Apparatus and method of placement of a graft or graft system

Abstract

Some embodiments relate to endoluminal prostheses having a first stent portion and a second stent portion, a main graft body comprising first, second, and third portions, the second portion having a cross-sectional size that is significantly larger than a cross-sectional size of the first or third portions, and also significantly larger than a cross-sectional size of the target vessel. In some embodiments, the first portion of the main graft body can be attached to the first stent portion and the third portion of the main graft body can be attached to the second stent portion. The prostheses can be configured such that the second portion of the main graft body is not directly attached to the first stent portion, the second stent portion, or any other internal support structure. In some embodiments, one or more openings can be formed in the second portion of the main graft body.

Description

PRIORITY INFORMATION AND INCORPORATION BY REFERENCE[0001]This application claims priority benefit under 35 U.S.C. §119(e) of Provisional Application 61 / 173,485 filed Apr. 28, 2009, Provisional Application 61 / 228,048 filed Jul. 23, 2009, and Provisional Application 61 / 231,898 filed Aug. 6, 2009, which applications are hereby incorporated by reference as if fully set forth herein. Additionally, U.S. patent application Ser. No. 12 / 496,446, filed on Jul. 1, 2009 (entitled “CATHETER SYSTEM AND METHODS OF USING SAME”), U.S. patent application Ser. No. 12 / 390,346, filed on Feb. 20, 2009 (entitled “DESIGN AND METHOD OF PLACEMENT OF A GRAFT OR GRAFT SYSTEM”), U.S. patent application Ser. No. 12 / 101,863, filed on Apr. 11, 2008 (entitled “BIFURCATED GRAFT DEPLOYMENT SYSTEMS AND METHODS”), U.S. Pat. No. 6,077,296, filed on Mar. 4, 1998 (entitled “ENDOLUMINAL VASCULAR PROSTHESIS”), U.S. Pat. No. 6,953,475, filed on Sep. 30, 2003 (entitled “BIFURCATION GRAFT DEPLOYMENT CATHETER”), and U.S. Pat. N...

AI Technical Summary

Benefits of technology

[0016]Some embodiments of the endoluminal prostheses disclosed (directly and / or by incorporation by reference) herein pertain to designs and methods of placement of a branch graft or branch graft system having lateral openings in the main graft. The main graft can be positioned within the main blood vessel such as the aorta so that the lateral openings (also referred to herein as fenestrations) can be aligned with the branch blood vessels, to allow blood to flow through the openings in the main graft and into the branch vessels. Because the axial and angular position of the branch blood vessels can vary from one patient's anatomy to the next, the embodiments of the graft systems disclosed herein can allow a surgeon to adjust the position of the fenestrations so as to align the fenestrations with the branch vessels so that blood flow through the branch vessels is not obstructed by the main graft.

[0028]Some embodiments or arrangements are directed to endoluminal prostheses comprising a main graft body defining a flow lumen therethrough, a first opening passing through a wall of the main graft body, and a first support member supported by the main graft body and overlapping an edge of the first opening, the first support member being configured to increase the tear resistance of the main graft body adjacent to the first opening.

Problems solved by technology

When left untreated, the aneurysm may eventually cause rupture of the sac with ensuing fatal hemorrhaging in a very short time.

High mortality associated with the rupture led initially to transabdominal surgical repair of abdominal aortic aneurysms.

Surgery involving the abdominal wall, however, is a major undertaking with associated high risks.

There is considerable mortality and morbidity associated with this magnitude of surgical intervention, which in essence involves replacing the diseased and aneurysmal segment of blood vessel with a prosthetic device which typically is a synthetic tube, or graft, usually fabricated of polyester, urethane, Dacron™, Teflon™, or other suitable material.

Thus, if the patient is not receiving routine examinations, it is possible that the aneurysm will progress to the rupture stage, wherein the mortality rates are significantly higher.

Disadvantages associated with the conventional, prior art surgery, in addition to the high mortality rate include the extended recovery period associated with such surgery; difficulties in suturing the graft, or tube, to the aorta; the loss of the existing aorta wall and thrombosis to support and reinforce the graft; the unsuitability of the surgery for many patients having abdominal aortic aneurysms; and the problems associated with performing the surgery on an emergency basis after the aneurysm has ruptured.

Since the graft must typically be secured, or sutured, to the remaining portion of the aorta, it is many times difficult to perform the suturing step because the thrombosis present on the remaining portion of the aorta, and that remaining portion of the aorta wall may be friable, or easily crumbled.

Since many patients having abdominal aortic aneurysms have other chronic illnesses, such as heart, lung, liver, and / or kidney disease, coupled with the fact that many of these patients are older, the average age being approximately 67 years old, these patients are not ideal candidates for such major surgery.

When this occurs, it may be detrimental to implant a conventional tubular graft in this location of the aorta or the blood vessel, since such a graft may obstruct the flow of blood from the aorta into the branches.

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