A stent-graft (20) comprises strut members (30) and a graft member (32), which is fixed to the strut members (30). The strut members (30) and the graft member (32) are arranged so as to define, when the stent-graft (20) is in a radially-expanded state: a main tube (40), which is shaped so as to define a main lumen (42); and a lateral tube (50), which (a) has (i) a distal end (52) and (ii) a proximal end (54) that is joined to a lateral wall (56) of the main tube (40) at a junction (60), (b) is shaped so as to define a lateral lumen (62) that is in fluid communication with the main lumen (42), and (c) defines a central longitudinal axis (64). The strut members (30) that define the lateral tube (50) are shaped so as to define two to four non-contiguous arcuate members (70), which (a) are centered around the central longitudinal axis (64), and (b) collectively subtend at least 150 degrees around the central longitudinal axis (64).
A61F 2/91 - Stents in a form characterised by wire-like elementsStents in a form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes
A61F 2/848 - Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents having means for fixation to the vessel wall, e.g. barbs
A61F 2/89 - Stents in a form characterised by wire-like elementsStents in a form characterised by a net-like or mesh-like structure the wire-like elements comprising two or more adjacent rings flexibly connected by separate members
An elongate delivery shaft assembly (30) includes an outer covering shaft (38) and an inner support shaft (40). When the delivery shaft assembly (30) is unconstrained and a stent-graft (20) is removably constrained in a radially-compressed delivery state along a distal end portion (34) of the delivery shaft assembly (30), radially between the outer covering shaft (38) and the inner support shaft (40): (a) the delivery shaft assembly (30) is shaped so as to define a self-orienting portion (50), which (i) is shaped so as to define at least proximal and distal curved portions (52A, 52B), the proximal curved portion (52A) disposed more proximal than the distal curved portion (52B), and (ii) at least one point of inflection (53) on a central longitudinal axis (36) of the delivery shaft assembly (30) longitudinally between the proximal and the distal curved portions (52A, 52B), and (b) respective smallest radii of curvature of the proximal and the distal curved portions (52A, 52B), measured at the central longitudinal axis (36), are each between 2.5 and 12 cm.
A61F 2/966 - Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
A main stent-graft (22) is provided that includes an internal support channel (120) disposed within a generally tubular main fluid flow guide (28). When the internal support channel (120) is in a collapsed state, a distal channel-fluid-flow guide end opening (127B) of a channel fluid flow guide (128) faces radially inward. When the internal support channel (120) is in an expanded state and the main stent- graft (22) is in a radially- expanded deployment state, the distal channel-fluid-flow guide end opening (127B) faces at least partially distally within the main fluid flow guide (28). An elongate member (160A, 160B) is removably positioned passing sequentially through (a) a proximal main- fluid-flow guide end opening (27 A), (b) a longitudinal portion (142) of a main fluid flow lumen (29) of the main- stent-graft fluid flow guide (28), (c) the distal channel-fluid-flow guide end opening (127B), and (d) a main-fluid-flow guide lateral opening (30) to outside the main fluid flow lumen (29). Other embodiments are also described.
A61F 2/966 - Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
An elongate delivery shaft assembly (30) includes an outer covering shaft (38) and an inner support shaft (40). When the delivery shaft assembly (30) is unconstrained and a stent-graft (20) is removably constrained in a radially-compressed delivery state along a distal end portion (34) of the delivery shaft assembly (30), radially between the outer covering shaft (38) and the inner support shaft (40): (a) the delivery shaft assembly (30) is shaped so as to define a self-orienting portion (50), which (i) is shaped so as to define at least proximal and distal curved portions (52A, 52B), the proximal curved portion (52A) disposed more proximal than the distal curved portion (52B), and (ii) at least one point of inflection (53) on a central longitudinal axis (36) of the delivery shaft assembly (30) longitudinally between the proximal and the distal curved portions (52A, 52B), and (b) respective smallest radii of curvature of the proximal and the distal curved portions (52A, 52B), measured at the central longitudinal axis (36), are each between 2.5 and 12 cm.
A61F 2/856 - Single tubular stent with side portal passage
A61F 2/966 - Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
7.
Endovascular stent-graft with fatigue-resistant lateral tube
A stent-graft (20) comprises strut members (30) and a graft member (32), which is fixed to the strut members (30). The strut members (30) and the graft member (32) are arranged so as to define, when the stent-graft (20) is in a radially-expanded state: a main tube (40), which is shaped so as to define a main lumen (42); and a lateral tube (50), which (a) has (i) a distal end (52) and (ii) a proximal end (54) that is joined to a lateral wall (56) of the main tube (40) at a junction (60), (b) is shaped so as to define a lateral lumen (62) that is in fluid communication with the main lumen (42), and (c) defines a central longitudinal axis (64). The strut members (30) that define the lateral tube (50) are shaped so as to define two to four non-contiguous arcuate members (70), which (a) are centered around the central longitudinal axis (64), and (b) collectively subtend at least 150 degrees around the central longitudinal axis (64).
A61F 2/91 - Stents in a form characterised by wire-like elementsStents in a form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes
A61F 2/848 - Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents having means for fixation to the vessel wall, e.g. barbs
A61F 2/89 - Stents in a form characterised by wire-like elementsStents in a form characterised by a net-like or mesh-like structure the wire-like elements comprising two or more adjacent rings flexibly connected by separate members
An endovascular system includes an elongate delivery shaft assembly, which, when a stent-graft is removably constrained in a radially-compressed delivery state along a distal end portion of the delivery shaft assembly, is shaped so as to define a self-orienting portion, which is shaped so as to define (a) at least proximal and distal curved portions, the proximal curved portion disposed more proximal than the distal curved portion, and (b) at least one point of inflection on a central longitudinal axis of the delivery shaft assembly longitudinally between the proximal and the distal curved portions. Upon positioning of a distal tip of the system near a bifurcation of a brachiocephalic artery from an aortic arch, the self-orienting portion automatically rotationally orients itself in the aortic arch to a rotational orientation in which an inferior lateral opening of the stent-graft faces upstream in the aortic arch. Other embodiments are also described.
A61F 2/856 - Single tubular stent with side portal passage
A61F 2/966 - Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
First and second stent-grafts are provided. The first stent-graft defines a first lateral opening, and is configured for positioning a first end thereof in a descending aorta, and a second end thereof in one of the branches of an aortic arch, with the first lateral opening disposed in the aortic arch facing upstream. The second stent-graft includes a second generally tubular support element and a second covering element that partially covers the second support element. The first and the second stent-grafts are configured such that the second stent-graft forms a blood-impervious seal with the first stent-graft around the first lateral opening when the second stent-graft is disposed therethrough such that a proximal portion of the second support element is disposed within the first stent-graft. The second covering element does not fully cover the proximal portion, thereby allowing blood flow through the first stent-graft. Other embodiments are also described.
