Devices for aortic repair and related systems and methods

Abstract

Aortic repair devices and associated systems and methods are disclosed herein. An aortic repair device configured in accordance with an embodiment of the present technology may include a base member configured to be implanted in the aorta proximate a diseased portion of the aorta, such as an aneurysm or dissection. The base member may direct blood flow through a diseased portion of the aorta to perfuse a portion of the aorta distal to the diseased portion and / or various branch vessels. In some embodiments, one or more spanning members or other implants may be coupled (e.g., docked) to the base member during the same or separate intravascular procedure to provide an additional flow path through the diseased portion.

Description

[0001] Cross-reference to related applications

[0002] This application claims the benefit of U.S. Provisional Patent Application No. 63 / 316,896, filed March 4, 2022, entitled “DEVICES FOR AORTIC REPAIR, AND ASSOCIATED SYSTEMS AND METHODS”; U.S. Provisional Patent Application No. 63 / 425,600, filed November 15, 2022, entitled “DEVICES FOR AORTIC REPAIR, AND ASSOCIATED SYSTEMS AND METHODS”; and U.S. Provisional Patent Application No. 63 / 437,916, filed January 9, 2023, entitled “DEVICES FOR AORTICREPAIR, AND ASSOCIATED SYSTEMS AND METHODS”, each of which is incorporated herein by reference in its entirety. Technical Field

[0003] This technology relates to devices, systems, and methods for repairing diseased aortas, and more specifically to devices configured to be at least partially implanted within the proximal aorta to treat aneurysms and dissections in the ascending aorta and / or aortic arch. Background Technology

[0004] Aneurysms, dissections, penetrating ulcers, intramural hematomas, and / or transverse sections can occur in blood vessels, and most commonly in the aorta and peripheral arteries. Affected areas of the aorta can extend to regions with bifurcations or aortic segments from which smaller “branch” arteries extend.

[0005] Diseased areas of the aorta and other blood vessels can be bypassed using stent grafts placed within the vessel to cross the diseased area. Stent grafts effectively seal the diseased area to prevent further exposure to blood flow, thus preventing aneurysms, dissections, or other types of disease from worsening. However, using stent grafts to bypass diseased areas within blood vessels is not without challenges. In particular, care must be taken to ensure that the stent graft does not cover or occlude critical branch vessels, but that the stent graft adequately seals healthy areas of the vessel wall while remaining open to provide a flow channel for blood to pass through the diseased area. Attached Figure Description

[0006] Many aspects of this disclosure can be better understood by referring to the following figures. The components in the figures are not necessarily drawn to scale. Rather, the focus is on clearly illustrating the principles of this disclosure.

[0007] Figure 1A and 1BThis is a side view of the diseased aorta and surrounding anatomical structures in which an aortic repair device can be implanted, according to an embodiment of the present technology.

[0008] Figure 2A-2D This is a lateral sectional view of a diseased aorta in which an aortic repair device can be implanted, according to an embodiment of the present technology.

[0009] Figure 3A and 3B These are, respectively, a side view and a perspective side view of an aortic repair device according to an embodiment of the present technology. Figure 3C According to embodiments of this technology, along Figure 3A The line 3C-3C cut Figure 3A and 3B Cross-sectional view of the aortic repair device. Figure 3D It is an implantation in the aorta according to an embodiment of this technology. Figures 3A-3C Side view of the aortic repair device.

[0010] Figure 4A This is a side view of an aortic repair device implanted in the aorta according to an embodiment of the present technology.

[0011] Figure 4B This is a side view of an aortic repair device implanted in the aorta according to another embodiment of the present technology.

[0012] Figure 5A This is a side view of an aortic repair device 500 according to an embodiment of the present technology. Figure 5B and 5C According to embodiments of this technology, along Figure 5A The line 5B-5B is cut off. Figure 5A Cross-sectional view of the aortic repair device.

[0013] Figure 6A This is a side view of an aortic repair device according to an embodiment of the present technology. Figure 6B According to embodiments of this technology, along Figure 6A The line 6B-6B in the middle is cut off Figure 6A Cross-sectional view of the aortic repair device.

[0014] Figure 7A and 7B These are, respectively, a distal fluoroscopic end view and a distal end view of the aortic repair device according to an embodiment of the present technology. Figure 7C It is an expansion within the aorta according to an embodiment of the present technology. Figure 7A and 7B The distal end view of the aortic repair device.

[0015] Figures 8A-8EThese are, respectively, a side view, a fluoroscopic side view, a fluoroscopic view facing the proximal side, a fluoroscopic end view facing the proximal side, and a fluoroscopic end view facing the distal side of the aortic repair device according to embodiments of the present technology. Figure 8F and 8G It is along Figure 8B The line 8F-8F is cut off. Figures 8A-8E Cross-sectional view of the aortic repair device. Figure 8H According to embodiments of this technology, along Figure 8B The line 8F-8F is cut off. Figure 8A-8G A cross-sectional view of an aortic repair device, wherein the traversing member is configured within the lumen of the aortic repair device.

[0016] Figure 9A and 9B According to embodiments of the present technology Figure 8H Cross-sectional view of the aortic repair device during the first and second delivery phases.

[0017] Figure 10A and 10B These are, respectively, a distal end view and a distal fluoroscopic end view of the aortic repair device according to an embodiment of the present technology. Figure 10C and Figure 10D These are embodiments based on the present technology. Figure 10A and Figure 10B The distal end view and distal fluoroscopic end view of the aortic repair device, wherein the traversing member is configured within the main lumen of the aortic repair device.

[0018] Figure 11A This is a cross-sectional view of an aortic repair device according to an embodiment of the present technology. Figure 11B According to embodiments of the present technology Figure 11A A cross-sectional side view of the stent spanning the aortic repair device.

[0019] Figure 12A This is a cross-sectional view of an aortic repair device according to an embodiment of the present technology. Figure 12B According to embodiments of the present technology Figure 12A A cross-sectional side view of the stent spanning the aortic repair device.

[0020] Figures 13A-13C These are, respectively, a perspective side view of the spanning member according to an embodiment of the present technology, a perspective end view facing the distance, and another perspective end view facing the distance.

[0021] Figure 14A and 14B This is a perspective side view of a component according to an embodiment of the present technology. Figure 14C and Figure 14DThese are, respectively, a distally facing fluoroscopic end view and an enlarged distally facing fluoroscopic end view of an aortic repair device according to an embodiment of the present technology, the aortic repair device including a component disposed within a base member. Figure 14A and Figure 14B The spanning component.

[0022] Figure 15A and 15B These are, respectively, a side view of the spanning member and an end view facing the far side, according to an embodiment of the present technology. Figure 15C This includes embodiments of the present technology. Figure 15A and 15B The distal end view of the aortic repair device spanning the component. Figure 15D and 15E According to embodiments of the present technology Figures 15A-15C A side view of the cross-bracing member when it is subjected to blood flow and has graft materials attached to the inner and outer sides of multiple stents respectively.

[0023] Figure 16A and 16B These are, respectively, perspective side views and perspective end views of the cross-member according to embodiments of the present technology.

[0024] Figures 17A to 17C These are, respectively, a perspective side view, a side sectional view, and a perspective end view of the spanning component according to an embodiment of the present technology.

[0025] Figure 18A This is an end view of the spanning member in the constrained and expanded configurations according to an embodiment of the present technology. Figure 18B This includes embodiments of the present technology. Figure 18A The distal end view of the aortic repair device 1800 spanning the component.

[0026] Figure 19 This is a distal end view of an aortic repair device according to an embodiment of the present technology.

[0027] Figure 20A and Figure 20B These are, respectively, an enlarged perspective side view of the spanning member and a perspective end view facing the distance, according to an embodiment of the present technology.

[0028] Figure 21 This is a perspective side view of the spanning member configured according to an embodiment of the present technology.

[0029] Figure 22A and 22B This is a perspective end view of an aortic repair device constructed according to an embodiment of the present technology.

[0030] Figure 23 According to embodiments of this technology and Figure 22A and 22B A side view of a stent used in conjunction with an aortic repair device.

[0031] Figure 24 This is a side view of the aorta, showing various aspects of the aortic repair device delivery process.

[0032] Figures 25A-25E This is a perspective side view of various aortic repair devices constructed according to embodiments of the present technology.

[0033] Figure 26A and 26B These are enlarged side views of a portion of an aortic repair device in a first position and a second position, respectively, according to embodiments of the present technology.

[0034] Figure 27A and 27B These are, respectively, a side perspective view and a fluoroscopic end view of an aortic repair device constructed according to embodiments of the present technology. Figure 27C According to embodiments of the present technology Figure 27A and 27B A perspective view of the first stent component of the aortic repair device. Figure 27D An embodiment of the present technology is shown, implanted within the aorta and conforming to the ascending aortic wall near the aortic arch. Figure 27A and 27B Aortic repair device.

[0035] Figure 28A and 28B These are perspective views and fluoroscopic end views of an aortic repair device constructed according to embodiments of the present technology.

[0036] Figure 29A and 29B This is a perspective end view of an aortic repair device constructed according to an embodiment of the present technology.

[0037] Figure 30A and 30B This is a perspective end view of an aortic repair device constructed according to an embodiment of the present technology. Figure 30C and Figure 30D These are embodiments based on the present technology. Figure 30A and Figure 30B Perspective end view and end view of the accessory lumen stent component of the aortic repair device. Figure 30E and Figure 30F According to embodiments of the present technology Figure 30A and Figure 30B A fluoroscopic end view of an aortic repair device, wherein the traverse member is configured within the main lumen of the aortic repair device.

[0038] Figure 31A and Figure 31B This is a perspective end view of an aortic repair device constructed according to an embodiment of the present technology. Figure 31C and 31D These are embodiments based on the present technology. Figure 31A and 31B Perspective end view and end view of the accessory lumen stent of the aortic repair device. Figure 31E-31G According to embodiments of the present technology Figure 31A and 31B A fluoroscopic end view of an aortic repair device, wherein the traverse member is configured within the main lumen of the aortic repair device. Figure 31H-31L yes Figure 31A and 31B A perspective end view of the aortic repair device, showing the increased radial compression of the aortic repair device according to an embodiment of the present technology.

[0039] Figure 32A This is a perspective end view of an aortic repair device configured within the lumen according to an embodiment of the present technology. Figure 32B According to embodiments of the present technology Figure 32A End view of the secondary lumen stent component of the aortic repair device. Figure 32C and Figure 32D According to embodiments of the present technology Figure 32A A fluoroscopic end view of an aortic repair device, wherein the traverse member is configured within the main lumen of the aortic repair device.

[0040] Figure 33 This is a cross-sectional view of an aortic repair device constructed according to an embodiment of the present technology.

[0041] Figure 34A and 34B These are perspective side views of an aortic repair device in a longitudinally elongated position and a longitudinally compressed position, respectively, according to embodiments of the present technology.

[0042] Figure 35A and 35B These are perspective side views of an aortic repair device in a longitudinally elongated position and a longitudinally compressed position, respectively, according to embodiments of the present technology.

[0043] Figure 36A and 36B This is a perspective side view of an aortic repair device in a longitudinally elongated position, viewed from different circumferential angles according to an embodiment of the present technology. Figure 36C This is a perspective side view of an aortic repair device in a longitudinally compressed position according to an embodiment of the present technology. Figure 36D According to embodiments of the present technology Figures 36A-36C Plan view of the first and second stents of the aortic repair device.

[0044] Figure 37A This is a perspective side view of an aortic repair device constructed according to an embodiment of the present technology. Figure 37B It is constructed according to embodiments of this technology. Figure 37A Plan view of the first and second stents of the aortic repair device.

[0045] Figure 38 This is a plan view of the first and second stents of an aortic repair device according to another embodiment of the present technology.

[0046] Figure 39A and 39B These are, respectively, a side view and a perspective side view of the aortic repair device in a longitudinally elongated position according to an embodiment of the present technology. Figure 39C It is in the longitudinal compression position according to an embodiment of the present technology. Figure 39A and 39B A lateral perspective view of an aortic repair device.

[0047] Figure 40A and 40B These are, respectively, a side view and a perspective side view of the aortic repair device in a longitudinally elongated position according to an embodiment of the present technology. Figure 40C It is in the longitudinal compression position according to an embodiment of the present technology. Figure 40A and 40B A lateral perspective view of an aortic repair device. Figure 40D It is an implantation in the aorta according to an embodiment of this technology. Figures 39A-39C Or a side view of the 40A-40C aortic repair device.

[0048] Figure 41A and Figure 41B This is a side view of a spanning member constructed according to an embodiment of the present technology. Figure 41C According to embodiments of the present technology Figure 41B An enlarged view of a portion of the spanning member shown.

[0049] Figure 41D-41F This is an enlarged view of the proximal or distal portion of a component of an aortic repair device according to an embodiment of the present technology.

[0050] Figure 42A It is a frontal view of the aorta and surrounding anatomical structures, in which an aortic repair device according to an embodiment of the present technology can be implanted. Figure 42B-42D This is a side view of various aortic repair devices according to embodiments of the present technology.

[0051] Figures 43A-43C These are, respectively, a side view, a fluoroscopic side view, and a fluoroscopic end view of the aortic repair device according to an embodiment of the present technology. Figure 43D It is an implantation in the aorta according to an embodiment of this technology. Figures 43A-43C Side view of the aortic repair device.

[0052] Figures 44A-44C These are, respectively, a side view across the component, a perspective side view, and a perspective end view facing the distance, according to an embodiment of the present technology. Figure 44D and 44E These are, respectively, a perspective side view and a side view of an aortic repair device according to an embodiment of the present technology, the aortic repair device including a connection to... Figures 43A-43D The base components Figures 44A-44C The spanning component.

[0053] Figure 45A This is an enlarged side view of the spanning member according to an embodiment of the present technology. Figure 45B This is a side view of an aortic repair device according to an embodiment of the present technology, the aortic repair device including a connection to... Figures 43A-43D The base components Figure 45A The spanning component. Figure 45C According to embodiments of the present technology Figure 45B A perspective view of the main leg of the base component facing the proximal side. Figure 45D According to embodiments of the present technology Figure 45A An enlarged perspective side view of the proximal portion of the spanning component. Figure 45E It is a link according to an embodiment of the present technology to Figure 45C The main leg of the base component Figure 45D A perspective view of the spanning component facing the near side.

[0054] Figure 46 This is a perspective side view of the base component of an aortic repair device according to an embodiment of the present technology.

[0055] Figure 47A and 47B These are, respectively, a distal perspective view and a proximal perspective end view of the aortic repair device according to an embodiment of the present technology. Figure 47C and 47D These are embodiments based on the present technology. Figure 47A and 47B A perspective side view and a perspective end view facing the distal side of the base component of the aortic repair device. Figure 47E-47G According to embodiments of the present technology Figure 47C and 47D A cross-sectional view of the base components of the aortic repair device.

[0056] Figures 48A-48DThese are, respectively, an isometric side view, a perspective side view, a magnified perspective side view, and a perspective end view facing the distal side of the aortic repair device according to an embodiment of the present technology. Figure 48E-48H As is the embodiment of this technology Figure 48A A cross-sectional view of the aortic repair device shown.

[0057] Figure 49 It is configured to connect to according to embodiments of the present technology. Figures 48A-48H An isometric side view of the base component of the aortic repair device spanning the component.

[0058] Figure 50 This is a side view of an aortic repair device according to an embodiment of the present technology, the aortic repair device comprising implantation within the aorta. Figures 48A-48H A pair of base components and Figure 49 The spanning component.

[0059] Figures 51A-51D These are, respectively, a side view, a fluoroscopic side view, a fluoroscopic end view, and a fluoroscopic end view of the aortic repair device according to an embodiment of the present technology. Figure 51E and 51F These are additional embodiments according to the present technology. Figures 51A-51C The distal end view and side view of the aortic repair device.

[0060] Figures 52A-52C According to embodiments of the present technology Figure 51D Side view of the aortic repair device during different stages of implantation in the aorta.

[0061] Figure 53A and 53B These are embodiments based on the present technology. Figures 51A-51C Enlarged side view and perspective side view of the diaphragm and stent of the aortic repair device.

[0062] Figures 54A-54C These are embodiments based on the present technology. Figures 51A-51C Enlarged side view, perspective top view, and perspective side view of the diaphragm and stent of the aortic repair device.

[0063] Figure 55A and 55B These are additional embodiments according to the present technology. Figures 51A-51C Cross-sectional view and perspective end view of the base components of the aortic repair device. Figure 55C and Figure 55D According to embodiments of the present technology Figure 55A and Figure 55B A perspective end view of a base member, the base member including a first spanning member, a second spanning member and a third spanning member connected to the base member.

[0064] Figure 56A This is an enlarged isometric end view of an aortic repair device according to an embodiment of the present technology. Figure 56B and 56C According to embodiments of the present technology Figure 56A Side view of the aortic repair device during different stages of implantation in the aorta.

[0065] Figure 57 This is a side view of an aortic repair device implanted in the aorta according to an embodiment of the present technology.

[0066] Figure 58A This is a side view of an aortic repair device implanted in the aorta according to another embodiment of the present technology.

[0067] Figure 58B It is an embodiment of the present technology that is implanted in the aorta with different structures. Figure 58A Side view of the aortic repair device.

[0068] Figure 58C An implantation in the aorta according to an embodiment of the present technology, including an additional extension member. Figure 58B Side view of the aortic repair device.

[0069] Figure 59 This is a side view of an aortic repair device constructed according to an embodiment of the present technology.

[0070] Figure 60A This is a side view of an aortic repair device implanted in the aorta according to another embodiment of the present technology. Figure 60B and 60C It is a section taken along line 60B-60B according to an embodiment of this technology. Figure 60A Cross-sectional view of the aortic repair device.

[0071] Figures 61A-61F This is a side view of various stages of a surgical procedure for implanting an aortic repair device into the aorta according to an embodiment of the present technology.

[0072] Figure 62A and 62B An embodiment of the present technology is provided for implantation in the aorta. Figures 61A-61F A schematic diagram of an aortic repair device.

[0073] Figure 63A and 63B Further embodiments of the present technology are provided for implantation in the aorta. Figures 61A-61F A schematic diagram of an aortic repair device.

[0074] Figure 64A and64B Further embodiments of the present technology are provided for implantation in the aorta. Figures 61A-61F A schematic diagram of an aortic repair device.

[0075] Figure 65A This is a side view of an aortic repair device implanted in the ascending aorta according to an embodiment of the present technology.

[0076] Figure 65B It is an implantation in the descending aorta according to an embodiment of this technology. Figure 65A Side view of the aortic repair device.

[0077] Figure 66A This is a side view of an aortic repair device implanted in the aorta according to another embodiment of the present technology. Figure 66B It is according to another embodiment of the present technology along Figure 66A The line 66B-66B in the middle is cut off Figure 66A A cross-sectional view of the aortic repair device.

[0078] Figure 67A This is a side view of an aortic repair device implanted in the aorta according to another embodiment of the present technology. Figure 67B It is according to another embodiment of the present technology along Figure 67A The line 67B-67B is cut off. Figure 67A A cross-sectional view of the aortic repair device.

[0079] Figure 68A This is a side view of an aortic repair device implanted in the aorta according to another embodiment of the present technology. Figure 68B It is according to another embodiment of the present technology along Figure 68A The line 68B-68B is cut off. Figure 68A A cross-sectional view of the aortic repair device.

[0080] Figure 69A This is a side view of an aortic repair device implanted in the aorta according to another embodiment of the present technology. Figure 69B It is according to another embodiment of the present technology along Figure 69A The line 69B-69B is cut off. Figure 69A A cross-sectional view of the aortic repair device.

[0081] Figure 70 This is a side view of an aortic repair device implanted in the aorta according to an embodiment of the present technology.

[0082] Figure 71 This is a side view of an aortic repair device implanted in the aorta according to an embodiment of the present technology.

[0083] Figure 72A and 72B This is an enlarged isometric side view of the base component of an aortic repair device according to an embodiment of the present technology.

[0084] Figure 73A and Figure 73B This illustrates an embodiment of the present technology for loading into a delivery conduit system. Figure 72A and Figure 72B The end view of the sequential collapse of the anchors of the base components.

[0085] Figure 74A and 74B According to embodiments of the present technology Figure 72B Enlarged isometric side view of the base components of the aortic repair device.

[0086] Figure 75A and 75B These are, respectively, a side view and an enlarged isometric side view of the aortic repair device according to an embodiment of the present technology. Figure 75C According to embodiments of the present technology Figure 75A and 75B Isometric side view of the stent of the aortic repair device. Figure 75D It is an implantation in the aorta according to an embodiment of this technology. Figures 75A-75C Side view of the aortic repair device.

[0087] Figures 76A-76C This is a side view of an aortic repair device implanted in the aorta at different stages according to an embodiment of the present technology.

[0088] Figure 77A and Figure 77B This is a side view of an aortic repair device implanted in the aorta at different stages according to an embodiment of the present technology.

[0089] Figure 78A and 78B This is a side view of an aortic repair device implanted in the aorta at different stages according to an embodiment of the present technology.

[0090] Figure 79A and 79B This is a side view of an aortic repair device implanted in the aorta according to an embodiment of the present technology.

[0091] Figure 80 This is a side view of an aortic repair device implanted in the aorta according to an embodiment of the present technology.

[0092] Figure 81A This is a side view of an aortic repair device implanted in the aorta according to an embodiment of the present technology. Figure 81B According to embodiments of the present technology Figure 81A An enlarged isometric side view of a portion of the aortic repair device.

[0093] Figure 82A and 82B These are side views of the branch injection member and the spanning member, respectively, according to embodiments of the present technology. Figure 82C This includes embodiments of the present technology. Figure 82A and 82B A side view of a portion of the aortic repair device, which consists of branch perfusion components and a modular assembly spanning components.

[0094] Figure 83A and 83B These are, respectively, a perspective side view of the spanning component and a perspective end view facing the distal side of the aortic repair device according to an embodiment of the present technology.

[0095] Figure 84 This is a perspective side view of the base component of an aortic repair device according to an embodiment of the present technology.

[0096] Figure 85A and 85B These are, respectively, a perspective side view and a perspective end view of the base component of the aortic repair device according to an embodiment of the present technology.

[0097] Figure 86 This is a side view of an aortic repair device according to an embodiment of the present technology.

[0098] Figure 87A and Figure 87B These are side views of the spanning member in a first position and a second position, respectively, according to embodiments of the present technology.

[0099] Figure 87C This is according to another embodiment of the present technology. Figure 87A and Figure 87B An enlarged side view of a portion of the spanning component.

[0100] Figure 88A and 88B These are perspective side views of the aortic repair device in the first and second positions according to embodiments of the present technology, respectively, of the crossing member.

[0101] Figure 88C It is based on the implementation scheme of this technology. Figure 88A and 88B An enlarged side view of a portion of the spanning member shows two different potential attachments of the elastic fibers of the tension member.

[0102] Figure 89A and 89BThese are perspective side views of the base components of the aortic repair device in the first and second positions according to embodiments of the present technology.

[0103] Figure 90A and 90B These are enlarged views of a pair of stents, components of an aortic repair device according to an embodiment of the present technology, in a free state and a compressed state, respectively.

[0104] Figure 90C and Figure 90D According to embodiments of this technology, after one or more tension sutures are attached to the support, they are in a free state and a compressed state, respectively. Figure 90A and Figure 90B An enlarged view of the bracket.

[0105] Figure 90E and 90F These are, respectively, the free state and the compressed state according to embodiments of this technology. Figure 90C and 90D A schematic side view of an aortic repair device.

[0106] Figure 91A and Figure 91B These are, respectively, the free state and the compressed state according to the additional embodiments of this technology. Figure 90A-90D An enlarged view of the bracket. Detailed Implementation

[0107] This technology relates to devices, systems, and methods for treating a diseased aorta in a patient (e.g., a human patient). In some embodiments, for example, the aortic repair device includes a base member configured to be at least partially implanted in the proximal region of the aorta near a diseased portion (e.g., an aneurysm or dissection). The base member can provide a catheter for guiding blood flow through the diseased portion of the aorta to perfuse a portion of the aorta distal to the diseased portion and / or various branch vessels. In some embodiments, one or more traversing members or other implants may be coupled (e.g., docked) to the base member during the same or separate endovascular procedure to provide additional flow catheters through the diseased portion.

[0108] This document describes specific details of several embodiments of the present technology with reference to Figures 1-91B. However, the present technology may be practiced without some of these specific details. In some instances, well-known structures and techniques commonly associated with catheter-based delivery systems, implantable repair devices, etc., have not been shown in detail so as not to obscure the present technology. The terminology used in the description presented below is intended to be interpreted in its broadest and most reasonable manner, even when used in conjunction with the detailed description of certain specific embodiments of this disclosure. Certain terms may even be emphasized below; however, any term intended to be interpreted in any limiting manner will be clearly and specifically defined in this Detailed Description section.

[0109] The accompanying drawings illustrate embodiments of the present technology and are not intended to limit its scope. The dimensions of the various depicted elements are not necessarily drawn to scale, and these various elements may be arbitrarily enlarged to improve readability. Component details may be abstracted in the drawings to exclude details such as the location of components and certain precise connections between these components when such details are unnecessary for a full understanding of how the present technology is manufactured and used. Many details, dimensions, angles, and other features shown in the drawings are merely illustrative of specific embodiments of this disclosure. Therefore, other embodiments may have different details, dimensions, angles, and features without departing from the spirit or scope of the present technology.

[0110] When referring to an aortic repair device, the term "distal" may refer to the portion of the aortic repair device positioned and / or configured to be located further away from the heart and downstream in the blood flow path, while the term "proximal" may refer to the portion of the aortic repair device positioned and / or configured to be located closer to the heart and upstream in the blood flow path. Conversely, when referring to a catheter subsystem or delivery procedure, the term "distal" may refer to the portion of the catheter system further away from the operator and / or handle, while the term "proximal" may refer to the portion of the catheter system closer to the operator and / or handle. Thus, as described below, the proximal portion of the aortic repair device is generally further away from the operator and / or the handle of the catheter system used to deliver the aortic repair device than the distal portion of the aortic repair device. Similarly, the distal portion of the aortic repair device is generally closer to the operator and / or the handle of the catheter system than the proximal portion.

[0111] Furthermore, as used herein, the terms "backward," "forward," "upward," "downward," etc., do not imply limitation of the referenced components to a particular orientation. It should be understood that these terms refer to the orientation of the reference component as shown in the figure; the system of this technology can be used in any orientation suitable for the user.

[0112] The titles provided in this article are for convenience only and should not be construed as limiting the topics disclosed.

[0113] I. Overview

[0114] Figure 1A and 1B This is a side view of the diseased aorta and surrounding anatomical structures into which an aortic repair device can be implanted, according to an embodiment of the present technology. (See also:) Figure 1A and 1B The aorta is the largest blood vessel in the human body, carrying oxygenated blood from the left ventricle of the heart and the aortic valve to circulate throughout the body. The aorta is divided into different segments, including the ascending aorta (which extends from the left ventricle), the aortic arch, and the descending thoracic aorta. The ascending aorta and the aortic arch can be collectively referred to as the "proximal aorta." The aorta includes branches that divide into several superior aortic arteries, including the brachiocephalic artery, the left common carotid artery, and the left subclavian artery, each extending from the aortic arch. The brachiocephalic artery is the first branch of the aortic arch and supplies blood to the right common carotid artery and the right subclavian artery, supplying the right arm, head, and neck. It is also called the brachiocephalic trunk or the brachiocephalic artery. The left common carotid artery is the second branch of the aortic arch and supplies blood to the left side of the head and neck. The left subclavian artery is the third branch of the aortic arch and supplies blood to the left arm.

[0115] Diseased aorta includes Figure 1A Aneurysm in the ascending aorta and Figure 1B An aortic aneurysm is an enlargement (e.g., dilation) of the aorta that weakens it and increases the likelihood of rupture. Most people with aortic aneurysms are asymptomatic until the aorta ruptures, and the mortality rate after an aortic aneurysm ruptures can exceed 90%. Aortic aneurysms are typically detected during routine medical tests such as chest X-rays, computed tomography (CT) imaging, echocardiography, magnetic resonance imaging (MRI), etc.

[0116] Figure 2A -D is a lateral sectional view of a diseased aorta in which an aortic repair device may be implanted according to an embodiment of the present technology. The diseased aorta includes Figure 2A Smaller type A aortic dissections and Figure 2B A relatively large type A aortic dissection. The affected aorta includes... Figure 2C Smaller type B aortic dissection and Figure 2D Type B aortic dissection is a relatively large aortic dissection. Aortic dissection is a tear in the intima of the aorta, causing blood to rupture and obstruct flow. Type A aortic dissection originates in the proximal aorta (e.g., the ascending aorta) and can gradually extend downwards from the ascending aorta along the aortic arch and / or along the descending aorta, such as... Figure 2B As shown. Type B aortic dissection originates from the descending aorta and can gradually extend downwards along the descending aorta, such as... Figure 2DAs shown. Aortic dissection can be acute or chronic, with acute aortic dissection often causing sudden, severe pain in the chest, back, and / or abdomen. Most acute aortic dissections require emergency surgery, and there is a mortality risk of approximately 1% per hour for the first two days after the dissection—meaning that urgent diagnosis and surgery are crucial for patient treatment.

[0117] Let's refer to each other. Figure 1A-2D This technology relates to aortic repair devices that can be implanted within the aorta to treat aortic aneurysms, type A aortic dissections, type B aortic dissections, and / or other types of disease conditions. In some embodiments, the aortic repair device may span the origin of the aneurysm or dissection and provide one or more flow conduits for diverting blood flow away from and / or through the diseased portion. In some embodiments, the aortic repair device may span between one or more flow conduits and provide one or more flow conduits for guiding blood flow between the aorta and one or more branch arteries.

[0118] II. Selected embodiments of aortic repair devices including internal septum and / or internal attachment mechanisms

[0119] Figure 3A and 3B These are, respectively, a side view and a perspective side view of an aortic repair device 300 (which may also be referred to as an aortic prosthesis, aortic treatment device, aortic implant, and / or similar) according to embodiments of the present technology. (See also:) Figure 3A and 3B In the illustrated embodiment, the aortic repair device 300 includes a base member 310 configured for implantation in a diseased aorta. The base member 310 includes a tubular body 312 (e.g., a main body) and a tubular leg 314 extending distally from the body 312. More specifically, the body 312 includes a proximal (e.g., first, leading) end portion 311 defining a proximal (e.g., first, leading) end portion 313 of the base member 310. The leg 314 includes a proximal (e.g., first, leading) end portion 315 integrally extending from the distal portion 313 of the body 312 and a distal (e.g., second, caudal) end portion 317 defining a distal (e.g., second, caudal) end portion 317 of the base member 310. In the illustrated embodiment, the body 312 has a first length L1 ( Figure 3A ), and the leg 314 has a second length L2 that is less than the first length L1. Figure 3A In some embodiments, the second length L2 is the same as or greater than the first length L1. In some embodiments, the first length L1 may be between about 20 and 120 mm, and the second length L2 may be between about 20 and 120 mm.

[0120] Figure 3C According to embodiments of this technology, along Figure 3A The line 3C-3C cut Figure 3A and 3B Cross-sectional view of the aortic repair device 300. (For reference only.) Figures 3A-3C The base member 310 may be generally hollow and define one or more lumens (e.g., flow conduits) therethrough. Therefore, in the illustrated embodiment, the base member 310 includes (i) a proximal portion 311 located on the body 312 and having a first diameter D1. Figure 3A (ii) A proximal opening 320 (e.g., a fluid opening, a first opening, a first bodily fluid opening, an inlet, and / or the like). (ii) A distal portion 313 of the body 312 having a second diameter D2. Figure 3A (iii) a distal body opening 321 (e.g., a fluid opening, a second opening, a second bodily fluid opening, a distal body outlet, and / or the like), and (iii) a distal leg opening 322 (e.g., a fluid opening, a third opening, a leg fluid opening, a distal leg outlet, etc.), the distal leg opening 322 being located at the distal portion 317 of the leg 314 and having a third diameter D3. Figure 3A The first diameter D1 is larger than the second diameter D2 and the third diameter D3, and can be sized to approximately match or be larger than (e.g., excessively large relative to the diameter of the patient's aorta) the diameter of the patient's aorta (e.g., between about 20-60 mm, between about 26-54 mm, about 40 mm). The third diameter D3 can be sized to approximately match or be larger than a branch vessel of the patient's aorta, such as the brachiocephalic artery (e.g., between about 10-22 mm, about 16 mm). In some embodiments, the second diameter D2 may be larger than the third diameter D3.

