Systems and methods having an anchoring device for securing a filling structure within a blood vessel

Abstract

A system for deployment within a blood vessel includes an anchoring device having a stent and a suture loop that engages a distal portion of the stent. When the stent is in a deployed state, a first filling structure and a second filling structure can be at least partially inserted through the suture loop into a region within the stent. When the first filling structure and the second filling structure have been at least partially inserted through the suture loop and have been filled, the anchoring device is sized such that at least a portion of the first filling structure and at least a portion of the second filling structure protrude through an opening in the anchoring device to form a seal against the blood vessel wall. A method of allowing the use of the system to repair one or more blood vessels.

Description

[0001] Cross - reference to related patent applications

[0002] This application claims the benefit of U.S. Provisional Patent Application Serial No. 62 / 678,956, filed May 31, 2018, the entire contents of which are incorporated herein by reference. Technical Field

[0003] The embodiments disclosed herein generally relate to systems having a stent and a filling structure for use in a blood vessel, and to methods of using a system having a stent and a filling structure in a blood vessel. Various embodiments relate to expandable prostheses and methods for treating abdominal aortic aneurysms and other aneurysms. Background Art

[0004] An aneurysm is an enlargement or bulge in a blood vessel, which is generally prone to rupture and thus poses a serious risk to the patient. Aneurysms can occur in any blood vessel, but are of particular concern when they occur in the cerebral vasculature or the aorta of a patient.

[0005] Abdominal aortic aneurysms (AAA) are classified based on their location within the aorta as well as their shape and complexity. An aneurysm found below the renal arteries is called an infrarenal abdominal aortic aneurysm. Suprarenal abdominal aortic aneurysms occur above the renal arteries. Thoracic aortic aneurysms (TAA) occur in the ascending, transverse, or descending portions of the upper aorta. Infrarenal aneurysms are the most common, accounting for approximately 70% of all aortic aneurysms. Suprarenal aneurysms are less common, accounting for approximately 20% of aortic aneurysms. Thoracic aortic aneurysms are the least common and are generally the most difficult to treat.

[0006] The most common aneurysm shape is "fusiform", in which the enlargement extends around the entire aortic circumference. Less commonly, an aneurysm presents as a bulge attached to one side of the blood vessel at a narrow neck. Thoracic aortic aneurysms are usually dissecting aneurysms caused by a hemorrhagic dissection in the aortic wall (usually within the media). One class of treatment for each of these types and forms of aneurysms is open surgical repair. Open surgical repair can be very successful for patients who are otherwise quite healthy and have no serious comorbidities. However, this open surgery can be problematic because it is difficult to access the abdominal and thoracic aortas, and because the aorta must be clamped, which places a great deal of stress on the patient's heart.

[0007] Endovascular grafts have been widely used to treat aortic aneurysms in patients. Typically, endovascular repair accesses the aneurysm "endovascularly" through one or two iliac arteries in the groin. A graft is then implanted. The recovery period for a successful endovascular procedure is much shorter than that of open surgery. However, various endovascular aortic aneurysm repairs are subject to many limitations. Some endovascular repair patients develop leaks at the proximal anastomosis (the attachment point closest to the heart). Another problem is graft migration. In cases where the graft migrates or slips from its intended position, open surgical repair is sometimes required. Since patients who receive endovascular grafts are typically those considered unfit for open surgery, this is a particular problem. SUMMARY OF THE INVENTION

[0008] A system for deployment in a blood vessel according to an embodiment includes an anchoring device. The anchoring device includes a stent and a suture loop that engages a distal portion of the stent. In various embodiments, the suture loop includes a plurality of suture segments. In various embodiments, the plurality of suture segments are arranged in a polygonal arrangement. In some embodiments, the stent includes a plurality of V-shaped stent elements, each of the plurality of V-shaped stent elements having two stent struts that meet at a bone-shaped apex, and the suture loop is wound around the bone-shaped apex. Additionally, in some embodiments, the suture loop is wound around each of the distal portions of the stent to engage the distal portions of the stent.

[0009] In various embodiments, the anchoring device includes barbs for attachment to the blood vessel. In various embodiments, the anchoring device further includes a radiopaque material positioned on at least a portion of the suture loop. In some embodiments, the stent is expandable to an expanded state, and the anchoring device is configured such that when the stent is in the expanded state, the diameter of the proximal orifice of the stent is greater than the diameter of the distal orifice of the stent defined by the suture loop. Additionally, in some embodiments, the anchoring device is configured such that when the stent is in the expanded state, the diameter of the distal orifice of the stent is at least 5% smaller than the diameter of the proximal orifice of the stent. In some embodiments, the anchoring device is configured such that when the stent is in the expanded state, the diameter of the distal orifice of the stent is not less than 25% smaller than the diameter of the proximal orifice of the stent.

[0010] In various embodiments, the system further includes a first filling structure and a second filling structure. In various embodiments, the stent is expandable to an expanded state, and when the stent is in the expanded state, the first filling structure and the second filling structure are at least partially insertable through the suture loop into the region within the stent. In some embodiments, the anchoring device is sized such that when the first filling structure and the second filling structure have been at least partially inserted through the suture loop and have been filled, at least a portion of the first filling structure and at least a portion of the second filling structure protrude through an opening in the anchoring device. In some embodiments, the opening in the anchoring device is defined by the stent struts of the stent and the suture loop. Additionally, in some embodiments, the first filling structure and the second filling structure are sealable against each other and lock onto the anchoring device when filled.

[0011] In various embodiments, the stent has a sufficient length such that it can be deployed within the stent when the first filling structure and the second filling structure extend at least 20 mm. In some embodiments, the anchoring device includes barbs that can be attached to the aortic wall above the renal artery, and when the barbs have been attached to the aorta above the renal artery and the first filling structure and the second filling structure have been at least partially inserted through the suture loop and have been filled, the anchoring device is sized such that at least a portion of the first filling structure and at least a portion of the second filling structure protrude through an opening in the anchoring device to contact the aortic wall below the renal artery.

[0012] In various embodiments, the suture loop is configured to at least partially constrain the first filling structure and the second filling structure when the first filling structure and the second filling structure have been at least partially inserted through the suture loop and have been filled. In some embodiments, the first filling structure can be deployed to provide a first lumen for blood flow from the aorta to the first iliac artery; the second filling structure can be deployed to provide a second lumen for blood flow from the aorta to the second iliac artery. Additionally, in some embodiments, the stent includes a plurality of stent struts, each of the plurality of stent struts being made of nitinol, and the suture loop is made of silk thread.

