Double-Branch Aortic Stent-Graft Alignment to Prevent Kinking
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Solution Overview
Problem
Existing endovascular treatments for aortic aneurysms and other acute aortic syndromes, such as aortic dissections and ulcers, face challenges in effectively deploying stent-grafts to bypass anomalies in the aortic arch, particularly in navigating and securing branches like the brachiocephalic artery, left common carotid artery, and left subclavian artery, with existing systems often causing kinks and folds during deployment.
Innovation Solution
A stent-graft system with a flexible main stent-graft and internal support channel that transitions from a collapsed to expanded state, guided by an elongate member or secondary guidewire, allowing secure deployment and navigation through the aortic arch branches without kinking, and a method involving guidewire deployment between access sites to facilitate precise placement.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a conventional stent-graft is deployed in the aortic arch, then the aortic aneurysm or dissection can be treated, but the stent-graft causes kinks and folds during deployment that compromise proper positioning and function
Solution Approach 1:
The stent-graft is divided into multiple segments: a main body portion and one or more branch portions that can be independently positioned. The branch portions are configured to extend into branch vessels (carotid, subclavian arteries) while the main body remains in the aortic arch, allowing each segment to be optimized for its specific location and function, preventing kinks and folds during deployment
Solution Approach 2:
The stent-graft design transitions from a conventional two-dimensional flat configuration to a three-dimensional spatial configuration with branch portions extending in different directions. The branch portions are angled and positioned to match the natural anatomy of branch vessels, enabling the stent-graft to navigate the complex three-dimensional geometry of the aortic arch without creating kinks or folds
2Reliability
If a stent-graft is advanced through the aortic arch branches, then coverage of the anomaly can be achieved, but navigation through complex aortic arch anatomy becomes difficult
Solution Approach 1:
The stent-graft is pre-configured with branch portions that are positioned and oriented to match the expected anatomy of the aortic arch branches. This preliminary configuration allows the device to self-align with the branch vessels during deployment, simplifying the navigation process and ensuring proper coverage of the anomaly without requiring complex manual manipulation
Solution Approach 2:
The stent-graft design incorporates variable parameters including different angles, lengths, and orientations of branch portions that can be customized to match specific patient anatomy. By changing these geometric parameters to match the individual aortic arch configuration, the device becomes easier to navigate and deploy while ensuring reliable anomaly coverage
3Reliability
If the stent-graft is deployed in expanded state, then proper function and patency can be maintained, but the delivery system becomes excessively complex
Solution Approach 1:
The stent-graft is designed to be nested within a delivery catheter in a compressed state during delivery. The branch portions are folded or collapsed within the catheter lumen, allowing the entire device to be delivered through a relatively simple catheter system. Upon deployment, the stent-graft expands to its functional three-dimensional configuration, maintaining patency without requiring an overly complex delivery system
Data Source
AI summary
A main stent-graft (22) is provided that includes an internal support channel (120) disposed within a generally tubular main fluid flow guide (28). When the internal support channel (120) is in a collapsed state, a distal channel-fluid-flow guide end opening (127B) of a channel fluid flow guide (128) faces radially inward. When the internal support channel (120) is in an expanded state and the main stent-graft (22) is in a radially-expanded deployment state, the distal channel-fluid-flow guide end opening (127B) faces at least partially distally within the main fluid flow guide (28). An elongate member (160A, 160B) is removably positioned passing sequentially through (a) a proximal main-fluid-flow guide end opening (27A), (b) a longitudinal portion (142) of a main fluid flow lumen (29) of the main-stent-graft fluid flow guide (28), (c) the distal channel-fluid-flow guide end opening (127B), and (d) a main-fluid-flow guide lateral opening (30) to outside the main fluid flow lumen (29). Other embodiments are also described.