A61F 2/90 - Stents in a form characterised by wire-like elementsStents in a form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
A method for treating a subject includes providing an endovascular system that includes a stent-graft and an elongate delivery shaft assembly. When the delivery shaft assembly is unconstrained and the stent-graft is removably constrained along a distal end portion of the delivery shaft assembly, the delivery shaft assembly is shaped so as to define a self-orienting portion, which is shaped so as to define at least proximal and distal curved portions. The delivery shaft assembly is transvascularly introduced into a descending aorta of the subject and a distal end of the delivery shaft assembly is advanced to an aortic arch, such that the self-orienting portion assumes a desired rotational orientation in the aortic arch. While the distal end of the delivery shaft assembly is positioned in the aortic arch, the stent-graft is released from the distal end portion of the delivery shaft assembly. Other embodiments are also described.
A61F 2/856 - Single tubular stent with side portal passage
A61F 2/966 - Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
An endovascular stent-graft is provided, including a plurality of circumferential strut members disposed at respective axial positions along a self-curving longitudinal portion thereof. Each of the circumferential strut members is shaped so as to define a plurality of proximal peaks. When the stent-graft is unconstrained in a radially-expanded state, for at least one of the circumferential strut members, a first set of the proximal peaks of the circumferential strut member, which includes at least a circumferentially-closest one of the proximal peaks to an outermost curve of the self-curving longitudinal portion, are bent radially inward at least an average angle of 20 degrees toward a central longitudinal axis of the self-curving longitudinal portion, and a second set of the proximal peaks of the circumferential strut member are not bent radially inward by at least an average angle of 20 degrees toward the central longitudinal axis. Other embodiments are also described.
A stent-graft (20) comprises strut members (30) and a graft member (32), which is fixed to the strut members (30). The strut members (30) and the graft member (32) are arranged so as to define, when the stent-graft (20) is in a radially-expanded state: a main tube (40), which is shaped so as to define a main lumen (42); and a lateral tube (50), which (a) has (i) a distal end (52) and (ii) a proximal end (54) that is joined to a lateral wall (56) of the main tube (40) at a junction (60), (b) is shaped so as to define a lateral lumen (62) that is in fluid communication with the main lumen (42), and (c) defines a central longitudinal axis (64). The strut members (30) that define the lateral tube (50) are shaped so as to define two to four non-contiguous arcuate members (70), which (a) are centered around the central longitudinal axis (64); and (b) collectively subtend at least 150 degrees around the central longitudinal axis (64).
A61F 2/91 - Stents in a form characterised by wire-like elementsStents in a form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes
A61F 2/89 - Stents in a form characterised by wire-like elementsStents in a form characterised by a net-like or mesh-like structure the wire-like elements comprising two or more adjacent rings flexibly connected by separate members
A61F 2/848 - Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents having means for fixation to the vessel wall, e.g. barbs
15.
Multi-component stent-graft system for implantation in a blood vessel with multiple branches
A multi-component stent-graft system is provided, which includes a first stent-graft, which is configured to assume radially-expanded and radially-compressed states; and a second stent-graft, which is configured to assume radially-expanded and radially-compressed states. A delivery tool includes an outer tube, in which the first and the second stent-grafts are initially positioned at respective axial sites within the outer tube, in their radially-compressed states without being fixed to each other. Other embodiments are also described.
A61F 2/90 - Stents in a form characterised by wire-like elementsStents in a form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
An endovascular prosthesis includes a stent-graft and an external coagulation inducer. The stent-graft includes a first portion of structural strut members and a first portion of a graft member, which, when the endovascular prosthesis is unconstrained in a radially-expanded state, together are shaped so as to define a blood-carrying tubular structure defining a lumen. The external coagulation inducer includes an extra-luminal skirt, which includes a second portion of the structural strut members and a second portion of the graft member, and is configured to assume: (i) when the endovascular prosthesis is removably disposed in a delivery sheath, a radially-compressed delivery state, in which the structural strut members of the first portion do not coincide with the structural stent members of the second portion, and (ii) when the endovascular prosthesis is unconstrained, a radially-expanded state, in which the extra-luminal skirt extends radially outward from an external surface of the stent-graft.
An endovascular stent-graft (10, 110, 210, 310) is provided that includes elastic struts (20) and a fluid flow guide (30) that is fixed to first and second subsets (32, 34) of the struts (20). The struts (20) of the first subset (32) are arranged as circumferential cells (80) in circumferentially-continuous rings (56), which cause the fluid flow guide (30) to define substantially cylindrical tubular portions (40). The struts (20) of the second subset (34) cause the fluid flow guide (30) to define a bulge (42) having a greatest bulge radius from a central longitudinal axis (38) that is at least 5% greater than an average radius of the substantially cylindrical tubular portions (40) proximally and distally adjacent the bulge (42). The struts (20) of the second subset (34) define tip portions (50). The number of the tip portions (50) of the struts (20) of the second subset (34) that define the bulge (42) is at least 50% greater than the average number of circumferential cells (80) in the two circumferentially-continuous rings (56) proximally and distally adjacent the bulge (42).
An endovascular stent-graft is provided that includes a flexible stent member and a tubular fluid flow guide. The tubular fluid flow guide includes first and second fabrics. The first fabric includes a first biologically-compatible substantially blood-impervious material, and is attached to and covers the stent member along a first longitudinal portion of the stent-graft. The second fabric includes a second biologically-compatible substantially blood-impervious material different from the first material, and is attached to and covers the stent member along a second longitudinal portion of the stent-graft. The second longitudinal portion is at least partially non-longitudinally-overlapping with the first longitudinal portion. Other embodiments are also described.
A61F 2/966 - Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
Apparatus is provided for use with a delivery catheter, including a primary stent-graft and a flared endovascular stent-graft, which is configured to initially be positioned in the delivery catheter in a radially-compressed state, and to assume a radially-expanded state upon being deployed from the delivery catheter. The primary stent-graft includes: a structural member, which includes a plurality of structural stent elements, and which, when the flared endovascular stent-graft assumes the radially-expanded state, is shaped so as to define a flared caudal portion, which flares radially outward in a caudal direction; at least one biologically-compatible substantially fluid-impervious flexible sheet, which is coupled to at least the flared caudal portion; and a stent-engagement member, which is generally tubular when the flared endovascular stent-graft assumes the radially-expanded state, which is disposed at least partially within the flared caudal portion, and which is configured to be sealingly coupled to the primary stent-graft.
A61F 2/848 - Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents having means for fixation to the vessel wall, e.g. barbs
A61F 2/89 - Stents in a form characterised by wire-like elementsStents in a form characterised by a net-like or mesh-like structure the wire-like elements comprising two or more adjacent rings flexibly connected by separate members
21.
Endovascular stent-graft with fatigue-resistant lateral tube
A stent-graft (20) comprises strut members (30) and a graft member (32), which is fixed to the strut members (30). The strut members (30) and the graft member (32) are arranged so as to define, when the stent-graft (20) is in a radially-expanded state: a main tube (40), which is shaped so as to define a main lumen (42); and a lateral tube (50), which (a) has (i) a distal end (52) and (ii) a proximal end (54) that is joined to a lateral wall (56) of the main tube (40) at a junction (60), (b) is shaped so as to define a lateral lumen (62) that is in fluid communication with the main lumen (42), and (c) defines a central longitudinal axis (64). The strut members (30) that define the lateral tube (50) are shaped so as to define two to four non-contiguous arcuate members (70), which (a) are centered around the central longitudinal axis (64), and (b) collectively subtend at least 150 degrees around the central longitudinal axis (64).