[0013] A method for repairing one or more blood vessels according to an embodiment includes: deploying an anchoring device having a stent and a suture loop that engages a distal portion of the stent; at least partially inserting a first filling structure through the suture loop; and filling the first filling structure such that one or more portions of the first filling structure protrude through one or more openings defined by one or more struts of the stent and at least a portion of the suture loop. In various embodiments, the method further includes: at least partially inserting a second filling structure through the suture loop; and filling the second filling structure such that one or more portions of the second filling structure protrude through corresponding ones of the one or more openings in the side of the stent.

[0014] In various embodiments, one or more portions of the first filling structure and one or more portions of the second filling structure contact the vessel wall of one or more blood vessels to form a seal against the wall. In various embodiments, the anchoring device is deployed using a first guidewire that passes through the first iliac artery; the first filling structure is deployed using the first guidewire; and the second filling structure is deployed using a second guidewire that is separate from the first guidewire and passes through the second iliac artery. In some embodiments, the anchoring device further includes a radiopaque material located on at least a portion of the suture loop; and the method further includes observing the radiopaque material to assist in at least partially inserting the first filling structure through the suture loop and to assist in at least partially inserting the second filling structure through the suture loop.

[0015] In various embodiments, the anchoring device is at least partially deployed in the proximal neck region of an aneurysm, and after deployment of the anchoring device, the distal orifice of the stent defined by the suture loop has a diameter that is at least 5% smaller than the diameter of the proximal neck region of the aneurysm. In some embodiments, the one or more blood vessels include the aorta, the anchoring device further includes barbs, deploying the anchoring device includes securing the barbs to the aortic wall above the renal artery, and after deployment of the anchoring device, the stent extends downward in the aorta past the renal artery and has a length of at least 20 mm below the renal artery. Additionally, in some embodiments, at least partially inserting the first filling structure through the suture loop includes: inserting the proximal end of the first filling structure more than 20 mm past the suture loop and completely below the renal artery.

[0016] In various embodiments, filling the first filling structure includes filling the first filling structure with a polymer that sets after one or more portions of the first filling structure have protruded through one or more openings to lock the first filling structure to the anchoring device. In various embodiments, the first filling structure is filled with a polymer, and when the first filling structure is filled with the polymer, the first filling structure is at least partially constrained by a suture loop. In some embodiments, the one or more blood vessels include the aorta having an aneurysm, and the method further includes: selecting an anchoring device from a plurality of anchoring devices of different sizes based on the diameter of the proximal neck region of the aneurysm. Additionally, in some embodiments, the method further includes: at least partially inserting a second filling structure through the suture loop; and filling the second filling structure to form a seal with the first filling structure both inside and outside the stent. BRIEF DESCRIPTION OF THE DRAWINGS

[0017] Figure 1 is a diagrammatic illustration of a cross-section of an exemplary patient anatomy with an infrarenal aortic aneurysm.

[0018] Figure 2 illustrates a system according to one embodiment for deployment in one or more blood vessels.

[0019] Figure 3 is a diagrammatic illustration of a side view of an anchoring device according to one embodiment.

[0020] Figure 4 is a perspective view of an anchoring device according to one embodiment.

[0021] Figure 5 is a diagrammatic illustration of a system according to one embodiment deployed to repair an aneurysm.

[0022] Figure 6 illustrates a Figure 5 portion of the system according to an embodiment, the portion including an anchoring device, a first filling structure, and a second filling structure.

[0023] Figure 7 is a flowchart of a method according to one embodiment for repairing one or more blood vessels.

[0024] Figure 8 is a diagrammatic illustration of a first wire inserted through the first iliac artery into the aorta.

[0025] Figure 9 is using Figure 8 the first wire to insert an anchoring device according to one embodiment into the aorta.

[0026] Figure 10Illustration of an anchoring device deployed in the aorta according to an embodiment.

[0027] Figure 11 Illustration of a first wire passing through an anchoring device according to an embodiment, and also showing a second wire that has been inserted through the second iliac artery and through the anchoring device.

[0028] Figure 12 Illustration of a first catheter holding a first filling structure being at least partially inserted into the anchoring device using the first wire according to an embodiment.

[0029] Figure 13 Illustration of a second catheter holding a second filling structure being at least partially inserted into the anchoring device using the second wire according to an embodiment.

[0030] Figure 14 Illustration of a system according to an embodiment, the system being deployed to repair one or more blood vessels, with the anchoring device positioned below the renal artery. Detailed Description

[0031] In the following detailed description, reference is made to the accompanying drawings which form a part hereof. In the drawings, like symbols typically refer to like items unless the context otherwise indicates. The illustrative embodiments described in the detailed description and the drawings are not meant to be limiting. Other embodiments may be utilized and other changes may be made without departing from the spirit or scope of the subject presented herein. It will be readily understood that the aspects of the present disclosure as generally described herein and illustrated in the drawings can be arranged, substituted, combined, and designed in a variety of different configurations, all of which are explicitly contemplated and form a part of this disclosure. For an anchoring device and filling structure insertable into a patient, such as in an endovascular prosthesis system and its components, the term "proximal" refers to a position toward the patient's heart in the direction of blood flow, and the term "distal" refers to a position away from the patient's heart.

[0032] Certain embodiments described herein relate to systems, methods, and devices for treating injuries, aneurysms, or other defects in blood vessels such as the aorta, including but not limited to the thoracic aorta, ascending aorta, and abdominal aorta, as well as the iliac and renal arteries. However, the systems, methods, and devices may be applied to other areas of the body or other fields, and such additional applications are intended to be part of this disclosure. For example, it will be appreciated that the systems, methods, and devices may be applied to the treatment of blood vessels in animals. Various embodiments and / or aspects of the endovascular prosthesis systems, methods, and devices described herein may be applied to other parts of the body or may also have other applications in addition to treating blood vessels such as the aorta and the iliac and renal arteries. And although specific embodiments may be described herein with respect to particular portions of the aorta, it should be understood that the described embodiments may be adapted for use in other portions of the aorta or other parts of the body and are not limited to the described portions of the aorta.

[0033] A system for placement in at least one blood vessel according to various embodiments includes a polymeric endovascular aneurysm sealing (EVAS) device having one or more filling structures such as endobags, which exclude an aneurysm by filling the aneurysm sac space with a polymer contained within the one or more filling structures. The system further includes an anchoring device to improve the fixation of such an EVAS device to the patient's anatomy by discrete anchoring devices that, in various embodiments, engage the EVAS device to hold the EVAS device in place.

