Endovascular prosthesis

Abstract

A endovascular prosthesis for implantation in a body passageway. The prosthesis comprises a tubular wall which is: (i) movable between a first longitudinal length and a second longitudinally length, and (ii) radially expandible for implantation of the prosthesis in the body passageway. In one embodiment, the tubular wall has a longitudinally length which is variable by an "accordian"-like action. In another embodiment, the tubular wall has a longitudinally length which is variable by an "telescoping"-like action. The longitudinal length of the tubular wall may be varied in vivo to optimize deployment of the endovascular prosthesis.

Description

[0001] In one of its aspects, the present invention relates to an endovascular prosthesis. In another of its aspects, the present invention relates to a method of treating an aortic disease condition in a patient.[0002] Stents are generally known. Indeed, the term "stent" has been used interchangeably with terms such as "intraluminal vascular graft" and "expandable prosthesis". As used throughout this specification the term "stent" is intended to have a broad meaning and encompasses any expandable prosthetic device for implantation in a body passageway (e.g., a lumen or artery).[0003] In the past ten years, the use of stents has attracted an increasing amount of attention due the potential of these devices to be used in certain cases, as an alternative to surgery. Generally, a stent is used to obtain and maintain the patency of the body passageway while maintaining the integrity of the passageway. As used in this specification, the term "body passageway" is intended to have a broad ...

AI Technical Summary

Benefits of technology

[0083] Generally, the present prosthesis can be advantageously used to treat the indications of aortic disease referred to hereinabove. Specifically, as will be described in more detail hereinbelow, the present endovascular prosthesis has a longitudinal length which may be varied in vivo to optimize the length there while obviating or mitigated side branch occlusion.

[0091] The present endovascular prosthesis may be used advantageously to wrap the intimal flaps and thrombi to the aortic wall and thereby obviate or mitigate the danger of stroke and emboli without the need for anticoagulation. As the preferred form of the present prosthesis covers only a radial portion of the aortic circumference, blocking of side arteries, which are supplying the back bone, is obviated or mitigated. As the preferred form of the present prosthesis is open and not blocking the flow from the proximal and distal aorta during the implantation, a blood pressure increase is obviated or mitigated. Thus, a unique advantage of the present prosthesis is that it can be used even in multiple places of the aorta when more parts of the aorta are showing thrombus formation.

Problems solved by technology

Such wall weakening leads to higher wall stress, which can induce aortic dilatation and aneurysm formation, eventually resulting in aortic dissection or rupture.

Diseases of the aorta are a significant problem in medicine.

Drug treatment is used to lower blood pressure--this approach is disadvantageous since, at best, it modulates the effect of the disease while still leaving the patient at significant risk.

Surgery is disadvantageous due to the high mortality and morbidity, even in centers of excellence.

As stated above, despite surgeries mortality is still high.

The main problem is the organ perfusion of the abdomen which results in shock and multiorgan failure.

However, tears are not always found and non-communicating dissections are not uncommon.

The dissection can spread from diseased segments of the aortic wall in an antegrate or retrograde fashion, involving side branches and causing other complications.

Partial ruptures of the inner layer of the aorta allow the blood to enter the already damaged media and thus cause dissection of the aortic wall, eventually leading to a second lumen within the wall, to a rupture or healing during follow-up.

False aneurysms, aortic rupture or dissections may occur.

This has lead to a significant occurrence of stroke in patients.

Currently, there is no reliable treatment approach for aortic sclerosis particularly the Grade IV type.

Anticoagulation is a known approach, however this treatment must be accepted with the danger of hemorrhagic strokes, particularly in the older patients Further, the therapy is very difficult to monitor.

Surgery is very complicated and has a high mortality and morbidity.

Currently, surgery is not seen as a desirable alternative to anticoagulation therapy.

As a consequence of this blunt chest trauma, mediastinal hematoma can occur with abrupt death of the patient.

Even if surgery was timely performed, there is a significant mortality rate.

Most prior art attempts to improve surgical techniques to treat aortic dissection have not be particularly successful.

It is also worth pointing out that the so-call "stent grafts" are not well suited for treating diseases of the aorta.

This is inconvenient and requires inventory stocking of a number of stent grafts having a variety of different longitudinal lengths to have devices on hand for use in most situations.

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