[0121] In some embodiments, the base member 310 further includes a diaphragm 318 (e.g., a diverter), the diaphragm 318 being positioned within the body 312 and dividing the body 312 into a main chamber 323. Figure 3C For example, the first lumen) and branch or secondary lumen 325 ( Figure 3C (e.g., the second lumen). Body 312 in Figure 3A The portion is shown as partially transparent, making the diaphragm 318 visible, and the diaphragm is... Figure 3BThe diaphragm 318 is partially obscured. In the illustrated embodiment, the diaphragm 318 (i) extends completely through the body 312 between the proximal portion 311 and the distal portion 313, and (ii) is centered within the body 312 such that the diaphragm 318 extends along a first diameter D1, and the main lumen 323 and the secondary lumen 325 have the same dimensions (e.g., cross-sectional area, volume) within the body 312. In other embodiments, as described in more detail below, the diaphragm 318 may (i) only partially extend through the body 312 and / or (ii) may be offset within the body 312 such that the main lumen 323 and the secondary lumen 325 have different dimensions. In other embodiments described below, the body 312 may include multiple diaphragms dividing the body into more than two lumens.

[0122] The main lumen 323 may extend between the proximal opening 320 and the main opening 321 and define a flow path (e.g., a catheter). Similarly, the secondary lumen 325 may extend between the proximal opening 320 and the leg opening 322 and define a flow path between the proximal opening 320 and the leg opening 322. Figure 3C As shown, when the diaphragm 318 branches the lumen defined by the body 312, the main lumen 323 and the secondary lumen 325 may each have a D-shaped cross-sectional shape within the body 312. The secondary lumen 325 may have a circular cross-sectional shape within the leg 314.

[0123] In some embodiments, the base member 310 is an expandable scaffold graft comprising one or more supports 326 and graft material 328. Supports 326 may include one or more interconnected struts and may also be referred to as a scaffold structure. The body 312 and legs 314 may be integrally formed as part of the same scaffold graft, or may be separate components releasably or permanently coupled together. Graft material 328 may include fabric, woven polyester, polytetrafluoroethylene, polyurethane, silicone, and / or other suitable materials known in the field of scaffold grafts, and is configured to inhibit or even prevent blood flow therethrough. In some embodiments, the diaphragm 318 comprises the same material as graft material 328 or another type of graft material. Thus, graft material 328 and diaphragm 318 may define and surround the main lumen 323 and the secondary lumen 325, and are configured to maintain blood flow along the flow path defined therein. As described further in detail below, in some embodiments, diaphragm 318 may include a non-graft material, such as a blood-permeable metal mesh. In some such embodiments, the aortic repair device 300 may include one or more sealing features located near the distal portion 313 of the body 312.

[0124] The support 326 may extend circumferentially to define the tubular shape of the body 312 and the legs 314, and may be interconnected or detached. In some embodiments, the support 326 has the V-shaped pattern shape shown (e.g., including alternating proximal and distal vertices). Figures 3A-3C As shown, the scaffold 326 can be attached to the outer surface of the graft material 328 via suturing and / or suitable techniques, and / or can be attached to the inner surface of the graft material 328. The scaffold 326 can be configured to expand and therefore can be formed of a shape memory material, such as a nickel-titanium alloy (NiTiNO3). In other embodiments, the shape of the scaffold 326, the number of scaffolds 326, and / or the arrangement of the scaffolds 326 can vary.

[0125] Figure 3D This is a side view of an aortic repair device 300 implanted in the aorta according to an embodiment of the present technology. In some embodiments, the aorta may include an aneurysm, dissection, and / or other diseased portions, as referenced above. Figure 1A-2B Detailed description. In the illustrated embodiment, the body 312 is implanted within the proximal aorta (e.g., the ascending aorta and / or aortic arch), wherein the proximal portion 311 is positioned near the aortic valve, and the leg 314 extends from the body 312 to the brachiocephalic artery, where the distal portion 317 is positioned. See also: Figures 3A-3D The stent 326 allows the graft material 328 to expand into contact with the inner wall of the aorta and / or brachiocephalic artery to provide a seal between the vessel and the base member 310. More specifically, the body 312 can sealably contact the inner wall of the proximal aorta, allowing all or substantially all blood flow through the aorta to enter the proximal opening 320 and flow through the main lumen 323 or the secondary lumen 325. Figure 3D As shown, the base member 310 can guide blood flow (i) through the main lumen 323 and out of the body opening 321 into the aorta to perfuse the aorta, and (ii) through the secondary lumen 325 and out of the leg opening 322 into the brachiocephalic artery to perfuse the brachiocephalic artery.

[0126] In some aspects of this technology, the base member 310 may be positioned against / adjacent to a diseased portion of the aorta, such as the origin of a dissection and / or aneurysm, to prevent blood flow into the diseased portion by diverting blood flow through the base member 310 and past the diseased portion. In another aspect of this technology, the entire outer surface of the body 312 has a tubular shape configured to engage and seal with the inner wall of the aorta. That is, the body 312 may provide a relatively long sealing area along all or substantially all of the first length L1.

[0127] The base component 310 can be delivered to the aorta in a collapsed configuration within the catheter system (not shown). The catheter system can enter the aorta via any suitable intravascular route, such as the aortic approach, femoral approach, carotid approach, subclavian approach, etc.

[0128] In some embodiments, as described in detail below, other implantable devices may be modularly coupled to the base member 310 during the same or different surgical / interventional procedures. For example, the length L2 of the leg 314 may be relatively short, such that the distal portion 317 of the leg 314 is positioned in the aorta, and a separate tubular stent graft or other implant may be coupled to the leg 314 and extend into the brachiocephalic artery or another branch vessel. Similarly, a separate tubular graft or other implant may be coupled to the body 312 and extend further through the aorta and / or into branch vessels.

[0129] As described in detail below, in some embodiments, the base member 310 may be implanted within the descending aorta in a reversed or inverted orientation. Thus, in the inverted orientation, the “distal” portion of the base member 310 replaces the “proximal” portion, and vice versa. Therefore, those skilled in the art will understand that the terms “proximal” and “distal” may be used based on the orientation of the base member 310, or may refer to the corresponding structure of the base member 310 (i.e., “distal” and “proximal” portions may refer to the corresponding structure of the base member 310 as described in detail herein, regardless of the actual orientation of the base member 310 within the aorta). Similarly, the terms “distal” and “proximal” may be replaced by the terms “first” and “second,” “leader” and “tail,” etc.

[0130] Figure 4A This is a side view of an aortic repair device 400a implanted in the aorta according to an embodiment of the present technology. In the illustrated embodiment, the aortic repair device 400a includes the above-referenced... Figures 3A-3D The base member 310 is described in detail, as well as a separate bridging member 450 connected to (e.g., attached to, butt-attached to) the base member 310. The bridging member 450 may have a tubular shape defining a lumen and may include features substantially similar to those of the base member 310. For example, in some embodiments, the bridging member 450 is an expandable scaffold graft that includes one or more struts or supports 456 and graft material 458 connected to the supports 456.

[0131] In the illustrated embodiment, the crossing member 450 includes a proximal portion 451 (e.g., a first end, a leading portion, etc.; partially obscured by the base member 310) defining a proximal end of the crossing member 450 and a distal portion 453 (e.g., a second end, a tail portion, etc.) defining a distal end of the crossing member 450. The crossing member 450 may be generally hollow and defines one or more lumens (e.g., a flow conduit) therethrough. Thus, in the illustrated embodiment, the crossing member 450 includes a proximal opening (e.g., a fluid opening, a first crossing fluid opening, a pre-crossing fluid opening, etc.) obscured by the base member 310 and a distal opening 455 (e.g., a fluid opening, a second crossing fluid opening, a post-crossing fluid opening, etc.).

[0132] Let's refer to each other. Figures 3A-4A The proximal portion 451 of the traverse member 450 is at least partially located within the body 312 within the main lumen 323 and can be sealingly engaged with the body 312 within the main lumen 323 to define a continuous blood flow path from the proximal opening 320 of the base member 310 through the main lumen 323 and through the lumen of the traverse member 450 to the distal opening 455. That is, the graft material 458 of the traverse member 450 can sealingly engage the diaphragm 318 and the graft material 328 of the base member 310 within the main lumen 323, such that blood flow is guided through the main lumen 323 to the lumen of the traverse member 450. In some aspects of this art, because the diaphragm 318 extends the entire length of the body 312, the diaphragm 318 provides a mating or sealing region for engaging the traverse member 450 along the entire length of the main lumen 323. In some embodiments, at least a portion of the traverse member 450 (e.g., the distal portion 453) sealingly engages the aorta and / or the descending thoracic aorta within the aortic arch. Therefore, the aortic repair device 400 can guide blood flow through the secondary lumen 325 to the brachiocephalic artery, and through the main lumen 323 and the crossing member 450 to the descending thoracic aorta.

[0133] Therefore, in some aspects of this technology, the aortic repair device 400 can redirect blood flow through the diseased portion of the aorta, such as an aneurysm in the aortic arch as shown in Figure 4. In some embodiments, the crossing member 450 can be delivered to the aorta in a collapsed configuration within a catheter system (not shown) in the same or separate procedure as the base member 310. For example, a patient may initially require only treatment within the ascending aorta and / or aortic arch to treat the initial dissection or aneurysm, but at a later time (e.g., months or years later), as the condition progresses, additional treatment of the aortic arch and / or descending thoracic aorta may be required. Therefore, the base member 310 can be implanted during the initial procedure, and the crossing member 450 can be implanted during a subsequent procedure and modularly coupled to the base member 310 to provide further treatment of the aortic arch and / or descending thoracic aorta (e.g., by bypassing blood flow through the aneurysm shown in Figure 4).

[0134] Reference Figure 4A The traversing member 450 bypasses the left common carotid artery and the left subclavian artery, and thus can partially or completely occlude these vessels. In some embodiments, a bypass 402 between the perfused brachiocephalic arteries and / or a bypass 404 between the left common carotid artery and the left subclavian artery (and / or between the brachiocephalic artery and the left subclavian artery) can be surgically created to perfuse those vessels. In other embodiments described in detail below, the aortic repair device 400 may include additional implantable devices (e.g., stent grafts) coupled to the traversing member 450 and / or the base member 310, which are configured (e.g., sized, shaped, positioned) to perfuse different branch vessels. Similarly, in some embodiments, the traversing member 450 interlocks with the aorta in an unsealed manner, allowing blood to flow retrogradely to the left subclavian artery and the left common carotid artery to perfuse those vessels.

[0135] Figure 4B This is a side view of an aortic repair device 400b implanted in the aorta according to an embodiment of the present technology. In the illustrated embodiment, the aortic repair device 400a includes the above-referenced... Figures 3A-3D The detailed description includes a base member 310 (identified as first base member 310a) and a crossing member 450 connected to (e.g., attached to, butt-attached to) the first base member 310a. In the illustrated embodiment, the aortic repair device 400b also includes a second base member 310b (which may be identical or substantially identical to the first base member 310a) implanted at least partially within the descending thoracic aorta. The crossing member 450 crosses over the base member 310a and connects to the second base member 310b. Specifically, see also references... Figures 3A-4BThe distal portion 453 of the traversing member 450 can be positioned within the main lumen 323 of the second base member 310b within the body 312, and the body 312 can be hermetically engaged within the main lumen 323 to define a continuous blood flow path from the traversing member 450 through the main lumen 323 and exiting the proximal opening 320 of the second base member 310b. The leg portion 314b of the second base member 310b can extend into a second branch artery (e.g., the left subclavian artery) for perfusion of the second branch artery. For example, the second base member 310b can receive retrograde blood flow through the caudal opening 320 for perfusion of the second branch artery. Alternatively or additionally, the secondary lumen 325 of the second base member 310b can be perfused via the main lumen 323, wherein the diaphragm 318 extends only partially from the leading portion 313 toward the caudal portion 311. That is, blood flow from the traversing member 450 can flow into the main lumen 323 within the body 312 and into the secondary lumen 325 around the diaphragm 318, which terminates within the body 312. In some aspects of this technology, the aortic repair device 400b can provide total arch treatment, wherein (i) the leg 314a of the first base member 310a directs blood flow to a first branch artery (e.g., the brachiocephalic artery), (ii) the leg 314b of the second base member 310b directs blood flow to a second branch artery (e.g., the left subclavian artery), (iii) a third branch artery (e.g., the left common carotid artery) is perfused via bypass 402 and / or 404, and (iv) the main lumen of the first base member 310a and the second base member 310b and the traversing member 450 together direct blood flow to the descending thoracic aorta.

[0136] Figure 5A-8H Further embodiments of an aortic repair device including a base member and / or a bridging member according to the present technology are shown. Various aortic repair devices may include features that are structurally and functionally similar to each other and / or related to those referenced above. Figure 3A -4. The corresponding features of the aortic repair devices 300 and 400 described in detail in section 4 are at least substantially similar, or are identical in structure and function, and can operate in a manner substantially similar to or identical to each other and / or to the aortic repair devices 300 and 400. Furthermore, one or more different features of the aortic repair devices of this technology may be combined and / or omitted.

[0137] Figure 5AThis is a side view of an aortic repair device 500 according to an embodiment of the present technology. In the illustrated embodiment, the aortic repair device 500 includes a base member 510 having a body 512 and legs 514. The body 512 includes a proximal portion 511, a distal portion 513, and a diaphragm 518 extending only partially from the distal portion 513 toward the proximal portion 511. That is, the diaphragm 518 extends only partially through the body 512 and has a second length L2 that is less than a first length L1 of the body 512. In some aspects of the present technology, the diaphragm 518 reduces the volume of the base member 510 (e.g., the total volume and / or maximum volume per unit length anywhere along the length of the aortic repair device 500) compared to a diaphragm that extends completely through the body 512 (e.g., the second length L2 equals the first length L1). In some aspects of this technology, reducing the volume of the base member 510 can reduce the delivery profile of the aortic repair device 500—potentially allowing the aortic repair device 500 to be loaded into and delivered through a relatively small catheter and / or along a narrower intravascular delivery channel. However, a shorter septum 518 can reduce the need for sealingly engaging (e.g., mating) across members (such as...) Figure 5C The available area of ​​the crossing member 550 shown. In the illustrated embodiment, the leg 514 also includes an angled portion 519 extending from the body 512, which reduces the diameter of the secondary lumen defined by the leg 514. Furthermore, because the diaphragm 518 extends only partially through the body 512, the body 512 can define a sealing region near the proximal portion 511 of the body 512, which can receive the extension member, as referenced below. Figure 36C As described in further detail, this extension member can be attached to the proximal portion 511 of the body 512 to provide further sealing and / or anchoring within the aorta.

[0138] Figure 5B and 5C According to embodiments of this technology, along Figure 5A The line 5B-5B is cut off. Figure 5A Cross-sectional view of the aortic repair device 500. (Reference) Figure 5B The body 512 has a generally circular cross-sectional shape, and the diaphragm 518 is generally centered within the body 512, such that the diaphragm 518 divides the body 512 into (e.g., bifurcated) a main lumen 523 and a secondary lumen 525 of the same size. Figure 5C An aortic repair device 500 is shown, having a traversing member 550 that is coupled to a base member 510 within a main lumen 523 and defines a traversing lumen 557. In the illustrated embodiment, the outer surface of the traversing member 550 at least partially sealably engages the inner surfaces of a diaphragm 518 and a body 512, such that blood flow is substantially guided through the traversing lumen 557.

[0139] In some embodiments, when expanding within the body 512, the diaphragm 518 is deflected away from the center of the body 512 across the member 550, such as Figure 5C As shown. This deflection can reduce the cross-sectional size of the secondary lumen 525 and the corresponding volumetric flow rate provided by the secondary lumen 525, while increasing the cross-sectional size of the main lumen 523 and the volumetric flow rate provided by the main lumen 523. In some aspects of this technology, this change in the dimensions of the main lumen 523 and the secondary lumen 525 is advantageous because the main lumen 523 is positioned to perfuse the aorta and all its branch vessels, while the secondary lumen 525 is positioned to perfuse branch vessels that require less blood flow than the aorta. However, in some embodiments, when configured across member 550, the shape of the secondary lumen 525 (e.g., a thin crescent shape) can restrict blood flow through the secondary lumen 525. Therefore, as described in detail below, in some embodiments, the body 512 may be shaped differently and / or the diaphragm 518 may be positioned differently to allow for more uniform blood flow through the main lumen 523 and the secondary lumen 525 and / or blood flow through the main lumen 523 and the secondary lumen 525 in proportion to the patient’s physiological needs (e.g., the aorta receives more blood flow than the branch vessels).

[0140] Figure 6A This is a side view of an aortic repair device 600 according to an embodiment of the present technology. Figure 6B According to embodiments of this technology, along Figure 6A The line 6B-6B in the middle is cut off Figure 6A Cross-sectional view of the aortic repair device 600. (Reference) Figure 6A The aortic repair device 600 includes a base member 610 having a body 612 and legs 614. The body 612 includes a proximal portion 611, a distal portion 613, and a septum 618 extending only partially from the distal portion 613 toward the proximal portion 611. That is, the septum 618 may terminate at a distance from the proximal portion 611. (Reference) Figure 6B The body 612 has a generally circular cross-sectional shape, and the diaphragm 618 is offset within the body 612 such that the diaphragm 618 divides the body 612 into a main cavity 623 and a secondary cavity 625, the secondary cavity 625 having a smaller size and corresponding volumetric flow rate than the main cavity 623. In some embodiments, when the traversing member is disposed within the main cavity 623, the diaphragm 618 is configured to be undeflected or only slightly deflected.

[0141] Figure 7A and 7B These are, respectively, a distal fluoroscopic end view and a distal end view of the aortic repair device 700 according to an embodiment of the present technology. (See also:) Figure 7A and 7BThe aortic repair device 700 includes a base member 710 having a body 712, the body 712 having a diaphragm 718 extending wholly or partially through the body 712 and defining a main lumen 723 and a secondary lumen 725. In the illustrated embodiment, when the aortic repair device 700 expands without radial constraint (e.g., outside the aorta), the body 712 has a small diameter D. 小 ( Figure 7A ) and large diameter D 大 ( Figure 7A The diaphragm 718 has an elliptical cross-sectional shape. It can be approximately along the small diameter D. 小 Extend, and can have a smaller diameter D 小 The long length allows the diaphragm 718 to be loose or soft (e.g., not fully tensioned) when the base member 710 expands outside the aorta. In some embodiments, the diaphragm 718 may have a diameter approximately equal to the small diameter D. 小 The length of the membrane 718 is such that it is taut (e.g., with minimal looseness).

[0142] Figure 7C This is a distal end view of an aortic repair device 700 that expands within the aorta according to an embodiment of the present technology. (See also:) Figures 7A-7C In some embodiments, the body 712 may be along at least the large diameter D 大 The aorta is too large relative to the aorta, so that when the base component 710 expands within the aorta, the aorta moves along the large diameter D. 大 Compression and shortening of the body 712. In some embodiments, a small diameter D can be selected. 小 To match the size of the aorta or be too large relative to the size of the aorta, so that when implanted into the aorta, the small diameter D 小 Keep them roughly the same. In other embodiments, the smaller diameter D 小 It can be selected to be smaller than the size of the aorta, such that the body 712 is along the large diameter D 大 The compression accordingly causes the body 712 to move along the small diameter D. 小 The diaphragm 718 is elongated to increase tension within it. That is, in such an embodiment, the body 712 can have a generally circular cross-sectional shape within the aorta, wherein the large diameter D is [missing information] relative to its expanded state outside the aorta. 大 Reduce and smaller diameter D 小 Increase. In some aspects of this technology, when the traversing member (not shown) is configured within the main tube cavity 723, the increased tension in the diaphragm 718 can suppress significant deflection of the diaphragm 718 through the traversing member (not shown) (e.g., Figure 5C (Deflection of the type shown). This maintains the dimensions of the flow path through the main cavity 723 and the secondary cavity 725.

[0143] Figures 8A-8E These are, respectively, a side view, a perspective side view, a perspective view facing the proximal side, a perspective end view facing the proximal side, and a perspective end view facing the distal side of the aortic repair device 800 according to an embodiment of the present technology. Figure 8F and 8G According to embodiments of this technology, along Figure 8B A cross-sectional view of the aortic repair device 800 taken from line 8F-8F. (See also: [reference needed]) Figure 8A-8G The aortic repair device 800 includes a base member 810 having a body 812, the body 812 having a diaphragm 818 extending wholly or partially through the body 812. The diaphragm 818 is laterally offset within the body 812 (e.g., as referenced above). Figure 6A and 6B (As described in detail), such that the diaphragm 818 divides the body 812 into a main cavity 823 and a secondary cavity 825 having a smaller size than the main cavity 823. The dimensions of the diaphragm 818 (e.g., having a length) allow the diaphragm 818 to have a curved shape when the base member 810 expands, and the secondary cavity 825 to have a corresponding curved cross-sectional shape (e.g., generally circular, generally elliptical).

[0144] Let's refer to each other. Figure 8D and 8E The aortic repair device 800 also includes a stent graft or stent 830, which is at least partially positioned within a secondary lumen 825 within the body 812. The stent 830 may be delivered and positioned within the secondary lumen 825 during the same procedure and / or from the same catheter system used for implanting the base member 810, and / or may be delivered to the secondary lumen 825 in a separate procedure and / or from a different catheter system. In some embodiments, the stent 830 is delivered from a separate catheter that advances through a branch lumen in which the outlet of the leg 814 is positioned, such as the brachiocephalic artery. The stent 830 may include an expandable network of interconnected stents or a similar structure and may have a tubular shape having a generally circular cross-sectional shape. When positioned within the secondary lumen 825, the stent 830 may expand against the inner surface of the diaphragm 818 and the body 812 to expand the secondary lumen 825. Therefore, when the spanning member is deployed within the main cavity 823, the support 830 can help maintain the shape of the secondary cavity 825—maintaining its cross-sectional area and flow velocity.

[0145] For example, Figure 8H According to embodiments of this technology, along Figure 8B A cross-sectional view of the aortic repair device taken from line 8F-8F, wherein the traversing member 850 is disposed within the main lumen 823. (See figure) Figure 8HAs shown, the bridging member 850 and the support 830 can conform to each other's shapes. More specifically, the support 830 is configured to apply a greater radially outward force than the bridging member 850, such that the support 830 inhibits the diaphragm 818 from significantly deflecting and narrowing the secondary lumen 825, thereby maintaining a good flow path through the secondary lumen 825. Figure 8H As shown, the bridging member 850 can slightly compress the support 830 so that the support 830 has a generally elliptical cross-sectional shape, and the bridging member 850 can conform to the diaphragm 818 and the support 830 and seal around the diaphragm 818 and the support 830.

[0146] Continue to refer to Figure 8H In some embodiments, the bridging member 850 may not be fully conformable to the diaphragm 818 and the stent 830, thereby creating one or more gaps 831 between the bridging member 850 and the diaphragm 818 and / or the body 812. The gaps 831 may exist along defined sharp angles, narrow regions, etc., of the diaphragm 818 and the body 812. Such gaps 831 can provide a leakage path for blood flow through the aortic repair device 800.

[0147] Figure 9A-20B Additional embodiments of an aortic repair device according to the present technology are shown, which include features for suppressing (e.g., filling, blocking, preventing) gaps (e.g., gap 831). Various aortic repair devices may include features that are structurally and functionally similar to each other and / or related to those referenced above. Figure 3A-8H The corresponding features of the aortic repair devices described in detail are at least substantially similar, or identical in structure and function, and can operate in a manner substantially similar to or identical to each other and / or to the aortic repair devices described above.

[0148] For example, Figure 9A and 9B According to embodiments of the present technology Figure 8H A cross-sectional view of the aortic repair device 800 during the first and second delivery phases (e.g., an end cross-sectional view along a plane perpendicular to the longitudinal axis of the main lumen 823). Reference Figure 9A After the aortic repair device 800 is implanted into the aorta, the balloon catheter assembly 934 can advance into the traversing member 850. The balloon catheter assembly 934 may include an inflation source 935 and a balloon 936 fluidly coupled to the inflation source 935. The inflation source 935 may include one or more inflatable lumens configured to direct fluid into the balloon 936 to inflate / expand the balloon 936. Figure 9A The balloon 936 before inflation is shown, and Figure 9B The inflated balloon 936 is shown. (Reference) Figure 9BIn some embodiments, balloon 936 has a cross-sectional shape that substantially matches the contour of the main lumen 823, and traversing member 950 should conform to and seal the main lumen 823. Therefore, inflating balloon 936 helps to drive traversing member 950 to conform to and seal the entire circumference of the main lumen 823—including within gaps 831 that are difficult to seal. After balloon 936 has been inflated to drive traversing member 950 to conform to and seal into body 812 within the main lumen 823, balloon 936 can be deflated, and balloon catheter assembly 934 can be removed from aortic repair device 800 and the patient.

[0149] In some embodiments, balloon 936 may have a crescent, D-shape, semi-circular, quarter-circular, or other cross-sectional shape that matches or substantially matches the profile (e.g., circumference, perimeter) of the main lumen 823. In some embodiments, different portions of balloon 936 may have different conformations to facilitate a non-circular cross-sectional shape. In some embodiments, inflation source 935 may inflate balloon 936 according to a predetermined sequence, rate, pressure, etc. In some embodiments, one or more additional balloon catheter assemblies may be inserted into traversing member 850 and / or stent 830. For example, balloon 936 may be a moderately semi-conformal balloon with a substantially circular cross-sectional shape and may inflate in traversing member 950 to a point that partially compresses stent 830, such that traversing member 850 and balloon 936 reach and fill gap 831. An unconformal balloon (not shown) may then be inserted into stent 830 and slowly inflated within stent 830. As the conformal balloon inflates and fills the secondary lumen 825, the conformal balloon can slowly deflate the balloon 936, thereby relinquishing space for inflation but maintaining support in the gap 831. In some embodiments, as the volume of the balloon 936 is compressed and reduced, the pressure within the balloon 936 can be maintained by using an inflation source 935 to reduce the inflation pressure of the balloon 936.

[0150] In some embodiments, the balloon 936 may have a generally cylindrical shape and may inflate to fully compress the stent 830. After the stent 830 is fully compressed, the balloon 936 may deflate to allow the stent 830 to expand against the diaphragm 818 and the traverse member 850 to re-establish the flow path through the secondary lumen 825. In some aspects of the art, fully compressing the stent 830 and diaphragm 818 while positioning the traverse member 850 can promote good conformability of the traverse member 850 to the diaphragm 818, thereby reducing or eliminating gap 831. In some embodiments, the balloon may be inserted into the stent 830 and expand within the stent 830 to promote its expansion against the traverse member 850. In other embodiments, the traverse member 850 may deploy first, and the balloon 936 expands before the stent 830 is positioned within the compressed secondary lumen 825 and allowed to expand.

[0151] Figure 10A and 10B These are, respectively, a distal end view and a fluoroscopic end view of the aortic repair device 1000 according to an embodiment of the present technology. (See also:) Figure 10A and 10B In the illustrated embodiment, the aortic repair device 1000 includes a base member 1010 having a body 1012, wherein a diaphragm 1018 extends wholly or partially through the body 1012. The diaphragm 1018 is laterally offset within the body 1012 such that it divides the body 1012 into a main lumen 1023 and a secondary lumen 1025 having a smaller size than the main lumen 1023. In the illustrated embodiment, the base member 1010 also includes one or more filling portions 1032 (e.g., gussets, caps) coupled to the diaphragm 1018 between the main lumen 1023 and the secondary lumen 1025. The filling portions 1032 may include fabrics and / or materials impermeable to blood flow.

[0152] Figure 10C and Figure 10D These are distal end views and fluoroscopic end views of an aortic repair device 1000 according to an embodiment of the present technology, wherein the traversing member 1050 is disposed within the main lumen 1023. Figure 10C An optional support 1030 configured within the secondary lumen 1025 is further illustrated. (See also: Reference) Figure 10C and 10D In the illustrated embodiment, the filling portion 1032 helps to define a relatively uniform elliptical cross-sectional shape for the main cavity 1023. That is, the filling portion 1032 can fill any sharp corners, narrowed areas, etc., across the member 1050 that might be difficult to conform to (e.g., in...). Figure 8H (In the area surrounding the gap 831 shown). Therefore, in some aspects of this technology, the filling portion 1032 can help improve the conformity and sealing of the span member 1050 within the body 1012, thereby reducing or eliminating leakage through the aortic repair device 1000 when the device is deployed within the aorta.

[0153] Figure 11AThis is a cross-sectional view of an aortic repair device 1100 according to an embodiment of the present technology. In the illustrated embodiment, the aortic repair device 1100 includes a base member 1110 having a body 1112 having a diaphragm 1118 extending wholly or partially therethrough. The diaphragm 1118 is laterally offset within the body 1112 such that it divides the body 1112 into a main lumen 1123 and a secondary lumen 1125 having a smaller size than the main lumen 1123. In the illustrated embodiment, a bridging member 1150 is disposed within the main lumen 1123, and a stent 1130 is disposed within the secondary lumen 1125. As shown, the bridging member 1150 may not be fully conformable to and seal the periphery of the main lumen 1123, thus allowing for one or more gaps 1131.

[0154] Figure 11B This is a cross-sectional side view of the support 1156 of the traversing member 1150 according to an embodiment of the present technology. The traversing member 1150 may include one or more supports 1156 attached to graft material (not shown; for example, as described in detail above with reference to FIG. 4). In some embodiments, the supports 1156 have an annular shape having a periodic or V-shaped pattern. In the illustrated embodiment, the supports 1156 have a relatively large amplitude and a low frequency. In some aspects of the present technology, the relatively large amplitude and low frequency of the supports 1156 may make the traversing member 1150 relatively easy to manufacture and / or load into a catheter for delivery. However, the traversing member 1150 may not be as... Figure 11A The shape shown is very conformal, thus resulting in gap 1131.

[0155] Figure 12A This is a cross-sectional view of an aortic repair device 1200 according to an embodiment of the present technology. In the illustrated embodiment, the aortic repair device 1200 includes a reference... Figure 11A The base member 1110 and the support 1130 are described in detail, but include different spanning members 1250. Figure 12B This is a cross-sectional side view of a support 1256 spanning member 1250 according to an embodiment of the present technology. In the illustrated embodiment, the support 1256 has a relatively small amplitude and a high frequency (e.g., compared to reference...). Figure 11B Compared to the scaffold 1156 described in detail. In some aspects of this technology, the relatively small amplitude and high frequency of the scaffold 1256 can make the crossing member 1250 relatively more difficult to manufacture (e.g., by requiring additional attachment of the graft material) and / or more challenging to load into the catheter for delivery. However, the crossing member 1250 can be as Figure 12A The result is a more circumferential conformal design—eliminating or reducing the presence of gaps 1231.

[0156] Typically, the scaffold of the traverse member according to this technology can be selected to balance the radial forces (e.g., force juxtaposition) with conformability (e.g., profile adaptation) of the traverse member by modifying one or more of the scaffold's amplitude, frequency (e.g., number of vertices), wall thickness, and / or wire diameter / support geometry and dimensions. For example, the wall thickness of the traverse member can be reduced to improve conformability while reducing radial forces. In some embodiments, the manner in which the traverse member is laid on the mating surface can be improved by “fanning” unsupported V-shaped spaces at the ends of the traverse member, thereby producing a degree of serration. Furthermore, one or both ends of the traverse member can be flared outward to improve juxtaposition. In addition, the traverse member can include a series of scaffold rings with different characteristics (e.g., the first scaffold ring at the end can be softer, with a smaller wire diameter and / or wall thickness and a fan or flare; the second scaffold ring can be stiffer, with a larger wire diameter and / or wall thickness, a shorter amplitude, etc.; the third scaffold ring can be a standard / typical design used in conventional scaffold grafts, etc.).

[0157] For example, Figures 13A-13C These are, respectively, a perspective side view of the spanning member 1350 according to an embodiment of the present technology, a perspective end view facing the distance, and another perspective end view facing the distance. Reference Figure 13A The traversing member 1350 includes a proximal portion 1351 and a distal portion 1353. The proximal portion 1351 is configured to expand within and conform to the base member, and the distal portion 1353 is configured to expand within and conform to a blood vessel, such as the aorta (e.g., the aortic arch, descending thoracic aorta). The traversing member 1350 includes a plurality of stents 1356 (e.g., including individually identified first stents 1356a and second stents 1356b) attached to the graft material 1358. In the illustrated embodiment, the first stent 1356a has a larger amplitude and a lower frequency than the second stent 1356b. In some embodiments, the first stent 1356a may have a larger wire diameter than the second stent 1356b.