A61F 2/91 - Stents in a form characterised by wire-like elementsStents in a form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes
A61F 2/89 - Stents in a form characterised by wire-like elementsStents in a form characterised by a net-like or mesh-like structure the wire-like elements comprising two or more adjacent rings flexibly connected by separate members
A61F 2/848 - Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents having means for fixation to the vessel wall, e.g. barbs
An endovascular prosthesis (200) includes a stent-graft (240) and an external coagulation inducer (750). The stent-graft (240) includes a first portion (734A) of structural strut members (730) and a first portion (736A) of a graft member (732), which, when the endovascular prosthesis (200) is unconstrained in a radially-expanded state, together are shaped so as to define a blood-carrying tubular structure defining a lumen. The external coagulation inducer (750) includes an extra-luminal skirt (760), which includes a second portion (734B) of the structural strut members (730) and a second portion (736B) of the graft member (732), and is configured to assume: (i) when the endovascular prosthesis (200) is removably disposed in a delivery sheath, a radially- compressed delivery state, in which the structural strut members (730) of the first portion (734A) do not coincide with the structural stent members (730) of the second portion (734B), and (ii) when the endovascular prosthesis (200) is unconstrained, a radially- expanded state, in which the extra-luminal skirt extends (760) radially outward from an external surface (252) of the stent-graft (240).
An endovascular prosthesis (200) includes a stent-graft (240) and an external coagulation inducer (750). The stent-graft (240) includes a first portion (734A) of structural strut members (730) and a first portion (736A) of a graft member (732), which, when the endovascular prosthesis (200) is unconstrained in a radially-expanded state, together are shaped so as to define a blood-carrying tubular structure defining a lumen. The external coagulation inducer (750) includes an extra-luminal skirt (760), which includes a second portion (734B) of the structural strut members (730) and a second portion (736B) of the graft member (732), and is configured to assume: (i) when the endovascular prosthesis (200) is removably disposed in a delivery sheath, a radially- compressed delivery state, in which the structural strut members (730) of the first portion (734A) do not coincide with the structural stent members (730) of the second portion (734B), and (ii) when the endovascular prosthesis (200) is unconstrained, a radially- expanded state, in which the extra-luminal skirt extends (760) radially outward from an external surface (252) of the stent-graft (240).
A deployment system (10, 410) includes an inner shaft (36, 436), removably disposed in a self-expanding stent-graft (40), and shaped so as to define (a) at least one conduit therealong (50, 450), which is (i) not coaxial with the inner shaft (36, 436), and (ii) shaped so as to define at least first (52, 452) and second enclosed longitudinal segments (54, 454), and (b) a restraining longitudinal portion (56, 456) that is longitudinally disposed between the first (52, 452) and second enclosed longitudinal segments (54, 454). The deployment system (10, 410) is configured such that (a) when a restraining wire (60, 460) thereof is removably disposed in the first (52, 452) and second enclosed longitudinal segments (54, 454), a portion (62, 463) of the restraining wire (60, 460) disposed alongside the restraining longitudinal portion (56, 456) prevents full radial expansion of a longitudinal portion (70, 470) of the stent-graft (40) by physically engaging the stent-graft longitudinal portion (70, 470), and (b) when the restraining wire (60, 460) has been withdrawn from at least the first enclosed longitudinal segment (52, 452), the restraining wire (60, 460) does not prevent the full radial expansion of the stent-graft longitudinal portion (70, 470).
A61F 2/966 - Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
An elongate delivery shaft assembly (30) includes an outer covering shaft (38) and an inner support shaft (40). When the delivery shaft assembly (30) is unconstrained and a stent-graft (20) is removably constrained in a radially-compressed delivery state along a distal end portion (34) of the delivery shaft assembly (30), radially between the outer covering shaft (38) and the inner support shaft (40): (a) the delivery shaft assembly (30) is shaped so as to define a self-orienting portion (50), which (i) is shaped so as to define at least proximal and distal curved portions (52A, 52B), the proximal curved portion (52A) disposed more proximal than the distal curved portion (52B), and (ii) at least one point of inflection (53) on a central longitudinal axis (36) of the delivery shaft assembly (30) longitudinally between the proximal and the distal curved portions (52A, 52B), and (b) respective smallest radii of curvature of the proximal and the distal curved portions (52A, 2B), measured at the central longitudinal axis (36), are each between 2.5 and 12 cm.
A61F 2/966 - Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
An endovascular self-curving stent-graft (20) includes a self-curving longitudinal portion (22), which is curved so as to define an innermost curve (26) and an outermost curve (28), when the stent-graft (20) is unconstrained in a radially-expanded state. The stent-graft (20) includes a plurality of circumferential strut members (30); a compression-generation spring (40), which (a) is in an elongated configuration when the stent-graft (20) is in a radially-compressed state, and (b) overlaps respective first portions (44) of at least two of the circumferential strut members (30); and an anti-buckling spring (50), which overlaps respective second portions (54) of at least two of the circumferential strut members (30). The anti-buckling spring (50) and the compression-generation spring (40) are together configured to curve the self-curving longitudinal portion (22) when the stent-graft (20) is unconstrained in the radially-expanded state, such that a lesser length of the self-curving longitudinal portion (22), measured along the innermost curve (26), is less than 80% of a greater length of the self-curving longitudinal portion (22), measured along the outermost curve (28).
A stent-graft (20) comprises strut members (30) and a graft member (32), which is fixed to the strut members (30). The strut members (30) and the graft member (32) are arranged so as to define, when the stent-graft (20) is in a radially-expanded state: a main tube (40), which is shaped so as to define a main lumen (42); and a lateral tube (50), which (a) has (i) a distal end (52) and (ii) a proximal end (54) that is joined to a lateral wall (56) of the main tube (40) at a junction (60), (b) is shaped so as to define a lateral lumen (62) that is in fluid communication with the main lumen (42), and (c) defines a central longitudinal axis (64). The strut members (30) that define the lateral tube (50) are shaped so as to define two to four non-contiguous arcuate members (70), which (a) are centered around the central longitudinal axis (64), and (b) collectively subtend at least 150 degrees around the central longitudinal axis (64).
A stent-graft (20) comprises strut members (30) and a graft member (32), which is fixed to the strut members (30). The strut members (30) and the graft member (32) are arranged so as to define, when the stent-graft (20) is in a radially-expanded state: a main tube (40), which is shaped so as to define a main lumen (42); and a lateral tube (50), which (a) has (i) a distal end (52) and (ii) a proximal end (54) that is joined to a lateral wall (56) of the main tube (40) at a junction (60), (b) is shaped so as to define a lateral lumen (62) that is in fluid communication with the main lumen (42), and (c) defines a central longitudinal axis (64). The strut members (30) that define the lateral tube (50) are shaped so as to define two to four non-contiguous arcuate members (70), which (a) are centered around the central longitudinal axis (64), and (b) collectively subtend at least 150 degrees around the central longitudinal axis (64).
