Pivotable Fenestration for Dynamic Aortic Branch Sealing
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Solution Overview
Problem
Endoluminal prostheses face challenges in accommodating branch vessels during surgical interventions for aneurysms, as they often lack sufficient healthy tissue to seal without blocking blood flow, especially when dealing with multiple branching vessels like the celiac, mesenteric, and renal arteries.
Innovation Solution
The development of an endoluminal prosthesis with pivotable fenestrations that can dynamically adjust to accommodate the geometry of aortic branches, allowing for flexible orientation of branch vessel stents to ensure proper sealing and blood flow, enabling a single geometry to fit various patient anatomies.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a prosthesis is designed with fixed fenestrations to seal branch vessels, then sealing effectiveness is improved, but adaptability to varying patient anatomies deteriorates
Solution Approach 1:
The fenestration is designed with a pivotable band that can rotate relative to the prosthesis body, transitioning from a fixed to a dynamic structure. This allows the fenestration to adapt its orientation to match the specific anatomical configuration of different patients while maintaining effective sealing contact with the branch vessel.
Solution Approach 2:
The band of the fenestration is made flexible to change its angular parameter, allowing rotation between approximately 45 to 135 degrees from the perpendicular axis. This parameter change enables the fenestration to accommodate various anatomical orientations while preserving sealing effectiveness.
2Adaptability or versatility
If a prosthesis is designed with customized geometry for each patient, then adaptability to patient anatomy is improved, but device complexity and manufacturing difficulty deteriorates
Solution Approach 1:
A single standardized prosthesis design incorporates a pivotable fenestration that can accommodate multiple anatomical configurations. This universal design eliminates the need for custom-made prostheses for each patient, reducing manufacturing complexity while maintaining adaptability through the mechanical flexibility of the fenestration.
Solution Approach 2:
The dynamic pivotable fenestration allows one standardized device to perform multiple functions across different patient anatomies, replacing the need for multiple customized device variants.
3Reliability
If a prosthesis uses sufficient healthy tissue for sealing, then sealing effectiveness is improved, but blockage of branch vessels deteriorates
Solution Approach 1:
The prosthesis is segmented with a dedicated fenestration portion that separates the sealing function from the main body. This segmentation allows the fenestration to specifically target and seal the branch vessel opening without requiring extensive healthy tissue from the main vessel, thereby preventing blockage of other branch vessels.
Solution Approach 2:
The fenestration provides localized sealing capability at the branch vessel opening, concentrating the sealing function where needed without affecting other areas. This local quality approach enables effective sealing using minimal healthy tissue while preserving patency of other branch vessels.
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 pivotable fenestrations allow for effective sealing of branch vessels while maintaining unobstructed blood flow, reducing the need for customization and accommodating dynamic anatomical changes, thus enhancing the applicability of 'off-the-shelf' stent grafts for a wide range of aneurysm cases.
Implementation Method 1
The band of material extending from the surface of the prosthesis is sufficiently flexible to permit the fenestration to move such that a branch stent disposed in the fenestration may be oriented upwardly, downwardly, laterally, diagonally and the like
Data Source
AI summary
The present disclosure relates to an endoluminal prosthesis, such as a stent graft that includes one or more fenestrations to accommodate endovascular disease, such as an aneurysm in cases where one or more side branches is involved. In one aspect, the prosthesis includes fenestrations that are pivotable to accommodate the dynamic geometry of the aortic branches. In another aspect, the pivotable fenestrations include a first perimeter, a band of flexible material attached and surrounding the first perimeter, a second perimeter attached to and surrounding the band of flexible material and a support frame disposed about a surface of the band of flexible material. The first perimeter, band of flexible material, and second perimeter have a geometric shape. The support frame includes a plurality of support units having curved segments. The curved segments of the support units may be concave with respect to an exterior surface of the prosthesis.