[0158] The second support 1356b can be positioned at, near, and / or adjacent to, the proximal portion 1351 and the distal portion 1353 to provide increased conformity at the proximal portion 1351 and the distal portion 1353. For example, Figure 13CThis illustrates the relatively high circumferential conformability of the traverse member 1350 at its proximal portion 1351 when an external force, indicated by arrow F, is applied to the traverse member 1350 (e.g., by a support disposed within the secondary lumen of the base member). A first support 1356a may be positioned in the intermediate region of the traverse member 1350. In some embodiments, the traverse member 1350 includes additional second supports 1356b near the proximal portion 1351, such that the proximal portion 1351 is relatively conformally adapted for engagement with and sealing the base member.

[0159] Refer to together Figures 13A-13C In some embodiments, the proximal and / or distal support in the second support 1356b has a larger diameter than the other supports in the support 1356, causing the bridging member 1350 to open at one or both of the proximal and distal portions 1351 and 1353. In the illustrated embodiment, the graft material 1358 may be cut to follow the pattern of the proximal and / or distal support in the second support 1356b, such that the graft material 1358 has a fan-shaped or V-shaped pattern at one or both of the proximal and distal portions 1353. In some aspects of this technology, this opening and / or fanning of the proximal and distal portions 1351 and 1353 can improve the fit and sealing performance of the bridging member 1350.

[0160] Figure 14A and 14B This is a perspective side view spanning member 1450 according to an embodiment of the present technology. (See also:) Figure 14A and 14B The traversing member 1450 includes a proximal portion 1451 and a distal portion 1453, the proximal portion 1451 being configured to expand within and conform to the base member, and the distal portion 1453 being configured to expand within and conform to a vessel such as the aorta (e.g., the aortic arch, descending thoracic aorta). The traversing member 1450 includes a plurality of stents 1456 (e.g., each including individually identified first to eighth stents 1456a-h) attached to the graft material 1458.

[0161] In the illustrated embodiment, the first support 1456a, the second support 1456b, the seventh support 1456g, and the eighth support 1456h are positioned at the proximal portion 1451 and the distal portion 1453, and have smaller amplitudes and larger frequencies than the third support 1456c to the sixth support 1456f positioned therebetween. The third support 1456c to the sixth support 1456f may have the same or substantially the same frequency, and the third support 1456c and the sixth support 1456f may have larger amplitudes than the fourth support 1456d and the fifth support 1456e located therebetween. The first support 1456a may have a first diameter, for example, about 44 mm. The second to seventh supports 1456b-g may have a second diameter smaller than the first diameter, for example, about 40 mm. The eighth support 1456h may have a third diameter larger than the second diameter and smaller than the first diameter, for example, about 42 mm. Therefore, the proximal portion 1451 can open relative to the remainder of the spanning member 1450 to improve fit and seal with the base member. Similarly, the distal portion 1453 can also unfold relative to the adjacent support in the support 1456 (e.g., but to a lesser extent than the proximal portion 1451).

[0162] In some embodiments, the first support 1456a, the second support 1456b, the seventh support 1456g, and the eighth support 1456h may each have a relatively small first wire diameter, for example, about 0.14 inches, to provide a high level of radial conformability. The third to sixth supports 1456c-f may each have a larger second wire diameter to provide a relatively greater radially outward force. For example, in some embodiments, the third to sixth supports 1456c-f have wire diameters of about 0.025 inches, 0.018 inches, 0.016 inches, and 0.022 inches, respectively. Furthermore, in some embodiments, the third to sixth supports 1456c-f may be spaced apart from each other by a distance greater than the distance between the first support 1456a, the second support 1456b, the seventh support 1456g, and the eighth support 1456h.

[0163] Figure 14C and 14D These are, respectively, a distal fluoroscopic view and an enlarged distal fluoroscopic view of an aortic repair device 1400 according to an embodiment of the present technology, the aortic repair device 1400 including a traversing member 1450 disposed within a base member 1410. (See also:) Figure 14C and 14DThe base member 1410 includes a body 1412 through which a diaphragm 1418 extends wholly or partially. The diaphragm 1418 is laterally offset within the body 1412 such that it divides the body 1412 into a main lumen 1423 and a secondary lumen 1425 having dimensions smaller than the main lumen 1423. A support 1430 extends within the secondary lumen 1425. As shown, a relatively conformable proximal portion 1451 spanning member 1450 can conform to and seal around the diaphragm 1418 and support 1430 without leaving significant gaps (e.g., leakage paths).

[0164] Figure 15A and 15B These are, respectively, a side view and an end view of the spanning member 1550 according to an embodiment of the present technology. Figure 15C This includes embodiments of the present technology. Figure 15A and 15B A distal end view of the aortic repair device 1500 spanning component 1550. (Reference) Figure 15C The aortic repair device 1500 may include a base member 1510 having a body 1512 having a diaphragm 1518 extending wholly or partially therethrough. The diaphragm 1518 is laterally offset within the body 1512 such that it divides the body 1512 into a main lumen 1523 and a secondary lumen 1525 having a smaller size than the main lumen 1523. A stent 1530 is disposed within the secondary lumen 1525.

[0165] Refer to together Figures 15A-15C The bridging member 1550 may include a plurality of supports 1556 attached to the graft material 1558. In the illustrated embodiment, the graft material 1558 includes a filling portion 1559, which may be a cavity, loose portion, and / or pouch-like portion of the graft material 1558. The filling portion 1559 may extend radially outward from the supports 1556 and is circumferentially and / or longitudinally disposed around the bridging member 1550. In some embodiments, the filling portion 1559 may protrude outward in response to intravascular blood pressure, such as... Figure 15B and 15C As indicated by the arrow in the image. (Reference) Figure 15C In some aspects of this technology, the filling portion 1559 can help the traverse member 1550 conform to and seal around the circumference of the main cavity 1523 without leaving significant gaps (e.g., leakage paths). In some embodiments, the filling portion 1559 is positioned asymmetrically around the traverse member 1550 (e.g., only along a portion of its periphery), and the traverse member 1550 can be aligned within the body 1512 during surgical procedures such that the filling portion 1559 engages and surrounds the diaphragm 1518.

[0166] The graft material 1558 can be radially attached to the outside of the scaffold 1556 or radially attached to the inside of the scaffold 1556, such that the filling portion 1559 extends / extrudes through the scaffold 1556. Figure 15D and Figure 15E This is a side view of the cross member 1550 according to an embodiment of the present technology when subjected to blood flow (e.g., when implanted into a blood vessel (not shown)) and having graft material 1558 respectively attached to the interior and exterior of the stent 1556. Figure 15D As shown, when the graft material 1558 is attached within the stent 1556, blood flow through / through the traversing member 1550 can cause the filling portion 1559 to extend radially across the stent 1556 in the region therebetween. Figure 15E As shown, when the graft material 1558 is attached to the outside of the stent 1556, the blood flow through / passing across the cross member 1550 can cause the filling portion 1559 to bulge outward around the attachment point between the graft material 1558 and the stent 1556.

[0167] Figure 16A and 16B These are, respectively, perspective side views and perspective end views of the spanning member 1650 according to an embodiment of the present technology. (See also:) Figure 16A and 16B The bridging member 1650 includes graft material 1658 attached to the outer side of a plurality of supports 1656. The graft material 1658 may be oversized relative to the supports 1656, such that the graft material 1658 is loose or soft, and thus helps fill and seal any gaps when the bridging member 1650 is disposed within the base member. For example, the diameter of the graft material 1658 (e.g., about 50 mm) may be larger than the diameter of the supports 1656 (e.g., about 40 mm).

[0168] Figures 17A-17C These are, respectively, a perspective side view, a side sectional view, and a perspective end view of the spanning member 1750 according to an embodiment of the present technology. (See also...) Figures 17A-17CThe bridging member 1750 includes graft material 1758 attached to a plurality of supports 1756 (e.g., including individually identified proximal support 1756a and distal support 1756b). The graft material 1758 may be excessively large relative to the supports 1756, such that the graft material 1758 is loose or soft, and thus helps fill and seal any gaps when the bridging member 1750 is configured within the base member. In the illustrated embodiment, the proximal support 1756a and distal support 1756b are high-frequency and low-amplitude supports attached to the exterior of the graft material 1758, and can help improve the conformity of the bridging member 1750. The graft material 1758 may be attached to the exterior of the supports 1756 other than the proximal support 1756a and distal support 1756b.

[0169] Figure 18A This is an end view of the spanning member 1850 in a constrained (e.g., first) construction and an expanded (e.g., second) construction according to an embodiment of the present technology. Figure 18B This includes embodiments of the present technology. Figure 18A A distal end view of the aortic repair device 1800 spanning component 1850. (Reference) Figure 18B The aortic repair device 1800 may include a base member 1810 having a body 1812 having a diaphragm 1818 extending therethrough, either wholly or partially. The diaphragm 1818 is laterally offset within the body 1812 such that it divides the body 1812 into a main lumen 1823 and a secondary lumen 1825 having a smaller size than the main lumen 1823. A stent 1830 is disposed within the secondary lumen 1825.

[0170] refer to Figure 18A The bridging member 1850 includes graft material 1858 attached to a plurality of struts 1856 of the support. The bridging member 1850 has a first diameter D1 in a constrained configuration and a second diameter D2 larger than the first diameter D1 in an expanded configuration. The graft material 1858 is configured to be relatively loose or relaxed in the constrained configuration and taut in the expanded configuration. In some embodiments, the second diameter D2 is about 1.2-2.5 times larger than the first diameter D1 (e.g., about 1.3-2.0 times). See also: Figure 18A and 18BIn some embodiments, the diameter D1 is selected to be equal to or approximately equal to the diameter of the target blood vessel (e.g., the aorta) into which the traversing member 1850 is to be implanted, such that the traversing member 1850 presents a constrained configuration when disposed within the base member 1810. Thus, in some aspects of this technology, the loose graft material 1858 can aid in filling, helping the traversing member 1850 to conform to and seal around the circumference of the main lumen 1823 without leaving substantial gaps (e.g., leakage paths) through the body 1812.

[0171] Figure 19 This is a distal end view of an aortic repair device 1900 according to an embodiment of the present technology. In the illustrated embodiment, the aortic repair device 1900 includes a base member 1910 having a body 1912 having a diaphragm 1918 extending wholly or partially through the body 1912. The diaphragm 1918 is laterally offset within the body 1912 such that it divides the body 1912 into a main lumen 1923 and a secondary lumen 1925 having a smaller size than the main lumen 1923. A stent 1930 is disposed within the secondary lumen 1925, and a traversing member 1950 is disposed within the main lumen 1923. In the illustrated embodiment, both the stent 1930 and the traversing member 1950 have a D-shaped cross-sectional shape, which together form a generally circular shape. The matching D-shaped cross-sectional shape can help improve the conformity and sealing of (i) the spanning member 1950 in the main lumen 1923 and (ii) the support 1930 in the secondary lumen 1925, thereby suppressing leakage through the body 1912.

[0172] Figure 20A and 20B These are, respectively, an enlarged perspective side view and a perspective end view facing the far side of the spanning member 2050 according to an embodiment of the present technology. (See also:) Figure 20A and 20B The bridging member 2050 includes graft material 2058 attached to a plurality of supports 2056. The bridging member 2050 may also include a proximal portion 2051 configured to be positioned on a base member (such as those referenced above). Figures 8A-8H Within the lumen of the base member 810 (described in detail). In the illustrated embodiment, the support 2056 near the proximal portion 2051 is configured (e.g., shaped and sized to) form a recess 2037, such that the proximal portion 2051 spanning member 2050 has, for example, a crescent-shaped or kidney-shaped cross-sectional shape. See also... Figures 8A-8HWhen the traversing member 2050 is disposed within the main cavity 823 of the base member 810, the notch 2037 can be positioned adjacent to the support 830 and the diaphragm 818 and shaped to substantially match the shape of the support 830 and the diaphragm 818, such that the traversing member 850 conforms to and seals the circumference of the main cavity 823.

[0173] Figure 21 This is a perspective side view of a traversing member 2150 according to an embodiment of the present technology. In the illustrated embodiment, the traversing member 2150 includes a proximal portion 2151 and a distal portion 2153, the proximal portion 2151 being configured to expand within and conform to a base member, and the distal portion 2153 being configured to expand within and conform to a blood vessel, such as the aorta (e.g., the aortic arch, descending thoracic aorta) and / or another base member. The traversing member 2150 includes a plurality of stents 2156 (e.g., including individually identified first stent 2156a, second stent 2156b, and third stent 2156c) attached to graft material 2158. A first support 2156a defines a first (e.g., proximal) region 2155a spanning member 2150, a second support 2156b defines a second (e.g., intermediate) region 2155b spanning member 2150, and a third support 2156c defines a third (e.g., distal) region 2155c spanning member 2150. In some embodiments, the second support 2156b may have a reduced diameter compared to the first support 2156a and / or the third support 2156c, such that the second region 2155b is narrower than the first region 2155a and / or the third region 2155c. In the illustrated embodiment, the graft material 2158 (i) does not extend proximally through the nearest-side support in the first support 2156a, such that the bridging member 2150 has a proximal opening 2159a (e.g., arranged in a fan-shaped pattern) that follows the contour of the nearest-side support in the first support 2156a, and (ii) does not extend distally through the farthest-side support in the third support 2156c, such that the bridging member 2150 has a distal opening 2159b that follows the contour of the farthest-side support in the third support 2156c. That is, the nearest-side support in the first support 2156a may be exposed proximally from the graft material 2158, and the farthest-side support in the third support 2156c may be exposed distally from the graft material 2158. In some aspects of this technology, omitting graft material 2158 in this way to form proximal opening 2159a and distal opening 2159b can improve the ability to position the traversing member 2150 in one or more base members by reducing the risk of unintentional sealing if the traversing member 2150 is too long or positioned too far from the base member.

[0174] Figure 22A and 22BThis is a perspective end view of an aortic repair device 2200 according to an embodiment of the present technology. In the illustrated embodiment, the aortic repair device 2200 includes a base member 2210 having a body 2212, wherein a diaphragm 2218 extends wholly or partially through the body 2212 and divides the body 2212 into a main lumen 2223 and a secondary lumen 2225 smaller in size than the main lumen 2223. In the illustrated embodiment, a bridging member 2250 is disposed within the main lumen 2223, and a stent 2230 is disposed within the secondary lumen 2225.

[0175] like Figure 22B As best shown, if the traversing member 2250 has a significantly greater radial strength than the support 2230, the traversing member 2250 can compress, flatten, and / or crush the support 2230, causing the secondary lumen 2225 to excessively contract and narrow. Therefore, in some embodiments, the support 2230 can be configured to have radial strength that inhibits excessive compression of the traversing member 2250.

[0176] For example, Figure 23 According to embodiments of this technology and Figure 22A and 22B A side view of a stent 2330 used in conjunction with an aortic repair device 2200, which has increased radial strength (e.g., radial resistance). In the illustrated embodiment, the stent 2330 has a plurality of first struts 2332 having a zigzag or wavy shape (e.g., including a plurality of V-shaped portions) or a rhomboid shape (e.g., including a plurality of rhomboid portions), the plurality of first struts 2332 extending in a circumferential direction and interconnected by longitudinally extending second struts 2334. The support 2330 can be manufactured with increased radial strength by: (i) increasing the thickness of the first pillar 2332 and / or the second pillar 2334 in the radial direction, for example, by cutting (e.g., laser-cutting) the support 2330 from a tube with thicker walls; (ii) increasing the width of the first pillar 2332 and / or the second pillar 2334 in the longitudinal and / or circumferential directions; (iii) increasing the number of second pillars 2334 (e.g., by including second pillars 2334 between all or most of the vertices of adjacent first pillars 2332); and / or (iv) increasing the “V-angle” of the first pillar 2332 (e.g., by including fewer and shorter V-shaped or rhomboid portions around the circumference of the first pillar 2332). See also: Figure 22A-23 The increased radial strength can suppress or even prevent excessive compression of the support 2330 across the component 2550 and narrowing of the secondary lumen 2225.

[0177] Figure 24 This is a side view of the aorta, illustrating various aspects of the aortic repair device delivery process. (As shown...) Figure 24As shown, line 2402 illustrates a tubular body of a basal component implanted in the ascending aorta that can be lifted from the aorta near the aortic arch and is not conforming to the location of the aorta near the aortic arch. Similarly, Figure 24 The second line 2404 illustrates a situation where the tubular body of the basal member implanted in the descending aorta can be lifted away from the aorta near the aortic arch and is not conformable to the aorta near the aortic arch. In this case, the sealing length of the basal member can be reduced. In some embodiments, any aortic repair device described herein may include features configured to promote conformity of the aortic repair device to the aorta (e.g., along a relatively curved portion of the aorta, such as the aortic arch) to inhibit or even prevent the aortic repair device from detaching from the aortic wall. For example, Figure 25A-27D Additional embodiments of the aortic repair device according to the present technology are shown, which include features that enhance the conformability of the base member to the arched vessel wall, and Figures 87A-87C Additional embodiments of an aortic repair device according to the present technology are shown, which include features that enhance the conformity of the traverse member with the arched vessel wall. Various aortic repair devices may include features that are structurally and functionally similar to each other and / or related to those referenced above. Figure 3A-23 The corresponding features of the aortic repair devices described in detail are at least substantially similar, or identical in structure and function, and can operate in a manner substantially similar to or identical to each other and / or to the aortic repair devices described above.

[0178] For example, Figures 25A-25E These are perspective side views of various aortic repair devices 2500a-2500e according to embodiments of the present technology. In the illustrated embodiments, each of the aortic repair devices 2500a-2500e includes a base member 2510. It has (i) a body 2512 including a proximal portion 2511 and a distal portion 2513, and (ii) a leg 2514 extending from the distal portion 2513. Each base member 2510 includes one or more supports 2526 coupled to graft material 2528. In some embodiments, the body 2512 of any of the aortic repair devices 2500a-e may flare outward at the proximal portion 2511 and / or the distal portion 2513. For example, the distal portion 2513 may be along and / or substantially along... Figure 25B-25E The lines F shown in each of them flare outward to improve the conformability and / or sealing of the body 2512 within the aorta and particularly around the curved portions of the aorta (e.g., near the aortic arch).

[0179] Refer to together Figure 25A and 25BThe support 2526 along the body 2512 includes a separately identified intermediate support 2526a, which is positioned at and / or near the distal portion 2513 between the body 2512 and the leg 2514 and has a V-shaped pattern (e.g., including alternating proximal and distal vertices). Figure 25A In the illustrated embodiment, one of the V-shaped portions of the intermediate support 2526a and the graft material thereon are removed relative to the leg 2514 to form an opening or incision 2519a (e.g., having a fan or spoon shape). Figure 25B In the illustrated embodiment, the intermediate stent 2526a has a wedge-shaped portion 2519b, which is opposite to the leg 2514 and has a reduced amplitude relative to the rest of the intermediate stent 2526a. In some aspects of this technology, the incision 2519a and / or the wedge-shaped portion 2519b can improve the conformity and seal of the body 2512 within the aorta, particularly around the tortuous portions of the aorta (e.g., near the aortic arch).

[0180] Refer to together Figure 25C-25D The scaffold 2526 along the body 2512 includes a separately identified proximal scaffold 2526a at and / or near the proximal portion 2511, a distal scaffold 2526b at and / or near the distal portion 2513, and an intermediate scaffold 2526c between the proximal scaffold 2526a and the distal scaffold 2526b. Each of the scaffolds 2526a-c has a periodic V-shaped pattern (e.g., including alternating proximal and distal vertices). Figure 25C In the illustrated embodiment, the distal support 2526b has a larger amplitude (e.g., length in the direction between apexes and between the proximal portion 2511 and the distal portion 2513 of the body 2512) and a lower frequency than the proximal support 2526a and the intermediate support 2526c. Therefore, the proximal portion 2511 of the body 2512 (e.g., the inlet) can have a relatively high frequency. Figure 25D In the illustrated embodiment, the proximal support 2526a has a larger amplitude (e.g., length in the direction between the apexes and between the proximal portion 2511 and the distal portion 2513 of the body 2512) and a lower frequency than the distal support 2526b and the intermediate support 2526c. Therefore, the distal portion 2513 of the body 2512 (e.g., the outlet) can have a relatively high frequency. Figure 25E In the illustrated embodiment, brackets 2526a-c each have the same amplitude and frequency. In some aspects of this technology, Figure 25C-25E The arrangement of one or more stents 2526a-c in the aorta can improve the fit and seal of the body 2512 within the aorta, particularly around the tortuous portions of the aorta (e.g., near the aortic arch).

[0181] Figure 26A and 26B These are enlarged side views of portions of the aortic repair device 2600 in a first position (e.g., non-configured position) and a second position (e.g., configured position) according to embodiments of the present technology. (See also: [link to accompanying text]) Figure 26A and 26B The aortic repair device 2600 includes a base member 2610 having a body 2612, the body 2612 including one or more stents 2626 connected to graft material 2628. Similar to... Figure 25B In the illustrated embodiment, the stent 2626 has a V-shaped pattern with decreasing amplitude along direction D (e.g., including alternating proximal and distal vertices). Direction D can be a direction toward the inner wall of the aortic arch with a smaller curvature (e.g., a smaller radius of curvature, a shorter length). In some aspects of this technology, the reduced amplitude of the stent 2626 can improve the conformity and seal of the body 2612 within the aorta, particularly around the tortuous portions of the aorta (e.g., near the aortic arch). In some embodiments, the graft material 2628 and / or the stent 2626 can be pre-bent to have Figure 26B The second position shown.

[0182] Figure 27A and 27B These are enlarged side perspective views and fluoroscopic end views of the aortic repair device 2700 according to an embodiment of the present technology. (See also: [link to reference]) Figure 27A and 27B The aortic repair device 2700 includes a base member 2710, the base member 2710 having a body 2712, a leg 2714 extending from the body 2712, and a portion extending wholly or partially through therethrough and dividing the body 2712 into a main lumen 2723. Figure 27B ) and a secondary lumen 2725, smaller in size than the main lumen 2223. Figure 27B ) diaphragm 2718 ( Figure 27B The base component 2710 includes one or more supports 2726 connected to the graft material 2728. More specifically, see... Figure 27A The support 2726 along the body 2712 may include a first support 2726a extending circumferentially around the body 2712 and a support 2725 extending around the secondary lumen 2725. Figure 27B A second support 2726b that extends circumferentially, either fully or partially. See below for reference. Figure 28A-33 In more detail, when the spanning member is configured in the main tube cavity 2723 ( Figure 27B When inside, the second support 2726b can support and maintain the secondary lumen 2725. Figure 27B ).

[0183] Figure 27C This is a perspective view of a first support 2726a according to an embodiment of the present technology. (See also:) Figure 27A and 27C And similar to the reference above. Figure 25B The aortic repair device 2500b described in detail includes a first stent 2726a that may have a V-shaped pattern (e.g., including alternating proximal and distal apexes) whose amplitude varies (e.g., decreases) in a direction away from the leg 2714. In some embodiments, the portion of the first stent 2726a positioned furthest from the leg 2714 may also be angled outward from the leg 2714 at an angle A. Figure 27A In some aspects of this technology, the reduced amplitude and / or outward angle A of the first stent 2726a can improve the conformity and seal of the body 2712 within the aorta, particularly around the tortuous portions of the aorta (e.g., near the aortic arch). For example, Figure 27D An aortic repair device 2700, which is implanted in the aorta and conforms to the ascending aortic wall near the aortic arch according to an embodiment of the present technology, is shown.

[0184] Figure 87A and Figure 87B These are side views of the aortic repair device, according to embodiments of the present technology, in a first position (e.g., straight position, extended position) and a second position (e.g., curved position, relaxed position). See also: Figure 87A and 87B In the illustrated embodiment, the traversing member 8750 includes a plurality of stents 8756 attached to the graft material 8758. The traversing member 8750 also has a leading (e.g., proximal) end 8751, a tail (e.g., distal) end 8753, a first side portion 8754, and a second side portion 8755. The first side portion 8754 is configured to conform to the inner wall of the aortic arch and has a smaller curvature (e.g., smaller radius of curvature, shorter length). The second side portion 8755 is opposite to the first side portion 8754 and is configured to conform to the inner wall of the aortic arch and has a larger curvature (e.g., larger radius of curvature, longer length). The first side portion 8754 may include features that passively shorten the traversing member, such that the traversing member 8750 presents an arched shape when deployed. Figure 87B In some embodiments, for example, the support 8756 has a V-shaped pattern shape (e.g., including alternating proximal and distal vertices) that decreases in amplitude in the direction from the second side 8755 toward the first side 8754. In some aspects of this technology, the amplitude reduction of the support 8756 can be in accordance with the above reference. Figure 26A and 26BThe manner described in the detailed description improves the conformability and sealing of the spanning member 8750 within the aorta, particularly the conformability and sealing of the curved portion around the aorta (e.g., near the aortic arch).

[0185] In some embodiments, the spanning member 8750 may include a tension member 8757 (e.g., a shortening member) positioned along at least one segment of the first side 8754. The tension member 8757 may be an elongated member that completely or partially spans between the leading end 8751 and the trailing end 8753, and may be configured to passively shorten the first side 8754 of the spanning member 8750 to allow the spanning member 8750 to... Figure 87A The straight first position shown changes to Figure 87B The second bending position is shown. The tension member 8757 may be (i) an elastic band, rope, or other element, (ii) a spring (e.g., a leaf spring, a serrated nitinol tension leaf spring, a flat helical spring), (iii) a strip of stretchable material (e.g., polyurethane, thermoplastic elastomer (TPE)), (iv) a support-like element, and / or (v) the like. The tension member 8757 may be secured inside the graft material 8758 (e.g., to minimize wear on the tension member 8757) or outside the graft material 8758 (e.g., to minimize potential embolisms across the member 8750). In some embodiments, the tension member 8757 is covered with a polymer or other material and / or inserted into a seam / channel formed in the graft material 8758. In some embodiments, the tension member 8757 may include multiple individual springs or other shortening members positioned between individual supports in the support 8756. For example, Figure 87C This is an enlarged side view of a portion of a spanning member 8750 according to another embodiment of the present technology. In the illustrated embodiment, the tension member 8757 includes one or more springs 8759 positioned between the respective supports in the bracket 8756.

[0186] Figure 88A and 88B These are perspective side views of the aortic repair device according to embodiments of the present technology, showing the spanning member 8800 in a first position (e.g., straight position, extended position) and a second position (e.g., curved position, relaxed position). See also: Figure 88A and 88BIn the illustrated embodiment, the traversing member 8850 includes a plurality of stents 8856 attached to the graft material 8858. The traversing member 8850 also has a leading (e.g., proximal) end 8851, a tail (e.g., distal) end 8853, a first side portion 8854, and a second side portion 8855. The first side portion 8854 is configured to conform to the inner wall of the aortic arch with a smaller curvature (e.g., a smaller radius of curvature, a shorter length), and the second side portion 8855 is opposite to the first side portion 8854 and is configured to conform to the inner wall of the aortic arch with a larger curvature (e.g., a larger radius of curvature, a longer length).

[0187] The first side portion 8854 includes a tension member 8857 comprising multiple individual elastic (e.g., Lycra) fibers that span between adjacent supports in the support 8856 and passively shorten the first side portion 8854 when the spanning member 8850 is unrestrained, such that the spanning member 8850 presents an arched shape when configured. Figure 88B For example, in the illustrated embodiment, tension member 8857 may include six elastic fibers (also referred to as “elastic components”) – one located between each pair of adjacent supports in the seven illustrated supports 8856. In some embodiments, more elastic fibers can be positioned between adjacent pairs of supports 8856. The elastic fibers of tension member 8857 may be sewn to the exterior of graft material 8858 at the apex (or another portion) of support 8856, such that the elastic component pulls supports 8856 toward each other along a first side 8854. Tension member 8857 may be stretched to a straight first position ( Figure 88A ), for loading into a delivery conduit in a cylindrical configuration. In configuration, tension member 8857 can allow the spanning member 8850 to present a bent second position ( Figure 88B ).

[0188] In some embodiments, tension member 8857 pulls some or all of the stents in stent 8856 toward an adjacent one in stent 8856 and at least partially above / below an adjacent one in stent 8856. Thus, the first side portion 8854 may have a series of steps (e.g., rising and falling) along it. In some embodiments, this overlap may resemble a “shingled” pattern, where the overlap of adjacent stents 8856 occurs in a consistent pattern. For example, for adjacent stents in stent 8856, tension member 8857 is capable of consistently pulling the leading stent in stent 8856 toward and / or above the trailing stent in stent 8856. This consistent overlap pattern (“shingled”) can facilitate consistent blood flow across member 8850.

[0189] The elastic fibers of the tension member 8857 can be fixed between adjacent supports in the bracket 8856 in various arrangements. For example, Figure 88C This is an enlarged side view of a portion of a spanning member 8850 according to an embodiment of the present technology, illustrating two different potential attachments of the elastic fibers of the tension member 8857. In the illustrated embodiment, a pair of first elastic fibers 8859a of the tension member 8857 are secured via knots to adjacent vertices of an adjacent pair of supports 8856 (e.g., arranged vertex-to-vertex between individually identified first supports 8856a and second supports 8856b). Furthermore, a pair of second elastic fibers 8859b of the tension member 8857 are secured via knots to a vertex of one of the supports 8856 in an adjacent pair and to the same base of the other support in the adjacent pair 8856 (e.g., arranged vertex-to-base between a second support 8856b and an individually identified third support 8856b). In other embodiments, the elastic fibers of the tension member 8857 may be secured to the supports 8856 in other ways.

[0190] In various embodiments, one or more tension members may be incorporated into other components of the aortic repair device described herein. For example, Figure 89A and 89B These are perspective side views of the base member 8910 of the aortic repair device according to embodiments of the present technology in a first position (e.g., straight position, extended position) and a second position (e.g., curved position, relaxed position). See also: Figure 89A and 89B The base member 8910 has a body 8912 configured for implantation in the aorta and a leg 8914 extending from the body 8912 and configured for implantation in a branch vessel. The base member 8910 includes a plurality of stents 8926 attached to graft material 8928. The body 8912 also includes a first side portion 8921 and a second side portion 8922, the first side portion 8921 being configured to conform to the inner wall of the aortic arch with a smaller curvature (e.g., a smaller radius of curvature, a shorter length), and the second side portion 8922 being opposite the first side portion 8921 and configured to conform to the inner wall of the aortic arch with a larger curvature (e.g., a larger radius of curvature, a longer length).

[0191] In the illustrated embodiment, the first side portion 8921 of the body 8912 includes a tension member 8927 comprising a plurality of individual elastic (e.g., Lycra) fibers that traverse between adjacent supports in the support 8926 along the body 8912 and passively shorten the first side portion 8921 when the base member 8910 is unrestrained, such that the body 8912 presents an arched shape when configured. Figure 89BFor example, in the illustrated embodiment, tension member 8927 may include two of the elastic fibers—one elastic fiber positioned along body 8912 between each pair of adjacent supports in the three illustrated supports 8926. The elastic fibers of tension member 8957 may be sewn to the exterior of graft material 8928 at the apex (or another portion) of support 8926, such that the elastic member pulls supports 8926 toward each other along first side 8921. In some embodiments, the elastic fibers of tension member 8957 may be in the same manner as described above. Figure 88C The member 8927 is fixed to the bracket 8926 in the same or similar manner as described in the detailed description (e.g., vertex-to-vertex, vertex-to-base, and / or other arrangements). The tension member 8927 can be stretched to a straight first position. Figure 89A ), for loading into a delivery conduit in a cylindrical configuration. In configuration, the body 8912 of the base member 8910 can present a bent second position ( Figure 88B In some embodiments, at the second bent position ( Figure 89B Tension member 8927 pulls some or all of the brackets 8926 toward an adjacent bracket 8926 and at least partially above / below the adjacent bracket 8926, such that the first side 8921 has a stepped “shingle” pattern, as shown in the reference above. Figure 88B Detailed description.

