Endoluminal Prosthesis Fenestration for Aortic Arch Branch Vessels
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Solution Overview
Problem
Current endovascular techniques for treating aneurysms in the ascending aorta or aortic arch are invasive and carry high risks due to the complexity of accessing these areas and the need to manage major arteries and neural ischemia, limiting their suitability for all patients.
Innovation Solution
An endoluminal prosthesis system comprising a main graft and extension grafts that can be deployed within the thoracic aorta, featuring fenestrations and support structures to accommodate branch vessels, allowing for minimally invasive treatment by establishing fluid-tight connections and maintaining blood flow to critical arteries.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If open chest surgery is performed to treat aneurysms in the ascending aorta or arch, then complete repair and replacement can be achieved, but procedural invasiveness and mortality rate increase significantly
Solution Approach 1:
The patent replaces the mechanical open chest surgical system with an endovascular delivery system. The prosthesis is delivered through catheters inserted percutaneously in the femoral artery, eliminating the need for thoracotomy and direct surgical access to the aortic arch. This substitution of delivery mechanism reduces procedural invasiveness while maintaining repair effectiveness.
Solution Approach 2:
The patent introduces an endovascular prosthesis as an intermediary device between the blood flow and the aneurysmal aortic wall. This prosthesis serves as a mediator that restores normal blood flow through the arch while excluding the aneurysm, avoiding direct surgical manipulation of the arch vessels and reducing associated risks.
2Ease of operation
If traditional endovascular techniques are used for ascending aorta or arch aneurysms, then procedural invasiveness is reduced, but technical difficulty and risk increase due to arched nature and proximity to major arteries
Solution Approach 1:
The patent segments the prosthesis into multiple functional zones: a proximal portion for ascending aorta engagement, a mid-portion for arch navigation with fenestrations aligned with branch vessels, and a distal portion for descending aorta placement. This segmentation allows each section to be optimized for its specific functional requirements, simplifying the overall deployment process despite the complex anatomy.
Solution Approach 2:
The patent applies local quality by providing fenestrations and branches only in the mid-portion of the prosthesis where the aortic arch branch vessels (brachiocephalic, left common carotid, left subclavian) originate. The proximal and distal portions maintain different structural characteristics optimized for their respective locations, allowing the prosthesis to address local anatomical requirements without unnecessary complexity throughout its entire length.
3Reliability
If fenestrations are provided for each branch vessel in the aortic arch, then blood flow to all arteries can be maintained, but device complexity and procedural difficulty increase
Solution Approach 1:
The patent applies universality by designing the mid-portion of the prosthesis with fenestrations that can accommodate multiple branch vessels (brachiocephalic, left common carotid, and left subclavian arteries) through a single integrated structure. This multi-functional design allows one prosthesis to serve multiple vascular territories, reducing the need for separate interventions for each branch vessel while maintaining reliable blood flow to all affected arteries.
Data Source
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AI summary
An endoluminal prosthesis system may include a main graft (100) and an extension graft (200). The main graft (100) may include a tubular main body (102) having a sidewall (104), open proximal and distal ends (106, 108), a lumen(110), and a fenestration (114) in the sidewall (104). The extension graft (200) may include a tubular extension body (210), and tubular first and second extension legs (220, 230). Each of the first and second extension legs (220, 230) may extend from the extension body (210) and include a lumen (226,236) in fluid communication with the extension body lumen (216). The extension graft (200) may be deployable within the main graft (100) such that the extension body (200) extends through the fenestration (114) in the sidewall of the main body (102). Each of the first and second extension legs (220, 230) may extend outward away from the main graft (100). An auxiliary guide such as an auxiliary cannula (618) and/or auxiliary guide wire (620) may be preloaded in the extension graft (200) and extend through the lumen of each of the second extension leg and the extension body.