A generally tubular stent-graft (24) has distal and proximal stent-graft ends (36, 38) and includes a generally tubular support element (30) and a covering element (32). When the stent-graft (24) is unconstrained in a radially-expanded state: (1) the covering and support elements (32, 30) are shaped so as to together define a lateral fenestration (34) having distal and proximal fenestration ends (35, 37), (2) a perimeter (P1) of the distal stent-graft end (36) equals at least 200% of a perimeter (P2) of the proximal stent-graft end (38), and (3) the stent-graft (24) includes a dissection-reinforcement axial portion (48), which (a) has a proximal dissection-reinforcement end (52) that is disposed no more than 20 mm proximal to the proximal fenestration end (37), (b) extends along the stent-graft for a distance equal to between 5% and 32% of a greatest perimeter of the stent-graft (24) distally to the distal fenestration end (35), and (c) has a radial strength that is at least 10% greater than an average radial strength of the entire stent-graft (24). Other embodiments are also described.
A61F 2/856 - Single tubular stent with side portal passage
A61F 2/89 - Stents in a form characterised by wire-like elementsStents in a form characterised by a net-like or mesh-like structure the wire-like elements comprising two or more adjacent rings flexibly connected by separate members
An endovascular system (10) includes an endovascular implant (20) and a delivery tool (30). The implant (20) is configured to assume a radially-compressed delivery state, and a radially-expanded deployment state. The delivery tool (30) includes a proximal main delivery catheter (36), having a distal portion (46) in which the implant (20) is disposed while in the radially-compressed delivery state; and a distal restraining assembly (50), which includes a restraining-assembly tubular shaft (52) disposed distal to the proximal main delivery catheter (36). The distal restraining assembly (50) is configured to assume an engaged state, in which the distal restraining assembly (50) prevents proximal displacement of the implant (20) relative to the distal restraining assembly (50), and a disengaged state, in which the distal restraining assembly (50) allows proximal displacement of the implant (20) relative to the distal restraining assembly (50). Other embodiments are also described.
A61F 2/966 - Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
A deployment system (10, 410) includes an inner shaft (36, 436), removably disposed in a self-expanding stent-graft (40), and shaped so as to define (a) at least one conduit therealong (50, 450), which is (i) not coaxial with the inner shaft (36, 436), and (ii) shaped so as to define at least first (52, 452) and second enclosed longitudinal segments (54, 454), and (b) a restraining longitudinal portion (56, 456) that is longitudinally disposed between the first (52, 452) and second enclosed longitudinal segments (54, 454). The deployment system (10, 410) is configured such that (a) when a restraining wire (60, 460) thereof is removably disposed in the first (52, 452) and second enclosed longitudinal segments (54, 454), a portion (62, 463) of the restraining wire (60, 460) disposed alongside the restraining longitudinal portion (56, 456) prevents full radial expansion of a longitudinal portion (70, 470) of the stent-graft (40) by physically engaging the stent-graft longitudinal portion (70, 470), and (b) when the restraining wire (60, 460) has been withdrawn from at least the first enclosed longitudinal segment (52, 452), the restraining wire (60, 460) does not prevent the full radial expansion of the stent-graft longitudinal portion (70, 470).
An endovascular stent-graft is provided that includes a flexible stent member, which includes a plurality of struts, which are shaped so as to define a generally circumferential section; a tubular fluid flow guide, which includes a graft material, and which is attached to the stent member; and at least one fixation member shaped so as to define a base at a first end thereof and a sharp tip at a second end thereof. The base is coupled to one of the struts that are shaped so as to define the generally circumferential section. When the stent-graft is in a radially-expanded deployment state, the fixation member protrudes radially outward. When the stent-graft is in a radially-compressed delivery state, at least a portion of the fixation member between the base and the sharp tip is convex as viewed from outside the stent-graft, such that the sharp tip points radially inward.
A61F 2/82 - Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
A61F 2/966 - Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
A61F 2/848 - Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents having means for fixation to the vessel wall, e.g. barbs
33.
Multi-component stent-graft system for implantation in a blood vessel with multiple branches
A multi-component stent-graft system includes a first stent-graft, and second, third, and fourth branching stent-grafts. The first stent-graft is shaped so as to define, when in a radially-expanded state, proximal and distal superior first lateral openings facing in a first radial direction, and a distal inferior first lateral opening facing a second radial direction generally opposite the first radial direction. The second, third, and fourth branching stent-grafts are configured assume radially-expanded states, wherein the first, the second, the third, and the fourth stent-grafts are configured such that the branching stent-grafts form respective blood-impervious seals with the first stent-graft around the distal inferior first lateral opening, the distal superior first lateral opening, and the proximal superior first lateral opening, respectively, when the branching stent-grafts are disposed therethrough, respectively, and the first, the second, the third, and the fourth stent-grafts are in their radially-expanded states.
A61F 2/90 - Stents in a form characterised by wire-like elementsStents in a form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
An endovascular stent-graft is provided that includes a structural member, which includes structural stent elements, at least a portion of which define a stent body when the stent-graft assumes a radially-expanded state; and a fluid flow guide. When the stent-graft assumes the radially-expanded state, (a) a first subset of the structural stent elements are configured to cause the stent body and the fluid flow guide to define a bulge that extends radially outward and has a greatest cross-sectional area that is equal to at least 120% of a cross-sectional area of a narrowest portion of the stent-graft rostral to the bulge, and (b) a second subset of the structural stent elements are not configured to cause the fluid flow guide to define the bulge. The structural stent elements of the first subset at least partially overlap the structural stent elements of the second subset lengthwise along the stent body.
A61F 2/848 - Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents having means for fixation to the vessel wall, e.g. barbs
A61F 2/89 - Stents in a form characterised by wire-like elementsStents in a form characterised by a net-like or mesh-like structure the wire-like elements comprising two or more adjacent rings flexibly connected by separate members
A generally tubular stent-graft (20) includes a generally tubular support element (30) and a covering element (32) that is attached to and at least partially covers the support element (30). When the stent-graft (20) is unconstrained in a radially-expanded state, a proximal end portion (40) of the covering element (32) is shaped so as to define at least first and second proximally-extending pieces (42A, 42B). When the stent-graft (20) is unconstrained in the radially-expanded state and the proximally-extending pieces (42A, 42B) are fully proximally extended, the proximally-extending pieces (42A, 42B) (a) are shaped so as to define respective distal bases (46), which (i) have respective base lengths (L1) measured circumferentially around the stent-graft (20), and (ii) circumferentially circumscribe respective base arcs (α) of between 100 and 140 degrees, (b) are shaped so as to define respective proximal-most portions (48) more proximal than all other respective portions of the covering element (32) that circumscribe the respective base arcs (α), and (c) have respective axial lengths (L2) that equal between 50% and 150% of the respective base lengths (L1).