[0192] In some embodiments, the tension member for the aortic repair device may include inelastic fibers, sutures, and / or structures arranged to passively shorten a portion of the aortic repair device. For example, Figure 90A and Figure 90B This is an enlarged view of a pair of stents 9026 (including individually identified first stent 9026a and second stent 9026b) of an aortic repair device 9000 according to an embodiment of the present technology, such as any base member and / or bridging member described herein, in a free state and a compressed state, respectively. In the illustrated embodiment, the stents 9026 are identical and positioned in phase with each other (e.g., their apexes are aligned). Figure 90C and Figure 90DThese are enlarged views, respectively, of a stent 9026 in a free state and a compressed state after one or more tension sutures 9027 have been attached to it, according to embodiments of the present technology. The tension sutures 9027 may comprise typical surgical suture materials and may be inelastic. In the illustrated embodiment, the tension sutures 9027 connect a single vertex of a first stent 9026a to a pair of bases of a second stent 9026b to reduce the distance between the stents 9026 in the free state. Therefore, in the free state, the tension sutures 9027 can selectively shorten the portion of the aortic repair device 9000 near the tension sutures 9027 (e.g., the side portion) to, for example, better conform the aortic repair device 9000 to the curvature within the aorta. In the compressed state, the tension sutures 9027 can be moved (e.g., folded or pivoted around the vertex of the first stent 9026a) so that the aortic repair device 9000 can return to an elongated cylindrical state. In some embodiments, the tension suture 9027 may connect the supports 9026 in different ways. For example, the tension suture 9027 may connect one or more vertices of the first support 9026a to one or more distal vertices 9029 of the second support 9026b to reduce the distance between the supports 9026 in the free state and increase their nesting / overlapping. Figure 90E and 90F These are schematic side views of an aortic repair device 9000 in a free state (e.g., a bent state) and a compressed state (e.g., a straight state) according to embodiments of the present technology.

[0193] In some embodiments, the stent 9026 may have different constructions (e.g., shape, size, pattern) to vary the amount of nesting therebetween or otherwise affect the shortening of the aortic repair device 9000. For example, Figure 91A and Figure 91B The images show enlarged views of the stent 9026 in a free state and a compressed state, respectively, according to an additional embodiment of the present technology, wherein the second stent 9026b has alternating stent apex heights. In particular, the second stent 9026b may have a smaller amplitude at the apex / base where the tension suture 9027 is joined, to further increase the nesting amount between the stents 9026 (and the corresponding shortening and arching of the aortic repair device 9000).

[0194] Figure 28A-33Additional embodiments of an aortic repair device according to the present technology are shown, the device comprising a base member having integrated features for supporting the diaphragm and the auxiliary leg cavity, such as inhibiting compression of the auxiliary leg cavity and maintaining blood flow through the auxiliary leg cavity when the traverse member is disposed within the base member. Such features can replace the need for a separate support stent to be implanted within the base member. Various aortic repair devices may include features that are at least substantially similar to each other in structure and function and / or referenced above. Figure 3A-27D The corresponding features of the aortic repair devices described in detail are at least substantially similar, or identical in structure and function, and can operate in a manner substantially similar to or identical to each other and / or to the aortic repair devices described above.

[0195] For example, Figure 28A and 28B These are perspective views and fluoroscopic end views of the aortic repair device 2800 according to an embodiment of the present technology. (See also:) Figure 28A and 28B The aortic repair device 2800 includes a base member 2810 having (i) a body 2812 defining a main lumen 2823 and (ii) a leg 2814 defining a secondary lumen 2825. In the illustrated embodiment, the body 2812 and the leg 2814 are separate stent grafts fixed together, for example, by sutures. More specifically, the body 2812 includes a body stent 2826a coupled to a main graft material 2828a, and the leg 2814 includes a leg stent 2826b coupled to a leg graft material 2828b. The body and leg stents 2826a-b may be formed of the same material and have similar shapes (e.g., including a circumferential V-shaped pattern), and the body and leg graft materials 2828a-b may be formed of the same material (e.g., fabric). The leg graft material 2828b may serve as a diaphragm and define the secondary lumen 2825. In some embodiments, the leg support 2826b extends circumferentially around the secondary lumen 2825, while in other embodiments (e.g., as referenced below) Figures 32A-32D (In more detail), the leg support 2826b can extend only partially circumferentially around the secondary lumen 2825.

[0196] When the support 830 is not positioned within the secondary lumen 825, it is in contrast to an unsupported diaphragm (e.g., Figures 8A-8HCompared to the diaphragm 818 shown, the leg support 2826b can provide increased radial support for the leg graft material 2828b. Therefore, in some aspects of this technology, when the traverse member is configured within the main lumen 2823, the leg support 2826b can help maintain the cross-sectional flow area of ​​the secondary lumen 2825. Furthermore, the leg support 2826b is integral with the base member 2810, eliminating the need for a separate step or procedure to implant the leg support 2826b therein (e.g., as shown in the reference above). Figures 8A-8H (Compared to the configuration of the bracket 830 in detailed description).

[0197] Figure 29A and 29B This is a fluoroscopic end view of an aortic repair device 2900 according to an embodiment of the present technology. Figure 29B In this embodiment, the aortic repair device 2900 is disposed within the lumen 2902, for example, a portion of the aorta. (See also: [reference needed]) Figure 29A and 29B The aortic repair device 2900 includes a base member 2910 having a body 2912, wherein a diaphragm 2918 extends wholly or partially through the body 2912 and divides the body 2912 into a main lumen 2923 and a secondary lumen 2925 smaller than the main lumen 2923. In the illustrated embodiment, the body 2912 includes a body support 2926 coupled to a graft material 2928. In the illustrated embodiment, the base member 2910 also includes one or more secondary lumen supports 2929 positioned within the secondary lumen 2925. In some embodiments, the secondary lumen supports 2929 extend completely circumferentially around the secondary lumen 2925 and are coupled to the graft material 2928 and / or the diaphragm 2918 via, for example, sutures. The secondary lumen supports 2929 may be self-expanding and may have a V-shaped pattern or other shapes. In some embodiments, the secondary lumen supports 2929 have a circular cross-sectional shape. In other embodiments, the secondary lumen supports 2929 have a non-circular cross-sectional shape, such as an ellipse or other shapes. In some embodiments, such as Figure 29B As shown, when the aortic repair device 2900 is compressed within the lumen 2902, the accessory lumen stent 2929 bends outward toward the main lumen 2223.

[0198] When the support 830 is not positioned within the secondary lumen 825, it is in contrast to an unsupported diaphragm (e.g., Figures 8A-8HCompared to the diaphragm 2918 shown, the secondary lumen support 2929 can provide increased radial support for the diaphragm 2918. Therefore, in some aspects of this technology, when the traversing member is configured within the main lumen 2923, the secondary lumen support 2929 can help maintain the cross-sectional flow area of ​​the secondary lumen 2925. For example, the secondary lumen support 2929 can resist and / or match the radial forces of the traversing member configured within the main lumen 2923 to suppress displacement of the diaphragm 2918 and maintain the cross-sectional flow area of ​​the secondary lumen 2925. The outward bending of the secondary lumen support 2929 can further resist compression from the traversing member. In some embodiments, the secondary lumen support 2929 can be sufficiently rigid to suppress compression of the secondary lumen 2925 while also being sufficiently compliant to adequately conform to the traversing member, thereby suppressing significant grooves or openings between the traversing member and the diaphragm 2918. In an additional aspect of this technology, the secondary lumen stent 2929 is integral with the base member 2910, thereby eliminating the need for a separate step or procedure to implant the secondary lumen stent 2929 therein (e.g., as referenced above). Figures 8A-8H (Compared to the configuration of the bracket 830 in detailed description).

[0199] Figure 30A and 30B This is a fluoroscopic end view of an aortic repair device 3000 according to an embodiment of the present technology. Figure 30B In this embodiment, the aortic repair device 3000 is disposed within the lumen 3002, for example, a portion of the aorta. (See also: [link to reference]) Figure 30A and 30B The aortic repair device 3000 includes a base member 3010 having a body 3012, wherein a diaphragm 3018 extends wholly or partially through the body 3012 and divides the body 3012 into a main lumen 3023 and a secondary lumen 3025 smaller than the main lumen 3023. In the illustrated embodiment, the body 3012 includes a body support 3026 coupled to a graft material 3028. The base member 3010 may also include one or more secondary lumen supports 3029 positioned within the secondary lumen 3025. In some embodiments, the secondary lumen supports 3029 extend circumferentially around the secondary lumen 3025 and are coupled to the graft material 3028 and / or the diaphragm 3018 via, for example, sutures.

[0200] Figure 30C and Figure 30D These are, respectively, a perspective end view and an end view of one of the secondary lumen stents 3029 according to an embodiment of the present technology. (See also:) Figure 30C and Figure 30D The secondary lumen stent 3029 may have a D-shaped cross-sectional shape including a generally flat portion 3021 and a generally curved portion 3027. The secondary lumen stent 3029 may also include a V-shaped pattern extending circumferentially around the flat portion 3021 and the curved portion 3027, such as... Figure 30C As shown. Refer to the above together. Figures 30A-30D The flat portion 3021 of the secondary lumen stent 3029 can be positioned adjacent to and / or connected to the diaphragm 3018, and the curved portion 3027 of the secondary lumen stent 3029 can be positioned adjacent to and / or connected to the graft material 3028 of the main body 3012. Therefore, respectively in Figure 30A and 30B As shown in the unconstrained and constrained positions, the diaphragm 3018 can extend approximately linearly between the main lumen 3023 and the secondary lumen 3025.

[0201] Similar to the reference above Figure 28A The embodiment described in detail in -29C, when the support 830 is not configured within the secondary lumen 825, is similar to an unsupported diaphragm (e.g. Figures 8A-8H Compared to the diaphragm 818 shown, the secondary lumen support 3029 can provide increased radial support for the diaphragm 3018. Therefore, in some aspects of this technology, when the traversing member is configured within the main lumen 3023, the secondary lumen support 3029 can help maintain the cross-sectional flow area of ​​the secondary lumen 3025. For example, Figure 30E and Figure 30F This is a fluoroscopic end view of the aortic repair device 3000, wherein the traversing member 3050 is disposed within the main lumen 3023. Figure 30F In this design, the aortic repair device 3000 is disposed within the lumen 3002. (See also: [link to reference]) Figure 30E and 30F The secondary lumen support 3029 resists and / or matches the radial forces of the traversing member 3050 to suppress displacement of the diaphragm 3018 and maintain the cross-sectional flow area of ​​the secondary lumen 3025. In some embodiments, the secondary lumen support 3029 may be sufficiently rigid to suppress compression of the secondary lumen 3025, while also being sufficiently compliant to adequately conform to the traversing member 3050, thereby suppressing significant grooves or openings between the traversing member 3050 and the diaphragm 3018. Furthermore, the flat portion 3021 of the secondary lumen support 3029 may hold the diaphragm 3018 in a generally flat or linear configuration, allowing the traversing member 3050 to conform to it with minimal grooves or openings between the diaphragm 3018 and the traversing member 3050. (See also: [link to related documentation]) Figures 30A-30F In another aspect of this technology, the secondary lumen stent 3029 is integrated with the base member 3010, so that no separate step or procedure is required to implant the secondary lumen stent 3029 therein (e.g., as described above). Figures 8A-8H (Compared to the configuration of the bracket 830 in detailed description).

[0202] Figure 31A and Figure 31BThis is a fluoroscopic end view of an aortic repair device 3100 according to an embodiment of the present technology. Figure 31B In this embodiment, the aortic repair device 3100 is disposed within the first lumen 3102, for example, a portion of the aorta. (See also: [reference needed]) Figure 31A and 31B The aortic repair device 3100 includes a base member 3110 having a body 3112, wherein a diaphragm 3118 extends wholly or partially through the body 3112 and divides the body 3112 into a main lumen 3123 and a secondary lumen 3125 smaller than the main lumen 3123. In the illustrated embodiment, the body 3112 includes a body support 3126 coupled to a graft material 3128. In the illustrated embodiment, the base member 3110 also includes one or more secondary lumen supports 3129 positioned within the secondary lumen 3125. In some embodiments, the secondary lumen supports 3129 extend circumferentially around the secondary lumen 3125 and are coupled to the graft material 3128 and / or the diaphragm 3118 via, for example, sutures.

[0203] Figure 31C and 31D These are, respectively, a perspective end view and an end view of one of the secondary lumen stents 3129 according to an embodiment of the present technology. (See also:) Figure 31C and 31D The secondary lumen stent 3129 may have an arcuate D-shaped cross-sectional shape, including a curved first portion 3121 and a curved second portion 3127. The radius of curvature of the curved first portion 3121 may be greater than the radius of curvature of the curved second portion 3127. That is, the curved first portion 3121 may be relatively flatter than the curved second portion 3127. The curved first portion 3121 may also be referred to as a spacer, an arcuate portion, etc. The secondary lumen stent 3129 may also include a V-shaped pattern extending circumferentially around the curved first portion 3121 and the curved second portion 3129, such as... Figure 31C As shown. Refer to the above together. Figures 31A-31D The first bent portion 3121 of the secondary lumen stent 3129 can be positioned adjacent to and / or connected to the diaphragm 3118, and the second bent portion 3127 of the secondary lumen stent 3129 can be positioned adjacent to and / or connected to the graft material 3128 of the body 3112. Therefore, respectively in Figure 31A and Figure 31B In the unconstrained and constrained positions shown, the diaphragm 3118 can bend outward (e.g., bend outward) along the curved first portion 3121 between the main lumen 3123 and the secondary lumen 3125.

[0204] Similar to the reference above Figure 28A-30FThe detailed embodiment describes that when the support 830 is not positioned within the secondary lumen 825, it is in contrast to an unsupported diaphragm (e.g., Figures 8A-8H Compared to the diaphragm 818 shown, the secondary lumen support 3129 can provide increased radial support for the diaphragm 3118. Therefore, in some aspects of this technology, the secondary lumen support 3129 can help maintain the cross-sectional flow area of ​​the secondary lumen 3125 when the traverse member is deployed within the main lumen 3123. For example, Figure 31E-31G This is a fluoroscopic end view of an aortic repair device 3100 according to an embodiment of the present technology, wherein the traversing member 3150 is disposed within the main lumen 3123. Figure 31E In the middle, the aortic repair device 3100 is unrestrained, in Figure 31F In this process, the aortic repair device 3100 is disposed within a first lumen 3102 having a first diameter (e.g., 31 mm), and... Figure 31G In this embodiment, the aortic repair device 3100 is disposed within a second lumen 3104 having a second diameter (e.g., 29 mm) smaller than the first diameter. (See also: [reference needed]) Figure 31E-31G The secondary lumen support 3129 resists and / or matches the radial forces of the traversing member 3150 to suppress displacement of the diaphragm 3118 and maintain the cross-sectional flow area of ​​the secondary lumen 3125. In some embodiments, the secondary lumen support 3129 may be sufficiently rigid to suppress compression of the secondary lumen 3125, while also being sufficiently compliant to adequately conform to the traversing member 3150, thereby suppressing significant grooves or openings between the traversing member 3150 and the diaphragm 3118. (See also: [link to related documentation]) Figure 31A-31G In another aspect of this technology, the secondary lumen stent 3129 is integral with the base member 3110, so that no separate step or procedure is required to implant the secondary lumen stent 3129 therein (e.g., as referenced above). Figures 8A-8H (Compared to the configuration of the bracket 831 described in detail).

[0205] like Figure 31G As shown, when the lumen 3104 is smaller and further restricts the overall radial expansion of the aortic repair device 3100, the bent first portion 3121 of the secondary lumen stent 3129 can be further bent outward and / or flexed (e.g., bent more, becoming more convex) to maintain the cross-sectional flow area of ​​the secondary lumen 3125. In some embodiments, the structure defining the first lumen 3123 can be relatively more compressible (e.g., less compressible) than the structure defining the second lumen 3125, such that when the aortic repair device 3100 is radially compressed, the ratio of the cross-sectional flow area of ​​the first lumen 3123 to the cross-sectional flow area of ​​the secondary lumen 3125 decreases, regardless of whether the traversing member 3150 is disposed within the main lumen 3123. For example, Figure 31H-31LThis is a perspective end view of an aortic repair device 3100 according to an embodiment of the present technology, showing the increased radial compression of the aortic repair device 3100. Specifically, see also... Figure 31H-31L The aortic repair device 3100 is configured in a space with aortic repair device 3100. Figures 31H to 31L Within a gradually decreasing diameter lumen 3106 (e.g., a portion of the aorta). In the illustrated embodiment, Figure 31L The diameter of the lumen 3106 in the middle (e.g., 20 mm) is greater than Figure 31H The diameter of the lumen 3106 in the middle (e.g., 24 mm) is 20% smaller, and... Figures 31I to 31K The diameter gradually decreases during this period (e.g., from 23 mm to 22 mm to 21 mm, respectively). In some embodiments, the aortic repair device 3100 may have a diameter that is similar to that of the aortic repair device. Figure 31H The diameter of the lumen 3106 shown is matched to a diameter (e.g., 24 mm) so that the aortic repair device 3100 is not excessively large relative to the lumen 3106. The structure defining the secondary lumen 3125 is relatively less compressible than the primary lumen 3123, such that as the radial expansion of the aortic repair device 3100 is further constrained by the lumen 3106 (e.g., the inner diameter of the aorta), the ratio of the cross-sectional flow area of ​​the secondary lumen 3125 to the cross-sectional flow area of ​​the primary lumen 3123 is reduced from... Figure 31H Increase to Figure 31L Therefore, in some aspects of this technology, the accessory lumen 3125 is well preserved by means of the aortic repair device 3100 being too large relative to the lumen 3106.

[0206] Figure 32A This is a perspective end view of an aortic repair device 3200 configured within a lumen 3202 according to an embodiment of the present technology. In the illustrated embodiment, the aortic repair device 3200 includes a base member 3210 having a body 3212, wherein a diaphragm 3218 extends wholly or partially through the body 3212 and divides the body 3212 into a main lumen 3223 and a secondary lumen 3225 smaller in size than the main lumen 3223. In the illustrated embodiment, the body 3212 includes a body support 3226 coupled to a graft material 3228. In the illustrated embodiment, the base member 3210 also includes one or more secondary lumen supports 3229 positioned within the secondary lumen 3225. In some embodiments, the secondary lumen supports 3229 extend only partially circumferentially around the secondary lumen 3225 and are coupled to the graft material 3228 and / or the diaphragm 3218 via, for example, sutures. More specifically, Figure 32B This is an end view of one of the secondary lumen stents 3229 according to an embodiment of the present technology. In the illustrated embodiment, the secondary lumen stent 3229 may only partially surround the longitudinal axis L of the secondary lumen 3225. Figure 32AIt extends and may have a curved shape, such as a semi-circular or arcuate shape. The secondary lumen stent 3229 may also include a V-shaped pattern extending circumferentially thereafter. See also... Figure 32A and 32B The secondary lumen support 3229 can be positioned adjacent to and / or connected to the diaphragm 3218. Therefore, in Figure 32A As shown in the unconstrained position (not shown) and constrained position, the diaphragm 3218 can bend outward (e.g., bend outward) along the secondary lumen support 3229 between the main lumen 3223 and the secondary lumen 3225. In some aspects of this art, the secondary lumen support 3229 can reduce the overall delivery profile of the base member 3210 by omitting the secondary lumen support 3229 adjacent to the main support 3226 (e.g., where the main support 3226 provides an outward sealing force to the body 3212).

[0207] Similar to the reference above Figure 28A-31G The detailed embodiment describes that when the support 830 is not positioned within the secondary lumen 825, it is in contrast to an unsupported diaphragm (e.g., Figures 8A-8H Compared to the diaphragm 818 shown, the secondary lumen support 3229 can provide increased radial support for the diaphragm 3218. Therefore, in some aspects of this technology, when the traversing member is configured within the main lumen 3223, the secondary lumen support 3229 can help maintain the cross-sectional flow area of ​​the secondary lumen 3225. For example, Figure 32C and 32D This is a fluoroscopic end view of the aortic repair device 3200, wherein the traversing member 3250 is disposed within the main lumen 3223. Figure 32C In the middle, the aortic repair device 3200 is unrestrained, and... Figure 32D In this configuration, the aortic repair device 3200 is disposed within the lumen 3202. (See also...) Figure 32C and 32D The secondary lumen support 3229 resists and / or matches the radial forces of the traversing member 3250 to suppress displacement of the diaphragm 3218 and maintain the cross-sectional flow area of ​​the secondary lumen 3225. In some embodiments, the secondary lumen support 3229 may be sufficiently rigid to suppress compression of the secondary lumen 3225, while also being sufficiently compliant to adequately conform to the traversing member 3250, thereby suppressing significant grooves or openings between the traversing member 3250 and the diaphragm 3218. (See also...) Figures 32A-32D In an additional aspect of this technology, the secondary lumen stent 3229 is integral with the base member 3210, thereby eliminating the need for a separate step or procedure to implant the secondary lumen stent 3229 therein (e.g., as described above with reference to...). Figures 8A-8H (Compared to the configuration of the bracket 832 described in detail).

[0208] Figure 33This is a cross-sectional view of an aortic repair device 3300 according to an embodiment of the present technology. In the illustrated embodiment, the aortic repair device 3300 includes a base member 3310, which includes one or more main stents 3326 defining a main lumen 3323 and one or more secondary lumen stents 3329 defining secondary lumens 3325. In the illustrated embodiment, the secondary lumen stent has an arcuate D-shaped cross-sectional shape, including a bent first portion 3321 and a bent second portion 3327. The bent first portion 3321 of the secondary lumen stent 3329 may be positioned adjacent to and / or coupled to a diaphragm of the base member 3310, and the bent second portion 3327 of the secondary lumen stent 3329 may be positioned adjacent to and / or coupled to graft material of the main body of the base member 3310. In some aspects of this technology, the secondary lumen support 3329 resists and / or matches the radial forces of the transverse members that unfold within the main lumen 3323 to suppress diaphragm displacement and maintain the cross-sectional flow area of ​​the secondary lumen 3325.

[0209] In the illustrated embodiment, the main stent 3326 can extend only partially around the longitudinal axis L of the main lumen 3323 and can have a curved shape, such as a circular shape. The curved second portion 3327 of the main stent 3326 and the secondary lumen stent 3329 can together define a constant or nearly constant circumferential stent structure around the base member 3310 to provide an outward sealing force, for example, when the base member 3310 is implanted into the aorta. Furthermore, in some aspects of this technology, the arrangement of the main stent 3326 and the secondary lumen stent 3329 can reduce the overall delivery profile of the base member 3310 by omitting a portion of the main stent 3326 adjacent to the curved second portion 3327 of the secondary lumen stent 3329 (e.g., so that the individual stents do not overlap).

[0210] Refer to together Figure 28A-33 One of the sub-lumen supports can be made more robust (e.g., to have increased radial force, increased compressive strength, etc.) by increasing the wire diameter of the sub-lumen support and / or by heat-treating the wire (e.g., shaping) for a longer duration and / or at a higher temperature. Increasing the strength of the sub-lumen support can help improve its ability to maintain the cross-sectional flow area of ​​the sub-lumen during said radial compression and / or when the traverse member is configured within the main lumen.

[0211] Figure 34A-40C Additional embodiments of an aortic repair device according to the present technology are shown, the aortic repair device including a base member with a stent configured to inhibit or allow longitudinal compression of the base member. Various aortic repair devices may include features that are at least substantially similar to each other in structure and function and / or related to those referenced above. Figure 3A-33The corresponding features of the aortic repair devices described in detail are at least substantially similar, or identical in structure and function, and can operate in a manner substantially similar to or identical to each other and / or to the aortic repair devices described above.

[0212] For example, Figure 34A and 34B These are perspective side views of the aortic repair device 3400 in the longitudinally extended position and the longitudinally compressed position, respectively, according to embodiments of the present technology. Similarly, Figure 35A and 35B These are perspective side views of an aortic repair device 3500 in a longitudinally elongated position and a longitudinally compressed position, respectively, according to embodiments of the present technology. The aortic repair device 3400 and the aortic repair device 3500 may include several substantially similar or identical features. For example, see also... Figures 34A-35B Both the aortic repair device 3400 and the aortic repair device 3500 include a base member 3410 having a body 3412, a leg 3414 extending from the body 3412, and a diaphragm extending completely or partially through the body 3412 and dividing the body 3412 into a main lumen and a secondary lumen. Figures 34A-35B (Obscured in the middle). The base member 3410 includes one or more supports 3426 connected to the graft material 3428. More specifically, the supports 3426 along the body 3412 may include a first support 3426a (e.g., a proximal support) and a second support 3426b (e.g., a distal support), each having a periodic V-shaped pattern shape including alternating proximal vertices 3421 and distal vertices 3423. In some embodiments, the first support 3426a and the second support 3426b are identical—e.g., each having the same dimensions and the same number of proximal vertices 3421 and distal vertices 3423.

[0213] Refer to together Figure 34A and 34B The proximal vertex 3421 of the first support 3426a is circumferentially aligned or substantially aligned with the proximal vertex 3421 of the second support 3426b. Similarly, the distal vertex 3423 of the first support 3426a is circumferentially aligned or substantially aligned with the distal vertex 3423 of the second support 3426b. That is to say, the first support 3426a and the second support 3426b can be arranged in phase or substantially in phase. Figure 34BAs shown, this arrangement of stents 3426a-b allows the body 3412 to compress longitudinally when, for example, the aortic repair device 3400 is implanted into the aorta and subjected to forces from blood flow through the aorta. For example, the distal apex 3423 of the first stent 3426a can move toward the distal apex 3423 of the second stent 3426b while folding or otherwise compressing the graft material 3428 therebetween. In some embodiments, longitudinal compression (e.g., Figure 34A The length L1 of the main body 3412 in the longitudinally elongated position shown is... Figure 34B The difference between the lengths L2 of the main body 3412 in the longitudinally compressed position shown can be approximately 40%, less than approximately 40%, approximately 20%, less than approximately 20%, etc.

[0214] Refer to together Figure 35A and 35B The proximal vertex 3421 of the first support 3426a and the distal vertex 3423 of the second support 3426b are circumferentially aligned or substantially aligned. Similarly, the distal vertex 3423 of the first support 3426a and the proximal vertex 3421 of the second support 3426b are circumferentially aligned or substantially aligned. That is, the first support 3426a and the second support 3426b can be arranged out of phase (e.g., 180 degrees out of phase) or substantially out of phase. Figure 35A As shown, in the longitudinally extended position, the distal vertex 3423 of the first support 3426a can be spaced apart by a gap G from the corresponding proximal vertex 3421 of the proximal vertex 3426b. The gap G provides high flexibility to the body 3412 because the body 3412 can bend along the gap G, where supports 3426a-b are omitted. Figure 35B As shown, this arrangement of stents 3426a-b allows the body 3412 to compress longitudinally when, for example, the aortic repair device 3400 is implanted into the aorta and subjected to forces from blood flow through the aorta. For example, the distal apex 3423 of the first stent 3426a can move toward and below and / or above the proximal apex 3421 of the second stent 3426b (e.g., reducing or eliminating gap G), while folding or otherwise compressing the graft material 3428 therebetween. In some embodiments, longitudinal compression (e.g., Figure 35A The length L1 of the main body 3412 in the longitudinally elongated position shown is... Figure 35B The difference between the length L2 of the body 3412 in the longitudinally compressed position shown can be approximately 20%.

[0215] Figure 36A and 36B This is a perspective side view of the aortic repair device 3600 in a longitudinally elongated position, viewed from different circumferential angles according to an embodiment of the present technology. Figure 36C This is a perspective side view of an aortic repair device 3600 in a longitudinally compressed position according to an embodiment of the present technology. (Reference) Figures 36A-36C The aortic repair device 3600 may include a base member 3610, the base member 3610 having a body 3612 and legs extending from the body 3612 (in Figures 36A-36C (obscured in the middle), and a diaphragm that extends completely or partially through the main body 3612 and divides the main body 3612 into a main lumen and a secondary lumen (in Figures 36A-36C (Obscured in the middle). The base member 3610 includes one or more supports 3626 connected to the graft material 3628. More specifically, the supports 3626 along the body 3612 may include a first support 3626a (e.g., a proximal support) and a second support 3626b (e.g., a distal support), each support having a periodic V-shaped pattern shape including alternating proximal vertices 3621 and distal vertices 3623. In the illustrated embodiment, the first support 3626a and the second support 3626b each have a different number of proximal vertices 3621 and distal vertices 3623 (e.g., different frequencies).

[0216] More specifically, Figure 36D This is a plan view of a first support 3626a and a second support 3626b according to an embodiment of the present technology. In the illustrated embodiment, the first support 3626a includes eight V-shaped portions, such that the first support 3626a has eight of the proximal vertices 3621 and eight of the distal vertices 3623, and the second support 3626b includes six V-shaped portions, such that the second support 3626b has six of the proximal vertices 3621 and six of the distal vertices 3623. In other embodiments, supports 3626a-b may have different numbers of proximal vertices 3621 and / or distal vertices 3623. In the illustrated embodiment, the first support 3626a and the second support 3626b each have a regular pattern, such that their V-shaped portions are equidistant from each other. Therefore, a first subgroup of the distal vertices 3623 of the first support 3626a can be circumferentially aligned with the proximal vertices 3621 of the second support 3626b, while a second subgroup of the distal vertices 3623 of the first support 3626a can be circumferentially offset from the proximal vertices 3621 of the second support 3626b. In the illustrated embodiment, the first subgroup includes two of the distal vertices 3623 of the first support 3626a, and the second subgroup includes six of the distal vertices 3623 of the first support 3626a. Figure 36D A surround view is shown such that the distal vertices 3623 of the first support 3626a at the right and left ends of the first support 3636a represent the same distal vertex among the distal vertices 3623 of the first support 3626a. For example, positioning approximately 180 degrees apart (e.g., in...). Figures 36A-36CIn the illustrated body 3612, the distal vertex 3623 of the first support 3626a (on opposite sides) is circumferentially aligned with the corresponding proximal vertex 3621 of the proximal vertex 3621 of the second support 3626b. In other embodiments, the number of distal vertices 3623 of the first support 3626a in the first and second subgroups can vary based on, for example, the total number of vertices of supports 3626a-b. Furthermore, in the illustrated embodiment, the aligned vertices of the distal vertices 3623 of the first support 3626a and the proximal vertices 3621 of the second support 3626b can be adjacent to each other, such that they are not separated by gaps.

[0217] Refer to together Figures 36A-36D When, for example, the aortic repair device 3600 is implanted into the aorta and subjected to forces from blood flow through the aorta, the circumferentially aligned apexes of the distal apex 3623 of the first stent 3626a and the proximal apex 3621 of the second stent 3626b can suppress longitudinal compression (e.g., provide increased column force). For example, longitudinal compression (e.g., Figure 36A The length L1 of the main body 3612 in the longitudinally elongated position shown is... Figure 36C The difference between the lengths L2 of the body 3612 in the longitudinally compressed position shown can be about 10% or less. In some aspects of this technology, this inhibition of longitudinal compression helps maintain a seal between the body 3612 and the aorta when the aortic repair device 3600 is implanted therein. Furthermore, the circumferentially offset apexes of the distal apex 3623 of the first stent 3626a and the proximal apex 3621 of the second stent 3626b provide relatively high flexibility to the body 3612.

[0218] For any aortic repair device disclosed herein, the phase, amplitude, frequency, and / or spacing of different stents (also referred to as stent components, such as stent rings) of the aortic repair device can be selected to at least partially provide the desired axial stiffness and / or flexibility profile. Additionally or alternatively, the phase, amplitude, and / or frequency of each stent may differ along its circumference to at least partially provide the desired axial stiffness and / or flexibility profile. For example, Figure 37A This is a perspective side view of an aortic repair device 3700 according to an embodiment of the present technology. In the illustrated embodiment, the aortic repair device 3700 may include a base member 3710 having a body 3712 and legs 3714 extending from the body 3712. Figure 37A (partially obscured), and a diaphragm that extends completely or partially through the main body 3712 and divides the main body 3712 into a main lumen and a secondary lumen (in Figure 37A(Obscured in the middle). The base member 3710 includes one or more supports 3726 connected to the graft material 3728. More specifically, the supports 3726 along the body 3712 can include a first support 3726a (e.g., a proximal support), a second support 3726b (e.g., an intermediate support), and a third support 3726c (e.g., a distal support), each support having a periodic V-shaped pattern shape including alternating proximal vertices 3721 and distal vertices 3723. In the illustrated embodiment, the first support 3726a and the second support 3726b each have a different number of proximal vertices 3721 and distal vertices 3723 (e.g., different frequencies), and are arranged such that a subset (e.g., two) of the distal vertices 3723 of the first support 3726a is circumferentially aligned with the corresponding proximal vertices of the proximal vertices 3721 of the second support 3726b (e.g., as referred to above). Figures 36A-36D (Detailed description). The second bracket 3726b and the third bracket 3726c are substantially the same and arranged in phase (e.g., as described above). Figure 34A and 34B (Detailed description)

[0219] More specifically, Figure 37B This is a plan view of a first support 3726a and a second support 3726b according to an embodiment of the present technology. In the illustrated embodiment, the first support 3726a has a varying amplitude such that (i) the V-shaped portion of the first support 3726a has a greater amplitude at some of the distal vertices 3723 that are circumferentially aligned with the proximal vertex 3721 of the second support 3726b, and (ii) there is a gap G between some of the circumferentially offset distal vertices 3723 of the first support 3726a and the proximal vertex 3721 of the second support 3726b. (See also...) Figure 37A and 37B In some aspects of this technology, this arrangement of the first and second supports 3726a-b (i) positions more flexible graft material 3728 between the supports 3726a-b (e.g., not supported by the supports 3726a-b), wherein the distal vertex 3723 of the first support 3726a is circumferentially offset from the proximal vertex 3721 of the second support 3726b to increase flexibility therebetween, and (ii) abuts the distal vertex 3723 of the first support 3726a with a circumferentially aligned proximal vertex of the proximal vertex 3721 of the second support 3726b to provide axial stiffness, wherein the distal vertex 3723 of the first support 3726a is aligned with the proximal vertex 3721 of the second support 3726b.

