Aortic Prosthesis Cuff Design for Sino-Tubular Junction Anchoring
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Solution Overview
Problem
Current endovascular prostheses face challenges in secure implantation and effective treatment of aortic dissections in the ascending thoracic aorta due to limited anchoring options and potential leaks that can exacerbate the condition, especially in the small size of the ascending aorta.
Innovation Solution
A prosthesis with a tubular body made of biocompatible graft material and a cuff configured to conform to the sino-tubular junction, combined with at least one stent for secure fixation, and optionally a second stent extending into the descending aorta, along with internal sockets for secondary prostheses in branch arteries, to ensure proper placement and sealing of the dissection.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a prosthesis is implanted in the ascending aorta to treat aortic dissection, then the dissection is sealed and blood flow into the false lumen is stopped, but secure anchoring is difficult due to the small size of the ascending aorta and limited anchoring options
Solution Approach 1:
The prosthesis incorporates a cuff with fixation elements specifically at the proximal end that can engage with the sino-tubular junction, providing localized anchoring capability in the challenging ascending aorta anatomy. This allows the main body of the prosthesis to maintain sealing function while the cuff provides dedicated fixation at the optimal location.
Solution Approach 2:
The fixation mechanism utilizes the radial dimension by expanding the cuff outward to engage the aortic wall, and the axial dimension by positioning the cuff at the sino-tubular junction. This multi-dimensional anchoring approach overcomes the limited space in the ascending aorta by utilizing spatial relationships in multiple directions.
2Adaptability or versatility
If a modular prosthesis is used to accommodate variations in vessel morphology, then adaptability to different aortic sizes and shapes is improved, but device complexity increases
Solution Approach 1:
The prosthesis is divided into distinct modules including a proximal cuff with fixation elements, a tubular body, and optionally a distal stent portion. This segmentation allows each component to be optimized for its specific function while enabling modular assembly to accommodate different aortic anatomies without requiring completely different device designs.
Solution Approach 2:
The cuff component serves multiple functions: it provides sealing against the aortic wall, offers fixation through engagement with the sino-tubular junction, and accommodates variations in aortic size. This multi-functionality reduces the need for multiple specialized components, thereby managing device complexity while maintaining adaptability.
3Reliability
If the cuff is configured to conform to the sino-tubular junction for secure fixation, then anchoring reliability is improved, but manufacturing precision requirements increase
Solution Approach 1:
The cuff is designed with adjustable geometric parameters including expandability and conformability features that allow it to adapt to the sino-tubular junction anatomy. These parameter changes enable the cuff to achieve reliable fixation through controlled expansion and shaping, reducing the need for extremely precise pre-manufacturing dimensions while maintaining fixation security.
Data Source
AI summary
Prosthesis for implantation in the ascending aorta comprising a tubular body made of biocompatible graft material, a cuff at the proximal portion of the tubular body for biasing pressure onto a sino-tubular junction and that is configured to conform to the junction. A stent assembly can also be used to the prosthesis to bias pressure on the wall of a dissection to substantially deflate a false lumen.