[0034] In various embodiments, the anchoring device is pre-deployed into an arterial segment, such as into the proximal neck of an abdominal aortic aneurysm (AAA), and the deployment of the anchoring device is followed by the deployment of the EVAS device. In some embodiments for treating an AAA, the anchoring device includes a stent having barbs at the proximal end and the distal end of the stent is joined in a polygonal arrangement of suture segments forming a suture loop. In various embodiments, the suture loop includes a radiopaque material to improve the visibility of the suture loop and to assist in cannulating the orifice of the suture loop formed by the suture segments. In various embodiments, such cannulation is required to allow a contralateral catheter to pass through the anchoring device to deploy the filling structure. In some embodiments, an ipsilateral catheter for deploying another filling structure advances over the guidewire used for pre-deploying the anchoring device, such that in such cases no cannulation step is required for the ipsilateral catheter.

[0035] In various embodiments, the distal orifice of the anchoring device is sized such that its diameter is about 5% to 25% smaller than the proximal neck region of the aneurysm, such that the endoscope-specific bag can expand and protrude through the gap or opening in the anchoring device, the gap or opening being defined by the strut of the stent and the suture segment of the suture loop. When the polymer solidifies in the endoscope-specific bag, the endoscope-specific bag engages (geometrically locks or engages) with the anchoring device, which attaches the entire system to the artery (such as the aorta). The anchoring device can be made of Nitinol or other materials and may or may not include suture material. Such an anchoring device can also be used at the distal landing site, such as in the iliac artery.

[0036] In various embodiments, only the proximal barbed portion of the stent structure is deployed to the proximal end of the renal artery to allow a significant length (such as at least about 20 mm to 30 mm) of the proximal bag portion of each endoscope-specific bag to be deployed close to the suture loop but away from the renal artery. This allows the endoscope-specific bag to have sufficient length to achieve sufficient radial expansion and arterial wall contact. Since the AAA neck diameter varies over a wide range, typically from 16 mm to 32 mm, various sizes of the anchoring device can be obtained in various embodiments, such as 5 different proximal stent sizes. This allows for a fairly constant lumen constriction to be achieved across a wide range of AAA neck diameters by the suture loop of the anchoring device. In various embodiments, the anchoring device is deployed using a staged delivery system prior to deploying the endoscope-specific bag. In some embodiments, the anchoring device is used in cases involving the visceral aortic segment, such as for endovascular aneurysm sealing (chEVAS) in combination with a chimney graft.

[0037] Figure 1 is a cross-sectional illustration of an exemplary patient anatomy with an infrarenal aortic aneurysm. In Figure 1 , the aorta 10 bifurcates into two iliac arteries 12 and 13 at the aortic bifurcation 11. The aneurysm sac 14 represents the bulging segment of the aorta 10. As the name implies, the infrarenal aortic aneurysm is located below the renal arteries 15 and 16. The segment of the aorta 10 between the renal arteries 15, 16 and the aneurysm sac 14 is referred to as the proximal neck region 17. For different patients, the proximal neck region 17 has a diameter 83 that may vary. Wall thrombus 18 typically forms on the inner wall of the aneurysm sac 14.

[0038] Figure 2 is an illustration of a system 20 according to an embodiment for deployment in one or more blood vessels, such as disposed in Figure 1 the aorta 10 and the iliac arteries 12 and 13 as shown. Referring to Figure 2, the system 20 includes an anchoring device 30 and an endovascular aneurysm sealing (EVAS) device 100. The anchoring device 30 includes a stent 40 and a suture loop 70. The suture loop 70 engages a distal portion 41 of the stent 40. In various embodiments, the suture loop 70 includes a plurality of suture segments 71 that are joined together to form the suture loop 70.

[0039] In various embodiments, the stent 40 has a tapered cylindrical body that is wider at the proximal end of the stent 40 and narrower at the distal end of the stent 40. In various embodiments, the stent 40 is formed of a suitable biocompatible material such as a biocompatible alloy, a biocompatible metal, or a biocompatible polymer (which may be a thermoplastic material). In some embodiments, the stent 40 is formed of a steel alloy, a cobalt-chromium alloy, a nickel-titanium alloy (such as nitinol), and / or any suitable type of shape memory alloy. The stent 40 is configured to have an expandable geometry to expand from a compressed state to an expanded state. For example, in some embodiments, the stent 40 is a self-expanding stent. In some embodiments, the stent 40 is a balloon-expandable stent.

[0040] In various embodiments, the suture loop 70 includes a plurality of suture segments 71, all of which are made of suture material. In some embodiments, the suture material is silk thread. In some embodiments, the suture material includes silk, polypropylene, polyester, and / or nylon. In some embodiments, the suture material is elastic. In some embodiments, the suture material includes natural or synthetic fibers. In various embodiments, the suture loop 70 serves as a distal restraint member for the stent 40. In various embodiments, a distal restraint member made of a material different from the suture material may be used in place of the suture loop 70, and the distal restraint member may engage the distal portion 41 of the stent 40.

[0041] The EVAS device 100 includes a filling structure 112 located on a delivery catheter 114 and having an expandable element 116 (such as an inflatable balloon, etc.). In various embodiments, the filling structure 112 is a bag, such as an endoscope-specific bag, etc. In some embodiments, the EVAS device 100 includes an expandable stent 129. The catheter 114 includes a wire lumen 118 for inserting a wire, and also includes a filling tube 120 for delivering a filling medium or material to the internal space 122 of the filling structure 112. The internal space 122 is defined between the outer wall 124 and the inner wall 126 of the filling structure 112. When inflated with a filling material or medium, the outer wall 124 will expand radially outward, as shown by the dashed line, and the inner wall 126 will also expand radially outward, also as shown by the dashed line. The expansion of the inner wall 126 defines a lumen 128, which may also be defined by the expansion of the stent 129 in the case of using the stent 129. The expandable balloon or other structure 116 will be expandable to support, for example, the inner surface of the lumen 128 when the internal space 122 is filled, also as Figure 2 shown by the dashed line in

