Endovascular Graft Cannulation Pocket for Short Iliac Access
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Solution Overview
Problem
Existing endovascular stent grafts face challenges in designing and manufacturing for patients with short common iliacs due to limited space, and difficulties arise in closing mechanisms for valved fenestrations, making the 'up and over' access method not ideal for all patients.
Innovation Solution
A stent graft with a main tubular body, a side arm, and a cannulation pocket that includes an exit and entry aperture, along with a central self-expanding stent and a temporary diameter reduction constraint arrangement, allowing for ipsilateral access and easier deployment by utilizing the space created by iliac aneurysms rather than relying on the stent graft's lumen or wall access.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If the 'up and over' access method with fenestrations or valves is used, then deployment is possible, but design and manufacturing become difficult for patients with short common iliacs due to lack of space
Solution Approach 1:
The stent graft is divided into distinct functional segments: a main body portion and a separate cannulation pocket portion. The cannulation pocket is positioned away from the main lumen, creating dedicated space for catheter access and covered stent deployment without interfering with the main graft structure or requiring complex valved fenestrations in the common iliac region.
Solution Approach 2:
The cannulation pocket extends laterally from the main tubular body, utilizing the radial dimension to create access space. This lateral extension provides the necessary room for catheter manipulation and covered stent deployment without requiring additional longitudinal space in the common iliac artery, thereby solving the space constraint for short common iliacs.
2Ease of operation
If valved fenestrations are used, then covered stent deployment is enabled, but closing mechanisms become difficult to design
Solution Approach 1:
The cannulation function is extracted from the main stent graft body and placed into a separate cannulation pocket structure. This separation eliminates the need for complex closing mechanisms within the main graft, as the cannulation pocket can be temporarily accessed and then sealed using simpler distal sealing portions without interfering with the main lumen or requiring intricate valved fenestration designs.
Solution Approach 2:
The cannulation pocket acts as an intermediary structure that facilitates covered stent deployment without requiring direct fenestrations in the main graft body. The pocket provides a dedicated access pathway that can be temporarily opened, used for deployment, and then sealed using straightforward distal sealing mechanisms, avoiding the complexity of valved fenestrations with closing mechanisms.
3Adaptability or versatility
If space in the common iliac region is limited, then standard stent graft design is constrained, but the cannulation pocket utilizes space created by iliac aneurysms
Solution Approach 1:
The invention converts the presence of an iliac aneurysm, which creates irregular space, into a beneficial feature by positioning the cannulation pocket within or adjacent to the aneurysmal region. The aneurysm-induced space expansion provides the necessary room for the cannulation pocket without requiring additional longitudinal length in the common iliac artery, thereby adapting the design to patients with short common iliacs.
Data Source
AI summary
A stent graft for placement in a lumen of a patient is disclosed. The stent graft comprises: a main tubular body of a biocompatible graft material having a main lumen, the main tubular body having a proximal end and a distal end; a side arm extending from the main tubular body, the side arm having a side arm lumen, the side arm lumen being in fluid communication with the main lumen through a side arm opening in the main tubular body; and a cannulation pocket. The pocket comprises: an exit aperture positioned opposite the side arm opening; an entry aperture longitudinally spaced from the entry aperture in a direction toward the distal end of the main tubular body; and a wall, the wall laterally spaced from the main lumen so as to provide a guide surface for a cannula fed through the entry aperture.