Eversible Branch Stent-Graft Perfusion Continuity
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Solution Overview
Problem
The deployment of branch stent-grafts in vascular procedures is complex and risky due to the need for custom fabrication and temporary interruption of blood perfusion to branch vessels during the formation of side openings in main stent-grafts, which increases the risk of complications, especially when perfusing critical areas like the brain.
Innovation Solution
An eversible branch stent-graft system is deployed with a collateral opening aligned with the ostium of a branch vessel, allowing continuous perfusion through the branch stent-graft during deployment by releasing a branch anchor suture and pulling a branch stent ring suture through the collateral opening to evert the branch stent-graft into the vessel, ensuring uninterrupted blood flow and simplifying the deployment process.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of manufacture
If side openings are formed in situ in the main stent-graft, then custom fabrication is avoided, but perfusion to branch vessels is temporarily interrupted increasing procedural risk
Solution Approach 1:
The branch stent-graft is pre-positioned within the main stent-graft before side opening formation, and blood flow is redirected through the branch stent-graft's collateral opening before the main stent-graft side opening is created. This preliminary positioning and flow redirection ensures perfusion continuity throughout the procedure.
Solution Approach 2:
The branch stent-graft acts as an intermediary structure that provides an alternative perfusion pathway through its collateral opening. This intermediary channel allows blood to bypass the main stent-graft side opening formation process, maintaining continuous flow to the branch vessel.
2Adaptability or versatility
If custom side openings are fabricated in main stent-grafts, then branch vessel perfusion is accommodated, but deployment complexity and time increase
Solution Approach 1:
The system is divided into two independent components: the main stent-graft and the branch stent-graft. The branch stent-graft is a separate, self-contained unit with its own collateral opening that can be independently positioned and deployed, simplifying the overall deployment process while maintaining adaptability to branch vessel locations.
Solution Approach 2:
The branch stent-graft design provides universal applicability for accommodating branch vessels at various locations. The collateral opening can be oriented to match different branch vessel positions without requiring custom fabrication of the main stent-graft, making the system versatile for different patient anatomies.
3Ease of operation
If perfusion to critical vessels like carotids is interrupted, then side openings can be formed, but procedural risk and complications increase
Solution Approach 1:
Blood flow to the branch vessel is maintained continuously throughout the procedure through the branch stent-graft's collateral opening. The useful action of perfusing the branch vessel never ceases, even while the main stent-graft side opening is being formed, thereby eliminating the harmful effect of perfusion interruption.
Data Source
AI summary
A method of deploying an eversible branch stent-graft includes deploying the eversible branch stent-graft into a main vessel such that a collateral opening in a main stent-graft of the eversible branch stent-graft is aligned with an ostium of a branch vessel emanating from the main vessel. A branch stent ring suture threaded though outer exposed crowns of an outer stent ring of the branch stent-graft is grasped and pulled through the collateral opening to evert the branch stent-graft into the branch vessel as a branch anchor suture is removed to release a protruding end of a branch stent-graft from a proximal end of the main stent-graft.