[0042] The EVAS device 100 also includes another filling structure 212 located on a delivery catheter 214 and having an expandable element 216 (such as an inflatable balloon). In various embodiments, the filling structure 212 is a bag, such as an endoscope-specific bag, etc. In some embodiments, the EVAS device 100 includes an expandable stent 229. The catheter 214 includes a wire lumen 218 for inserting a wire, and also includes a filling tube 220 for delivering a filling medium or material to the internal space 222 of the filling structure 212. The internal space 222 is defined between the outer wall 224 and the inner wall 226 of the filling structure 212. When inflated with a filling material or medium, the outer wall 2244 will expand radially outward, as shown by the dashed line, and the inner wall 226 will also expand radially outward, also as shown by the dashed line. The expansion of the inner wall 226 defines a lumen 228, which may also be defined by the expansion of the stent 229 in the case of using the stent 229. The expandable balloon or other structure 216 will be expandable to support, for example, the inner surface of the lumen 228 when the internal space 222 is filled, also as Figure 2 shown by the dashed line in

[0043] Various embodiments disclosed herein provide methods and systems for endovascular treatment of aneurysms, particularly aortic aneurysms including abdominal aortic aneurysms (AAA) and thoracic aortic aneurysms (TAA). In various embodiments, the system 20 includes a prosthesis, which includes a double-walled filling structure, such as the filling structures 112 and 212, which are preformed and / or otherwise adapted to substantially fill the enlarged volume of an aneurysm, particularly a fusiform aneurysm, leaving one or more lumens for blood flow in place.

[0044] In various embodiments, the filling structures 112 and 212 include: a generally toroidal structure having an outer wall, an inner wall, and a potential space or volume therebetween filled with a filling medium; and a generally tubular lumen within the inner wall, which provides a blood flow lumen after the prosthesis is deployed. In various embodiments, the shapes of the filling structures 112 and 212 are adapted to conform to the aneurysm being treated. In some cases, imaging and computer-aided design and manufacturing techniques can be used to shape the filling structures 112 and 212 to the aneurysm geometry of a particular patient. In other cases, a series or collection of filling structures with different geometries and sizes can be manufactured such that a treating physician can select a particular filling structure to treat a patient based on the size and geometry of the aneurysm of that particular patient. In various embodiments, when the prosthesis is deployed, the outer wall 124 of the filling structure 112 and the outer wall 224 of the filling structure 212 can conform to the inner surface of the aneurysm being treated, while the inner wall 126 of the filling structure 112 and the inner wall 226 of the filling structure 212 can be aligned with the lumen of the blood vessel on either side of the prosthesis.

[0045] In various embodiments, the filling structures 112 and 212 are formed from non-compliant materials such as parylene, polyester (e.g., ), polyethylene terephthalate (PET), polytetrafluoroethylene (PTFE)) and / or compliant materials such as silicone, polyurethane, latex, or combinations thereof. In some embodiments, the filling structures 112 and 212 are formed from expanded PTFE (ePTFE). The walls of the filling structures 112 and 212 can consist of a single layer or can include multiple layers that are laminated, glued, heat-bonded, ultrasonically bonded, or otherwise formed together. The different layers can include different materials, including compliant materials and / or non-compliant materials. The walls of the filling structures 112 and 212 can also be reinforced in various ways, including braided reinforcement layers, filament reinforcement layers, and the like.

[0046] In various embodiments, the stent 129 can expand within a generally tubular lumen 128 that provides blood flow after the filling structure 112 has been deployed in the aneurysm. Additionally, in various embodiments, the stent 229 can expand within a generally tubular lumen 228 that provides blood flow after the filling structure 212 has been deployed in the aneurysm.

[0047] In various embodiments, the support frames 129 and 229 are formed of an elastic material (specifically spring steel or a shape memory alloy) such that they can be delivered in a constrained configuration and allowed to expand to anchor within the respective generally tubular cavities 128 and 228 of the respective filling structures 112 and 212. Alternatively, the support frames 129 and 229 can be formed of a malleable metal or other material (such as stainless steel) and delivered using a balloon catheter or other conventional stent expansion device (such as the respective expandable elements 116 and 216). The geometry of the support frames 129 and 229 can also vary significantly. In some embodiments, each support frame 129 and 229 will extend along substantially the entire length of the respective inner wall of the respective generally tubular cavities 128 and 228 of the respective filling structures 112 and 212. In some embodiments, each support frame 129 and 229 extends outwardly from at least one end of the respective generally tubular cavities 128 and 228 into the adjacent blood vessel. Each support frame 129 and 229 can also extend outwardly from both ends of the respective generally tubular cavities 128 and 228 and cover the entire inner wall surface of the respective cavities 128 and 228.

[0048] In other cases, multiple support frame structures can be disposed within a single generally tubular cavity of each filling structure 112 and 212. In such cases, two or more stents can be adapted to be placed in series and stacked. In other cases, the stents can be adapted to be spaced apart at either or both ends and optionally in regions between the ends. In some embodiments, each support frame 129 and 229 includes a metal frame, at least a portion of which is covered by a polymer film or other covering. In some cases, each support frame 129 and 229 or portions thereof can be polymeric and optionally formed of a biodegradable polyester. In some embodiments, each support frame 129 and 229 is covered on at least those portions of the support frames 129 and 229 that engage the inner walls of the respective generally tubular cavities 128 and 228 of the respective filling structures 112 and 212. For various purposes, such as promoting tissue ingrowth, reducing thrombosis, reducing the risk of infection, etc., the support frames 129 and 229 and / or their coverings can be coated with, infused with, or otherwise combined with a drug or other bioactive substance.

[0049] In various embodiments, the delivery schemes for filling structures 112 and 212 will utilize respective delivery catheters 114 and 214 having respective expandable elements 116 and 216. When balloons are used for expandable elements 116 and 216, the balloons will preferably be substantially or completely non-compliant, although compliant and combined compliant / non-compliant balloons may also be used. Each expandable element 116 and 216 or other mechanical expansion components of respective delivery catheters 114 and 214 will initially be disposed within respective lumens 128 and 228 of respective filling structures 112 and 212, and respective filling structures 112 and 212 will typically collapse onto the corresponding expandable elements 116 and 216 into a low-width or low-profile configuration. Then, each delivery catheter 114 and 214 can be introduced endoluminally into a patient (such as into a corresponding iliac artery) and advanced into the region within the aorta to be treated. Each delivery catheter 114 and 214 also includes respective filling tubes 120 and 220 or other components or structures for delivering a filling medium in fluid form to respective internal spaces 122 and 222 of respective filling structures 112 and 212. Once positioned at the aneurysm site, the respective expandable elements 116 and 216 on respective delivery catheters 114 and 214 can be used to expand respective lumens 128 and 228 of respective filling structures 112 and 212. By delivering the filling medium via respective delivery catheters 114 and 214 into respective internal spaces 122 and 222 of corresponding filling structures 112 and 212, each filling structure 112 and 212 itself will be filled and expanded. The expansion and filling operations can be performed simultaneously, or the expansion and filling operations can be performed in any order. The filling structures 112 and 212 and / or the expandable elements 116 and 216 can have radiopaque markers to facilitate placement and / or pressure sensors for monitoring filling and inflation pressures during deployment.