A61F 2/90 - Stents in a form characterised by wire-like elementsStents in a form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
36.
Stent-grafts with post-deployment variable radial displacement
A61F 2/89 - Stents in a form characterised by wire-like elementsStents in a form characterised by a net-like or mesh-like structure the wire-like elements comprising two or more adjacent rings flexibly connected by separate members
An endovascular stent-graft (20, 120, 180, 220, 320) includes a fluid flow guide (22), and a plurality of structural stent elements (24) attached to at least a portion of the fluid flow guide (22). The stent-graft is configured to define a generally tubular foldable section (30), which comprises first, second, and third subsections (32, 34, 36). The stent-graft is configured to assume a delivery configuration and a deployment configuration. In the delivery configuration, (a) the stent-graft, including the foldable section (30), is in a radially-compressed state, and (b) the foldable section (30) is in a longitudinally-expanded state, in which state the first and the third subsections (32, 36) longitudinally surround the second subsection (34). In the deployment configuration, (a) the stent-graft, including the foldable section (30), is in a radially-expanded state, and (b) the foldable section (30) is in a longitudinally-folded state, such that the second subsection (34) is radially sandwiched between the first and the third subsections (32, 36). Other embodiments are also described.
A61F 2/966 - Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
A61F 2/89 - Stents in a form characterised by wire-like elementsStents in a form characterised by a net-like or mesh-like structure the wire-like elements comprising two or more adjacent rings flexibly connected by separate members
A61F 2/90 - Stents in a form characterised by wire-like elementsStents in a form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
38.
MULTI-COMPONENT STENT-GRAFT SYSTEM FOR AORTIC DISSECTIONS
A generally tubular stent-graft has distal and proximal stent-graft ends and includes a generally tubular support element and a covering element. When the stent-graft is unconstrained in a radially-expanded state: the covering and support elements are shaped so as to together define a lateral fenestration having distal and proximal fenestration ends, a perimeter of the distal stent-graft end equals at least 200% of a perimeter of the proximal stent-graft end, and the stent-graft includes a dissection-reinforcement axial portion, which (a) has a proximal dissection-reinforcement end that is disposed no more than 20 mm proximal to the proximal fenestration end, extends along the stent-graft for a distance equal to between 5% and 32% of a greatest perimeter of the stent-graft distally to the distal fenestration end, and (c) has a radial strength that is at least 10% greater than an average radial strength of the entire stent-graft.
An endovascular system (10) includes an endovascular implant (20) and a delivery tool (30). The implant (20) is configured to assume a radially-compressed delivery state, and a radially-expanded deployment state. The delivery tool (30) includes a proximal main delivery catheter (36), having a distal portion (46) in which the implant (20) is disposed while in the radially-compressed delivery state; and a distal restraining assembly (50), which includes a restraining-assembly tubular shaft (52) disposed distal to the proximal main delivery catheter (36). The distal restraining assembly (50) is configured to assume an engaged state, in which the distal restraining assembly (50) prevents proximal displacement of the implant (20) relative to the distal restraining assembly (50), and a disengaged state, in which the distal restraining assembly (50) allows proximal displacement of the implant (20) relative to the distal restraining assembly (50). Other embodiments are also described.
A61F 2/966 - Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
40.
STENT-GRAFTS CONFIGURED FOR POST-IMPLANTATION EXPANSION
An endovascular stent-grafl includes a generally tubular body, which is shaped so as to define a stepwise expanding portion, and is configured to assume (a) a radially-compressed delivery state and (b) at least first and second radially expanded deployment states, of which the second has a greater internal penmeter than the first. The tubular body is restrained from transitioning from the first radially expanded deployment state to the second. The tubular body includes a self expandable flexible stent member, and a generally tubular fluid flow guide attached to the stent member and includes a graft material. When the tubular body is in the first radially expanded deployment state, one or more folds of the graft material is radially outside the stent member.
A61F 2/89 - Stents in a form characterised by wire-like elementsStents in a form characterised by a net-like or mesh-like structure the wire-like elements comprising two or more adjacent rings flexibly connected by separate members
41.
STENT-GRAFT WITH FIXATION ELEMENTS THAT ARE RADIALLY CONFINED FOR DELIVERY
An endovascular stent-graft (10) is configured to assume a radially-compressed delivery state and a radially-expanded deployment state, and includes a flexible stent member (24), and a tubular fluid flow guide (26), which is attached to the stent member (24). The stent member (24) includes a generally circumferential section (40) that is shaped so as to define: (a) a plurality of first struts (42), (b) a plurality of second struts (43), and (c) a plurality of fixation members (44), which are coupled to respective ones of the first struts (42). The circumferential section (40) is configured such that (a) when the stent-graft (10) is in the delivery state, the second struts (43) radially constrain the fixation members (44), respectively, from protruding radially outward, and (b) when the stent-graft (10) is in the deployment state, the fixation members (44) are not radially-constrained by the second struts (43) and protrude radially outward.
An endovascular stent-graft (10) includes a generally tubular hourglass-shaped body (22), which is configured to assume a radially-compressed delivery configuration and a radially-expanded deployment configuration. The hourglass -shaped body (22) includes a flexible stent member (26), which includes a plurality of structural stent elements (28); and a tubular fluid flow guide (24), which includes a fabric (29), and is attached to the structural stent elements (28). The hourglass- shaped body (22) is shaped so as to define a narrow waist portion (32) longitudinally surrounded by and adjacent to wider first and second longitudinal portions (30, 34). The fabric (29) along the waist portion (32) is shaped so as to define at least first and second lateral apertures (36, 38). Other embodiments are also described.
An endovascular stent-graft (20, 120, 180, 220, 320) includes a fluid flow guide (22), and a plurality of structural stent elements (24) attached to at least a portion of the fluid flow guide (22). The stent-graft is configured to define a generally tubular foldable 5 section (30), which comprises first, second, and third subsections (32, 34, 36). The stent-graft is configured to assume a delivery configuration and a deployment configuration. In the delivery configuration, (a) the stent-graft, including the foldable section (30), is in a radially-compressed state, and (b) the foldable section (30) is in a longitudinally-expanded state, in which state the first and the third subsections (32, 36) longitudinally surround the 10 second subsection (34).
A multiple-component expandable endoluminal system for treating a lesion at a bifurcation including a self expandable tubular root member having a side-looking engagement aperture, a self expandable tubular trunk member comprising a substantially blood impervious polymeric liner secured therealong; both having a radially compressed state adapted for percutaneous intraluminal delivery and a radially expanded state adapted for endoluminal support.
An endovascular stent-graft (20) includes a generally tubular body (22), which is configured to assume a radially-compressed delivery state and a radially-expanded deployment state. The body (22) includes a flexible stent member (24), and a tubular fluid flow guide (26) attached to the stent member (24). The body (22) includes a compliance-restoration body portion (34), which extends axially along a portion of the body, and which comprises a portion of the stent member (24) and a portion of the fluid flow guide (26). When the body (22) is in the radially-expanded deployment state, the compliance-restoration body portion (34) is (a) characterized by a greatest diastolic outer radius (RD) when the body (22) is internally pressurized by fluid having a pressure of 80 mmHg, and (b) radially expandable to a greatest systolic outer radius (RS) when the body (22) is internally pressurized by fluid having a pressure of 120 mmHg. The greatest systolic outer radius (RS) is at least 5% greater than the greatest diastolic outer radius (RD).