[0220] Figure 38This is a plan view of a first stent 3826a (e.g., a proximal stent) and a second stent 3826b (e.g., a distal stent) of an aortic repair device 3800 according to an additional embodiment of the present technology. The first stent 3826a and the second stent 3826b each have a periodic V-shaped pattern shape including alternating proximal vertices 3821 and distal vertices 3823. In the illustrated embodiment, the first stent 3826a has an irregular frequency (e.g., the interval between the proximal vertices 3821 and / or the distal vertices 3823), and the second stent 3826b has a regular frequency, such that one of the distal vertices 3823 of the first stent 3826a (identified as aligned distal vertices 3823i) is circumferentially aligned with a corresponding one of the proximal vertices 3821 of the second stent 3826b (identified as aligned proximal vertices 3821i). In other words, an offset in the spacing between the proximal vertices 3821 and / or the distal vertices 3823 of the first stent 3826a (e.g., an offset in the width of its V-shaped portion) allows the aligned distal vertices 3823i to be closely aligned with the aligned proximal vertices 3821i. In some aspects of this technology, the arrangement of the aligned distal vertices 3823i and the aligned proximal vertices 3821i can increase the axial (e.g., columnar) stiffness of the aortic repair device 3800. In other embodiments, the frequencies of the first stent 3826a and / or the second stent 3826b can be varied in other ways to align one or more distal vertices of the distal vertices 3823 of the first stent 3826a with one or more proximal vertices of the proximal vertices 3821 of the second stent 3826b, thereby providing a desired amount of axial stiffness.

[0221] Figure 34A-38 Various aortic repair devices are illustrated, having a stent configuration extending around the entire periphery / circumference of the base member, which inhibits or allows longitudinal compression of the base member. In some embodiments, the axial stiffness and / or flexible profile of the aortic repair device may also be selected based on the configuration of one or more accessory lumen stents (e.g., as referenced above). Figure 28A-33 (detailed description). For example, Figure 39A and 39B These are, respectively, a side view and a perspective side view of the aortic repair device 3900 in its first position. Figure 39C It is in the second position according to the embodiments of this technology. Figure 39B A lateral perspective view of the aortic repair device 3900, wherein the aortic repair device 3900 is longitudinally compressed. Similarly, Figure 40A and 40B These are, respectively, a side view and a perspective side view of the aortic repair device 4000 in its first position. Figure 40CThis is a perspective side view of an aortic repair device 4000 in a second position according to an embodiment of the present technology, wherein the aortic repair device 3900 is longitudinally compressed.

[0222] Aortic repair devices 3900 and 4000 may include several features that are substantially similar or identical. For example, see reference together. Figure 39A-40C Both the aortic repair device 3900 and the aortic repair device 4000 include a base member 3910, which has a main body 3912 and legs 3914 extending from the main body 3912. Figure 39A-40C (partially obscured), and a diaphragm that extends completely or partially through the main body 3912 and divides the main body 3912 into a main lumen and a secondary lumen (in Figure 39A-40C (Obscured in the middle). The base member 3910 includes one or more main stents 3926 (which may also be referred to as "aortic stents") connected to the graft material 3928. In the illustrated embodiment, the main stents 3926 (i) are generally identical (e.g., each has a periodic V-shaped pattern shape including alternating proximal and distal vertices, and has the same amplitude and frequency), (ii) are arranged in phase with each other, and (iii) are separated from adjacent main stents 3926 by a gap G1 ( Figure 39A and 40A The base component 3910 also includes one or more secondary lumen supports 3929 (in...). Figure 39B , Figure 39C , Figure 40B and Figure 40C (Partially obscured), the one or more sub-lumen supports 3929 are positioned within a sub-lumen defined within the body 3912. In the illustrated embodiment, the sub-lumen supports 3929 (i) are substantially identical (e.g., each has a periodic V-shaped pattern shape including alternating proximal and distal vertices, and has the same amplitude and frequency), (ii) are arranged in phase with each other, and (iii) are spaced apart from adjacent sub-lumen supports 3929 by a gap G2 ( Figure 39A and 40A In some embodiments, the main support 3926 has approximately the same amplitude as the secondary lumen support 3929, but has a lower frequency.

[0223] Refer to together Figures 39A-39CIn the illustrated embodiment, the secondary lumen support 3929 substantially overlaps (e.g., axially aligned) with the corresponding primary support 3926. Therefore, the gaps G1 and G2 between the primary support 3926 and the secondary lumen support 3929 partially or completely overlap, such that the graft material 3928 in the overlap is not supported by either the primary support 3926 or the secondary lumen support 3929, and can be easily folded and compressed to reduce or eliminate the gaps G1 and G2 between adjacent primary supports 3926 and secondary lumen supports 3929. Figure 39C As shown, this arrangement of the main stent 3926 and the secondary lumen stent 3929 allows the main body 3912 to undergo longitudinal compression when, for example, the aortic repair device 3900 is implanted in the aorta and subjected to forces from blood flow through the aorta. In some embodiments, longitudinal compression (e.g., the main body 3912 in...) Figure 39B The length L1 in the first position shown is related to the body 3912. Figure 39C The difference between the lengths L2 in the second position of the longitudinal compression shown can be approximately 40%, less than approximately 40%, approximately 20%, less than approximately 20%, etc.

[0224] Refer to together Figure 40A-40C In the illustrated embodiment, the secondary lumen support 3929 is displaced relative to the main support 3926 such that the secondary lumen support 3929 extends along a corresponding gap in the gap G1 between the main supports 3926 (e.g., substantially overlapping, axially aligned). Similarly, the main support 3926 extends along a corresponding gap in the gap G2 between the secondary lumen supports 3929. Therefore, the graft material 3928 along the body 3912 has little or no axial position in which it is not supported by either the main support 3926 or the secondary lumen support 3929. Figure 40C As shown, when, for example, the aortic repair device 3900 is implanted in the aorta and subjected to forces from blood flow through the aorta, this arrangement of the main stent 3926 and the accessory stent 3929 can substantially suppress longitudinal compression of the main body 3912. In some embodiments, longitudinal compression (e.g., the main body 3912 in...) Figure 39B The length L1 in the first position shown is related to the body 3912. Figure 39C The difference between the lengths L2 in the second position of the longitudinal compression shown can be about 20%, less than about 20%, about 10%, less than about 10%, etc.

[0225] Let's refer to it again. Figure 39A-40CThe secondary lumen stent 3929 can be combined with the main stent 3926 to provide selected axial stiffness around the circumference of the implantable device 3900 / 4000. Because the secondary lumen stent 3929 is positioned within the secondary lumen of the main body 3912, the stiffness provided by the secondary lumen stent 3929 only affects the portion of the main body 3912 adjacent to the secondary lumen of the main body 3912 (e.g., the side). Therefore, in some embodiments, the portion of the main body 3912 adjacent to the secondary lumen of the main body 3912 and the secondary lumen stent 3929 therein can have greater axial stiffness than the portion of the main body 3912 adjacent to the primary lumen. In some aspects of the art, the relatively less rigid portion of the main body 3912 adjacent to the primary lumen is configured to be positioned along the inner wall of the aortic arch with a smaller curvature.

[0226] More specifically, for example, Figure 40D This is a side view of an aortic repair device 3900 or 4000 implanted in the aorta according to an embodiment of the present technology. In the illustrated embodiment, the aortic repair device 3900 / 4000 is implanted in the ascending aorta such that a leg portion 3914 extends into a branch artery, such as the brachiocephalic artery. Therefore, a first side portion 4001 of the leg portion 3914 and the body 3912 (e.g., the side adjacent to a secondary lumen extending through the body 3912) can be positioned against and / or adjacent to a first wall portion W1 of the aorta, and a second side portion 4002 (e.g., the side adjacent to a primary lumen extending through the body 3912) can be positioned against and / or adjacent to a second wall portion W2 of the aorta, which has a smaller curvature (e.g., a smaller radius of curvature) and a shorter length than the first wall portion W1. In some embodiments, as described in detail above, the aortic repair device 3900 / 4000 may have greater axial stiffness (e.g., minimum compression) at the first side 4001 of the body 3912 adjacent to the first wall portion W1 than at the second side 4002 of the body 3912 adjacent to the second wall portion W2. For example, a secondary lumen stent 3929 (39A-40C) may cooperate with the main stent 3926 to resist longitudinal compression at the first side 4001, but is not present at the second side 4002, making the second side 4002 relatively more flexible. Thus, in some aspects of the art, the first side 4001 is in a tensioned state after configuration, while the relatively more flexible second side 4002 can be axially compressed and / or nested along the second wall portion W2.

[0227] In other embodiments, the main support 3926 and / or the secondary lumen support 3929 may have other configurations (e.g., different frequencies, amplitudes, shapes) and / or may be arranged differently relative to each other (e.g., with no gap or almost no gap between them, out of phase with each other). See also Figure 37AFor example, one or more secondary lumen supports 3729 (partially shielded) are capable of (i) extending fully or partially between a first main support 3726a and a second main support 3726b having a variable frequency to provide increased axial stiffness therebetween, and / or (ii) extending fully or partially between the second main support 3726b and the third main support 3726c to provide increased axial stiffness therebetween.

[0228] In any of the embodiments described herein, the graft material of the aortic repair device may be sutured or otherwise attached to the stent of the aortic repair device. In other embodiments, the stent may be inserted through corresponding channels or recesses in the graft material to secure the stent to the graft material. For example, Figure 41A and Figure 41B This is a side view of the spanning member 4150 according to an embodiment of the present technology. Figure 41C According to embodiments of the present technology Figure 41B An enlarged view of a portion spanning member 4150 shown. (See also: [link to reference]) Figures 41A-41C The bridging member 4150 includes graft material 4158, which has a recess or channel 4159 configured (e.g., shaped and sized to) receive corresponding supports from a plurality of supports 4156 through a small access opening or port 4157. The supports 4156 are then... Figure 41A Remove from channel 4159 and insert Figure 41B and 41C The graft material 4158 is formed in the channel 4159. The graft material 4158 can be formed by weaving or another suitable method capable of creating the channel 4159 in its walls. A stent 4156 can then be inserted into the channel 4159 to have a desired shape. For example, the channel 4159 can have a zigzag pattern, a Z-shaped pattern, a V-shaped pattern, a straight line pattern, a sinusoidal spiral pattern, etc., such that the stent 4156 conforms to the shape of the channel 4159. The stent 4156 can be a wire inserted through the opening 4157 (e.g., by pulling and / or pushing via a tether) and passing through the channel 4159, and can have a non-traumatic (e.g., ball-shaped) end and / or can be coiled after insertion into the channel 4159. Any component of the aortic repair device described herein (e.g., bridging member, base member, etc.) can be formed in this manner.

[0229] In some embodiments, graft material may be omitted or removed from the distal and / or proximal portions of any component of the aortic repair device described herein (e.g., spanning member, base member, etc.). For example, Figure 41D-41FThese are enlarged views of the proximal or distal portions of components (e.g., any of the base member and / or traverse member described herein) of various aortic repair devices 4100a-4100c according to embodiments of the present technology. See also... Figure 41D-41F Each of the aortic repair devices 4100a-c includes a stent 4126 having a apex 4121 and graft material 4128 secured to the stent 4126 via sutures 4127. The apex 4121 may be located at the distal and / or proximal portions of the component.

[0230] Reference Figure 41D The graft material 4128 may extend only partially along the scaffold 4126, such that the apex 4121 is exposed from the graft material 4128. In the illustrated embodiment, the edge 4129a of the graft material 4128 is linear. This configuration defines an aperture between the respective apex 4121 and the edge 4129a of the graft material 4128, and leaves a portion of the space between adjacent apex 4121 open, both of which allow blood to flow through.

[0231] Reference Figure 41E The graft material 4128 may extend only partially along the support 4126 and follow the curvature of the support 4126 between vertices 4121, exposing the vertices 4121 and the space between them from the graft material 4128. Therefore, in the illustrated embodiment, the graft material 4128 may define an edge 4129b that generally follows (e.g., conforms to) the struts of the support 4126 between vertices 4121 to form an entrance 4122b (also referred to as an opening, recess, or serration) at the edge 4129b of the graft material 4128. The entrance 4122b can be formed along the edge 4129b by removing all or part of the graft material 4128 between vertices 4121 before and / or after attachment to the support 4126 (e.g., via trimming).

[0232] Reference Figure 41F The graft material 4128 may extend fully to the apex 4121 of the scaffold 4126, and the graft material 4128 may include a first opening 4122c (e.g., serration, entrance) between the apex 4121 and a second opening 4124 within (e.g., below) each apex 4121. The first opening 4122c and the second opening 4124 may be formed by removing some of the graft material 4128 between and / or within the apex, respectively. Thus, in the illustrated embodiment, the graft material 4128 defines an edge 4129c that generally follows (e.g., follows) the curvature of the struts of the scaffold 4126 along the periphery of the scaffold 4126 and also provides openings between the struts.

[0233] As mentioned above, Figure 41D-41F The arrangement of the graft material 4128 and stent 4126 shown provides openings, inlets, and / or bare stent regions at one or both ends of the traversing member and / or base member. This allows lateral flow through the end regions of the traversing / base member, which can aid in configuration as it increases the feasible landing area of ​​the device and reduces the precision required to align the end regions with the target site. For example, the traversing / base member may extend beyond the target site, such that the end regions are exposed within the vessel and / or the end regions may partially or completely cover the branch lumen (e.g., the vessel or other stent assembly) without obstructing blood flow. This can be particularly useful when configured within tortuous vessels (e.g., the aortic arch), where curvature may make stent alignment more difficult than in substantially linear vessels.

[0234] In some embodiments described herein, the legs and / or other portions of the aortic repair device may be angled or otherwise oriented to match the anatomy of the aorta. For example, Figure 42A This is a frontal view of the aorta and surrounding anatomical structures, in which an aortic repair device according to embodiments of the present technology can be implanted. Figure 42A As shown, the aorta (e.g., the ascending aorta, aortic arch, and / or the upper part of the descending thoracic aorta) can generally be located in plane P. The left common carotid artery and the left subclavian artery can extend along axes A1 and A2, respectively, at an angle (e.g., not parallel to plane P) relative to plane P, and the brachiocephalic artery can extend along axis A3, at an angle farther from plane P than axes A1 and A2. That is, the brachiocephalic artery can be located further away from the aorta in plane P than the left common carotid artery and the left subclavian artery. Therefore, the aortic repair device according to embodiments of the present technology may have legs arranged to accommodate the angles of branches of the brachiocephalic artery, the left common carotid artery, and / or the left subclavian artery.

[0235] More specifically, for example, Figure 42B-42D These are side views of the aortic repair devices 4200b-4200d according to embodiments of the present technology. (See also:) Figure 42B-42D The aortic repair devices 4200b-d may each include a base member 4210, the base member 4210 having a body 4212 configured for implantation in the aorta, a leg 4214 extending from the body 4212 and configured for implantation in a branch vessel (e.g., the brachiocephalic artery, the left common carotid artery, and / or the left subclavian artery), and a septum extending wholly or partially through the body 4212 and dividing the body 4212 into a main lumen and a secondary lumen. Figure 42B-42D (The middle is obscured).

[0236] refer to Figure 42B The legs 4214 can extend approximately parallel to the longitudinal axis L of the main body 4212. (See also...) Figure 42C and 42D The leg 4214 can form an angle B relative to the longitudinal axis L of the main body 4212. (See reference below.) Figure 42A , 42C And 42D, angle B can be selected as an angle corresponding to or substantially matching one of the brachiocephalic artery, left common carotid artery, and / or left subclavian artery relative to plane P. Therefore, in some aspects of this technology, the leg 4214 of the aortic repair device 4200c-d can be offset from the longitudinal axis L of the body 4212 to better align with the anatomical structure of the branch vessels relative to the aorta implanted in the body 4212. This can reduce the degree of bending of the leg 4214 relative to the body 4212 and / or reduce kinking of the leg 4214 when the aortic repair device 4200c-d is implanted into an anatomical structure with offset branch arteries. Reference Figure 42C In some embodiments, the proximal opening 4215 leading to the leg 4214 is also angled relative to the longitudinal axis L of the body 4212. (See reference...) Figure 42D In some embodiments, the proximal opening 4215 is inclined such that the proximal opening 4215 extends orthogonally to the longitudinal axis L, in order to maintain, for example, the cross-sectional flow area of ​​the proximal opening 4215.

[0237] Figure 86 This is a side view of an aortic repair device 8600 according to an embodiment of the present technology. In the illustrated embodiment, the aortic repair device 8600 includes a base member 8610 having a body 8612 configured for implantation in the aorta and a leg 8614 extending from the body 8612 and configured for implantation in a branch vessel (e.g., the brachiocephalic artery, the left common carotid artery, and / or the left subclavian artery). Figure 86 In the diagram, the aortic repair device 8600 is shown partially disassembled, with the leg 8614 separated from the main lumen of the body 8612 for clarity. When the aortic repair device 8600 is assembled, a diaphragm 8618 extends completely or partially through the body 8612 to divide the body 8612 into a main lumen and a secondary lumen. The main lumen provides fluid flow through the portion of the body 8612 not occupied by the leg 8614, while the secondary lumen provides fluid flow through the leg 8614.

[0238] In the illustrated embodiment, the leg 8614 has a central axis C extending orthogonally to its distal (e.g., distal) opening 8622, and the body 8612 has a central axis L extending orthogonally to its leading (e.g., proximal) opening 8620 and distal (e.g., distal) main lumen opening 8621. In some embodiments, the central axis C of the leg 8614 is not parallel to the central axis L of the body 8612 (e.g., at an angle, offset). This offset of the central axes of the body 8612 and the leg 8614 when the aortic repair device 8600 is implanted in the aorta can cause the leg 8614 to bend, coil, or spiral (e.g., partially spiral) around the aortic lumen. The angled leg 8614 allows the aortic repair device 8600 to advantageously absorb forces and / or flow near the leading portion of the leg 8614 (e.g., a D-shaped channel of the leg 8614 formed by one or more D-shaped stents), which is closer to the smaller bend of the aorta, before transitioning to the tail portion of the leg 8614 as it curls away from the aorta. In some embodiments, the aortic repair device 8600 may include one or more radiopaque markers 8619 positioned, for example, proximal to the body 8612 (e.g., on the outer curve of the body 8612).

[0239] III. Selected embodiments of aortic repair devices for multiple legs

[0240] Figure 43A and 43B These are, respectively, a side view and a perspective side view of an aortic repair device 4300 according to an embodiment of the present technology. The aortic repair device 4300 may include components similar to those referenced above. Figure 3A-42D The corresponding features of any aortic repair device described in detail are at least substantially similar in structure and function, or have some features that are the same in structure and function, and can be compared with... Figure 3A-42D The aortic repair device operates in a generally similar or identical manner. For example, in the illustrated embodiment, the aortic repair device 4300 includes a base member 4310 configured to be implanted in a diseased aorta and includes, for example, a stent graft comprising graft material 4328 attached to a plurality of stents 4326.

[0241] In the illustrated embodiment, the base member 4310 includes (i) a tubular body 4312, (ii) a tubular main leg 4340 extending distally from the body 4312, and (iii) a tubular secondary leg 4314 extending distally from the body 4312. More specifically, the body 4312 includes a proximal portion 4311 and a distal portion 4313 defining a proximal end of the base member 4310. The main leg 4340 includes a proximal portion 4345 coupled to the distal portion 4313 of the body 4312, and also includes a distal portion 4347. The secondary leg 4314 includes a proximal portion 4315 coupled to the distal portion 4313 of the body 4312 and a distal portion 4327 defining a distal end of the base member 4310. In the illustrated embodiment, the body 4312 has a first length L1, the main leg 4340 has a second length L2 that is less than the first length L1, and the auxiliary leg 4324 has a third length L3 that is greater than the second length L2. In other embodiments, the first to third lengths L1-L3 can be different. For example, the third length L3 can be shorter than length L1 and / or shorter than length L2. In some embodiments, the first length L1 can be between about 20-80 mm, the second length L2 can be between about 20-40 mm, and the third length L3 can be between about 30-100 mm.

[0242] The base member 4310 may be generally hollow and define one or more lumens therethrough. Therefore, in the illustrated embodiment, the base member 4310 includes (i) a proximal opening 4320 (e.g., a first opening, inlet) located at the proximal portion 4311 of the body 4310 and having a first diameter D1. Figure 43A (ii) A distal main leg opening 4321 (e.g., a second opening, a distal body outlet) at the distal portion 4347 of the main leg 4340 and having a second diameter D2. Figure 43A (iii) a distal secondary leg opening 4322 (e.g., a third opening, a distal leg outlet) at the distal portion 4317 of the secondary leg 4314 and having a third diameter D3. Figure 43A The first diameter D1 is larger than the second diameter D2 and the third diameter D3, and can be sized to approximately match or be larger than (e.g., excessively large relative to the diameter of the patient's aorta) the diameter of the patient's aorta (e.g., between about 20-60 mm, between about 26-54 mm, about 40 mm). The third diameter D3 can be sized to approximately match or be larger than a branch vessel of the patient's aorta, such as the brachiocephalic artery (e.g., between about 10-30 mm, about 18 mm). In some embodiments, the second diameter D2 can be larger than the third diameter D3 (e.g., between about 20-40 mm, about 28 mm).

[0243] Figure 43CAccording to embodiments of the present technology Figure 43A and 43B A distal fluoroscopic view of the aortic repair device 4300. See also Figure 43C The main body 4312 and the main leg 4340 together define a main tube cavity 4323 passing through the base member 4310, and the main body 4312 and the secondary leg 4314 together define a secondary tube cavity 4325 passing through the base member 4310. (See also...) Figures 43A-43C The main lumen 4323 can extend from the proximal opening 4320 and the main leg opening 4321 and define a flow path between the proximal opening 4320 and the main leg opening 4321. Similarly, the secondary lumen 4325 can extend from the proximal opening 4320 and the secondary leg opening 4322 and define a flow path between the proximal opening 4320 and the secondary leg opening 4322. Figure 43C As shown, the main cavity 4323 and the secondary cavity 4325 may each have a generally circular cross-sectional shape within the main body 4312 and within the main leg 4340 and the secondary leg 4314, respectively.

[0244] Figure 43D This is a side view of an aortic repair device 4300 implanted in the aorta according to an embodiment of the present technology. In some embodiments, the aorta may include an aneurysm, dissection, and / or other diseased portions, as referenced above. Figure 1A-2B Detailed description. In the illustrated embodiment, the body 4312 is implanted within the proximal aorta (e.g., the ascending aorta and / or aortic arch), wherein the proximal portion 4311 is positioned near the aortic valve, and the accessory leg 4314 extends from the body 4312 to the brachiocephalic artery, where the distal portion 4317 is positioned. See also: Figures 43A-43D The stent 4326 allows the graft material 4328 to expand into contact with the inner wall of the aorta and / or brachiocephalic artery to provide a seal between the vessel and the base member 4310. More specifically, the body 4312 can sealably contact the inner wall of the proximal aorta, allowing all or substantially all blood flow through the aorta to enter the proximal opening 4320 and flow through the main lumen 4323 or the secondary lumen 4325. Figure 43D As shown, the base member 4310 can guide blood flow (i) through the main lumen 4323 and out through the main leg opening 4321 into the aorta to perfuse the aorta, and (ii) through the secondary lumen 4325 and out through the secondary leg opening 4322 into the brachiocephalic artery to perfuse the brachiocephalic artery.

[0245] The base component 4310 can be delivered to the aorta in a collapsed configuration within the catheter system (not shown). The catheter system can enter the aorta via any suitable intravascular route, such as the aortic route, the femoral route, the carotid route, the left common carotid artery (LCCA) route, the left subclavian artery (LSA) route, etc.

[0246] In some aspects of this technology, the base member 4310 may be positioned abutting against / adjacent to a diseased portion of the aorta (e.g., the origin of a dissection and / or aneurysm) to prevent blood flow into the diseased portion by diverting blood flow through the base member 4310 and past the diseased portion. In another aspect of this technology, the outer surface of the body 4310 has a tubular shape configured to engage and seal with the inner wall of the aorta—however, the base member 4310 may not seal the aorta along the length of the main leg 4340 and the accessory leg 4314. Thus, as referenced above, for example... Figures 3A-3D Compared to the base member 310 described in detail, the base member 4310 can provide a relatively short sealing area. However, the main tube cavity 4323 may have a generally circular cross-sectional shape within the main leg portion 4340. This facilitates the attachment of other implantable devices, such as bridging members, to the base member 4310.

[0247] For example, Figures 44A-44C These are, respectively, a side view, a perspective side view, and a perspective end view facing the distance from the cross member 4450 according to an embodiment of the present technology. (See also:) Figures 44A-44C The spanning member 4450 may include the reference above. Figure 3A-38 B describes in detail any corresponding features across components that are at least substantially similar in structure and function, or identical in structure and function, and may be in accordance with... Figure 3A-38 B operates in a similar or identical manner across components.

[0248] For example, in the illustrated embodiment, the traversing member 4450 includes a body 4452 having a tubular shape defining a traversing lumen 4457 and extending between a proximal portion 4451 and a distal portion 4453. Thus, in the illustrated embodiment, the body 4452 includes a proximal opening 4454 and a distal opening 4455. The traversing member 4450 may include an expandable scaffold graft comprising one or more struts or supports 4456 and graft material 4458 coupled to the supports 4456.

[0249] In the illustrated embodiment, the traversing member 4450 further includes an anchor 4460 at and / or coupled to the proximal portion 4451 of the body 4452. The anchor 4460 may be a bare stent or other expandable element, and may have a second diameter D2 greater than that of the body 4452 when the traversing member 4450 is expanded and unrestrained (e.g., outside the aorta). Figure 44B The first diameter D1 () Figure 44BIn the illustrated embodiment, anchor 4460 is a bare support having a generally circular cross-sectional shape and a V-shaped pattern. In some embodiments, anchor 4460 may be laterally offset relative to body 4452 such that, for example, a longitudinal axis concentric with anchor 4460 is offset from a longitudinal axis concentric with body 4452.

[0250] Figure 44D and 44E These are, respectively, a perspective side view and a side view of an aortic repair device 4400 according to an embodiment of the present technology, the aortic repair device 4400 including components connected to (e.g., docked to). Figures 43A-43D The base member 4310 and the spanning member 4450. (See also...) Figure 44D and 44E Anchor 4460 and the proximal portion 4451 of body 4452 are at least partially positioned within base member 4310. More specifically, (i) anchor 4460 may expand to contact the inner surface of body 4312 to anchor and secure body 4452 of spanning member 4450 relative to base member 4310, and (ii) the proximal portion 4451 of body 4452 may expand to contact and sealably engage the inner surface of main leg 4344. In the illustrated embodiment, anchor 4460 is offset relative to body 4452 of spanning member 4450 such that anchor 4460 substantially engages the entire circumference of body 4312.

[0251] Let's refer to each other. Figures 43A-44E The aortic repair device 4400 can define a continuous blood flow path from the proximal opening 4320 of the base member 4310, through the main lumen 4325, and through the lumen 4457 to the distal opening 4455. In some aspects of this technology, a second length L2 of the main leg 4344 is increased. Figure 43A This increases the available area for a seal between member 4450 and base member 4310, thereby increasing the potential robustness of the seal therebetween. However, increasing the second length L2 would require reducing the length L1 of body 4312—thus reducing the available area for a seal between body 4312 and the aorta—or increasing the overall length of body 4312 and main leg 4344. Therefore, in some aspects of this art, the second length L2 is chosen to be (i) just long enough to ensure a robust seal between member 4350 and main leg 4344, and (ii) accordingly maximize the first length L1 to ensure a robust seal between body 4312 and the aorta. In some embodiments, the second length L2 is approximately 1 cm.

[0252] As described in detail above with reference to, for example, Figure 4, when the aortic repair device 4400 is implanted in a patient, the cross member 4450 can redirect blood flow through the diseased portion of the aorta, such as an aneurysm in the aortic arch. Figure 43D In some embodiments, the traverse member 4450 may be delivered in a collapsed configuration to the aorta within a catheter system (not shown) in the same or separate procedure as the base member 4310. For example, typically, a patient may initially require only treatment within the ascending aorta and / or aortic arch to treat an initial dissection or aneurysm, but at a later time (e.g., months or years later), as the condition progresses, additional treatment of the aortic arch and / or descending thoracic aorta may be necessary. Therefore, the base member 4310 may be implanted during the initial procedure, and the traverse member 4450 may be implanted during a later procedure and modularly coupled to the base member 4310 to provide further treatment of the aortic arch and / or descending thoracic aorta (e.g., by bypassing the traverse member 4310). Figure 43D (Blood flow in the aneurysm shown).

[0253] Figure 45A This is an enlarged side view of the spanning member 4550 according to an embodiment of the present technology. The spanning member 4550 may include components referenced above. Figures 44A-44E The corresponding features of the traversing member 4450 described in detail are at least substantially similar in structure and function, or have some features that are structurally and functionally identical, and can operate in a manner substantially similar to or identical to that of the traversing member 4450. For example, the traversing member 4550 includes a tubular body 4552 (e.g., a scaffold graft) defining a lumen and having a proximal portion 4551. In the illustrated embodiment, the traversing member 4550 also includes a plurality of anchoring or securing elements 4560 at and / or coupled to the proximal portion 4551. The securing elements 4560 may be hooks, lines, loops, and / or other elements.

[0254] Figure 45B This is a side view of an aortic repair device 4500 according to an embodiment of the present technology, the aortic repair device 4500 including components coupled to (e.g., mated to). Figures 43A-43D The base member 4310 has a spanning member 4550. In the illustrated embodiment, a retaining element 4560 secures and seals the proximal portion 4551 of the body 4552 to the inner surface of the main leg 4340 of the base member 4310. In other embodiments, additional retaining elements may be alternatively or additionally positioned on the inner surface of the main leg 4340. For example, such retaining elements may include a portion of one or more supports that form the base member 4310 and project inwardly into the lumen of the main leg 4340.

[0255] Figure 45C It is based on the implementation scheme of this technology. Figure 45B A perspective view of the main leg 4340 of the base member 4310 facing the proximal side. Figure 45D According to embodiments of the present technology Figure 45A Enlarged perspective side view of the proximal portion 4551 of the spanning member 4550. Figure 45E This is a perspective view of the proximal side of the spanning member 4550, which is connected to the main leg 4340 of the base member 4310 according to an embodiment of the present technology. Figure 45C As shown, some or all of the supports 4326 within the main leg portion 4340 may include (i) a first portion 4529 (e.g., via sutures) fixed to and juxtaposed with the graft material 4328; and (ii) a second portion 4527 (e.g., an exposed portion, an unsutured portion) not fixed to the graft material 4328 and extending radially inward from the inner surface of the graft material 4328 (e.g., inclined or lifted from the inner surface of the graft material 4328). Figure 45D As shown, the spanning member 4550 may include one or more supports 4556 and graft material 4558. Some or all of the supports 4556 may similarly include (i) a first portion 4559 that is fixed to and juxtaposed with the graft material 4558 (e.g., via sutures); and (ii) a second portion 4557 (e.g., an exposed portion, an unsutured portion) that is not fixed to the graft material 4558 and extends radially outward from the outer surface of the graft material 4558 (e.g., inclined or lifted from the outer surface of the graft material 4558).