[0050] A suitable filling material will initially be a fluid to allow delivery through delivery conduits 114 and 214 and will be curable or otherwise hardenable such that once in place, filling structures 112 and 212 can be given a final shape that will remain after removal of delivery conduits 114 and 214. In various embodiments, the fillable material is a curable polymer that will have a fixed shape after curing. The polymer can be delivered in the form of a liquid, gel, foam, slurry, etc. In some cases, the polymer can be an epoxy resin or other curable two-part system. In other cases, the polymer can include a single material that changes state over time (typically from zero to ten minutes) when exposed to the vascular environment within the filling structure. The filling material or medium can also include bulking agents and other reagents to modify density, viscosity, mechanical properties, etc., including microspheres, fibers, powders, gases, radiopaque materials, drugs, etc. Exemplary filling materials include polyurethane, collagen, polyethylene glycol, microspheres, etc. In some embodiments, the filling material or medium includes polyethylene glycol (PEG) or another polymer that can be polymerized in situ.

[0051] The filling structures 112 and 212 can be modified in a variety of other ways. For example, the outer surfaces of the filling structures 112 and 212 can be partially or fully modified to enhance placement within the aneurysm space, such as by promoting tissue ingrowth or mechanically interlocking with the inner surface of the aneurysm. Such surface modifications include surface roughening, surface stippling, surface flocking, fibers disposed above the surface, foam layers disposed above the surface, rings, etc. Bioactive substances, such as thrombogenic substances, tissue growth promoters, bioadhesives, etc., can also be provided on all or part of the outer surfaces of the filling structures 112 and 212. Synthetic adhesives, such as polyacrylamide, can also be provided on the surface to enhance adhesion. In some cases, it will be desirable to modify all or part of the inner surfaces of the filling structures 112 and 212. Such surface modifications can include surface roughening, rings, dotting, flocking, foam layers, fibers, adhesives, etc. The purpose of such surface modifications will generally be to enhance filling and bonding with the filling material or medium and to control the minimum wall thickness when filling each of the filling structures 112 and 212, particularly after the filling material has cured.

[0052] Figure 3 is an illustration of a side view of an anchoring device 30 according to an embodiment. Figure 4 is a perspective view of an anchoring device 30 according to an embodiment, looking up from the bottom of the anchoring device 30. Refer to Figure 3 and Figure 4, the anchoring device 30 includes a stent 40 and a suture loop 70. The stent 40 includes stent struts 43 on the lower portion of the stent 40 and includes stent struts 45 on the upper portion of the stent 40. The suture loop 70 engages the distal portion 41 of the stent 40. In various embodiments, the suture loop 70 includes a plurality of suture segments 71 that are joined together to form the suture loop 70. In various embodiments, the plurality of suture segments 71 are arranged in a polygonal arrangement. In some embodiments, the stent 40 includes a plurality of V-shaped stent elements 42, each V-shaped stent element having a respective two stent struts 43 that meet at a bone-shaped apex 44 around which the suture loop 70 is wound. In some embodiments, instead of the bone-shaped apex 44 there is an eyelet through which the suture loop 70 passes. Additionally, in some embodiments, the suture loop 70 is wound around each of the distal portions 41 of the stent 40 to engage the distal portions 41 of the stent 40.

[0053] In various embodiments, the anchoring device 30 includes a stent 40, and the stent 40 includes barbs 46 on the stent struts 45 for attachment to a blood vessel (such as the aortic wall). In various embodiments, the anchoring device 30 further includes a radiopaque material 72 that is positioned on at least a portion of the suture loop 70. In some embodiments, the radiopaque material 72 includes one or more thin-walled metal tubes that are placed at one or more locations on the suture loop 70 to be visible under x-ray fluoroscopy, and the radiopaque material includes, for example, a high-density metal such as platinum, gold, tantalum, etc.

[0054] In some embodiments, the stent 40 is expandable to an expanded state, such as Figure 3 and Figure 4 as shown, and the anchoring device 30 is configured such that when the stent 40 is in the expanded state, the diameter 52 of the proximal orifice 51 of the stent 40 is greater than the diameter 54 of the distal orifice 53 of the stent 40 defined by the suture loop 70. Additionally, in some embodiments, the anchoring device 30 is configured such that when the stent 40 is in the expanded state, the diameter 54 of the distal orifice 53 of the stent 40 is at least 5% smaller than the diameter 52 of the proximal orifice 51 of the stent 40. In some embodiments, the anchoring device 30 is configured such that when the stent 40 is in the expanded state, the diameter 54 of the distal orifice 53 of the stent 40 is not less than 25% smaller than the diameter 52 of the proximal orifice 51 of the stent 40. There is an area 55 within the stent 40 into which a filling structure can be inserted. The anchoring device 30 has openings 56, each opening being defined by a respective two stent struts 43 and a respective portion of the suture loop 70. One or more of the openings 56 are in the side 59 of the stent 40. The stent 40 has a length 57 from the proximal end of the stent 40 to the distal end of the stent 40.

[0055] Figure 5 FIG. 0 is an illustration of a system 20 according to an embodiment, the system being deployed to repair an aneurysm 14 in an aorta 10. Figure 6 FIG. 1 shows a portion of the system 20 according to an embodiment Figure 5 that includes an anchoring device 30, a filling structure 112, and a filling structure 212. In various embodiments, the stent 40 can be expanded to an expanded state, such as Figure 5 and Figure 6 shown, and when the stent 40 is in the expanded state, the filling structure 112 and the filling structure 212 can be at least partially inserted through the suture loop 70 into an area within the stent 40. In some embodiments, when the filling structure 112 and the filling structure 212 have been at least partially inserted through the suture loop 70 and have been filled, the anchoring device 30 is sized such that one or more portions 131 of the filling structure 112 and one or more portions 231 of the filling structure 212 protrude through an opening 56 in the anchoring device 30. Referring to Figure 3 , Figure 4 , Figure 5 and Figure 6 , in some embodiments, the opening 56 in the anchoring device 30 is defined by a stent strut 43 of the stent 40 and the suture loop 70. Additionally, in some embodiments, the filling structure 112 and the filling structure 212 can be sealed to each other (as shown by sealing regions 141 and 142) and can be locked to, or fixed to, or engaged with the anchoring device 30 when filled (as shown by locking regions 143 and 243).