A multi-component endovascular stent system (10) includes an outer generally tubular stent (20), configured to assume radially-compressed and radially-expanded states, and an inner generally tubular stent (22), including a braided metal wire mesh (24) including wire, and configured to assume a radially-compressed and longitudinally-elongated state and a radially-expanded and longitudinally-contracted state. The inner stent (22) is configured to be nested in the outer stent (20), such that the inner and the outer stents (22, 20) are fixed together when the inner stent (22) is in its radially-expanded and longitudinally-contracted state and the outer stent (20) is in its radially-expanded state.
An endovascular stent system (10) includes first and second generally tubular stents An endovascular stent system (10) includes first and second generally tubular stents members (20, 22), which are shaped so as to define first and second interface sections (40, 42), respectively, which are securely coupleable to each other. The first interface section (40) is shaped so as to define an opening (44). The second interface section (42) is shaped so as to define a neck portion (50). When the first and second stent members (20, 22) are coupled together, the neck portion (50) is at least in part defined by:(a) first ones (72) of structural elements (70), positioned at respective first circumferential locations, which are configured to apply, to the opening (44), distally- and radially- outwardly-directed forces, without applying any proximally-directed forces, and (b) separate from the first structural elements (72), second ones (74) of the structural elements (70).
A multi-component stent-graft system (10) comprises first, second, and third generally tubular stent-grafts (20, 22, 24), which are configured to assume radially-expanded states. The first (20) is shaped so as to define a first lateral opening (34) when radially-expanded. The second (22) is shaped so as to define a second lateral opening (44) when radially-expanded. The first and second (20, 22) are configured such that the second (22) forms a blood-impervious seal with the first (20) around the first lateral opening (34) when the second stent-graft (22) is disposed therethrough, and the first and the second (20, 22) are radially-expanded. The second and the third (22, 24) are configured such that the third (24) forms a blood-impervious seal with the second (22) around the second lateral opening (44) when the third (24) is disposed therethrough, and the second and third (22, 24) are radially-expanded. Other embodiments also described.
A61F 2/90 - Stents in a form characterised by wire-like elementsStents in a form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
49.
ENDOVASCULAR SYSTEM WITH CIRCUMFERENTIALLY-OVERLAPPING STENT-GRAFTS
A multi-component endovascular stent-graft system (10) includes a body portion (16), which includes a plurality of stent-grafts (20), which include: (a) respective stent members (22), which are shaped, when the stent-grafts (20) are in respective radially-expanded states, so as to define respective tubes, each of which is circumferentially complete at at least one longitudinal location therealong; and (b) respective graft members (24), which circumscribe respective circumferential arcs (40) of the respective stent members (22). The circumferential arcs (40) have respective extents that are less than entire circumferences of the respective stent members (22) at least partially along respective axial lengths of the stent members (22).
A stent (120) has proximal and distal ends (140, 142), and is configured to assume radially-compressed and radially-expanded states. The stent (120) comprises a plurality of circumferential bands (122) disposed about a longitudinal axis (123) of the stent (120), each of which bands (122) comprises a plurality of struts (124) connected to one another. At least one of the bands (122) is shaped so as to define a plurality of distally-directed peaks (126) alternating with a plurality of proximally-directed troughs (128), and one or more strain-concentration modules (132). Each of the modules (132) has a central axis (156) parallel to the longitudinal axis (123) of the stent (120), and comprises: (a) an open loop section (150), which comprises one of the distally-directed peaks (126); (b) a primary neck section (152); and (c) a secondary section (154). Other embodiments are also described.
Apparatus (10) is provided that includes an extra-vascular ring (12) and an endo vascular stent-graft (14). The ring (12) comprises a structural member (30), which is configured to assume an elongate hollow shape (32), which has first and second longitudinal ends (40, 42), and is suitable for placement at least partially around an aorta (20) so as to provide a generally cylindrical landing zone. The endovascular stent-graft (14) is suitable for endovascular placement inside the aorta (20) such that a portion of the stent-graft (14) is positioned against an internal wall of the aorta (20) at the landing zone provided by the structural member (30). If the structural member (30) is unrolled to a planar shape (82), one side (90) of the planar shape (82) is defined by the first longitudinal end (40), and at least the first longitudinal end (40) has a profile that defines a series of curved portions and has no singularities or discontinuities, which profile extends along at least 50% of the first longitudinal end (40).
An extra-luminal ring (1200) includes a structural member (1202), which assumes a first elongate hollow shape (1206) when in a relaxed state; when deformed to a planar state (1208), generally defines a planar shape (1209) having two first sides (1220A, 1220B) parallel to each other, and two second sides (1222A, 1222B) parallel to each other; and when in the relaxed state, is configured such that the two first sides (1220A, 1220B) are generally straight and parallel with each other, and the two second sides (1222A, 1222B) are curved at least partially around a first longitudinal axis (1230) defined by the first elongate hollow shape (1206). The structural member (1202), when in a deformed state, has a second elongate hollow shape (1240), different from the first elongate hollow shape (1206), in which the two second sides (1222A, 1222B) are generally straight and parallel with each other.
Medical apparatus (100) is provided for insertion into a mammalian body. The apparatus (100) includes structural stent elements (110), at least a portion of which are shaped so as to define (a) at least one generally circumferential band (112), and (b) a plurality of engagement members (114) that are joined to and extend radially inwardly from the band (112). The apparatus (100) further includes an elongated latch member (118) which is threaded through the engagement members (114), thereby physically latching the engagement members (114). The band (112) and the engagement members (114) are configured such that (a) when the latch member (118) is threaded through and thus physically latches the engagement members (114), the engagement members (114) retain the band (112) in a radially-compressed state, and (b) when the latch member (118) is removed from the engagement members (114), the band (112) assumes a radially-expanded state. Other embodiments are also described.
An endovascular sealing stent-graft is configured to initially be positioned in a delivery catheter in a radially-compressed state, and to assume a radially-expanded state upon being deployed from the delivery catheter. The stent-graft includes a structural member, which includes a plurality of structural stent elements, and which, when the stent-graft assumes the radially-expanded state, has a generally tubular shape, and is shaped so as to define at least two elongated indentations, each of which extends rostrally to a rostral end of the structural member, and is tapered in a caudal direction until the indentation converges with the generally tubular shape of the structural member, and each of which has an axial length of at least 2 cm. The stent-graft further includes a fluid flow guide, which is coupled to at least a portion of the structural member, and covers at least a portion of each of the elongated indentations.