[0256] When the spanning member 4550 is connected to the main leg 4340, such as Figure 45E As shown, the second portion 4527 of the main leg 4340 may be opposite, interlocked and / or engaged with the second portion 4557 of the traversing member 4550 to suppress the migration of the traversing member 4550 relative to the base member 4310. In some embodiments, the connection between the spanning member 4550 and the main leg 4340 of the base member 4310 can be adjusted by regulating the following: (i) the degree to which the second portion 4527 of the support 4326 of the base member 4310 protrudes inward toward the spanning member 4550; (ii) the degree to which the second portion 4557 of the support 4556 of the spanning member 4550 protrudes outward toward the main leg 4340; (iii) the frequency / periodicity of the second portion 4527 of the support 4326 of the main leg 4340; and / or (iv) the frequency / periodicity of the second portion 4557 of the support 4556 of the spanning member 4550, such that when the spanning member 4550 is connected to the main leg 4340, some areas of the free second portions 4527, 4557 may engage.

[0257] Figure 46This is a perspective side view of the base member 4610 of an aortic repair device 4600 according to an embodiment of the present technology. The base member 4610 may include components referenced above. Figure 39A The corresponding features of the base member 3910 described in detail in -39D are at least substantially similar in structure and function, or have some features that are structurally and functionally identical, and can operate in a manner substantially similar to or identical to that of the base member 3910. For example, the base member 4610 includes a proximal body 4612, a primary leg 4640 extending distally from the body 4612, and a secondary leg 4614 extending distally from the body 4612. However, in the illustrated embodiment, the primary leg 4660 extends at an angle A relative to the body 4612 and the secondary leg 4614, the angle A being, for example, between about 30° and 60° (e.g., about 45°). In some aspects of this technology, the angled primary leg 4640 may be angled toward / along the ascending aorta or another portion of the aorta, thereby making it easier for the primary leg 4640 to be coupled across a member or other implant. More specifically, the angled primary leg 4640 may be directed toward / along the natural internal curvature of the ascending aorta.

[0258] IV. Selected embodiments of aortic repair devices with reduced delivery profiles

[0259] In some aspects of this technology, graft material is a key component of the aortic repair device, contributing to the device's volume and its ability to be packaged into a catheter. Therefore, reducing the amount of graft material throughout the aortic repair device and / or effectively distributing the graft material across individually delivered components of the aortic repair device (e.g., base members, bridging members, etc.) can reduce the delivery profile of the aortic repair device—potentially allowing the aortic repair device to be loaded into and delivered through a relatively small catheter and / or along a narrower intravascular delivery channel. Figure 47A-56C Different examples of aortic repair devices with reduced delivery profiles are shown. (Reference) Figure 47A-56C The detailed description of the aortic repair device may include features that are structurally and functionally related to and / or analogous to those referenced above. Figure 3A-46 The corresponding features of any aortic repair device described in detail are at least substantially similar or identical, and may be comparable to or related to each other. Figure 3A-46 The aortic repair devices operate in a similar or identical manner.

[0260] Figure 47A and 47B These are, respectively, a distal perspective view and a distal fluoroscopic end view of the aortic repair device 4700 according to an embodiment of the present technology. (See also:) Figure 47A and 47BThe aortic repair device 4700 includes a base member 4710 having a body 4712 defining a primary lumen 4723. The aortic repair device 4700 also includes a separate leg member 4714 coupled to the body 4712 and defining a second lumen 4725. The leg member 4714 may be a stent graft having a similar construction to the base member 4710.

[0261] Figure 47C and 47D These are embodiments based on the present technology. Figure 47A and 47B A perspective side view and a perspective end view facing the proximal end of the base component 4710. (See also:) Figures 47A-47D The base member 4710 includes graft material 4728 attached to a plurality of supports 4726. In the illustrated embodiment, one or more exposed portions 4727 (e.g., V-shaped segments) of the supports 4726 are not attached to the graft material 4728, and the exposed portions 4727 are at least partially aligned to define a channel 4729. A proximal portion 4715 of the leg member 4714 is inserted into the channel 4729 and sealably engages the inner surface of the body 4712. In some embodiments, the exposed portions 4727 of the supports 4726 apply a radial force to the leg member 4714, which holds the leg member 4714 in a sealable engagement with the inner surface of the body 4712. That is, the exposed portions 4727 of the supports 4726 can serve as an internal attachment mechanism for the leg member 4714. Therefore, in the illustrated embodiment, the leg member 4714 is a separate component from the base member 4710, and the base member 4710 does not include a diaphragm.

[0262] Figure 47E-47G This is a cross-sectional view of the base member 4710 taken along one of the supports 4726 according to an embodiment of the present technology. Figure 47E As shown, in some embodiments, in leg member 4714 ( Figure 47A and 47B Before insertion through the channel 4729 between the exposed portion 4727 and the graft material 4728, the exposed portion 4727 of the scaffold 4726 fully contacts / juxtaposes the inner surface of the graft material 4728. Figure 47F As shown, in some embodiments, in leg member 4714 ( Figure 47A and 47B Before insertion of the channel 4729 through the exposed portion 4727 and the graft material 4728, the exposed portion 4727 extends radially inward from the inner surface of the graft material 4728 (e.g., "sloping" from the inner surface of the graft material 4728). Figure 47GAs shown, in some embodiments, the exposed portion 4727 includes a contact portion 4797 juxtaposed with the graft material 4728 and a vertex portion 4798, the vertex portion 4798 being located on the leg member 4714. Figure 47A and 47B Before insertion through the channel 4729 between the exposed portion 4727 and the graft material 4728, the channel extends radially inward from the inner surface of the graft material 4728 (e.g., lifted from the inner surface of the graft material 4728).

[0263] In some embodiments, the leg member 4714 may be implanted during the same or separate procedure as the base member 4710. For example, the base member 4710 may be implanted during the initial procedure (e.g., indexing procedure) such that the stent 4726 drives the graft material 4728 against the aorta to seal and divert flow through the diseased portion of the aorta. Then, if the disease progresses, the leg member 4714 may be implanted alone or in combination with one or more implantable devices to divert flow through the progressive disease. Figure 47F and 47G In the embodiment shown, the exposed portion 4727 of the stent 4726 can provide a path for cannulation of the guidewire for implantation in the leg 4714 because the exposed portion 4727 does not completely juxtapose the graft material 4728.

[0264] Figures 48A-48D These are respectively an isometric side view, a perspective side view, a magnified perspective side view, and a perspective end view facing the distal side of the aortic repair device 4800 according to an embodiment of the present technology. Figure 48E-48H As is the embodiment of this technology Figure 48A A cross-sectional view of the aortic repair device 4800 is shown. (See also: [link to reference]). Figures 48A-48DIn the illustrated embodiment, the aortic repair device 4800 includes a base member 4810 configured for implantation in a diseased aorta. The base member 4810 may include a body 4812 and a leg 4814 extending distally from the body 4812. The body 4812 may define a proximal portion 4811 of the base member 4810, and the leg 4814 may define a distal portion 4817 of the base member 4810. The base member 4810 may include a stent graft comprising graft material 4828 attached to a plurality of stents 4826, including individually identified proximal stents 4826a and distal stents 4826b. In the illustrated embodiment, the proximal stent 4826a has a generally circular or annular shape, and the graft material 4828 extends only around a portion of the proximal stent 4826a to divide the body 4812 into (i) a main lumen 4823 not surrounded by the graft material 4828 and (ii) a secondary lumen 4825 surrounded by the graft material 4828. In some embodiments, the graft material 4828 includes a separate or integral septum 4818 dividing the body 4812 into the main lumen 4823 and the secondary lumen 4825. The septum 4818 may extend completely or partially through the body 4812 and may be centered or offset within the body 4812 such that the main lumen 4823 and the secondary lumen 4825 have the same or different dimensions. Thus, as Figure 48E and 48F As shown, the main cavity 4823 and the secondary cavity 4825 may each have a generally D-shaped cross-sectional shape within the main body 4812.

[0265] The secondary lumen 4825 may extend into and pass through the leg 4814. In the illustrated embodiment, the distal stent 4826b also has a generally circular or annular shape, and the graft material 4828 may extend completely around the distal stent 4826b to partially define the secondary lumen 4825. The secondary lumen 4825 may have a generally circular cross-sectional shape within the leg 4814, such as... Figure 48H As shown. In some embodiments, the base member 4810 includes a transition region 4861 between the leg 4814 and the body 4812. Figure 48A Furthermore, the secondary lumen 4825 extends through the transition region 4861, where the secondary lumen 4825 has the following characteristics: Figure 48B The cross-sectional shape shown transitions between a D-shaped cross-sectional shape within the body 4812 and a circular cross-sectional shape within the leg 4814.

[0266] The base component 4810 and the corresponding crossing component can be delivered to the aorta in a collapsed configuration within the same or separate catheter system. The catheter system can enter the aorta via any suitable intravascular route, such as the aortic route, the femoral route, the carotid route, the left common carotid artery (LCCA) route, the left subclavian artery (LSA) route, etc. In some aspects of this technology, omitting the graft material around the main lumen 4823 can reduce the overall delivery profile of the base component 4810—potentially allowing the base component 4810 to be loaded into a relatively small catheter and delivered through a relatively small catheter and / or along a narrower intravascular delivery path.

[0267] The main lumen 4823 is configured (e.g., shape, size, and location) to receive a traversing member therein and / or around it when the base member 4810 is implanted within the aorta. For example, Figure 49 This is an isometric side view of a traversing member 4950 configured to be connected to a base member 4810 according to an embodiment of the present technology. In the illustrated embodiment, the traversing member 4950 is a scaffold graft that includes graft material 4958 defining a traversing lumen 4957 and extending between a proximal portion 4951 and a distal portion 4953.

[0268] Let's refer to each other. Figure 48A-49 The traversing member 4950 may have a D-shaped cross-section, its dimensions designed to match the D-shaped cross-section of the main lumen 4823. The traversing member 4950 may be fixed around and / or within the main lumen 4823 to a proximal stent 4826a, such that the graft material 4958 of the traversing member 4950 engages and seals to (i) the graft material 4828 surrounding the secondary lumen 4825 (e.g., diaphragm 4818) and (ii) the aortic wall. In this way, the body 4812 (e.g., graft material 4828 surrounding the secondary lumen 4825) and the traversing member 4950, connected within / around the main lumen 4823, can together provide a complete circumferential seal around the aortic wall and can be positioned against / adjacent to a diseased portion of the aorta (e.g., the origin of a dissection and / or aneurysm) to prevent blood flow into the diseased portion by diverting blood flow through the base member 4810 and the traversing member 4950 and across the diseased portion.

[0269] Figure 50 This is a side view of an aortic repair device 4600 according to an embodiment of the present technology, the aortic repair device 4600 comprising a pair of implanted within the aorta. Figures 48A-48H The base member 4810 (separately identified as proximal base member 4810a and distal base member 4810b) and Figure 49The aorta spans member 4950. Various components of the proximal base member 4810a are designated by tail “a” (e.g., body 4812a), and various components of the distal base member 4810b are designated by tail “b” (e.g., body 4812b). In some embodiments, the aorta may include aneurysms, dissections, and / or other diseased portions, as referenced above. Figure 1A-2B Detailed description.

[0270] In the illustrated embodiment, the body 4812a of the proximal base member 4810a is implanted within the proximal aorta (e.g., the ascending aorta and / or aortic arch), wherein (i) the proximal portion 4811a is positioned near the aortic valve, and (ii) the accessory leg 4814a extends from the body 4812a to the brachiocephalic artery positioned at the distal portion 4817a. The body 4812b of the distal base member 4810b is implanted within the descending thoracic aorta (and / or partially within the aortic arch), wherein (i) the distal end 4811b is positioned at the most distal end within the aorta, and (ii) the accessory leg 4814b extends from the body 4812b to the left common carotid artery positioned at the distal end 4817b. Thus, the distal base member 4810b can be oriented relative to the proximal base member 4810a. The bridging member 4950 may extend between the base members 4810, wherein the proximal portion 4951 is connected to the body 4812a of the proximal base member 4810a, and the distal portion 4953 is connected to the body 4812b of the distal base member 4810b.

[0271] The body 4812a of the proximal base member 4810a and the proximal portion 4951 of the crossing member 4950 can together engage and seal the proximal portion of the aorta (e.g., the diseased portion of the ascending aorta, including the tear) against the proximal portion of the aorta. The body 4812b of the distal base member 4810b and the distal portion 4953 of the crossing member 4950 can together engage and seal the distal portion of the aorta (e.g., a portion of the descending thoracic aorta). Thus, the proximal base member 4810a can guide blood flow from the aortic valve (i) through the accessory leg 4814a into the brachiocephalic artery for perfusion, and (ii) through the crossing member 4950 and through the distal base member 4810b into the aorta for perfusion. In the illustrated embodiment, the crossing member 4950 guides blood flow through the diseased portion of the aortic arch, such as the aneurysm shown. In some embodiments, blood can flow retrogradely from the aorta through the accessory leg 4814b to perfuse the left common carotid artery. In some embodiments, a bypass can be surgically placed between the brachiocephalic artery and the left subclavian artery and / or between the left common carotid artery and the left subclavian artery to perfuse the left subclavian artery.

[0272] Figures 51A-51CThe figures shown are a side view, a perspective side view, and a perspective end view of an aortic repair device 5100 according to an embodiment of the present technology. In the illustrated embodiment, the aortic repair device 5100 includes a base member 5110, which includes a stent graft. The stent graft includes a septum 5118 attached to a plurality of stents 5126. In the illustrated embodiment, the stents 5126 are generally exposed (e.g., not covered in graft material), and each stent has a generally circular or annular shape with a V-shaped pattern and is at least partially coaxially aligned. The septum 5118 interconnects the stents 5126 and divides the base member 5110 into a main lumen 5123 and a secondary lumen 5125. In some embodiments, the septum 5118 extends along the diameter of each stent 5126 such that the main lumen 5123 and the secondary lumen 5125 have the same dimensions and a D-shaped cross-sectional shape. In other embodiments, one or more supports 5126 are offset relative to the diaphragm 5118, such that the main lumen 5123 and the secondary lumen 5125 have different dimensions.

[0273] Figure 51E and 51F These are distal end views and side views of an aortic repair device 5100 according to an additional embodiment of the present technology. (See also:) Figure 51E and 51F In the illustrated embodiment, the diaphragm 5118 includes a wedge-shaped segment 5199 to provide a more elliptical cross-sectional shape for the main lumen 5123 and the secondary lumen 5125, and to help prevent the diaphragm 5118 from tipping over into one lumen or the other. In some embodiments, the ends of the wedge-shaped segment 5199 are sutured closed to prevent blood from flowing through the wedge-shaped segment 5199. To keep the wedge-shaped ends of the diaphragm 5118 properly open, a support 5126 may be shaped to provide a longitudinal strut at the apex of the wedge-shaped segment 5199 to which the diaphragm 5118 can be sutured, such as Figure 51F As shown.

[0274] When the base member 5110 is implanted into the aorta, the main lumen 5123 and the secondary lumen 5125 are each configured (e.g., shaped, sized, and positioned) to receive the traversing member therein and / or around it. For example, Figure 51D According to embodiments of the present technology Figures 51A-51CThe distal fluoroscopic view of an aortic repair device 5100, which includes a first traversing member 5150a and a second traversing member 5150b connected to a base member 5110. Each of the traversing members 5150a-b may include an expandable stent graft, sized and shaped such that when the traversing members 5150a-b are respectively connected to the main lumen 5123 and the secondary lumen 5125 / within the main lumen 5123 and the secondary lumen 5125, and the aortic repair device 5100 is implanted into the aorta, the traversing members 5150(i) engage and seal the diaphragm 5118, (ii) engage and seal each other, and / or (iii) engage and seal the aortic wall.

[0275] More specifically, Figures 52A-52C According to embodiments of the present technology Figure 51D Side view of the aortic repair device 5100 during different stages of implantation in the aorta. First refer to... Figure 52A The base member 5110 is initially implanted within the proximal aorta (e.g., the ascending aorta and / or aortic arch). The base member 5110 can be delivered to the aorta in a collapsed configuration within a catheter system (not shown). In some aspects of this technology, omitting graft material around the main lumen 5123 and secondary lumen 5125 by including only the septum 5118 can reduce the overall delivery profile of the base member 5110—potentially allowing the base member 5110 to be loaded into and delivered through a relatively small catheter and / or along a narrower intravascular delivery path.

[0276] Let's refer to each other. Figure 52B and 52C Next, the traversing members 5150a-b can be delivered to and connected to the base member 5110 above and / or within the main tube lumen 5123 and the secondary tube lumen 5125. Figure 52A The spanning members 5150a-b (e.g., their proximal portions) can (i) engage and seal the diaphragm 5118. Figure 52A (ii) joined and sealed together, and / or (iii) joined and sealed to the aortic wall to divert blood flow through the cross members 5150a-b and through the diseased portion of the aorta. Figure 52A As shown, in some embodiments, the traversing members 5150a-b can be arranged parallel to each other within the aorta, such that the first traversing member 5150a guides blood flow further across the aorta, and the second traversing member 5150b guides blood flow from the aorta to branch vessels, such as the brachiocephalic artery. In other embodiments, such as Figure 52CAs shown, the crossing members 5150a-b can be arranged to cross each other within the aorta, such that the first crossing member 5150a guides blood flow from the aorta to branch vessels, such as the brachiocephalic artery, and the second crossing member 5150b guides blood flow further through the aorta.

[0277] Refer to together Figures 51A-52C In some embodiments, the diaphragm 5118 is configured to facilitate a seal between the members 5150 and suppress leakage. Figure 53A and 53B These are embodiments based on the present technology. Figures 51A-51C Enlarged side view and perspective side view of one of the base components 5110, namely the diaphragm 5118 and the support 5126. See also... Figure 53A and 53B The diaphragm 5118 may include a monolithic graft material attached to the support 5126 in a lateral ring. This ring can provide increased diaphragm thickness, which aids in sealing and facilitating communication with the spanning members 5150a-b ( Figure 51D The conformal shape of the scaffold. In some embodiments, the expandable foam may be placed within the lateral ring of the graft material of the scaffold 5126 to allow it to expand further and seal against the spanning members 5150a-b.

[0278] Similarly, Figures 54A-54C These are additional embodiments according to the present technology. Figures 51A-51C Enlarged side view, perspective top view, and perspective side view of the diaphragm 5118 of the base member 5110 and one of the supports 5126. See also... Figures 54A-54C The diaphragm 5118 may include a monolithic graft material attached to the support 5126 along a V-shaped pattern, such that the diaphragm 5118 has a corresponding fold or V-shape. Therefore, the diaphragm 5118 may have a first end 5462 (e.g., a first free end) and a second end 5463 (e.g., a second free end), the first end 5462 and the second end 5463 being inwardly conformable (e.g., molded, clamped, bent) across members 5150a-b. Figure 51D ), so as to facilitate sealing and conform to the spanning member 5150a-b.

[0279] Let's refer to it again. Figures 51A-52C In some embodiments, the base member 5110 may include a plurality of spacers defining more than two lumens within the base member 5110, each of which may receive a corresponding crossing member. For example, Figure 55A and Figure 55B These are, respectively, a cross-sectional view and a perspective end view of the base member 5110 according to another embodiment of the present technology. (See also:) Figure 55A and 55BIn the illustrated embodiment, the base member 5110 further includes a second diaphragm 5564 extending between the first diaphragm 5118 and / or one or more stents 5126. Thus, the first diaphragm 5118 and the second diaphragm 5564 can define a main lumen 5123, a first secondary lumen 5525a, and a second secondary lumen 5525b, which can, for example, each receive different traversing members for perfusing different branches or portions of the aorta. In other embodiments, the base member 5110 may include any number of lumens, and / or the first diaphragm 5118 and the second diaphragm 5564 may be positioned differently (e.g., offset) such that the lumens have different relative shapes and sizes.

[0280] For example, Figure 55C and 55D This is a perspective end view of a base member 5110 according to an embodiment of the present technology. The base member 5110 includes a first spanning member 5550a, a second spanning member 5550b, and a third spanning member 5550c connected to the base member 5110. The base member 5110 is... Figure 55C It is in a relaxed configuration and in Figure 55D It is in a radially compressed position. (See also: [reference needed]) Figure 55C and 55D The main cavity 5123 receives a first crossing member 5550a therein, the first secondary cavity 5525a receives a second crossing member 5550b therein, and the second secondary cavity 5525b receives a third crossing member 5550c therein. For example... Figure 55D As shown, the spanning members 5550a-c can conformally and sealingly engage the first diaphragm 5118 and the second diaphragm 5564 to prevent openings (e.g., grooves, leakage paths) between them even under radial compression.

[0281] Figure 56A This is an enlarged isometric end view of an aortic repair device 5600 according to an embodiment of the present technology. In the illustrated embodiment, the aortic repair device 5600 includes a base member 5610 having a body 5612, the body 5612 including a diaphragm 5618 defining a main lumen 5623 and a secondary lumen 5625. The aortic repair device 5600 also includes a separate leg member 5614 coupled to the body 5612 within the secondary lumen 5625. In some embodiments, the body 5612 is a stent graft including a proximal fixation stent 5626 and graft material 5628 attached to and extending distally from the proximal fixation stent 5626. That is, the body 5612 does not include a plurality of stents spaced apart along its length, but only includes the proximal fixation stent 5626.

[0282] Figure 56B and 56C According to embodiments of the present technology Figure 56A Side view of the aortic repair device 5600 during different stages of implantation in the aorta. First refer to... Figure 56B The base member 5610 is initially implanted within the proximal aorta (e.g., the ascending aorta, aortic arch, and / or aortic root), wherein the proximal fixation stent 5626 at least temporarily fixes the position of the base member 5610. The base member 5610 can be delivered to the aorta in a collapsed configuration within a catheter system (not shown). In some aspects of this technology, including only the proximal fixation stent 5626 instead of multiple stents along the body 5612 can reduce the overall delivery profile of the base member 5610—potentially allowing the base member 5610 to be loaded into and delivered through a relatively small catheter and / or along a narrower intravascular delivery path.

[0283] refer to Figure 56C Next, the leg member 5614 can be coupled within the secondary lumen 5625 and can be sealingly engaged with the body 5612. In some embodiments, the radially outward force of the leg member 5614 and the proximal fixation stent 5626 can drive the graft material 5628 to engage and seal the aorta. Thus, the aortic repair device 5600 can direct blood flow through the diseased portion of the aorta (e.g., an ascending aortic aneurysm) to one or more branch vessels and the distal aorta.

[0284] V. Selected embodiments of aortic repair devices having multiple components, such as those for total aortic arch treatment.

[0285] Embodiments of this technology (including one or more of the disclosed basal components, bridging components, and / or other implants) can be combined to provide an arrangement of an aortic repair device for treating all or substantially all of the entire proximal aorta (e.g., including the ascending aorta and aortic arch). That is, the aortic repair device of this technology can effectively reconstruct a portion of the proximal aorta and / or multiple aortic branch vessels. Figures 57 to 65B These are some example combinations of the disclosed techniques for whole dental arch treatment. However, those skilled in the art will understand that any of the devices and components described herein can be substituted in the exemplary combinations, and other combinations are possible.

[0286] For example, Figure 57This is a side view of an aortic repair device 5700 implanted in the aorta according to an embodiment of the present technology. In the illustrated embodiment, the aortic repair device 5700 includes a first base member 5710a implanted at least partially in the ascending aorta, a second base member 5710b implanted at least partially in the descending thoracic aorta, and a crossing member 5750 extending between and connecting the first and second base members 5710a-b. For example, the first base member 5710a may include a main leg portion 5740a that seals and secures the proximal portion of the crossing member 5750 (e.g., as referenced above). Figure 43A-46 (As described in detail), and the second base member 5710b may similarly include a main leg 5740b that seals and secures the distal portion of the traversing member 5750. Thus, the traversing member 5750 can guide blood flow distally through the aorta to a diseased portion of the aorta, such as an aortic arch aneurysm. The first base member 5710a may also include a secondary leg 5714a extending into a first branch artery (e.g., the brachiocephalic artery) for perfusion of the first branch artery, and the second base member 5710b may include a secondary leg 5714b extending into a second branch artery (e.g., the left subclavian artery) for perfusion of the second branch artery.

[0287] In the illustrated embodiment, the aortic repair device 5700 further includes a branch perfusion member 5766, which connects the traversing member 5750 to a third branch artery (e.g., the left common carotid artery) for perfusion of the third branch artery. In some embodiments, the traversing member 5750 may be fenestrated (either before or in situ after implantation), and the branch perfusion member 5766 is connected thereto to provide a flow path to the third branch artery. In other embodiments, the third branch artery may be perfused via a bypass or via a traversing member connected to one or both of the base members 5710a-b.

[0288] It is noteworthy that, in the illustrated embodiment, the second base member 5710b is implanted in a reverse or flipped orientation relative to the first base member 5710a, and is substantially similar to the first base member 5710. Therefore, the “distal” portion of the first base member 5710a corresponds to the “proximal” portion of the second base member 5710b, and vice versa. Thus, those skilled in the art will understand that the use of the terms “proximal” and “distal” is based on the orientation of the base members 5710a-b, and that a “distal” portion of one base member 5710a-b may correspond to a “proximal” portion of the other base member 5710a-b, and vice versa.

[0289] Figure 58AThis is a side view of an aortic repair device 5800 implanted in the aorta according to another embodiment of the present technology. In the illustrated embodiment, the aortic repair device 5800 includes a first base member 5810a implanted at least partially in the ascending aorta, a second base member 5810b implanted at least partially in the descending thoracic aorta, and a crossing member 5850 extending between and connecting the first and second base members 5810a-b. For example, the first base member 5810a may include a main lumen defined by a diaphragm (e.g., as per [reference to...]). Figure 3A-42D (As described in detail), the diaphragm sealably engages and secures the proximal portion of the traversing member 5850, and the second base member 5810b may similarly include a main lumen defined by the diaphragm, which sealably engages and secures the distal portion of the traversing member 5850. Thus, the traversing member 5850 can guide blood flow distally through the aorta to a diseased portion of the aorta, such as an aortic arch aneurysm. The first base member 5810a may also include a leg 5814a extending into a first branch artery (e.g., the left subclavian artery) for perfusion of the first branch artery, and the second base member 5810b may include a leg 5814b extending into a second branch artery (e.g., the brachiocephalic artery) for perfusion of the second branch artery. In the illustrated embodiment, the third branch artery (e.g., the left common carotid artery) includes a surgical block near the aorta and is perfused via a bypass between the first and third branch arteries. In some aspects of this technology, the crossing or overlapping arrangement of legs 5814a-b during delivery can be more easily achieved than in embodiments where legs 5814a-b perfuse the nearest branch artery of the aorta, due to the angle at which the branch artery exits the aorta and / or the required delivery path.

[0290] Figure 58B It is an embodiment of the present technology that is implanted in the aorta with different structures. Figure 58AA side view of the aortic repair device 5800. In the illustrated embodiment, a first base member 5810a is at least partially implanted within the ascending aorta, a second base member 5810b is at least partially implanted within the descending thoracic aorta, and a cross member 5850 extends between and connects the first and second base members 5810a-b. However, in the illustrated embodiment, a leg 5814a of the first base member 5810a extends into the brachiocephalic artery for perfusion, and a leg 5814b of the second base member 5810b extends into the left common carotid artery for perfusion. In some embodiments, a surgical block is formed in the left subclavian artery near the aorta, and perfusion can be achieved via a bypass between the left common carotid artery and the left subclavian artery. In some embodiments, the first stent 5830a may be at least partially implanted in the first leg 5814a to maintain the lumen therethrough, and the second stent 5830b may be at least partially implanted in the second leg 5814b to maintain the lumen therethrough.

[0291] Figure 58C An implantation in the aorta according to an embodiment of the present technology, including an additional extension member 5896. Figure 58B A side view of the aortic repair device 5800. In the illustrated embodiment, an extension member 5896 (which may also be referred to as an extender, collar, anchor, seal, etc.) is coupled to and / or positioned within the proximal portion 5811a of the first base member 5810a. More specifically, the extension member 5896 may be a stent graft or other device and may be at least partially positioned within the body 5812a of the first base member 5810a to extend proximally from the body 5810a toward the aortic valve. For example, the first base member 5810a may include a septum 5818a that extends only partially through the first body 5818a (e.g., as referenced above). Figure 5A-8H (as described in detail), such that the extension member 5896 conforms to the entire inner circumference of the body 5810a at and near the proximal portion 5811a of the first body 5810a.

[0292] The extension member 5896 can (i) sealably engage the body 5812a within the lumen (e.g., the main lumen) of the body 5812a and (ii) sealably engage the aorta proximal to the first base member 5810 to define a continuous blood flow path through the extension member 5896 and the first base member 5810a. The extension member 5896 can be implanted during the same procedure as the first base member 5810a or during a separate (e.g., a later) procedure and is configured to extend the aortic repair device 5800 to a seal within the aorta. Alternatively or additionally, the extension member 5896 can assist in anchoring the first base member 5810a within the aorta. In some such embodiments, the extension member 5896 can be a bare stent that is not sealably engaged with the aorta. In some embodiments, the extension member 5896 (or one or more other extension members 5896) may be coupled to the distal portion 5811b of the body 5812b of the second base member 5810b, to the end portion 5817a of the leg 5814a of the first base member 5810a within the brachiocephalic artery (or another branch vessel), and / or to the end portion 5817b of the leg 5814b of the second base member 5810b within the left common carotid artery (or another branch vessel) to provide extended sealing and / or anchoring.

[0293] Figure 59 This is a side view of an aortic repair device 5900 according to an embodiment of the present technology. In the illustrated embodiment, the aortic repair device 5900 includes (i) a first base member 5910a having a leg 5914a and configured to be at least partially implanted within the ascending aorta, and (ii) a second base member 5910b having a leg 5914b configured to be at least partially implanted within the descending thoracic aorta. The aortic repair device 5900 also includes a bridging member 5950 configured to extend between and connect the first and second base members 5910a-b. In the illustrated embodiment, the bridging member 5950 has enlarged sides and a reduced-diameter intermediate portion, as referenced above. Figure 21 Detailed description. In other embodiments, the spanning member 5950 may have other configurations as described herein. For example, the spanning member 5950 may have a substantially constant diameter, as referenced above. Figures 13A-14B Detailed description. The aortic repair device 5900 also includes (i) a first stent 5930a configured to be optionally implanted within a leg 5914a of the first base member 5910a to help maintain the shape and patency of the lumen therethrough, and (ii) a second stent 5930b configured to be optionally implanted within a leg 5914b of the second base member 5910b to help maintain the shape and patency of the lumen therethrough.

[0294] In some embodiments, the aortic repair device 5900 further includes an extension member 5996 configured to engage with the first base member 5910a to provide extended sealing and / or anchoring within the ascending aorta. The aortic repair device 5900 may also include an additional extension member (not shown) configured to engage with a second base member 5910b to provide extended sealing and / or anchoring within the descending aorta. In the illustrated embodiment, the aortic repair device 5900 also includes an expander stent graft 5997 configured to engage with a leg 5914a of the first base member 5910a to provide extended sealing and / or anchoring, for example, within the aorta and / or branch arteries (e.g., the brachiocephalic artery). The aortic repair device 5900 may also include an additional extender stent graft (not shown) configured to attach to a leg 5914b of the second base member 5910b to provide extended sealing and / or anchoring within the aorta and / or branch arteries (e.g., the left common carotid artery).

[0295] Figure 60A This is a side view of an aortic repair device 6000 implanted within the aorta according to another embodiment of the present technology. In the illustrated embodiment, the aortic repair device 6000 includes a base member 6010 at least partially implanted within the ascending aorta, and a crossing member 6050 coupled to the base member 6010 and extending through the aortic arch into the descending aorta. The base member 6010 may include an inner lumen defined by a diaphragm (e.g., as referenced). Figure 3A-38 (As described in detail in B), the diaphragm sealably engages and secures the proximal portion of the traversing member 6050. Therefore, the traversing member 6050 can guide blood flow distally through the aorta to a diseased portion of the aorta, such as an aortic arch aneurysm. The base member 6010 may also include a leg 6014 extending into a first branch artery (e.g., the brachiocephalic artery) for perfusion of the first branch artery.

[0296] In the illustrated embodiment, the aortic repair device 6000 further includes a first parallel member 6068a and a second parallel member 6068b extending from the aorta to a second branch artery and a third branch artery (e.g., the left common carotid artery and the left subclavian artery, respectively). The first parallel member 6068a and the second parallel member 6068b may include an expandable stent graft and may be arranged at least partially parallel to the crossing member 6050 (e.g., extending adjacent to each other). In some embodiments, the crossing member 6050 and the first parallel member 6068a and the second parallel member 6068b may be conformable to each other and to the wall of the aorta to circumferentially seal the aorta such that blood is substantially contained within the crossing member 6050 and the first parallel member 6068a and the second parallel member 6068b rather than flowing therebetween. Therefore, blood can flow retrogradely from the distal outlet of the crossing member 6050 and enter and pass through the first parallel member 6068a and the second parallel member 6068b to reach the left subclavian artery and the left common carotid artery for perfusion of these vessels. In some aspects of this technology, intravascular delivery of the transect member 6050 and the first parallel member 6068a and the second parallel member 6068b and arranging them in parallel can be relatively easier than docking / attaching these members to the distal basal member.