[0056] In various embodiments, the stent 40 has a sufficient length 57 such that the filling structure 112 and the filling structure 212 can be deployed within the stent 40 when they extend at least 20 mm. In some embodiments, the anchoring device 30 includes barbs 46 that can be attached to a wall 81 of the aorta 10 above the renal arteries 15 and 16, and when the barbs 46 have been attached to the aorta 10 above the renal arteries 15 and 16 and the filling structure 112 and the filling structure 212 have been at least partially inserted through the suture loop 70 and have been filled, the anchoring device 30 is sized such that one or more portions 131 of the filling structure 112 and one or more portions 231 of the filling structure 212 protrude through an opening 56 in the anchoring device 30 to contact a wall 82 of the aorta 10 below the renal arteries 15 and 16.

[0057] In various embodiments, when the filling structures 112 and 212 have been at least partially inserted through the suture loop 70 and have been filled, the suture loop 70 is configured to at least partially constrain the filling structures 112 and 212, as shown by the constraint region 73. In some embodiments, the filling structure 112 can be deployed to provide a lumen 128 for blood flow from the aorta 10 to the iliac artery 12, and the filling structure 212 can be deployed to provide a lumen 228 for blood flow from the aorta 10 to the iliac artery 12. Additionally, in some embodiments, the stent 40 includes a plurality of stent struts 43 and a plurality of stent struts 45, each stent strut being made of, for example, nitinol alloy, and the suture loop 70 being made of, for example, silk thread.

[0058] In various embodiments, when the filling structure 112 has been filled, one or more portions 131 of the filling structure 112 project through the anchoring device 30 to form a seal against the wall 82 of the aorta 10 below the renal arteries 15 and 16, as shown by the exemplary seal region 147. Additionally, in various embodiments, when the filling structure 212 has been filled, one or more portions 231 of the filling structure 212 project through the anchoring device 30 to form a seal against the wall 82 of the aorta 10 below the renal arteries 15 and 16, as shown by the exemplary seal region 247. In various embodiments, after the filling structure 112 has been filled, the proximal end 171 of the filling structure 112 remains below the tops of the renal arteries 15 and 16. Additionally, in various embodiments, after the filling structure 212 has been filled, the proximal end 271 of the filling structure 212 remains below the tops of the renal arteries 15 and 16.

[0059] In some embodiments, the suture loop 70 is elastic to allow additional expansion of the stent 40 when the filling structures 112 and 212 are filled. In various embodiments, the anchoring device 30 includes a mechanical interlocking device or the like so as not to expand beyond a certain point. In various embodiments, the filling structures 112 and 212 form a seal with each other both inside the stent 40 (as shown by the seal region 141) and outside the stent 40 (as shown by the seal region 142). In various embodiments, the filling structure 112 is filled to form a seal against the wall 82 of the aorta 10 below the renal arteries 15 and 16 (as shown by the seal region 147) and against the filling structure 212 (as shown by the seal region 141). In various embodiments, the filling structure 212 is filled to form a seal against the wall 82 of the aorta 10 below the renal arteries 15 and 16 (as shown by the seal region 247) and against the filling structure 112 (as shown by the seal region 141).

[0060] In various embodiments, the filling structures 112 and 212 are filled to form a seal with each other above the suture ring 70 (as shown by the seal area 141) and to form a seal with each other below the suture ring 70 (as shown by the seal area 142). In various embodiments, the filling structures 112 and 212 are filled to form a seal with the wall of the aorta 10 above and below the suture ring 70. In some embodiments, the filling structures 112 and 212 are preformed to have different expansion portions that are shaped differently for expansion above and below the suture ring 70.

[0061] Although the stent 40 has been described as an example having a plurality of stent struts 43, stent struts 45, and barbs 46, it should be understood that any desired number of stent struts 43, stent struts 45, and barbs 46 may be used in various embodiments. For example, in various embodiments, the number of barbs 46 can be 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or any other desired number of barbs 46. For different embodiments of the stent 40, the length 57 of the stent 40 can vary and can be selected, for example, based on the patient's anatomy. Additionally, for different embodiments of the stent 40, the diameter 52 of the proximal orifice 51 of the stent 40 and the diameter 54 of the distal orifice 53 of the stent 40 can be different, and the specific size of the stent can be selected, for example, based on the patient's anatomy. The lengths of the filling structures 112 and 212 can also be selected, for example, based on the patient's anatomy.

[0062] Figure 7 is a flowchart of a method for repairing one or more blood vessels according to an embodiment. The method of Figure 7 can be used to deploy the Figure 2 system 20 into one or more blood vessels (such as the Figure 1 aorta 10 and the iliac arteries 12 and 13). Figure 8 、 Figure 9 、 Figure 10 、 Figure 11 、 Figure 12 and Figure 13 illustrate the various steps of the deployment based on the Figure 7 method to obtain the Figure 5 deployment state of the system 20 shown.

[0063] Referring to Figure 7 , in step 400, an anchoring device is selected from a plurality of anchoring devices of different sizes based on the diameter of the proximal neck region of the aneurysm in the patient's body. For example, referring to Figure 1, the diameter 83 of the proximal neck region 17 of the aneurysm 14 in the aorta 10 of the patient can be measured, and then an anchoring device can be selected from a plurality of anchoring devices of different sizes based on the diameter 83 of the proximal neck region 17 of the aneurysm 14. Refer to Figure 7 , in step 401, an anchoring device is deployed, and the anchoring device has a stent and a suture loop that engages the distal portion of the stent. In Figure 8 , Figure 9 and Figure 10 examples of the steps of such a deployment are shown. Refer to Figure 8 , a wire 151 is inserted through an incision in the patient's groin and extended through the iliac artery 12 and past the renal arteries 15 and 16 and through the aorta 10. Refer to Figure 9 , a catheter that holds the anchoring device 30 in a compressed state is advanced on the wire 151 through the iliac artery 12 into the aorta 10 to the deployment position. The anchoring device 30 includes a stent 40 and a suture loop 70, and the anchoring device can be held in a compressed state, for example, by a sheath or the like. Refer to Figure 10 , the anchoring device 30 is expanded to an expanded state within the aorta 10. Thus, in various embodiments, the wire 151 passing through the iliac artery 12 is used to deploy the anchoring device 30.