A61F 2/848 - Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents having means for fixation to the vessel wall, e.g. barbs
A61F 2/89 - Stents in a form characterised by wire-like elementsStents in a form characterised by a net-like or mesh-like structure the wire-like elements comprising two or more adjacent rings flexibly connected by separate members
A biomedical tester includes a fluid-control container, shaped to define a fluid-control container port and a first interface surface defining fluid-control container apertures. A fluid controller is shaped to define a second interface surface defining controller ports. These elements and a motor are arranged to relative translation between the first and second interface surfaces; thereby effecting a time- varying overlap between subgroups of the system. Fixtures allow disposition therewithin of respective medical devices. Each of the fixtures includes one or more fixture first ports and fixture second ports. The fixture first ports are mounted in fluid Communication respective with the controller ports. A fluid pump includes first and second pump ports in fluid communication with the fixture second ports and the fluid-control container port, respectively.
G01F 17/00 - Methods or apparatus for determining the capacity of containers or cavities, or the volume of solid bodies
G01F 23/00 - Indicating or measuring liquid level or level of fluent solid material, e.g. indicating in terms of volume or indicating by means of an alarm
Apparatus (10) is provided, which includes an endovascular stent-graft (20) and a heating device (22) that is coupled to the stent-graft (20). The stent-graft (20) is configured to be implanted in at least one blood vessel in a vicinity of an aneurysm (102). The heating device (22) is configured to apply, to a region (24) external to the stent-graft (20), thermal energy sufficient to coagulate blood flowing into the aneurysm (102). Other embodiments are also described.
An endovascular tool (10) is provided, which includes a longitudinal delivery shaft (24) and a fin (20) coupled to the delivery shaft (24). The fin (20) is configured to assume (a) a compressed state for endoluminal delivery, and (b) an expanded state for endoluminal deployment, in which state the fin (20) is configured to pivot around an axis of rotation (18). Other embodiments are also described.
A61B 17/22 - Implements for squeezing-off ulcers or the like on inner organs of the bodyImplements for scraping-out cavities of body organs, e.g. bonesSurgical instruments, devices or methods for invasive removal or destruction of calculus using mechanical vibrationsSurgical instruments, devices or methods for removing obstructions in blood vessels, not otherwise provided for
A61D 1/02 - Trocars or cannulas for teatsVaccination appliances
60.
ENDOVASCULAR STENT-GRAFT SYSTEM WITH FENESTRATED AND CROSSING STENT-GRAFTS
An endovascular stent-graft system (10) includes fenestrated and crossing stent-grafts (20, 22). The fenestrated stent-graft (20) defines first and second lateral apertures (40, 42) in a central portion (34) thereof, which apertures (40, 42) face in generally radially opposing directions. The crossing stent-graft (22) includes one or more covering elements (58), which at least partially cover both end portions (44, 46) of the crossing stent-graft (22), such that a central portion (54) is at least partially uncovered. Both stent-grafts (20, 22) are sized and shaped such that, when the crossing stent-graft (22) is disposed through both apertures (40, 42) such that the central portion (54) thereof is within the central portion (34) of the fenestrated stent-graft (20), both end portions (44, 46) of the crossing stent-graft (22) (a) pass through both apertures (40, 42), respectively, and (b) when both stent-grafts (20, 22) are in radially-expanded states, form blood-impervious seals with both apertures (40, 42), respectively.
A stent-graft (20) is provided, which is configured to initially be placed in a delivery shaft (40) in a radially-compressed state, and which comprises a support structure (36) and a covering element (38). The support structure (36) has proximal and distal ends, and is shaped so as to define at least a coupling portion (30), which 5 is configured to transition to a partially-radially-expanded state upon deployment of the stent-graft (20) from the delivery shaft (40), in which state the coupling portion (30) defines a sharp tip (34) at the proximal end of the support structure (36). The covering element (38) is securely attached to and covers at least a portion of the support structure (36). A 10 coupling-end expansion tool (100) is configured to transition the coupling portion (30) from the partially-radially-expanded state to a more-radially-expanded state. Other embodiments are also described.
A61F 2/90 - Stents in a form characterised by wire-like elementsStents in a form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
62.
MULTI-COMPONENT STENT-GRAFT SYSTEM FOR IMPLANTATION IN A BLOOD VESSEL WITH MULTIPLE BRANCHES
A multi-component stent-graft system (10) comprises first, second, and third generally tubular stent-grafts (20, 22, 24), which are configured to assume radially-expanded states. The first (20) is shaped so as to define a first lateral opening (34) when radially-expanded. The second (22) is shaped so as to define a second lateral opening (44) when radially-expanded. The first and second (20, 22) are configured such that the second (22) forms a blood-impervious seal with the first (20) around the first lateral opening (34) when the second stent-graft (22) is disposed therethrough, and the first and the second (20, 22) are radially-expanded. The second and the third (22, 24) are configured such that the third (24) forms a blood-impervious seal with the second (22) around the second lateral opening (44) when the third (24) is disposed therethrough, and the second and third (22, 24) are radially-expanded. Other embodiments also described.
A multi-component stent-graft system (10) comprises first, second, and third generally tubular stent-grafts (20, 22, 24), which are configured to assume radially-expanded states. The first (20) is shaped so as to define a first lateral opening (34) when radially-expanded. The second (22) is shaped so as to define a second lateral opening (44) when radially-expanded. The first and second (20, 22) are configured such that the second (22) forms a blood-impervious seal with the first (20) around the first lateral opening (34) when the second stent-graft (22) is disposed therethrough, and the first and the second (20, 22) are radially-expanded. The second and the third (22, 24) are configured such that the third (24) forms a blood-impervious seal with the second (22) around the second lateral opening (44) when the third (24) is disposed therethrough, and the second and third (22, 24) are radially-expanded. Other embodiments also described.
An endovascular prosthesis (100) comprises a structural member (131), which defines, when the prosthesis (100) assumes an expanded state, a substantially tubular structure (111), and two wings (107, 108), which are coupled to a proximal end (118) of the tubular structure (111). If the wings (107, 108) are placed within and in contact with a right circular cylinder (102), which has a diameter of between 2.5 and 3 cm, such that a distal end (119) of the tubular structure (111) is outside the cylinder (102): (a) an axis (116) of the tubular structure (111) defines an angle of between 75 and 90 degrees with an axis (106) of the cylinder (102), (b) the wings (107, 108) at least partially occupy respective arcs (103A, 103B) of the cylinder (102), at least one of which arcs (103A, 103B) has an angle of no more than 180 degrees, and (c) the wings (107, 108) have respective greatest axial lengths (104) along the cylinder axis (106), at least one of which is at least 1.5 times a diameter (122) of the tubular structure (111).
Medical devices for cardiovascular procedures, namely, synthetic stent grafts and accessories, namely, medical instruments for treating cardiovascular conditions
67.
SIDEPORT ENGAGEMENT AND SEALING MECHANISM FOR ENDOLUMINAL STENT-GRAFTS
An endovascular prosthesis (10) includes first and second endovascular stent-grafts (20, 22), which include respective first and second stent bodies (32, 108), and respective first and second fluid flow guides (102, 109). The first stent-graft (20) is shaped to define an interface portion (103) having a distal interface end (34) that meets a proximal end (36) of the first stent body (32) at a peripheral juncture (104). The second stent-graft (22) defines an interface aperture (110), within which part of the interface portion (103) is positionable. The interface portion (103) comprises engagement support members (105) disposed around a periphery thereof, which are configured to transition from an initial state to (b) a sealing state, thereby sealingly coupling the first stent-graft (20) to the second stent-graft (22) when the part of the interface portion (103) is positioned within the interface aperture (110). Other embodiments are also described.