[0297] Figure 60B and 60C The aortic repair device 6000 and the aortic along the embodiment of the present technology are embodiments of the present technology. Figure 60A The cross-sectional view taken from line 60B-60B in the diagram. Figure 60B A first configuration of the bridging member 6050 and the first parallel member 6068a and the second parallel member 6068b is shown to suppress leakage therebetween (e.g., trench leakage). In the illustrated embodiment, the first parallel member 6068a and the second parallel member 6068b each have a circular cross-sectional shape, and the bridging member 6050 has a generally circular cross-section, including a first channel (e.g., a notch, recess) 6067a and a second channel 6067b formed therein to receive the first parallel member 6068a and the second parallel member 6068b, respectively. Thus, the bridging member 6050 and the first parallel member 6068a and the second parallel member 6068b can together define a generally circular cross-sectional shape for engaging and sealing the aorta.

[0298] Figure 60CA second configuration of the bridging member 6050 and the first parallel member 6068a and the second parallel member 6068b is shown to suppress leakage between them. In the illustrated embodiment, the first parallel member 6068a and the second parallel member 6068b each have a circular cross-sectional shape, and the bridging member 6050 is formed to be more compliant / conformable than the first parallel member 6068a and the second parallel member 6068b, such that the bridging member 6050 can conform to the more rigid first parallel member 6068a and the second parallel member 6068b. In some embodiments, the aortic repair device 6000 may further include a filler material 6069, which at least partially surrounds the bridging member 6050 and the first parallel member 6068a and the second parallel member 6068b, sealing the interface therebetween. The filler material 6069 may be a foam, a hydrogel, and / or other suitable material that is impermeable to blood.

[0299] In some embodiments, multiple base components of the aortic repair device may be nested together to treat all or substantially all of the proximal aorta (e.g., including the ascending aorta and aortic arch). For example, Figures 61A-61F These are side views (e.g., fluorescence fluoroscopic images) of various stages of a surgical procedure in which an aortic repair device 6100 is implanted into a patient's aorta according to an embodiment of the present technology.

[0300] First refer to Figure 61A The first base member 6110a can be implanted into the ascending aorta via, for example, a first catheter 6101. In some embodiments, the first catheter 6101 can be advanced into the ascending aorta via the brachiocephalic artery and / or via a transapical approach. The first base member 6110a may include a body 6112a positioned within the aorta, a leg 6114a extending from the body 6112a into a first branch artery (such as the brachiocephalic artery), and a diaphragm (e.g., as referenced). Figure 3A-38 (As described in detail in B), the diaphragm extends completely or partially through the body 6112a and defines (i) a main lumen for blood flow through the body 6112a to the aorta and (ii) a secondary lumen for blood flow through the body 6112a to the leg 6114a and the first branch artery.

[0301] Next reference Figure 61B A second catheter 6102, which includes (e.g., accommodates, constrains) a second base member 6110b, can be advanced toward the first base member 6110a and into the main lumen of its body 6112a. In some embodiments, the second catheter 6102 can advance through a second branch artery, such as the left common carotid artery, and into the aorta (e.g., via a transcarotid approach).

[0302] like Figure 61C As shown, the second catheter 6102 can be retracted relative to the second base member 6110b to position the second base member 6110b within the first base member 6110a within the aorta. More specifically, the body 6112b of the second base member 6110b can be at least partially positioned within the main lumen of the first base member 6110a, and the leg 6114b of the second base member 6110b can be positioned within a second branch artery (e.g., the left common carotid artery). The body 6112b of the second base member 6110b may include a diaphragm that extends wholly or partially through the body 6112b and defines (i) a main lumen for blood flow through the body 6112b to the aorta and (ii) a secondary lumen for blood flow through the body 6112b to the leg 6114b and the second branch artery. The diaphragm of the body 6112a and the first base member 6110a can be sealingly joined and secure the proximal portion of the body 6112b of the second base member 6110b. In some embodiments, the diameter of the second base member 6110b is smaller than the diameter of the first base member 6110a. In some embodiments, the body 6112b of the second base member 6110b extends distally from the body 6112a of the first base member 6110a to extend the sealing area of ​​the aortic repair device 6100 within the aorta along the ascending aorta and / or the aortic arch.

[0303] Next reference Figure 61D The third base member 6110c can be delivered via a third catheter (not shown) and implanted within the second base member 6110b in the aorta via, for example, a third branch artery (such as the left subclavian artery). More specifically, the body 6112c of the third base member 6110c can be at least partially disposed within the main lumen of the second base member 6110b, and the leg 6114c of the third base member 6110c can be disposed within the third branch artery (e.g., the left subclavian artery). The body 6112c of the second base member 6110c may include a diaphragm that extends wholly or partially through the body 6112c and defines (i) a main lumen for blood flow through the body 6112c to the aorta and (ii) a secondary lumen for blood flow through the body 6112c to the leg 6114c and the third branch artery. The diaphragm of the body 6112b and the second base member 6110b can sealably engage and secure the proximal portion of the body 6112c of the third base member 6110c. In some embodiments, the diameter of the third base member 6110c is smaller than the diameter of the first base member 6110a and the second base member 6110b. In some embodiments, the body 6112c of the third base member 6110c extends distally from the body 6112b of the second base member 6110b to extend the sealing area of ​​the aortic repair device 6100 within the aorta along the ascending aorta and / or the aortic arch.

[0304] Next reference Figure 61E The fourth catheter 6103, which includes (e.g., accommodates, constrains) the member 6150, can be advanced toward the third base member 6110c and into the main lumen of its body 6112c. In some embodiments, the fourth catheter 6103 can advance through the descending aorta.

[0305] like Figure 61F As shown, the fourth catheter 6103 ( Figure 61E The traversing member 6150 can be retracted relative to the traversing member 6150 to position the traversing member 6110c within the third basal member 6110c within the aorta. The diaphragm of the body 6112c and the third basal member 6110c can be sealingly engaged and secure the proximal portion of the traversing member 6150. The traversing member 6150 can extend along the aortic arch and into the descending aorta to guide blood flow distally through the aorta (e.g., to the thoracic descending aorta) across a diseased portion of the aorta, such as an aortic arch aneurysm. (See also: [link to reference]) Figures 61A-61F The aortic repair device 6100 can provide full arch treatment, wherein (i) the leg 6114a of the first base member 6110a directs blood flow to a first branch artery (e.g., the brachiocephalic artery); (ii) the leg 6114b of the second base member 6110b directs blood flow to a second branch artery (e.g., the left common carotid artery); (iii) the leg 6114c of the third base member 6110c directs blood flow to a third branch artery (e.g., the left subclavian artery); (iv) the main lumen of the first to third base members 6110a-c directs blood flow to a traversing member 6150; and (v) the traversing member 6150 directs blood flow to the descending aorta.

[0306] Figure 62A and 62B An embodiment of the present technology is provided for implantation in the aorta. Figures 61A-61F A schematic diagram of the aortic repair device 6100. Specifically, Figure 62B This is an exploded view of the various components of the aortic repair device 6100, showing their relative overlap in the proximal-to-distal direction, and Figure 62A This is a side view of the aorta, showing... Figure 62A The various components shown are implanted within the aorta at specific locations. For example, as... Figure 62B As shown, the first base member 6110a has a proximal portion or opening marked "1A", a distal portion marked "1B" defining an opening or outlet to the main lumen, and a leg marked "1C" defining a distal opening or outlet to the secondary lumen. These components of the first base member 6110a are configured to... Figure 62A Implanted at the corresponding positions indicated by the attached diagram. Figure 62AWithin the aorta shown. For example, the proximal opening of body 6112 (in... Figure 62B The device marked "1A" is configured to be implanted in the ascending aorta, such as Figure 62A As indicated by reference numeral "1A" in the attached drawing, the distal opening of the main body 6112 (in) Figure 62B The 1B (marked in the middle) is configured to be implanted at a proximal opening away from the ascending aorta and / or close to the aortic arch, such as Figure 62A As indicated by reference numeral "1B" in the attached figure, and the distal opening of the leg (in) Figure 62B The device marked "1C" is configured to be implanted into the brachiocephalic artery, such as... Figure 62A As indicated by reference numeral "1C" in the accompanying drawings. The various parts of the second base member 6110b, the third base member 6110c, and the spanning member 6150 are... Figure 61A and Figure 61B Similarly, it is marked in the middle. Therefore, Figure 62A The reference numerals shown in the figures illustrate the relative positioning and / or overlap of the corresponding portions of the base members 6110a-c and the spanning member 6150 when the aortic repair device 6100 is implanted into the aorta.

[0307] In some embodiments, refer together Figure 61A and 61B When the aortic repair device 6100 is implanted into the aorta, at least a portion of each base member 6110a-c and the spanning member 6150 may at least partially overlap (e.g., nest with each other), for example along... Figure 62B Line O is shown in the diagram. Therefore, the aortic repair device 6100 may have four layers of stents along this region, which allows the aortic repair device 6100 to be relatively rigid. In some embodiments, the stents of the base members 6110a-c and / or those spanning one or more of the members 6150 may be configured to increase flexibility and / or reduce thickness along this overlapping region, thereby reducing the total material of the aortic repair device 6100 and / or reducing the stiffness of the aortic repair device 6100.

[0308] For example, Figure 63A and 63B Further embodiments of the present technology are provided for implantation in the aorta. Figures 61A-61F A schematic diagram of the aortic repair device 6100. Various positions indicated by reference numerals (e.g., "1A", "1B", etc.) can be compared with reference numerals. Figures 61A to 62B The locations shown and described in detail are the same. In the illustrated embodiment, each of the base members 6110a-c has a support 6326 along its body, and... Figure 62A and Figure 62BCompared to the stents shown, stent 6326 may have a reduced diameter. In some aspects of this technology, the reduced-diameter stent 6326 may reduce the total material (e.g., metal) of the aortic repair device 6100 and / or increase the relative flexibility of the aortic repair device 6100, while providing sufficient radial strength to configure and open the base members 6100a-c. In some embodiments, a reduced-diameter stent may similarly be included across member 6150, such as in the overlapping region indicated by line O.

[0309] Similarly, Figure 64A and 64B Further embodiments of the present technology are provided for implantation in the aorta. Figures 61A-61F A schematic diagram of the aortic repair device 6100. Various positions indicated by reference numerals (e.g., "1A", "1B", etc.) can be compared with reference numerals. Figures 61A to 62B The locations shown and described in detail are the same. In the illustrated embodiment, each of the base members 6110a-c has a single, reduced-diameter support 6326 at its distal portion, and also includes a segment 6428 of unsupported graft material, wherein... Figures 62A-63B Compared to the embodiments shown, the stent has been omitted. In some aspects of this technology, omitting the stent in the graft material section 6428 can reduce the total material (e.g., metal) of the aortic repair device 6100 and / or increase the relative flexibility of the aortic repair device 6100, while the remaining stent provides sufficient radial strength to configure and open the base members 6100a-c. Additionally, as... Figure 64B As shown, the graft material segment 6428 can be selected such that the aortic repair device 6100 has at least two stent layers in each segment, for example in the overlapping region indicated by line O. In some embodiments, the spanning member 6150 may similarly include a reduced-diameter stent and / or an unsupported portion of the graft material, for example in the overlapping region indicated by line O.

[0310] Figure 65A This is a side view of an aortic repair device 6500 implanted in the ascending aorta according to an embodiment of the present technology. In the illustrated embodiment, the aortic repair device 6500 includes a first base member 6510a implanted at least partially within the ascending aorta and a second base member 6510b coupled to and extending proximally from the first base member 6510a. The base members 6510a-b may each include an inner lumen defined by a diaphragm (e.g., as referenced). Figure 3A-42D(detailed description), and a first leg 6514a and a second leg 6514b. Base members 6510a-b may conform to the aorta and seal against it. At least a portion of the second base member 6510b may extend into at least a portion of the first base member 6510a and seal against at least a portion of the first base member 6510a. For example, the second leg 6514b may extend at least partially into the first leg 6514a or a secondary lumen connected thereto. The first leg 6514a may extend into a first branch artery (e.g., the brachiocephalic artery) to perfuse the first branch artery. Thus, the second base member 6510b may guide blood into the first base member 6510a, which guides blood via the first leg 6514a into the first branch artery and distally through the aorta. In some aspects of this technology, the first base member 6510a may be configured prior to the first base member 6510a, and then the second base member 6510b may be configured at least partially within the first base member 6510a to extend the sealing range of the aortic repair device 6500. In an additional aspect of this technology, configuring the second base member 6510b at least partially within the first base member 6510a can improve configuration accuracy and control over the second base member 6510b.

[0311] Similarly, Figure 65B This is a side view of an aortic repair device 6500 implanted in the descending aorta according to another embodiment of the present technology. In the illustrated embodiment, the second base member 6510b can similarly improve the sealing range of the aortic repair device 6500 in the descending aorta, while also having improved configuration and accuracy, as well as control over its placement within the first base member 6510a. The first base member 6510a can be positioned to perfuse a second branch artery (e.g., the left subclavian artery) via a first arm 6514a. In some embodiments, the cross member can be coupled to... Figure 65A and Figure 65B The aortic repair device 6500 shown is used to completely treat the aortic arch.

[0312] VI. Another embodiment of the aortic repair device with a reduced delivery curve.

[0313] Figures 66A-69B Further embodiments of an aortic repair device are shown, comprising (i) a docking member or base member configured for implantation within the aorta and (ii) multiple crossing members configured to "dock" to the base member to provide different blood flow pathways to the distal aorta and / or branch arteries. Various aortic repair devices may include some features that are at least substantially similar to or identical to each other in structure and function, and / or referenced above. Figure 3A-65B The corresponding features of the aortic repair device are described in detail and can be referenced to each other and / or other sources. Figure 3A-65B The aortic repair devices described operate in a generally similar or identical manner.

[0314] Figure 66A This is a side view of an aortic repair device 6600 implanted in the aorta according to another embodiment of the present technology. Figure 66B It is according to another embodiment of the present technology along Figure 66A A cross-sectional view of the aortic repair device 6600 taken along lines 66B-66B. (See also...) Figure 66A and 66B The aortic repair device 6600 includes a docking member or base member 6610 at least partially implanted within the ascending aorta, and a plurality of traversing members 6650 (each individually identified as first to fourth traversing members 6650a-6650d) coupled to (e.g., docked to) the base member 6610. The base member 6610 and the traversing members 6650 may each include an expandable stent graft. In the illustrated embodiment, each of the traversing members 6650 includes a proximal portion positioned within the base member 6610.

[0315] In some embodiments, the base member 6610 defines a plurality of lumens (e.g., separated by one or more septa of graft material), each lumen configured to receive and secure a corresponding one of the traversing members 6650. In some embodiments, the base member 6610 includes an annulus defining a single lumen, and the traversing members 6650 are positioned therein in a parallel arrangement. In some embodiments, one or more of the traversing members 6650 may be integrally formed with the base member 6610 (e.g., may include an integral “leg”). For example, in the illustrated embodiment, a second traversing member 6650b is integrally formed with the base member 6610.

[0316] In the illustrated embodiment, the outer surface of the base member 6610 engages and seals with the wall of the aorta to circumferentially seal the aorta. The traversing members 6650 may engage and / or conform to each other and engage and / or conform to the inner surface of the base member 6610, such that blood is substantially contained within the traversing members 6650 rather than flowing therebetween. Therefore, blood can flow antegradely through each of the traversing members 6650. In the illustrated embodiment, the first traversing member 6650a has a larger cross-sectional area than each of the second to fourth traversing members 6650b-d and directs blood flow distally through the aorta (e.g., to the descending thoracic aorta) across a diseased portion of the aorta, such as an aortic arch aneurysm. The second to fourth traversing members 6650b-d extend from the base member 6610 to the brachiocephalic artery, the left common carotid artery, and the left subclavian artery, respectively, and direct blood flow thereto perfuse these vessels. In some aspects of this technology, the aortic repair device 6600 is configured to perfuse each of the distal aorta and its superior branches with antegrade blood flow—this can improve the volumetric flow rate through these vessels and help ensure adequate perfusion.

[0317] Figure 67A This is a side view of an aortic repair device 6700 implanted in the aorta according to another embodiment of the present technology. Figure 67B It is according to another embodiment of the present technology along Figure 67A A cross-sectional view of the aortic repair device 6700 taken along lines 67B-67B. (See also: [reference needed]) Figure 67A and 67B The aortic repair device 6700 includes a docking member or base member 6710 at least partially implanted within the descending thoracic aorta, and a plurality of traversing members 6750 (each individually identified as a first traversing member 6750a-6750d) coupled to (e.g., docked to) the base member 6710. Each of the traversing members 6750 may include a distal portion located within the base member 6710. The base member 6710 may include one or more lumens for receiving the distal portions of the traversing members 6750, and / or one or more traversing members 6750 may be integrally formed with the base member 6710. For example, in the illustrated embodiment, a second traversing member 6750b is integrally formed with the base member 6710.

[0318] In the illustrated embodiment, the outer surface of the base member 6710 engages and seals with the wall of the aorta to circumferentially seal the aorta. The distal portions of the traversing members 6750 may engage and / or conform to each other and engage and / or conform to the inner surface of the base member 6710, such that blood is substantially contained within the traversing members 6750 rather than flowing therebetween. In the illustrated embodiment, the first traversing member 6750a has a larger cross-sectional area than each of the second to fourth traversing members 6750b-d and has a proximal portion positioned in the ascending aorta. The first traversing member 6750a may engage and seal with the wall of the ascending aorta, allowing blood to flow antegradely through it toward the base member 6710. Thus, the first traversing member 6750a can distally guide blood flow through the aorta (e.g., to the descending thoracic aorta) across diseased portions of the aorta, such as aortic arch aneurysms. Blood can then flow retrogradely through and across the second to fourth traversing members 6750b-d, which extend from the base member 6710 to the brachiocephalic artery, the left common carotid artery, and the left subclavian artery, respectively, and direct blood flow to these second to fourth traversing members to perfuse these vessels. In some aspects of this technology, the base member 6710 and / or the traversing member 6750 can be delivered via a femoral artery route, since the base member 6710 is not located in the proximal aorta, and therefore the traversing member 6750 does not need to be "connected" to the base member 6710 within the proximal aorta.

[0319] Figure 60A This is a side view of an aortic repair device 6000 implanted in the aorta according to another embodiment of the present technology. Figure 60B It is according to another embodiment of the present technology along Figure 60A A cross-sectional view of the aortic repair device 6000, taken along line 60B-60B. (See also: [reference needed]) Figure 60A and 60B The aortic repair device 6000 includes a docking portion or base member 6010 at least partially implanted within the ascending aorta, and a plurality of traversing members 6050 (each individually identified as first to third traversing members 6050a-6050c) connected to (e.g., docked to) the base member 6010. Each traversing member 6050 may include a proximal portion located within the base member 6010.

[0320] In the illustrated embodiment, the base member 6810 defines a main lumen 6823, a first secondary lumen 6825a, and a second secondary lumen 6825b. In some embodiments, such as Figure 68BAs shown, the base member 6810 includes one or more fabric diaphragms extending therethrough, defining a main lumen 6823, a first secondary lumen 6825a, and / or a second secondary lumen 6825b. In the illustrated embodiment, a second bridging member 6850b is integrally formed with the base member 6810 such that the first secondary lumen 6825a extends continuously through it. The first bridging member 6850a includes a proximal portion that is at least partially positioned within the main lumen 6823 and configured (e.g., shaped, sized) to conform to its circumference and abut against its circumference for a circumferential seal. Similarly, a third bridging member 6850c includes a proximal portion that is at least partially positioned within the second secondary lumen 6825b and configured (e.g., shaped, sized) to conform to the circumference of the second secondary lumen 6825b and abut against the circumferential seal of the second secondary lumen 6825b. Therefore, the traversing member 6850 can engage and / or conform to the circumference of the lumens 6823, 6825a, 6825b and the base member 6810, such that blood is substantially contained within the traversing member 6850 rather than flowing therebetween. The outer surface of the base member 6810 engages with and seals the wall of the aorta to circumferentially seal the aorta. Thus, blood can flow antegradely through each of the traversing members 6850.

[0321] In the illustrated embodiment, the first traversing member 6850a has a larger cross-sectional area than the second traversing member 6850b and the third traversing member 6850c, and directs blood flow distally through the aorta (e.g., to the descending thoracic aorta) across a diseased portion of the aorta, such as an aortic arch aneurysm. The second traversing member 6850b and the third traversing member 6850c extend from the base member 6810 to the brachiocephalic artery and the left common carotid artery, respectively, and direct blood flow to these vessels for perfusion. In some embodiments, the left subclavian artery may be perfused via a surgical bypass or another implant coupled to one or more components of the aortic repair device 6800.

[0322] Figure 69A This is a side view of an aortic repair device 6900 implanted in the aorta according to another embodiment of the present technology. Figure 69B It is according to another embodiment of the present technology along Figure 69A A cross-sectional view of the aortic repair device 6900 taken along lines 69B-69B. (See also: [reference needed]) Figure 69A and 69BThe aortic repair device 6900 includes a docking member or base member 6910 at least partially implanted within the ascending aorta, and a plurality of traversing members 6950 (each individually identified as first to third traversing members 6950a-6950c) connected to (e.g., docked to) the base member 6910. Each of the traversing members 6950 may include a proximal portion located within the base member 6910.

[0323] In the illustrated embodiment, the base member 6910 defines a main lumen 6923, a first secondary lumen 6925a, and a second secondary lumen 6925b. In the illustrated embodiment, each of the traversing members 6950 is a separate component that can be modularly coupled to the base member 6910 (e.g., none of the traversing members 6950 are integrally formed with the base member 6910). The first to third traversing members 6950a-c each include a proximal portion that is at least partially positioned within the main lumen 6923, the first secondary lumen 6925a, and the second secondary lumen 6925b, and is configured (e.g., shaped, sized) to conform to and seal against its circumference. Therefore, the traversing member 6950 can engage and / or conform to the circumference of the lumens 6923, 6925a, 6925b, and the base member 6910, such that blood is substantially contained within the traversing member 6950 rather than flowing therebetween. The outer surface of the base member 6910 engages with and seals the wall of the aorta to circumferentially seal the aorta. Therefore, blood can flow antegradely through each of the traversing members 6950. In some aspects of this technology, forming the traversing members 6950 as separate components not integrally attached to the base member 6910 can reduce the profile of the base member 6910, thereby allowing the base member 6910 to be configured via a smaller delivery catheter and / or a narrower delivery path (e.g., via a transcarotid artery route rather than a transfemoral route).

[0324] In the illustrated embodiment, the first traversing member 6950a has a larger cross-sectional area than the second traversing member 6950b and the third traversing member 6950c, and directs blood flow distally through the aorta (e.g., to the descending thoracic aorta) across a diseased portion of the aorta, such as an aortic arch aneurysm. The second traversing member 6950b and the third traversing member 6950c extend from the base member 6910 to the brachiocephalic artery and the left common carotid artery, respectively, and direct blood flow to these vessels for perfusion. In some embodiments, the left subclavian artery may be perfused via a surgical bypass or another implant coupled to one or more components of the aortic repair device 6900.

[0325] VII. Selected Additional Embodiment of Anchoring Structure for Fixing Aortic Repair Devices

[0326] Figure 70-74BAnother embodiment of the aortic repair device is shown, which includes an anchoring structure for inhibiting proximal migration of the aortic repair device through the aorta. The illustrated aortic repair device may include features that are at least substantially similar to, or identical in structure and function to, those referenced above. Figure 3A-61B The corresponding features of the aortic repair device described in detail are identical and can be referenced to each other and / or by way of reference. Figure 3A-69B The described aortic repair devices operate in a largely similar or identical manner. Similarly, see reference... Figure 70-74B Any anchoring or other features described in detail can be incorporated into Figure 3A-61B In the aortic repair device.

[0327] Figure 70 This is a side view of an aortic repair device 7000 implanted within the aorta according to an embodiment of the present technology. In the illustrated embodiment, the aortic repair device 7000 includes a docking portion or base member 7010 at least partially implanted within the ascending aorta. The base member 7010 may include an expandable stent graft configured to expand and seal around a diseased portion of the aorta and define one or more lumens for modularly receiving one or more traverse members for guiding blood flow distally through the aorta and / or to one or more aortic branch vessels. More specifically, the base member 7010 includes a tubular body 7012 configured to expand within the aorta and seal against it.

[0328] In the illustrated embodiment, the base member 7010 also includes an anchor 7070 (e.g., a root anchor, a proximal anchor) extending proximally from the proximal portion 7011 of the body 7012. In some embodiments, the anchor 7070 comprises a wire having a “hoop-like” shape with a larger expansion diameter than the body 7012. The anchor 7070 may extend at least partially into the aortic root to anchor the body 7012 in a suitable location within the proximal aorta. The aortic root is typically spherical and has a larger maximum diameter than a healthy ascending aorta. The sinus junction is the junction between the distal end of the aortic root and the proximal end of the ascending aorta and is known to have “stronger” tissue (e.g., like the annulus fibrosus) compared to the tissue on either side. Therefore, in some aspects of this technology, the anchor 7070 may at least partially engage the sinus junction, providing the base member 7010 with a robust anchor point that inhibits or even prevents the body 7012 from migrating proximally. In some embodiments, the anchor 7070 may include an opening or arched portion 7071 surrounding the commissure of the aortic valve, providing space for insertion into the commissure such that the aortic valve function is not included.

[0329] In the illustrated embodiment, anchor 7070 includes a plurality of elongated hoop-like shapes spaced circumferentially around body 7012. In other embodiments, anchor 7070 may have other shapes. For example, Figure 71 This is a side view of an aortic repair device 7000 implanted in the aorta and including an anchor 7170 according to another embodiment of the present technology. In the illustrated embodiment, the anchor 7170 is in the form of a wire and includes a plurality of small flaring rings that engage the sinus junction. Figure 71 As shown, these flared suture loops can be extensions of the tubular suture loops forming the body 7010, thereby giving the flared suture loops additional strength to engage the sinus duct junction.

[0330] Figure 72A and 72B This is an enlarged isometric side view of the base component 7210 of an aortic repair device according to an embodiment of the present technology. (See also:) Figure 72A and 72B The base member 7210 includes a tubular body 7212 having a proximal portion 7211, and an anchor 7270 connected to the proximal portion 7211 of the body 7212. In the illustrated embodiment, the anchor 7270 is a circular member, such as an annular support formed of nitinol wire, with a diameter D1 larger than the diameter D2 of the body 7212. The anchor 7270 can be connected by means of... Figure 72A As shown, it is directly attached to the edge of the body 7212 (e.g., via stitch 7273) or through, for example, Figure 72B The proximal portion 7211, positioned within recess 7274 and attached to the body 7212, is shown. The body 7212 may include expandable graft material or a scaffold graft configured to expand and seal around a diseased portion of the aorta and define one or more lumens for modularly receiving one or more traverse members for guiding blood flow distally through the aorta and / or to one or more aortic branch vessels. Anchor 7270 is configured (e.g., sized and shaped to) engage the sinus junction when the base member 7210 is implanted within the aorta to anchor the body 7212 and inhibit or even prevent distal migration of the body 7212. In some aspects of this technology, the base member 7210 may have a windshoe shape when implanted within the aorta.

[0331] Anchor 7270 may include a continuous ring or an open ring (e.g., including a pair of free ends and a slot therethrough) and may collapse to be loaded into a delivery catheter system. For example, Figure 73AIncludes an end view illustrating the sequential collapse of anchor 7270 for loading into a delivery conduit system when anchor 7270 includes a closed loop, according to an embodiment of the present technology. As shown, anchor 7270 can be folded into a figure-eight shape to collapse anchor 7270 into a smaller delivery profile. Similarly, Figure 73B Includes an end view illustrating the sequential collapse of anchor 7270 for loading into a delivery conduit system when anchor 7270 includes an open ring, according to an embodiment of the present technology. As shown, anchor 7270 may include a pair of opposing free ends 7375 that can move relative to each other to coil anchor 7270 into a smaller delivery profile.

[0332] Figure 74A and Figure 74B According to embodiments of the present technology Figure 72B An enlarged isometric side view of the base component 7210. (See also...) Figure 74A and 74B In some embodiments, the anchor 7270 includes an open ring that, when in an extended state, is pushed through a channel 7476 in the body 7212. Figure 74A ) and surrounding the depression 7274 ( Figure 74B The anchor 7270 is positioned within the recess 7274. In some embodiments, the pushing element 7477 and / or the pulling element 7478 may be attached to the proximal and distal ends of the anchor, respectively, and are used to advance the anchor 7270 through the channel 7476 and around the recess 7274. The anchor 7270 may be delivered into the recess 7274 before or after the body 7212 is implanted into the aorta.

[0333] The attachment that is anchored to the aortic wall can be used with Figure 70-74B The base member of the device described herein, or the base member described in Figure 3-69B, or any other bridging member, parallel member, or other element described herein, may be used in conjunction with the device. Anchoring devices that pierce the aortic wall, such as the Heli-FX device manufactured by Medtronic, may also be used. The proximal end of any base member described herein, including... Figure 70-74B The flared end of the base member described herein may be specially reinforced or otherwise designed to accommodate a puncture anchor. An adhesive or other material promoting inward growth may be applied to the member or delivered separately. Stents having protruding elements capable of engaging the aortic wall, such as those described in International Patent Application Publication No. PCT / US2021 / 024020, filed March 24, 2020, entitled “EXPANDABLE DEVICES,” the entire contents of which are incorporated herein by reference, may also be used at the end of the base member to improve engagement with the vessel wall and permanent fixation.

[0334] VIII. Additional embodiments including the selection of aortic repair devices with spiral stents.

[0335] Figure 75A-81B Further embodiments of an aortic repair device including a spiral stent are shown. The illustrated aortic repair device may include features that are at least substantially similar to each other in structure and function, or are identical to each other in structure and function and / or related to those referenced above. Figure 3A-74B The corresponding features of the aortic repair device described in detail are identical and can be referenced from each other and / or by way of reference. Figure 3A-74B The described aortic repair devices operate in a largely similar or identical manner. Similarly, see reference... Figure 75A-81B Any stent or other feature described in detail can be incorporated into Figure 3A-74B In the aortic repair device.

[0336] Figure 75A and 75B These are, respectively, a side view and an enlarged isometric side view of the aortic repair device 7500 according to an embodiment of the present technology. (See also:) Figure 75A and 75B The aortic repair device 7500 may have an aortic axis L ( Figure 75A The aortic repair device 7500 extends in a generally tubular shape and includes a proximal portion 7581 and a distal portion 7583, defining a lumen 7584. In the illustrated embodiment, the aortic repair device 7500 includes graft material 7580 coupled to a stent 7582. In some embodiments, the graft material 7580 may include at least one fold 7585 (e.g., a ridge) extending at least partially between the proximal portion 7581 and the distal portion 7583 in a spiral or other pattern. In some aspects of the art, the fold 7585 may increase the flexibility and / or strength of the aortic repair device 7500 along its length.

[0337] Figure 75C This is an isometric side view of a bracket 7582 according to an embodiment of the present technology. In the illustrated embodiment, the bracket 7582 includes a single integral member that is spirally arranged along and about a longitudinal axis L. Figure 75A Additionally, the support 7582 includes a Z-shaped or V-shaped pattern along its length. The support 7582 may be referred to as a "Z-support," "spiral support," "Z-spiral support," etc. In some embodiments, the support 7582 may include features that enhance the opacity linearity, such as a platinum core and / or opacity linear markings attached thereto.

[0338] Figure 75D It is an implantation in the aorta according to an embodiment of this technology. Figures 75A-75CA side view of the aortic repair device 7500. In the illustrated embodiment, the proximal portion 7581 of the aortic repair device 7500 is implanted within the proximal aorta (e.g., the ascending aorta, the aortic root), and the distal portion 7583 is implanted within the aortic arch and / or the descending thoracic aorta. Therefore, the aortic repair device 7500 can guide blood flow through the lumen 7584 (…). Figure 75B The stent 7582 passes through a diseased portion of the aorta, such as an ascending aortic aneurysm. Superior branches of the aorta (e.g., the brachiocephalic artery, left common carotid artery, and left subclavian artery) can be perfused via retrograde flow, other implants (not shown), and / or surgical bypass. For example, the aortic repair device 7500 can be fenestrated, and one or more branch perfusion components can then be fluidly connected to the fenestration. In some embodiments, the helical orientation of the stent 7582 and graft material 7580 can mimic chiral blood flow through the aorta. In some aspects of this technology, the helical shape of the stent 7582 provides radial, circumferential (e.g., torsional), and longitudinal support to the graft material 7580 during motion induced by the cardiac cycle, as well as flexibility within the aorta (e.g., as opposed to a separate annular stent that may rely on the graft material for longitudinal and circumferential flexibility).

