid amorphous metal alloy stent |
US9707113B2 (en) | 2006-04-19 | 2017-07-18 | Cook Medical Technologies Llc | Twin bifurcated stent graft |
US20070250154A1 (en) * | 2006-04-19 | 2007-10-25 | William A. Cook Australia Pty Ltd. | Twin bifurcated stent graft |
US10143576B2 (en) | 2006-04-19 | 2018-12-04 | Cook Medical Technologies Llc | Twin bifurcated stent graft |
US8864812B2 (en) | 2006-06-23 | 2014-10-21 | W.L. Gore & Associates, Inc. | Branched stent delivery system |
US20100069853A1 (en) * | 2006-06-23 | 2010-03-18 | Stanislaw Zukowski | Branched Stent Delivery System |
US20070299495A1 (en) * | 2006-06-23 | 2007-12-27 | Stanislaw Zukowski | Branched stent delivery system |
US8080049B2 (en) * | 2006-06-23 | 2011-12-20 | Gore Enterprise Holdings, Inc. | Branched stent delivery system |
US20090005760A1 (en) * | 2006-07-31 | 2009-01-01 | Richard George Cartledge | Sealable endovascular implants and methods for their use |
US8252036B2 (en) | 2006-07-31 | 2012-08-28 | Syntheon Cardiology, Llc | Sealable endovascular implants and methods for their use |
US9827125B2 (en) | 2006-07-31 | 2017-11-28 | Edwards Lifesciences Cardiaq Llc | Sealable endovascular implants and methods for their use |
US9138335B2 (en) | 2006-07-31 | 2015-09-22 | Syntheon Cardiology, Llc | Surgical implant devices and methods for their manufacture and use |
US9585743B2 (en) | 2006-07-31 | 2017-03-07 | Edwards Lifesciences Cardiaq Llc | Surgical implant devices and methods for their manufacture and use |
US7988720B2 (en) | 2006-09-12 | 2011-08-02 | Boston Scientific Scimed, Inc. | Longitudinally flexible expandable stent |
US20110093061A1 (en) * | 2007-03-31 | 2011-04-21 | Biotronik Vi Patent Ag | Stent having radially expandable main body |
US9005265B2 (en) * | 2007-03-31 | 2015-04-14 | Biotronik Vi Patent Ag | Stent having radially expandable main body |
US20120179240A1 (en) * | 2007-05-30 | 2012-07-12 | Cordis Corporation | Stent/fiber structural combinations |
US8439967B2 (en) * | 2007-05-30 | 2013-05-14 | Cordis Corporation | Stent/fiber structural combinations |
US20080300668A1 (en) * | 2007-05-30 | 2008-12-04 | Craig Bonsignore | Stent/fiber structural combinations |
US8133268B2 (en) * | 2007-05-30 | 2012-03-13 | Cordis Corporation | Stent/fiber structural combinations |
US8043320B2 (en) | 2007-06-13 | 2011-10-25 | Edo Kaluski | Bifurcated balloon & stent delivery system |
US20100094247A1 (en) * | 2007-06-13 | 2010-04-15 | Edo Kaluski | Bifurcated balloon & stent delivery system |
WO2008152620A3 (en) * | 2007-06-13 | 2010-02-25 | Edo Kaluski | Bifurcated balloon & stent delivery system |
US9814611B2 (en) | 2007-07-31 | 2017-11-14 | Edwards Lifesciences Cardiaq Llc | Actively controllable stent, stent graft, heart valve and method of controlling same |
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 |
US8226701B2 (en) | 2007-09-26 | 2012-07-24 | Trivascular, Inc. | Stent and delivery system for deployment thereof |
US10159557B2 (en) | 2007-10-04 | 2018-12-25 | Trivascular, Inc. | Modular vascular graft for low profile percutaneous delivery |
US10682222B2 (en) | 2007-10-04 | 2020-06-16 | Trivascular, Inc. | Modular vascular graft for low profile percutaneous delivery |
US20200375725A1 (en) * | 2007-10-04 | 2020-12-03 | Trivascular, Inc. | Modular vascular graft for low profile percutaneous delivery |
US8083789B2 (en) | 2007-11-16 | 2011-12-27 | Trivascular, Inc. | Securement assembly and method for expandable endovascular device |
US8328861B2 (en) | 2007-11-16 | 2012-12-11 | Trivascular, Inc. | Delivery system and method for bifurcated graft |