[0064] Refer to Figure 3 , Figure 4 and Figure 10 , in various embodiments, the anchoring device 30 is at least partially deployed in the proximal neck region 17 of the aneurysm 14, and after the deployment of the anchoring device 30, the diameter 54 of the distal orifice 53 of the stent 40 defined by the suture loop 70 is at least 5% smaller than the diameter 83 of the proximal neck region 17 of the aneurysm 14. Refer to Figure 7 and Figure 10 , in various embodiments, the deployment of the anchoring device 30 includes step 402: fixing the barbs 46 to the wall 81 of the aorta 10 located above the renal arteries 15 and 16. In some embodiments, after the deployment of the anchoring device 30, the stent 40 extends downward in the aorta 10 past the renal arteries 15 and 16 and has a length of at least 20 mm below the renal arteries 15 and 16. To allow for the further deployment of the filling structure, after the anchoring device 30 has been deployed, the wire 151 passing through the iliac artery 12 can remain passing through the anchoring device 30 in the aorta 10. Then, another wire can be inserted through another iliac artery 13 to deploy another filling structure. Refer to Figure 11 , a wire 251 is passed through another incision inserted in the patient's groin and extended through the iliac artery 13 and past the renal arteries 15 and 16 through the aorta 10. The wire 251 passes through the stent 40 of the anchoring device 30. In various embodiments, the wire 251 crosses the wire 151 within the aneurysm 14.

[0065] Referring again to Figure 7 , in step 403, the first filling structure is at least partially inserted through the suture loop. For example, referring to Figure 12 , the delivery catheter 114 holding the filling structure 112 is advanced on the wire 151 through the iliac artery 12 and at least partially through the suture loop 70 into the region within the stent 40 of the anchoring device 30 in the aorta 10. Thus, in various embodiments, the same wire 151 used to deploy the anchoring device 30 and pass through the iliac artery 12 is used to insert the filling structure 112 for deployment. Referring to Figure 4 , Figure 7 and Figure 12 , in some embodiments, the insertion of the filling structure 112 includes step 404: viewing the radiopaque material 72 on at least a portion of the suture loop 70 to assist in at least partially inserting the filling structure 112 through the suture loop 70. In various embodiments, the viewing is performed using, for example, an x-ray fluoroscope. In some embodiments, the insertion of the filling structure 112 includes step 405: inserting the proximal end 171 of the filling structure 112 more than 20 mm beyond the suture loop 70 and keeping the filling structure 112 completely below the renal arteries 15 and 16. The filling structure 112 passes through the suture loop 70 by passing through the region surrounded by the suture loop 70 such that at least a portion of the filling structure 112 is surrounded by the suture loop 70.

[0066] In step 406, the second filling structure is at least partially inserted through the suture loop. For example, referring to Figure 13 , the delivery catheter 214 holding the filling structure 212 is advanced on the wire 251 through the iliac artery 13 and at least partially through the suture loop 70 into the region within the stent 40 of the anchoring device 30 in the aorta 10. Thus, in various embodiments, the wire 251 is used to insert the filling structure 212 for deployment through the iliac artery 13, and this wire is a wire separate from the wire 151 that passes through the iliac artery 12 and is used to insert the anchoring device 30 and the filling structure 112.

[0067] Referring to Figure 4 , Figure 7 and Figure 13, in some embodiments, the insertion of the filling structure 212 includes step 407: viewing the radiopaque material 72 on at least a portion of the suture loop 70 to assist in inserting the filling structure 212 at least partially through the suture loop 70. In various embodiments, the viewing is performed using an x-ray fluoroscope or the like. In some embodiments, the insertion of the filling structure 212 includes step 408: inserting the proximal end 271 of the filling structure 212 more than 20 mm beyond the suture loop 70 and maintaining the filling structure 212 completely below the renal arteries 15 and 16. The filling structure 212 passes through the suture loop 70 by passing through the area surrounded by the suture loop 70 such that at least a portion of the filling structure 212 is surrounded by the suture loop 70. In various embodiments, the filling structures 112 and 212 extend a length 144 within the stent 40. Additionally, in various embodiments, the length 58 of the stent 40 below the renal arteries 15 and 16 is sufficient such that the filling structures 112 and 212 can extend at least 20 mm above the suture loop 70 while still remaining completely below the renal arteries 15 and 16.

[0068] In step 409, the first filling structure is filled such that one or more portions of the first filling structure protrude through one or more openings defined by one or more stent struts of the stent and at least a portion of the suture loop. For example, Figure 5 is shown the filling structure 112 after having been filled with a filling material or medium. Referring to Figure 3 , Figure 4 and Figure 5 , the filling structure 112 is filled such that one or more portions 131 of the filling structure 112 protrude through one or more openings 56 defined by at least a respective portion of a respective one or more stent struts 43 of the stent 40 and the suture loop 70. Referring to Figure 3 , Figure 4 , Figure 5 , Figure 6 and Figure 7 , in various embodiments, filling the filling structure 112 includes step 410: filling the filling structure 112 with a polymer which solidifies after one or more portions 131 of the filling structure 112 have protruded through the one or more openings 56 to lock the filling structure 112 to the anchoring device 30 (as shown by the locking region 143). In various embodiments, the filling structure 112 is filled with a polymer and when the filling structure 112 is filled with the polymer, the filling structure 112 is at least partially constrained by the suture loop 70 (as shown by the constraint region 73).

[0069] In step 411, the second filling structure is filled so that one or more portions of the second filling structure protrude through corresponding ones of the openings in the side of the stent. For example, the filling structure 212 is filled so that one or more portions 231 of the filling structure 212 protrude through corresponding ones of the openings 56 in the side of the stent 40, the openings being defined by portions of the suture loop 70. In various embodiments, filling the filling structure 212 includes step 412: filling the filling structure 212 so that the filling structure 212 forms a seal both inside and outside the stent 40 with the filling structure 112, as shown by the two seal regions 141 and 142. In various embodiments, when the filling structure 212 has been filled, at least a portion of the filling structure 212 is constrained by the suture loop 70. In various embodiments, one or more portions 131 of the filling structure 112 and one or more portions 231 of the filling structure 212 contact the wall 82 of the aorta 10 to form a seal against the wall 82, as shown by the seal regions 147 and 247. In some embodiments, steps 403 and 406 are performed simultaneously with each other. Additionally, in some embodiments, steps 409 and 411 are performed simultaneously with each other. In some embodiments, steps 403, 406, 409, and 411 are performed sequentially.