[0339] Let's refer to each other. Figures 75A-75D In some embodiments, the graft material 7580 and the scaffold 7582 may extend together (e.g., as shown in the image). Figure 75A As shown), in other embodiments, the scaffold 7582 may extend further distally than the graft material 7580 (e.g., as shown). Figure 75D (as shown), and vice versa. In addition, the graft material 7580 can be fixedly attached to the stent material 7582 during manufacturing and before delivery to the aorta, or it can be separated from the stent material 7582, so that the graft material 7580 and the stent 7582 can be delivered to the aorta separately.

[0340] For example, Figures 76A-76C This is a side view of an aortic repair device 7600 implanted in the aorta at different stages according to an embodiment of the present technology. (See also: [link to reference]) Figures 76A-76C The aortic repair device 7600 includes a graft material 7680 and a Z-stent 7682, the Z-stent being configured to be positioned within and expand against the graft material 7680.

[0341] refer to Figure 76AThe graft material 7680 may be delivered to the proximal aorta (e.g., the ascending aorta) prior to the Z-stent 7682. In the illustrated embodiment, the graft material 7680 is implanted near the diseased portion (e.g., dissection) of the aorta. In some embodiments, the aortic repair device 7600 includes an anchor 7688 attached to the proximal portion 7681 of the graft material 7680. The anchor 7688 may include a metal frame (e.g., an expandable stent) and may at least temporarily maintain (i) fixation of the graft material 7680 within the aorta, (ii) a seal of the graft material 7680 within the aorta, and / or (iii) patency of the lumen 7684 of the graft material 7680.

[0342] Next, refer to Figure 76B The Z-stent 7682 can be advanced into the lumen 7684 of the graft material 7680 and expand at least partially within the lumen 7684 of the graft material 7680. Upon expansion, the Z-stent 7682 can apply a radially outward force to the graft material 7680, causing the graft material 7680 to seal against the aortic wall, thereby diverting blood flow through the lumen 7684 to the diseased portion of the aorta. In some embodiments, the graft material 7680 can be secured to an anchor 7688 and / or other anchoring structures attached to the graft material 7680.

[0343] In some embodiments, the overall length of the Z-bracket 7682 can be modified to change the pitch of the helical shape, thereby altering the radially outward force provided by the Z-bracket 7682. For example, increasing the length of the Z-bracket 7682 can decrease the radially outward force applied by the Z-bracket 7682, while decreasing the length of the Z-bracket 7682 can increase the radially outward force applied by the Z-bracket 7682. Figure 76C The illustration shows a Z-scaffold 7682, which has a smaller overall length and is fully positioned within the lumen 7684 of the graft material 7680 to provide a more... Figure 76C The arrangement of the Z-stent 7682 shown provides a greater radially outward force. The length of the Z-stent 7682 can be determined and changed during surgery using procedural imaging until the desired radial force is achieved.

[0344] Figure 77A and Figure 77B This is a side view of an aortic repair device 7700 implanted in the aorta at different stages according to an embodiment of the present technology. (See also:) Figure 77A and 77B The aortic repair device 7700 includes a graft material 7780 and a Z-stent 7782 configured to be positioned within and / or around the graft material 7780. (Reference) Figure 77AThe Z-stent 7782 can be delivered to the proximal aorta (e.g., ascending aorta and / or aortic arch) before the graft material 7780. In the illustrated embodiment, the Z-stent 7782 is implanted adjacent to the diseased portion (e.g., dissection) of the aorta. Next, as... Figure 77B As shown, graft material 7780 can advance to and connect to at least a portion of the Z-stent 7782 (e.g., a target anchorage location), such as a portion adjacent to the diseased portion of the aorta. Graft material 7780 may include an anchorage structure (not shown) for interlocking with the Z-stent 7782. After configuration, graft material 7780 is sealed to the aortic wall to redirect blood flow through the aortic repair device 7700, passing through the diseased portion of the aorta.

[0345] Figure 78A and 78B This is a side view of an aortic repair device 7800 implanted in the aorta at different stages according to an embodiment of the present technology. (See also:) Figure 78A and 78B The aortic repair device 7800 includes a graft material 7880 and a Z-stent 7882 configured to be positioned within and expand against the graft material 7880.

[0346] refer to Figure 78A The graft material 7880 may be delivered to the proximal aorta (e.g., the ascending aorta) prior to the Z-stent 7882. In the illustrated embodiment, the graft material 7880 is implanted adjacent to a diseased portion (e.g., an aneurysm) of the aorta. In the illustrated embodiment, the aortic repair device 7800 includes (i) a proximal anchor 7888 attached to the proximal portion 7881 of the graft material 7880 and (ii) a distal anchor 7889 implanted distal to the proximal anchor 7888 (e.g., within the aortic arch and / or the descending thoracic aorta). The proximal anchor 7888 and the distal anchor 7889 may each include a metal frame (e.g., an expandable stent, a mesh, and / or other structure). In the illustrated embodiment, the graft material 7880 is not connected to the distal anchor 7889 and extends only partially distally toward the distal anchor 7889. The proximal anchor 7888 may at least temporarily hold the graft material 7880 in place.

[0347] Next, refer to Figure 78BThe Z-stent 7882 can be advanced into the lumen 7884 of the graft material 7880 and expand at least partially within the lumen 7884 of the graft material 7880. In some embodiments, the graft material 7880 is secured to a proximal anchor 7888 and a distal anchor 7889 within the aorta. Upon expansion, the Z-stent 7882 can apply a radially outward force to the graft material 7880, causing the graft material 7880 to seal against the aortic wall, thereby diverting blood flow through the lumen 7884 to the diseased portion of the aorta.

[0348] Figure 79A and 79B This is a side view of an aortic repair device 7900 implanted in the aorta according to an embodiment of the present technology. (See also:) Figure 79A and 79B The aortic repair device 7900 may include graft material 7980 having a proximal portion 7981, which is attached to a proximal anchor 7988 and at least partially implanted within the proximal aorta. A Z-stent 7982 may be at least partially positioned within the graft material 7980 and secured to the proximal anchor 7988. More specifically, the Z-stent 7982 is elongated and... Figure 79A The central graft material 7980 extends distally, while the Z-scaffold 7982 is compressed and essentially completely contained within it. Figure 79B The graft material 7980 is positioned within the graft to provide greater radially outward force. In the illustrated embodiment, the graft material 7980 includes (i) a main outlet 7990 positioned to direct blood flow distally into the aorta for aortic perfusion, and (ii) an auxiliary outlet 7992 positioned to direct blood flow into branch vessels (e.g., the brachiocephalic artery) for branch vessel perfusion. The auxiliary outlet 7992 may include a branch anchor 7991, such as a stent, coupled thereto for securing the auxiliary outlet 7992 within the brachiocephalic artery.

[0349] In some implementations, multiple segments of the branch graft can be positioned within the aorta to provide complete aortic arch treatment. For example, Figure 80This is a side view of an aortic repair device 8000 implanted within the aorta according to an embodiment of the present technology. In the illustrated embodiment, the aortic repair device 8000 includes a first branch graft 8080a and a second branch graft 8080b implanted within the aorta. More specifically, the first branch graft 8080a is implanted within the proximal aorta adjacent to a diseased portion (e.g., an aneurysm) of the aorta and includes a main outlet 8090a positioned to guide blood flow distally into the aorta and an auxiliary outlet 8092a positioned to guide blood flow into a branch artery (e.g., the brachiocephalic artery). The first branch graft 8080a may be secured to a proximal anchor 8088a and / or a branch anchor 8091a. Similarly, the second branch graft 8080b may be implanted distal to the first branch graft 8080a within the aorta and includes a primary inlet 8090b and an auxiliary outlet 8092b positioned to guide blood flow into a branch artery, such as the left subclavian artery. The second branch graft 8080b can be secured to the distal anchor 8088b and / or the branch anchor 8091b.

[0350] In the illustrated embodiment, the main outlet 8090a of the first branch graft 8080a at least partially overlaps with and seals the main inlet 8090b of the second branch graft 8080b. Therefore, the aortic repair device 8000 is configured to guide blood flow through the first branch graft 8080a and the second branch graft 8080b to the brachiocephalic artery, the left subclavian artery, and distally within the aorta. In some embodiments, a Z-stent (not shown) may be disposed within one or both of the first branch graft 8080a and the second branch graft 8080b to secure the aortic repair device 8000 and help seal it within the aorta.

[0351] Figure 81A This is a side view of an aortic repair device 8100 implanted in the aorta according to an embodiment of the present technology. In the illustrated embodiment, the aortic repair device 8100 includes a Z-stent 8182 and graft material 8180 coupled to the Z-stent 8182. The Z-stent may have a proximal portion 8181 positioned in the proximal aorta (e.g., in the aortic root and / or ascending aorta) and a distal portion 8183 positioned within a branch vessel (such as the brachiocephalic artery). In other embodiments, the distal portion 8183 may be positioned within the aorta or another branch vessel. The graft material 8180 may have (i) a main outlet 8190 positioned to direct blood flow distally into the aorta for aortic perfusion, and (ii) an auxiliary outlet 8192 positioned to direct blood flow into a branch vessel (e.g., the brachiocephalic artery) for branch vessel perfusion.

[0352] The Z-stent 8182 defines a lumen 8194, and the graft material 8180 is attached to the Z-stent 8182 within the lumen 8194, and itself defines a flow lumen 8184. More specifically, Figure 81B This is an enlarged isometric side view of a portion of an aortic repair device 8100 according to an embodiment of the present technology. As shown, the graft material 8180 can be supported within the lumen 8194 by a connecting member 8195 located at a selected point along the stent 8182. For example, see also... Figure 81A and 81B The connecting member 8195 may be attached to the graft material 8180 at and / or near the proximal portion 8181 and the distal portion 8183 to maintain the patency of the flow lumen 8184 and to seal the aortic wall at the proximal portion 8181 and the distal portion 8183 to guide blood flow substantially entirely through the lumen 8184. In some embodiments, the flow lumen 8184 may have a substantially constant diameter between the proximal portion 8181 and the distal portion 8183. In some aspects of this technology, the Z-stent 8182 is oversized relative to the aorta such that movement caused by the cardiac cycle and traversing tortuous anatomy does not substantially affect the patency of the flow lumen 8184. In some embodiments, the graft material 8180 is reinforced with a specific braid density for additional structural support between the connecting members 8195. In some aspects of this technology, positioning the graft material 8180 within the lumen 8194 of the Z-stent 8182 can reduce the total amount of graft material in the device 8100 compared to embodiments where, for example, the graft material 8180 is directly attached to the outer or inner surface of the stent. This can help reduce the overall delivery distribution of the device 8100.

[0353] IX. Selected embodiments of methods for manufacturing aortic repair devices

[0354] Figure 82A-85B Various methods for manufacturing aortic repair devices are illustrated. The methods shown can be used to manufacture reference [devices / facilities]. Figure 3A-81B Describe in detail any aortic repair device or other features.

[0355] In many of the embodiments described above, the different components of the aortic repair device include individual stent grafts that can be modularly coupled (e.g., mated, docked) together such that graft material seals the area of ​​the diseased aorta. In some embodiments, instead of covering the circumference of each stent graft with graft material, graft material can be omitted from some components along the component area configured to contact another stent graft (e.g., reducing excess graft material). As mentioned above, graft material is a major element of the aortic repair device, contributing to the device's volume and thus its ability to be compressed into a smaller diameter catheter for delivery. Therefore, reducing the amount of graft material in this way can reduce the delivery profile of the aortic repair device—potentially allowing the aortic repair device to be loaded into a relatively small catheter and delivered through a relatively small catheter and / or along a narrower intravascular delivery channel.

[0356] More specifically, for example, Figure 82A and 82B These are side views of the branch injection member 8266 and the crossing member 8250, respectively, according to embodiments of the present technology. (See also:) Figure 82A and 82B The branch infusion member 8266 and the crossing member 8250 each include graft material 8258 attached to the support structure 8256 and extending only partially around the support structure 8256.

[0357] Figure 82C This is a side view of a portion of a modularly assembled aortic repair device 8200 according to an embodiment of the present technology. In the illustrated embodiment, the aortic repair device 8200 includes a component connected to a crossing member 8250 ( Figure 82B ) and a plurality of connecting members 8266 of a pair of base members 8210 Figure 82A (See also) Figure 82A-82C The graft material 8258 can be positioned on each component such that the assembled aortic repair device 8200 is completely (or to a selected extent) covered by the graft material 8258. As described above, this reduces the overall profile of the aortic repair device 8200. In another aspect of the technology, the partially covered components can be more easily delivered into the aorta because the open portion of the stent structure 8256 allows blood flow, thereby reducing forces on the components during delivery.

[0358] In many of the embodiments described above, the aortic repair device includes a plurality of annular stents spaced apart from each other, which may be completely exposed or only partially covered by graft material. In some embodiments, it may be advantageous to secure some or all of such ste...

Claims

1. An aortic repair device, comprising: a body having a first end and a second end, the body comprising a frame coupled to a cover defining a fluid conduit, wherein the first end of the body defines a first fluid opening; a septum extending through the body from the second end of the body toward the first end of the body, wherein the septum divides the fluid conduit into a primary lumen having a first cross-sectional area and a secondary lumen having a second cross-sectional area smaller than the first cross-sectional area, and wherein the second end of the body defines a second fluid opening for the primary lumen; as well as A leg extends from the second end of the body, wherein the leg defines a leg lumen fluidly coupled to the secondary lumen, and wherein the leg has an end defining a third fluid opening for the secondary lumen.

2. The aortic repair device according to claim 1, wherein: The body is configured to be implanted in an ascending portion of the thoracic aorta, The covering includes a graft material coupled to the stent, The aortic repair device further includes a plurality of secondary lumen stents positioned in the secondary lumen, The secondary lumen extends along the axis, The secondary lumen stent is configured to expand to an expanded state, and At least one of the secondary luminal stents has a generally D-shape or an arcuate D-shape about the axis in the expanded state.

3. The aortic repair device according to claim 1, wherein: The body is configured to be implanted in the descending portion of the thoracic aorta, The covering includes a graft material coupled to the stent, The aortic repair device further includes a plurality of secondary lumen stents positioned in the secondary lumen, The secondary lumen extends along the axis, The secondary lumen stent is configured to expand to an expanded state, and At least one of the secondary luminal stents has a generally D-shape or an arcuate D-shape about the axis in the expanded state.

4. The aortic repair device of claim 1, wherein the septum extends from the second end of the body and terminates at a distance from the first end of the body.

5. The aortic repair device of claim 1, wherein the septum extends completely from the second end of the body to the first end of the body.

6. The aortic repair device according to claim 1, wherein: The frame of the main body includes a plurality of brackets; The covering includes a graft material coupled to the stent; as well as The aortic repair device also includes a stent structure positioned within the secondary lumen.

7. The aortic repair device according to claim 6, wherein: The support structure is a tubular support.

8. The aortic repair device according to claim 6, wherein: The stent structure includes a plurality of secondary lumen stents.

9. An aortic repair device according to claim 8, wherein the secondary lumen extends along an axis, wherein the secondary lumen stents are configured to expand to an expanded state, and wherein at least one of the secondary lumen stents has a generally circular shape around the axis in the expanded state.

10. The aortic repair device of claim 8, wherein the secondary lumen extends along an axis, wherein the secondary lumen stents are configured to expand to an expanded state, and wherein at least one of the secondary lumen stents has a substantially D-shape about the axis in the expanded state.

11. The aortic repair device of claim 8, wherein the secondary lumen extends along an axis, wherein the secondary lumen stents are configured to expand to an expanded state, and wherein at least one of the secondary lumen stents has an arcuate D-shape about the axis in the expanded state.

12. The aortic repair device according to claim 8, wherein: The secondary lumen extends along an axis, wherein the secondary lumen support is configured to expand to an expanded state, and wherein, in the expanded state: At least one of the secondary lumen supports has a first curved portion extending along the body within the secondary lumen and a second curved portion extending along the septum within the secondary lumen, The first curved portion has a first radius of curvature, and The second curved portion has a second radius of curvature different from the first radius of curvature.

13. The aortic repair device according to claim 12, wherein: The first radius of curvature is smaller than the second radius of curvature.

14. The aortic repair device according to claim 8, wherein: The secondary lumen support only partially extends around the secondary lumen.

15. The aortic repair device according to claim 1, wherein: The body extends along an axis and has a first side portion and a second side portion, the first side portion being proximate to the secondary lumen and the second side portion being proximate to the primary lumen; as well as The frame includes a plurality of brackets, each bracket having an amplitude along the axis, and the amplitude of at least one bracket decreases in a direction from the first side toward the second side.

16. The aortic repair device according to claim 1, wherein: The body extends along an axis and has a first side portion and a second side portion, the first side portion being proximate to the secondary lumen and the second side portion being proximate to the primary lumen; as well as The aortic repair device also includes a tension member positioned at the second side portion and configured to tension the second side portion to have a curved shape.

17. The aortic repair device of claim 16, wherein the framework of the body comprises a plurality of stents, wherein the covering comprises a graft material coupled to the stents, and wherein the tension members comprise a plurality of elastic fibers secured between respective ones of the stents.

18. The aortic repair device of claim 1, wherein the body extends along a first axis and the legs extend along a second axis that is non-parallel to the first axis.

19. The aortic repair device of claim 1, wherein the body has a diameter between about 26-54 mm, and wherein the legs have a diameter between about 10-22 mm.

20. An aortic repair device according to claim 1, wherein the body is configured to be positioned in an ascending portion of the thoracic aorta, such that the first fluid opening receives blood flow from the ascending portion of the thoracic aorta and the second fluid opening discharges the blood flow into the thoracic aorta, and wherein at least a portion of the leg is configured to be positioned within a branch vessel branching from the thoracic aorta.

21. An aortic repair device according to claim 1, wherein the body is configured to be positioned in the descending portion of the thoracic aorta, so that the second fluid opening receives blood flow from the thoracic aorta and the first fluid opening discharges the blood flow into the descending portion of the thoracic aorta, and wherein at least a portion of the leg is configured to be positioned within a branch vessel branching from the thoracic aorta.

22. A method for repairing a thoracic aorta, the method comprising: delivering an aortic repair device intravascularly to a target site in the thoracic aorta; positioning a body of the aortic repair device such that an outer surface of the body sealingly contacts a wall of the thoracic aorta, a first fluid opening of the body being positioned to receive blood flow from the thoracic aorta, and a second fluid opening of the body being positioned to discharge a first portion of the blood flow into the thoracic aorta, wherein the aortic prosthesis device comprises a septum extending at least partially between the first fluid opening and the second fluid opening of the body, the septum dividing the body into a main lumen and a secondary lumen, and wherein the first fluid opening of the body is fluidly coupled to the main lumen to receive the first portion of the blood flow therethrough; and positioning at least a portion of a leg of the aortic repair device within a branch vessel branching from the thoracic aorta such that a third fluid opening of the leg is positioned within the branch vessel to discharge a second portion of the blood flow into the branch vessel, Wherein, the third fluid opening is fluidly coupled to the secondary lumen to receive the second portion of the blood flow therethrough.

23. The method of claim 22, wherein the body has a length extending between the first fluid opening and the second fluid opening, and wherein positioning the body of the aortic repair device comprises positioning the body to sealingly contact the wall of the thoracic aorta along substantially the entire length of the body.

24. The method according to claim 22, wherein: The wall of the thoracic aorta is a wall of an ascending portion of the thoracic aorta, wherein the legs extend from the body proximate the second fluid opening, and wherein the septum extends at least partially from the second fluid opening toward the first fluid opening.

25. The method of claim 24, wherein the branch vessel is the brachiocephalic artery.

26. The method according to claim 24, wherein: The branch vessel is the left subclavian artery.

27. The method of claim 24, wherein the branch vessel is the left common carotid artery.

28. The method of claim 22, wherein: The wall of the thoracic aorta is a wall of a descending portion of the thoracic aorta, wherein the legs extend from the body proximate the first fluid opening, and wherein the septum extends at least partially from the first fluid opening toward the first fluid opening.

29. The method according to claim 28, wherein: The branch vessel is the left subclavian artery.

30. The method of claim 28, wherein the branch vessel is the brachiocephalic artery.

31. The method of claim 28, wherein the branch vessel is the left common carotid artery.

32. The method of claim 22, further comprising expanding a stent structure at least partially within the secondary lumen.

33. The method of claim 32, wherein: Expanding the stent structure includes deploying a tubular stent at least partially within the secondary lumen.

34. The method of claim 32, wherein: Expanding the stent structure includes allowing the plurality of stents within the secondary lumen to self-expand.

35. The method of claim 34, wherein: The brackets each have a generally D-shape or an arcuate D-shape.

36. The method of claim 32, further comprising maintaining the cross-sectional area of ​​the secondary lumen with the stent structure.

37. The method of claim 32, further comprising: positioning a portion of a spanning member of an aortic repair device within a portion of a main lumen of a body; as well as When the portion of the spanning member is positioned within the secondary lumen, the cross-sectional area of ​​the secondary lumen is maintained by the stent structure.

38. The method of claim 37, wherein: The wall of the thoracic aorta is a wall of an ascending portion of the thoracic aorta, wherein the leg extends from the body proximate the second fluid opening, and wherein positioning the portion of the spanning member within the portion of the main lumen of the body comprises inserting the portion of the spanning member through the second fluid opening.

39. The method of claim 37, wherein: The wall of the thoracic aorta is a wall of a descending portion of the thoracic aorta, wherein the leg extends from the body proximate the first fluid opening, and wherein positioning the portion of the spanning member within the portion of the main lumen of the body includes inserting the portion of the spanning member through the first fluid opening.

40. The method of claim 22, wherein positioning the body of the aortic repair device comprises positioning the body adjacent an aortic aneurysm.

41. The method of claim 22, wherein: Positioning the body of the aortic repair device includes positioning the body adjacent to an aortic dissection.

42. An aortic repair device, comprising: A base member, the base member comprising- a body having a first end and a second end, the body comprising a frame coupled to a cover defining a fluid conduit, wherein the first end of the body defines a first bodily fluid opening; a septum extending through the body from the second end of the body toward the first end of the body, wherein the septum divides the fluid conduit into a primary lumen having a first cross-sectional area and a secondary lumen having a second cross-sectional area smaller than the first cross-sectional area, and wherein the second end of the body defines a second bodily fluid opening for the primary lumen; as well as a leg extending from the second end of the body, wherein the leg defines a leg lumen fluidly coupled to the secondary lumen, and wherein the leg has an end defining a leg fluid opening for the secondary lumen; as well as A spanning member having a first end defining a first spanning fluid opening and a second end defining a second spanning fluid opening, wherein the spanning member defines a spanning lumen extending between the first spanning fluid opening and the second spanning fluid opening, and wherein the first end is configured to (a) extend through the second body fluid opening, (b) be secured within the main lumen, and (c) sealingly engage the diaphragm and the body within the main lumen to define a continuous flow path through the main lumen, the first spanning fluid opening, the spanning lumen, and the second spanning fluid opening.

43. The aortic repair device of claim 42, wherein the base member comprises a first stent graft, and wherein the spanning member comprises a second stent graft.

44. An aortic repair device according to claim 42, wherein the framework of the body includes a plurality of stents, wherein the covering includes a graft material connected to the stents, and wherein the base member also includes a stent structure, which is positioned within the secondary lumen to maintain the second cross-sectional area when the first end of the spanning member is fixed within the primary lumen.

45. The aortic repair device of claim 44, wherein the stent structure is a tubular stent.

46. ​​The aortic repair device of claim 44, wherein the stent structure comprises a plurality of secondary lumen stents.

47. An aortic repair device according to claim 46, wherein the secondary lumen extends along an axis, wherein the secondary lumen stents are configured to expand to an expanded state, and wherein at least one of the secondary lumen stents has a generally circular shape around the axis in the expanded state.

48. The aortic repair device of claim 46, wherein the secondary lumen extends along an axis, wherein the secondary lumen stents are configured to expand to an expanded state, and wherein at least one of the secondary lumen stents has a substantially D-shape about the axis in the expanded state.

49. An aortic repair device according to claim 46, wherein the secondary lumen extends along an axis, wherein the secondary lumen stents are configured to expand to an expanded state, and wherein at least one of the secondary lumen stents has a generally arcuate D-shape about the axis in the expanded state.

50. The aortic repair device according to claim 42, wherein: The spanning member has a scalloped pattern at the first end.

51. The aortic repair device of claim 42, wherein the spanning member has a middle portion between the first end and the second end, wherein the first end has a first diameter, and wherein the middle portion has a second diameter that is smaller than the first diameter.

52. An aortic repair device according to claim 42, wherein the spanning member extends along an axis, wherein the spanning member has a middle portion between the first end and the second end, wherein the spanning member includes a graft material connected to a plurality of stents, wherein the stents extend circumferentially around the axis and have a periodic shape around the axis, wherein a first stent of the stents has a first amplitude at the first end, and wherein a second stent of the stents has a second amplitude at the middle portion that is greater than the first amplitude.

53. An aortic repair device according to claim 42, wherein the spanning member extends along an axis, wherein the spanning member has a middle portion between the first end and the second end, wherein the spanning member includes a graft material connected to a plurality of stents, wherein the stents extend circumferentially around the axis and have a periodic shape around the axis, wherein a first stent of the stents has a first frequency at the first end, and wherein a second stent of the stents has a second frequency at the middle portion that is less than the first frequency.

54. An aortic repair device according to claim 42, wherein the spanning member extends along an axis, wherein the spanning member has a middle portion between the first end and the second end, wherein the spanning member includes a graft material connected to a plurality of stents, wherein the stents extend circumferentially around the axis and have a periodic shape around the axis, wherein a first stent of the stents has a first frequency and a first amplitude at the first end, wherein a second stent of the stents has a second frequency and a second amplitude at the middle portion, wherein the first frequency is greater than the second frequency, and wherein the first amplitude is less than the second amplitude.

55. The aortic repair device of claim 42, wherein: The body is configured to be positioned in an ascending portion of the thoracic aorta such that the first body fluid opening receives blood flow from the ascending portion of the thoracic aorta, At least a portion of the leg is configured to be positioned within a branch vessel branching from the thoracic aorta such that the leg (a) receives a first portion of blood flow from the first body fluid opening through the secondary lumen and (b) directs the first portion of blood flow to be discharged through the leg fluid opening to the branch vessel, and The spanning member is configured to be positioned within the thoracic aorta to span the arched portion of the thoracic aorta such that (a) the first spanning inlet receives a second portion of the blood flow from the first body fluid opening through the main lumen, and (b) the spanning lumen directs the second portion of the blood flow to the second spanning outlet for discharge into the thoracic aorta through the second spanning fluid opening.

56. The aortic repair device of claim 42, wherein: The spanning member is configured to be positioned within the thoracic aorta to span an arch of the thoracic aorta such that (a) the second spanning fluid opening receives blood flow from the thoracic aorta, and (b) the spanning lumen directs the blood flow to the first spanning fluid opening, The body is configured to be positioned in a descending portion of the thoracic aorta such that (a) the second body fluid opening receives blood flow from the first spanning fluid opening, and (b) the main lumen directs the blood flow to the first body fluid opening for discharge into the descending thoracic aorta, and At least a portion of the leg is configured to be positioned within a branch vessel branching from the thoracic aorta.

57. The aortic repair device of claim 56, wherein: At least a portion of the leg is configured to be positioned within a branch vessel branching from the thoracic aorta, The first body fluid opening of the body is further configured to receive a portion of the retrograde blood flow from the descending thoracic aorta and / or the blood flow from the main lumen, and The secondary lumen is configured to direct retrograde blood flow and / or a portion of blood flow from the primary lumen to the leg for discharge through the leg fluid opening to a branch vessel.

58. A method for repairing a thoracic aorta, the method comprising: delivering an aortic repair device intravascularly to a target site in the thoracic aorta; positioning a body of the base member of the aortic repair device so that an outer surface of the body sealingly contacts a wall of the thoracic aorta, wherein the body comprises a first body fluid opening, a second body fluid opening, and a septum extending at least partially from the second body fluid opening toward the first body fluid opening, the septum dividing the body into a main lumen and a secondary lumen, and wherein the second bodily fluid opening of the body is fluidly coupled to the main lumen; positioning at least a portion of a leg of the base member within a branch vessel branching from the thoracic aorta such that a leg fluid opening of the leg is positioned within the branch vessel, wherein the leg fluid opening is fluidly coupled to the secondary lumen, and wherein the leg extends from the body proximate the second body fluid opening; positioning a spanning member within the thoracic aorta, wherein the spanning member has a first end defining a first spanning fluid opening and a second end defining a second spanning fluid opening, and wherein the spanning member defines a spanning lumen extending between the first spanning fluid opening and the second spanning fluid opening; positioning the first end of the spanning member within the main lumen through the second body fluid opening; and The first end of the spanning member is sealingly engaged with the septum and the body within the primary lumen to define a continuous flow path through the spanning lumen and the primary lumen.

59. The method of claim 58, wherein: The wall of the thoracic aorta is the wall of the ascending portion of the thoracic aorta, and wherein positioning the body of the base member includes positioning the first body fluid opening to receive blood flow from the ascending portion of the thoracic aorta such that (a) the main lumen receives a first portion of the blood flow and directs the first portion of the blood flow to the second body fluid opening, and (b) the secondary lumen receives a second portion of the blood flow and directs the second portion of the blood flow to the secondary body fluid opening.

60. The method of claim 59, wherein: Positioning the first end of the spanning member within the primary lumen includes positioning the spanning member to (a) receive the first portion of the blood flow from the secondary lumen of the body and (b) discharge the first portion of the blood flow into the thoracic aorta through the second spanning fluid opening.

61. The method of claim 60, wherein: Positioning the spanning member within the thoracic aorta includes positioning the spanning member to span an arched portion of the thoracic aorta, and wherein positioning the first end of the spanning member within the main lumen includes positioning the spanning member to discharge the first portion of the blood flow into a descending portion of the thoracic aorta.

62. The method of claim 58, wherein: The wall of the thoracic aorta is a wall of a descending portion of the thoracic aorta, wherein positioning the spanning member within the thoracic aorta includes positioning the spanning member so that (a) the second spanning fluid opening receives blood flow from the thoracic aorta, and (b) the spanning lumen directs blood flow to the main lumen of the body through the first spanning fluid opening.

63. The method of claim 62, wherein: Positioning the body of the base member includes positioning the first bodily fluid opening to discharge blood flow into a descending portion of the thoracic aorta.

64. The method of claim 63, wherein: The body of the base member is positioned to include: (a) positioning the first fluid opening to receive retrograde blood flow from the descending portion of the thoracic aorta, and (b) positioning the secondary lumen to direct the retrograde blood flow to the leg for discharge to the branch vessel through the leg fluid opening.

65. The method of claim 63, wherein: The diaphragm extends from the second body fluid opening of the body and terminates at a certain distance from the first body fluid opening of the body, and wherein the body of the base member is positioned to include positioning the secondary lumen to (a) receive a portion of the blood flow along the distance, and (b) direct the portion of the blood flow to the leg for discharge to the branch vessel through the leg fluid opening.

66. The method of claim 62, wherein: Positioning the spanning member within the thoracic aorta includes positioning the spanning member to span an arched portion of the thoracic aorta such that the second spanning fluid opening receives blood from an ascending portion of the thoracic aorta.

67. The method of claim 58, wherein: The body has a length extending between the first and second bodily fluid openings, and wherein positioning the body of the base member includes positioning the body to sealingly contact a wall of the thoracic aorta along substantially the entire length of the body.

68. The method of claim 58, wherein: Positioning the spanning member within the thoracic aorta includes positioning the spanning member to span an arched portion of the thoracic aorta.

69. The method of claim 58, further comprising expanding a stent structure at least partially within the secondary lumen to inhibit compression of the septum by the spanning member and to maintain a cross-sectional area of ​​the secondary lumen.

70. The method of claim 69, wherein: Expanding the stent structure includes deploying a tubular stent at least partially within the secondary lumen.

71. The method of claim 69, wherein: Expanding the stent structure includes allowing the plurality of stents within the secondary lumen to self-expand.

72. The method of claim 71 , wherein the stents each have a generally D-shape or a generally arcuate D-shape.

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