US9579130B2 (en) | 2008-04-08 | 2017-02-28 | Vexim Sas | Apparatus for restoration of the spine and methods of use thereof |
US8986386B2 (en) | 2009-03-12 | 2015-03-24 | Vexim Sas | Apparatus for bone restoration of the spine and methods of use |
US20100249898A1 (en) * | 2009-03-24 | 2010-09-30 | Medtronic Vascular, Inc. | Stent Graft |
US8361141B2 (en) | 2009-04-07 | 2013-01-29 | Cook Medical Technologies Llc | Modular stent assembly |
US20100256741A1 (en) * | 2009-04-07 | 2010-10-07 | William Cook Europe Aps | Modular stent assembly |
GB2469296B (en) * | 2009-04-07 | 2011-03-09 | Cook Inc | Modular stent assembly |
GB2469296A (en) * | 2009-04-07 | 2010-10-13 | Cook Inc | Modular stent assembly |
US9155639B2 (en) | 2009-04-22 | 2015-10-13 | Medinol Ltd. | Helical hybrid stent |
US9408607B2 (en) | 2009-07-02 | 2016-08-09 | Edwards Lifesciences Cardiaq Llc | Surgical implant devices and methods for their manufacture and use |
WO2011137215A1 (en) * | 2010-04-29 | 2011-11-03 | Vanderbilt University | Percutaneous collateral bypass |
US9566178B2 (en) | 2010-06-24 | 2017-02-14 | Edwards Lifesciences Cardiaq Llc | Actively controllable stent, stent graft, heart valve and method of controlling same |
US9414933B2 (en) | 2011-04-07 | 2016-08-16 | Vexim Sa | Expandable orthopedic device |
US9827093B2 (en) | 2011-10-21 | 2017-11-28 | Edwards Lifesciences Cardiaq Llc | Actively controllable stent, stent graft, heart valve and method of controlling same |
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 |
US20210369440A1 (en) * | 2012-04-12 | 2021-12-02 | Sanford Health | Debranching Visceral Stent Grant and Methods for Use |
US9314352B1 (en) * | 2012-04-17 | 2016-04-19 | W. L. Gore & Associates, Inc. | Endoprosthesis having open flow lumens |
US20140364935A1 (en) * | 2013-06-05 | 2014-12-11 | Abbott Cardiovascular Systems Inc. | Coupled scaffold segments |
US10039656B2 (en) * | 2013-06-05 | 2018-08-07 | Abbott Cardiovascular Systems Inc. | Coupled scaffold segments |
US10603080B2 (en) | 2013-12-23 | 2020-03-31 | Vexim | Expansible intravertebral implant system with posterior pedicle fixation |
US11344335B2 (en) | 2013-12-23 | 2022-05-31 | Stryker European Operations Limited | Methods of deploying an intravertebral implant having a pedicle fixation element |
US10512533B1 (en) | 2016-02-23 | 2019-12-24 | W. L. Gore & Associates, Inc. | Branched graft assembly method in vivo |
US11504222B1 (en) | 2016-02-23 | 2022-11-22 | W. L. Gore & Associates, Inc. | Branched graft assembly method in vivo |
US11096774B2 (en) | 2016-12-09 | 2021-08-24 | Zenflow, Inc. | Systems, devices, and methods for the accurate deployment of an implant in the prostatic urethra |
US11903859B1 (en) | 2016-12-09 | 2024-02-20 | Zenflow, Inc. | Methods for deployment of an implant |
US10702406B2 (en) | 2017-03-29 | 2020-07-07 | Cook Medical Technologies Llc | Prosthesis with flexible stent |
US10500078B2 (en) * | 2018-03-09 | 2019-12-10 | Vesper Medical, Inc. | Implantable stent |
US11344439B2 (en) | 2018-03-09 | 2022-05-31 | Vesper Medical, Inc. | Implantable stent |
US20190274853A1 (en) * | 2018-03-09 | 2019-09-12 | Vesper Medical, Inc. | Implantable stent |
US11890213B2 (en) | 2019-11-19 | 2024-02-06 | Zenflow, Inc. | Systems, devices, and methods for the accurate deployment and imaging of an implant in the prostatic urethra |
WO2023043680A1 (en) * | 2021-09-17 | 2023-03-23 | Boston Scientific Scimed, Inc. | Stent system |
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