Bifurcated Stent Graft Internal Limb for Contralateral Cannulation
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Solution Overview
Problem
The complexity of re-intervening in aortic aneurysm repairs due to anatomical changes, size mismatches, and complications such as endoleak and stent graft migration, which makes cannulation of the contralateral gate of a bifurcated prosthesis challenging, especially when the original stent graft was implanted in suboptimal anatomy or has insufficient design.
Innovation Solution
A bifurcated aortic stent graft with an internal limb that provides easy access for cannulating the contralateral gate, featuring a tubular main body with a diamond-shaped fenestration and nonlinear profile, allowing for insertion and alignment with existing stent graft limbs, and a method for inserting a limb extension through this fenestration for cannulation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If a traditional bifurcated stent graft is used for re-intervention, then the procedure requires complex maneuvers through the patient's anatomy and existing stent graft structure, but the cannulation of the contralateral gate becomes highly difficult and time-consuming
Solution Approach 1:
The internal limb is pre-positioned within the contralateral gate during initial implantation, creating a ready-made access pathway. This preliminary action eliminates the need for complex retrograde maneuvers during re-intervention, as catheters can be directly introduced through the pre-established internal limb channel.
Solution Approach 2:
The internal limb serves as an intermediary structure that mediates access to the contralateral gate. Instead of attempting direct cannulation through dense tissue and existing graft material, the internal limb provides a prepared conduit that facilitates smooth passage of catheters and delivery systems.
2Adaptability or versatility
If the original stent graft was implanted in suboptimal anatomy or has insufficient design, then anatomical changes and disease progression occur over time, but re-intervention becomes highly complex due to size mismatches and migration
Solution Approach 1:
The internal limb is nested within the contralateral gate structure, creating a multi-layered configuration where the internal limb provides an inner access pathway surrounded by the external gate structure. This nesting arrangement allows the device to adapt to anatomical variations while maintaining a relatively simple re-intervention approach through the nested internal channel.
3Reliability
If physicians must identify a landing zone proximal to the original stent graft for reline, then new or further involvement of visceral arteries is required, but this frequently involves complex stenting through fenestrations
Solution Approach 1:
The internal limb is pre-positioned to extend into the contralateral gate during initial implantation, establishing a ready-made access pathway that eliminates the need for subsequent fenestration creation and stenting. This preliminary action ensures reliable access while avoiding the complexity of later visceral artery involvement.
Data Source
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AI summary
A bifurcated endovascular prosthesis (10) that includes a tubular main body (18) having a diameter, a proximal end (12), a distal end (14), an internal lumen extending from the proximal end to the distal end, an anterior side, and a posterior side. The anterior and posterior sides are opposite each other circumferentially around the internal lumen. The prosthesis also includes a first limb (26) that extends from the distal end of the tubular main body along the anterior side of the main body. The first limb has a diameter less than the diameter of the tubular main body and having a proximal end and a distal end. The prosthesis also includes a fenestration (24) adjacent to the proximal end of the first limb. The fenestration extends from the proximal end of the first limb to the posterior side of the tubular main body. The prosthesis also includes a second limb (214) that extends within the internal lumen from the fenestration toward the proximal end of the tubular main body. The fenestration has a substantially diamond shape and a nonlinear profile, and the second limb extends into the lumen along the posterior side of the tubular main body.