An endovascular prosthesis (10) includes first and second endovascular stent-grafts (20, 22), which include respective first and second stent bodies (32, 108), and respective first and second fluid flow guides (102, 109). The first stent-graft (20) is shaped to define an interface portion (103) having a distal interface end (34) that meets a proximal end (36) of the first stent body (32) at a peripheral juncture (104). The second stent-graft (22) defines an interface aperture (110), within which part of the interface portion (103) is positionable. The interface portion (103) comprises engagement support members (105) disposed around a periphery thereof, which are configured to transition from an initial state to (b) a sealing state, thereby sealingly coupling the first stent-graft (20) to the second stent-graft (22) when the part of the interface portion (103) is positioned within the interface aperture (110). Other embodiments are also described.
A generally tubular endovascular prosthesis (100) is configured to transition between a radially-compressed state and a radially-expanded state. The prosthesis (100) includes a first generally cylindrical structural portion (101), which has first and second ends (102, 103), and a second generally cylindrical structural portion (104), which has first and second ends (105, 106). The first end (102) of the first structural portion (101) and the first end (105) of the second structural portion (104) meet each other at a juncture (107). The prosthesis (100) is configured to transition from (a) an initial folded state, in which the second structural portion (104) is folded into the first structural portion (101) at the juncture (107), to (b) an unfolded state, in which the second structural portion (104) is no longer positioned within the first structural portion (101), and the second end (103) of the first structural portion (101) and the second end (106) of the second structural portion (104) are positioned at opposite ends of the prosthesis (100). Other embodiments are also described.
A61F 2/90 - Stents in a form characterised by wire-like elementsStents in a form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
An endovascular stent-graft (5) is configured to initially be positioned in a delivery catheter (30) in a radially-compressed state, and to assume a radially-expanded state upon being deployed from the delivery catheter (30). The stent-graft (5) includes a structural member (10), including a plurality of structural stent elements (15), at least a portion of which structural stent elements (15) define a stent body (8) when the stent-graft (5) assumes the radially-expanded state. The stent-graft (5) further includes a fluid flow guide (16), including at least one biologically-compatible substantially fluid-impervious flexible sheet, and coupled to the stent body (8). When the stent-graft (5) assumes the radially-expanded state, the fluid flow guide (16) is shaped so as to define radially- diverging and radially-converging portions (13, 19), which together define a bulge (20) that extends radially outward, and has a greatest cross-sectional area that is equal to at least 120% of a cross-sectional area of a narrowest portion (17) of the stent-graft (5) rostral to the bulge (20). Other embodiments are also described.
An endovascular stent-graft (5) is configured to initially be positioned in a delivery catheter (30) in a radially-compressed state, and to assume a radially-expanded state upon being deployed from the delivery catheter (30). The stent-graft (5) includes a structural member (10), including a plurality of structural stent elements (15), at least a portion of which structural stent elements (15) define a stent body (8) when the stent-graft (5) assumes the radially-expanded state. The stent-graft (5) further includes a fluid flow guide (16), including at least one biologically- compatible substantially fluid-impervious flexible sheet, and coupled to the stent body (8). When the stent-graft (5) assumes the radially-expanded state, the fluid flow guide (16) is shaped so as to define radially- diverging and radially-converging portions (13, 19), which together define a bulge (20) that extends radially outward, and has a greatest cross-sectional area that is equal to at least 120% of a cross-sectional area of a narrowest portion (17) of the stent-graft (5) rostral to the bulge (20). Other embodiments are also described.
Apparatus is provided for use with a delivery catheter, including a primary stent-graft and a flared endovascular stent-graft, which is configured to initially be positioned in the delivery catheter in a radially-compressed state, and to assume a radially- expanded state upon being deployed from the delivery catheter. The primary stent-graft includes: a structural member, which includes a plurality of structural stent elements, and which, when the flared endovascular stent-graft assumes the radially-expanded state, is shaped so as to define a flared caudal portion, which flares radially outward in a caudal direction; at least one biologically-compatible substantially fluid-impervious flexible sheet, which is coupled to at least the flared caudal portion; and a stent-engagement member, which is generally tubular when the flared endovascular stent-graft assumes the radially-expanded state, which is disposed at least partially within the flared caudal portion, and which is configured to be sealingly coupled to the primary stent-graft.
An endovascular stent-graft (5) is configured to initially be positioned in a delivery catheter (30) in a radially-compressed state, and to assume a radially-expanded state upon being deployed from the delivery catheter (30). The stent-graft (5) includes a structural member (10), including a plurality of structural stent elements (15), at least a portion of which structural stent elements (15) define a stent body (8) when the stent-graft (5) assumes the radially-expanded state. The stent-graft (5) further includes a fluid flow guide (16), including at least one biologically-compatible substantially fluid-impervious flexible sheet, and coupled to the stent body (8). When the stent-graft (5) assumes the radially-expanded state, the fluid flow guide (16) is shaped so as to define radially- diverging and radially-converging portions (13, 19), which together define a bulge (20) that extends radially outward, and has a greatest cross-sectional area that is equal to at least 120% of a cross-sectional area of a narrowest portion (17) of the stent-graft (5) rostral to the bulge (20). Other embodiments are also described.
A multiple-component expandable endoluminal system for treating a lesion at a bifurcation including a self expandable tubular root member having a side-looking engagement aperture, a self expandable tubular trunk member comprising a substantially blood impervious polymeric liner secured therealong; both having a radially compressed state adapted for percutaneous intraluminal delivery and a radially expanded state adapted for endoluminal support.
A system for treating an aneurysmatic abdominal aorta, comprising (a) an extra-vascular wrapping (EVW) comprising (i) at least one medical textile member adapted to at least partially encircle a segment of aorta in proximity to the renal arteries, and (ii) a structural member, wherein EVW is adapted for laparoscopic delivery, and (b) an endovascular stent-graft (ESG) comprising (i) a compressible structural member, and (ii) a substantially fluid impervious fluid flow guide (FFG) attached thereto. Also described is an extra-vascular ring (EVR) adapted to encircle the neck of an aortic aneurysm. Further described are methods for treating an abdominal aortic aneurysm, comprising laparoscopically delivering the extra-vascular wrapping (EVW) and endovascularly placing an endovascular stent-graft (ESG). Also described are methods to treat a type I endoleak.
A multiple-component expandable endoluminal system for treating a lesion at a bifurcation including a self expandable tubular root member having a side-looking engagement aperture, a self expandable tubular trunk member comprising a substantially blood impervious polymeric liner secured therealong; both having a radially compressed state adapted for percutaneous intraluminal delivery and a radially expanded state adapted for endoluminal support.
