摘要:
A thoracic arch stent graft (1) has a tubular body of a biocompatible graft material (3) and at least one fenestration (13, 15) in the wall on one side thereof. A combination guide and tubular side arm assembly (20, 22) is mounted into the or each fenestration. The combination guide and tubular side arm assembly comprises a tubular portion (24) and a funnel portion (26) extending from a distal end of the tubular portion. The funnel portion has an angled open end. The tubular portion and the funnel portion are formed from a biocompatible graft material wall and have a lightweight space frame (38 40) formed from a resilient wire and supporting the graft material and defining the combination guide and tubular side arm assembly.
摘要:
A fenestration (32) for a stent graft (30). The fenestration is an aperture in the biocompatible graft material and has at least one flap (38, 40) of a biocompatible graft material covering the aperture on the inside whereby the flap closes off the aperture but can be displaced to allow access through the fenestration. An array of such fenestrations may be placed on a stent graft to facilitate alignment of a branch vessel with a fenestration. A slip knot (46, 46) which can be released by forcing a dilator between the flaps can be used to hold the flaps together.
摘要:
A side branch stent graft (1) suitable for the iliac arteries has a main tubular body (3) of a biocompatible graft material and a tubular side branch (5). The tubular side branch is affixed into the main tubular body so that a side branch lumen is in fluid communication with a main lumen. There is at least one external zig-zag stent (13) on the main tubular body proximal of the tubular side branch, one central external stent (14) which also encompasses the side arm, at least one external zig-zag stent (16) on the main tubular body distal of the tubular side branch and one internal zig-zag stent (15) at the distal end of the main tubular body. A reinforcing ring (9) is around the proximal end of the main tubular body and stitched thereto.
摘要:
A deployment system for introducing stent grafts which have a side arm or into which a side arm can be deployed. For instance the stent graft can be deployed into the thoracic arch of a patient. The deployment system including an introducer (1), an auxiliary catheter (13) disposed within the introducer and an auxiliary guide wire (14) disposed within the auxiliary catheter. The auxiliary guide wire extends to adjacent the proximal end (6) of the introducer and can be extended from the proximal end of the introducer so that it can be snared from a side branch artery (56) to assist with deployment of a side arm (23) of the stent graft into the side artery or for the deployment of a side arm stent graft into the stent graft.
摘要:
A pre-loaded stent graft delivery device and stent graft, the stent graft delivery device. The stent graft has at least one fenestration or side arm and the fenestration is preloaded with an indwelling guide wire. Indwelling access sheaths are provided within auxiliary lumens of a pusher catheter and dilators are preloaded into the access sheaths along with the indwelling guide wire. A handle assembly at a distal end of the guide wire catheter. The handle includes a multiport manifold with access ports to the auxiliary lumens in the pusher catheter. Upon deployment of the stent graft into the vasculature of a patient, the indwelling guide wire can be used to facilitate catheterization of a side branch or target vessel through the fenestration or be used to stabilize the access sheath during catheterization, advancement of the access sheath into the target vessel and deployment of a covered or uncovered stent therein through the access sheath.
摘要:
A thoracic arch stent graft (1) has a tubular body of a biocompatible graft material (3) and at least one fenestration (13, 15) in the wall on one side thereof. A combination guide and tubular side arm assembly (20, 22) is mounted into the or each fenestration. The combination guide and tubular side arm assembly comprises a tubular portion (24) and a funnel portion (26) extending from a distal end of the tubular portion. The funnel portion has an angled open end. The tubular portion and the funnel portion are formed from a biocompatible graft material wall and have a lightweight space frame (38 40) formed from a resilient wire and supporting the graft material and defining the combination guide and tubular side arm assembly.
摘要:
A stent graft introducer has a pusher, a nose cone, a region between the pusher and the nose cone for a stent graft, a sleeve extending over the pusher and proximally to the nose cone to cover the stent graft when retained in the region. An indwelling auxiliary catheter with a pre-curved proximal end is fitted into the introducer. The nose cone has an elongate groove and the auxiliary catheter has its proximal end in the elongate groove. In a partially retracted position of the sleeve the curved proximal end of the indwelling auxiliary catheter is exposed and uncovered by the sleeve and in an advanced position of the sleeve the curved proximal end of the indwelling auxiliary catheter is straightened, extends along the length of the groove in the nose cone and is covered by the sleeve.
摘要:
A stent graft (1) has at least one fenestration (13) or low profile side arm (34). A guide assembly (17) surrounds the fenestration or low profile side arm. The guide assembly has a continuous wall extending laterally away from the outer surface of the stent graft. The continuous wall is substantially elliptical or circular and extends distally of the fenestration at a distal end of the wall and being coincident with a proximal part (25) of the periphery of the fenestration or low profile side arm at a proximal end of the wall (23). The wall acts to define a guide area to guide a flexible probe extended from a side branch vessel to enter the fenestration or low profile side arm. Where there are two fenestrations or low profile side arms there can be a single continuous wall (50) around both or separate walls for each. The wall may have a peripheral wire reinforcement (19).
摘要:
A hybrid stent graft device for treatment of a Type A dissection having a first tubular portion for placement into the ascending aorta and a second tubular portion for extending around the thoracic arch and down the descending aorta is disclosed. The first tubular portion is connectable to the aorta between the sinotubular junction and the brachiocephalic artery so that it essentially replaces the ascending aorta. A temporary bypass tube allows perfusion during an operation. The second tubular portion has an elongate recess outside of the second tubular portion and an aperture defining a fluid flow path into the recess. The recess is intended to engage an outer curve of the thoracic arch to enable blood flow into the arteries of the thoracic arch. An introduction device in combination with the hybrid stent graft described above is also disclosed.
摘要:
A pre-loaded stent graft delivery device and stent graft, the stent graft delivery device. The stent graft has at least one fenestration or side arm and the fenestration is preloaded with an indwelling guide wire. Indwelling access sheaths are provided within auxiliary lumens of a pusher catheter and dilators are preloaded into the access sheaths along with the indwelling guide wire. A handle assembly at a distal end of the guide wire catheter. The handle includes a multiport manifold with access ports to the auxiliary lumens in the pusher catheter. Upon deployment of the stent graft into the vasculature of a patient, the indwelling guide wire can be used to facilitate cathertisation of a side branch or target vessel through the fenestration or be used to stabilise the access sheath during catheterisation, advancement of the access sheath into the target vessel and deployment of a covered or uncovered stent therein through the access sheath.