Fenestrated Prosthesis with Dynamic Sealing for Collateral Perfusion
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Solution Overview
Problem
Existing aortic prostheses face challenges in maintaining perfusion of collateral arteries during and after installation, as they often occlude these arteries, leading to potential damage or lack of blood supply, and struggle with precise positioning and sealing around collateral artery ostia, resulting in leakage and incomplete exclusion of aneurysms.
Innovation Solution
A prosthesis with a flexible fabric liner comprising multiple concentric layers that allow blood perfusion during installation and subsequent sealing by fibrin, enabling non-cutting passage formation for interconnecting branches with collateral arteries, ensuring controlled blood flow and secure sealing without occluding collateral arteries.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a prosthesis is installed intraluminally to treat aneurysms and aortic dissections, then the diseased portion is isolated and rupture is prevented, but collateral arteries may be occluded during expansion and installation
Solution Approach 1:
The prosthesis incorporates fenestrations at specific locations corresponding to collateral artery ostia, creating localized openings that maintain blood flow to critical branches while the rest of the prosthesis remains sealed to exclude the aneurysm. This local modification allows differential functionality across the prosthesis surface.
Solution Approach 2:
The prosthesis is divided into functional segments: sealed portions for aneurysm exclusion and fenestrated portions for collateral artery perfusion. The fenestrations create discrete openings that segment the prosthesis wall, allowing selective blood flow paths through the device structure.
2Ease of operation
If fenestrations are provided at precise locations to match collateral artery ostia, then blood flow continuity is maintained, but positioning precision and manufacturing complexity increase
Solution Approach 1:
The fenestrations are pre-formed in the prosthesis at manufacturing stage rather than created during implantation. This preliminary action allows precise positioning to be achieved through controlled manufacturing processes, reducing the skill requirement during surgical implantation while ensuring accurate alignment with collateral arteries.
Solution Approach 2:
The prosthesis employs different material properties and structural parameters in different regions: the fenestrated zones have modified porosity and structural characteristics compared to the sealed zones, allowing the same base material to achieve both precise positioning and functional differentiation through parameter variation.
3Ease of operation
If the prosthesis wall is made open to allow blood passage during installation, then collateral arteries remain perfused, but sealing becomes difficult after installation
Solution Approach 1:
The prosthesis transitions from a dynamic open state during implantation to a static sealed state after deployment. The fenestrations provide controlled openness during the installation phase, then sealing mechanisms (such as apposition to the vessel wall or deployment of sealing elements) convert the structure to a sealed configuration, achieving both requirements through temporal state changes.
Solution Approach 2:
The prosthesis functionality changes periodically: initially open to allow blood flow and facilitate installation, then sealed to prevent leakage and exclude the aneurysm. This periodic transition from open to sealed state resolves the contradiction between maintaining perfusion during installation and achieving reliable sealing afterward.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The prosthesis allows for successful installation and perfusion of collateral arteries during surgery, preventing occlusion and leakage, while ensuring complete exclusion of aneurysms by forming a sealed connection with collateral vessels, maintaining blood flow and preventing aneurysmal sac pressurization.
Implementation Method 1
which said pores are sealed by the fibrin of the patient's blood after said period of time has elapsed
Data Source
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AI summary
A prosthesis for repairing a blood vessel, wherein the prosthesis is inserted intraluminally and fixed in the vessel so as to isolate a diseased section thereof and maintain the flow of blood from the vessel to collateral vessels involved in the diseased section, and the prosthesis comprises a stent support and a flexible fabric liner of woven material comprising a plurality of concentric layers, wherein each of said layers has a very open fabric web which allows the passage of blood flow through the layers during the installation of the prosthesis but which allows the sealing of layers once the prosthesis is installed. A method is also provided for safe installation of the prosthesis.