[0070] In various embodiments, the filling structures 112 and 212 treat the aneurysm 14 by providing respective lumens 128 and 228 that span the aneurysm 14, respectively. In various embodiments, "spanning" the aneurysm 14 generally means that the filling structures 112 and 212 axially extend from respective anatomical locations (the respective anatomical locations having been determined by imaging or other means, such as above the origin of the aneurysm 14) to a respective location (below which the aneurysm 14 has been confirmed to terminate). In various embodiments, the filling structures 112 and 212 are positioned to span the aneurysm 14, and the respective outer walls 124 and 224 of each of the filling structures 112 and 212 conform to the inner surface of the aneurysm 14 and to each other, thus providing a pair of tubular lumens 128 and 228 for blood flow from the aorta 10 to each of the iliac arteries 12 and 13, respectively. In various embodiments, the iliac artery 12 is the ipsilateral iliac artery and the iliac artery 13 is the contralateral iliac artery.

[0071] [[ID=]]Figure 14 is Figure 2 An illustration of the system 20, which is deployed to repair the aorta 10 with the anchoring device 30 positioned below the renal arteries 15 and 16. Figure 14 The deployment in Figure 5 is similar to Figure 14 the deployment in Figure 14In [the figure], the filling structures 112 and 212 extend upward to the top of the anchoring device 30 such that the proximal ends 171 of the filling structure 112 and 271 of the filling structure 212 extend to or near the top of the stent 40. One or more portions 131 of the filling structure 112 protrude through one or more openings 56 defined by corresponding portions of the suture loop 70 to contact the wall 82 of the aorta 10 that is below the renal arteries 15 and 16 and form a seal with the wall 82, as shown by the seal area 147. One or more portions 231 of the filling structure 212 protrude through one or more openings 56 defined by corresponding portions of the suture loop 70 to contact the wall 82 of the aorta 10 that is below the renal arteries 15 and 16 and form a seal with the wall 82, as shown by the seal area 247. In some embodiments, barbs 46 are secured to the wall 82 of the aorta 10 that is below the renal arteries 15 and 16.

[0072] In all respects, the embodiments disclosed herein should be considered illustrative and not restrictive of the invention. The invention is in no way limited to the above embodiments. Various modifications and changes can be made to the embodiments without departing from the spirit and scope of the invention. All such modifications and changes that fall within the meaning and range of the equivalents of the claims are intended to fall within the scope of the invention.

Claims

1. A system for deployment in a blood vessel, the system comprising: An anchoring device including a stent and a suture loop, the suture loop engaging a distal portion of the stent; A first filling structure; Wherein the stent is expandable to an expanded state; and Wherein when the stent is in the expanded state, the first filling structure can be at least partially inserted through the suture loop into a region within the stent, and the anchoring device has a size that allows at least a portion of the first filling structure to protrude through an opening in the anchoring device.

2. The system according to claim 1, Among them, The suture loop includes a plurality of suture segments.

3. The system according to claim 2, Among them, The plurality of suture segments are arranged in a polygonal arrangement.

4. The system according to claim 1, Among them, The stent includes a plurality of V-shaped stent elements, each of the plurality of V-shaped stent elements having two stent struts that meet at a bone-shaped vertex, and the suture loop winds around the bone-shaped vertex.

5. The system according to claim 1, Among them, The suture loop winds around each of the distal portions of the stent to engage the distal portions of the stent.

6. The system according to claim 1, Among them, The anchoring device includes barbs for attachment to the blood vessel.

7. The system according to claim 1, Among them, The anchoring device further includes a radiopaque material positioned on at least a portion of the suture loop.

8. The system according to claim 1, Among them, The stent is expandable to an expanded state; and Wherein the anchoring device is configured such that when the stent is in the expanded state, the diameter of the proximal orifice of the stent is greater than the diameter of the distal orifice of the stent defined by the suture loop.

9. The system according to claim 8, Among them, The anchoring device is configured such that when the stent is in the expanded state, the diameter of the distal orifice of the stent is at least 5% smaller than the diameter of the proximal orifice of the stent.

10. The system according to claim 9, Among them, The anchoring device is configured such that when the stent is in the expanded state, the diameter of the distal orifice of the stent is not less than 25% smaller than the diameter of the proximal orifice of the stent.

11. The system according to claim 1, further comprising: A second filling structure; Wherein when the stent is in the expanded state, the second filling structure can be at least partially inserted through the suture loop into a region within the stent.

12. The system according to claim 11, Among them, When the second filling structure has been at least partially inserted through the suture loop and has been filled, the anchoring device has a size such that at least a portion of the second filling structure protrudes through an opening in the anchoring device.

13. The system according to claim 12, Among them, The opening in the anchoring device is defined by the stent struts of the stent and the suture loop.

14. The system according to claim 12, Among them, The first filling structure and the second filling structure can be sealed to each other and can be locked to the anchoring device when filled.

15. The system according to claim 11, Among them, the stent has a sufficient length such that it can be deployed within the stent when the first filling structure and the second filling structure extend at least 20 mm.

16. The system according to claim 11, Among them, the anchoring device includes barbs that can be attached to the wall of the aorta above the renal artery; and wherein, when the barbs have been attached to the aorta above the renal artery and the second filling structure has been at least partially inserted through the suture loop and has been filled, the anchoring device is sized such that at least a portion of the second filling structure protrudes through an opening in the anchoring device to contact the wall of the aorta below the renal artery.

17. The system according to claim 11, Among them, when the first filling structure and the second filling structure have been at least partially inserted through the suture loop and have been filled, the suture loop is configured to at least partially constrain the first filling structure and the second filling structure.

18. The system according to claim 11, Among them, the first filling structure can be deployed to provide a first lumen for blood flow from the aorta to the first iliac artery; and wherein, the second filling structure can be deployed to provide a second lumen for blood flow from the aorta to the second iliac artery.

19. The system according to claim 1, Among them, the stent includes a plurality of stent struts, each of the plurality of stent struts includes nitinol; and wherein, the suture loop includes silk thread.

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