Introducer for deploying a stent graft in a curved lumen and stent graft therefor

Patent metadata

Field	Value
Publication number	US-10675140-B2
Application number	US-201715839115-A
Country	US
Kind code	B2
Filing date	Dec 12, 2017
Priority date	Oct 31, 2008
Publication date	Jun 9, 2020
Grant date	Jun 9, 2020

Abstract

A stent graft for deployment in a curved lumen such as the aortic or thoracic arch comprises a constraining mechanism at its proximal end. A stent provided at the proximal end of the stent graft includes loops of material that co-operate with restraining wires that extend between a central guide wire carrier and a restraining wire cannula. The constraining mechanism maintains the proximal stent constrained at both of its proximal and distal ends. The proximal stent can then expand after expansion of the remainder of the stent graft during deployment. In an embodiment, the constraining mechanism acts to constrain two adjacent struts of the proximal stent at three points radially therearound, at the proximal end of the stent and at the distal end of the stent. The proximal stent may then overlap with the interior of an adjacent stent at an inner part of a curved vessel.

First claim

We claim:

1. An introducer for deploying a stent graft in a curved lumen, the introducer comprising:
a stent graft having an internal lumen, and a carrier for the stent graft, the stent graft disposed over the carrier for the stent graft;
the stent graft comprising a tube of graft material, a proximal stent at a proximal end of the stent graft entirely overlapping the graft material of the tube of graft material, and a distally adjacent stent, the proximal stent having a proximal end having a plurality of proximal apices and a distal end having a plurality of distal apices, wherein each of the proximal and distal ends of the proximal stent have a constrained circumference and an expanded circumference;
a first constraining mechanism configured to maintain the proximal end of the proximal stent at a partially constrained circumference on the carrier;
a second constraining mechanism configured to maintain the distal end of the proximal stent at a partially constrained circumference such that the distal end of the proximal stent is pulled inwardly towards the carrier, wherein the second constraining member comprises at least one thread that extends about the entire circumference of the stent graft such that first lengths of the at least one thread extend partially circumferentially about an exterior of the tube of graft material at a plurality of points and second lengths of the at least one thread extend through the graft material and at least partially circumferentially about an interior of the tube of graft material at a plurality of points to form a plurality of inwardly extending loops of thread within the internal lumen between the distal end of the proximal stent and the carrier such that the distal end of the proximal stent is pulled toward the carrier from the interior of the tube of graft material,
one or more longitudinally extending wire release mechanisms engaging the constraining mechanisms,
wherein each of the plurality of loops of the second constraining member engages one or more of the longitudinally extending wire release mechanisms; and
wherein the longitudinally extending wire release mechanisms are configured to release the proximal end of the proximal stent to the expanded circumference prior to the release of the distal end of the proximal stent to the expanded circumference.

2. The introducer of claim 1 , wherein the longitudinally extending wire release mechanism includes at least three longitudinally extending wires.

3. The introducer of claim 1 , wherein at the constrained circumference the proximal end of the proximal stent is pulled inwardly towards the carrier at at least two points each to form substantially equally sized lobes.

4. The introducer of claim 1 , wherein at the constrained circumference the proximal end of the proximal stent is pulled inwardly towards the carrier at at least three points each to form substantially equally sized lobes.

5. The introducer of claim 1 , wherein each of the loops of threads are disposed at a distal apex of the plurality of distal apices between two struts that form the apex.

6. The introducer of claim 1 , wherein the first lengths of the thread that extend partially circumferentially about the exterior of the tube of graft material extend at least partially between struts of adjacent distal apices.

7. The introducer of claim 6 , wherein the second lengths of the thread that extend partially circumferentially about the interior of the tube of graft material extend at least partially between struts of adjacent distal apices.

8. The introducer of claim 6 , wherein the first lengths of the thread that extend partially circumferentially about the exterior of the tube of graft material each extend over a strut of a first distal apex to a next adjacent strut of a second distal apex and over the next adjacent strut and through the graft material.

9. The introducer of claim 1 , wherein the at least one thread comprises a single length of thread circumscribing the entire circumference of the distal end of the proximal stent substantially entirely on the outside of the stent graft and only extends partially within the inner lumen of the stent graft at the plurality of apices.

10. An introducer for deploying a stent graft in an at least partially curved lumen, the introducer comprising:
a stent graft comprising a tube of graft material and having an internal lumen, and a carrier for the stent graft, the stent graft disposed over the carrier;
the stent graft comprising a proximal stent at a proximal end of the stent graft and a distally adjacent stent;
the proximal stent having a proximal end having a constrained circumference and an expanded circumference and a distal end having a constrained circumference and an expanded circumference;
a first constraining mechanism constraining the proximal end of the proximal stent at the constrained circumference;
a second constraining mechanism constraining the distal end of the proximal stent at the constrained circumference such that the entire circumference of the distal end is pulled inwardly towards the carrier;
at least one trigger wire release mechanism engaging the constraining mechanisms, the at least one trigger wire release mechanism configured to release firstly the proximal end of the proximal stent and secondly the distal end of the proximal stent to the expanded circumference,
wherein the second constraining member comprises at least one thread that extends circumferentially about the distal end of the proximal stent for a plurality of lengths exterior to the stent graft and a plurality of lengths interior to the stent graft, and
wherein the plurality of lengths interior to the stent graft comprise a plurality of loops within the internal lumen with each loop disposed at a distal apex between adjoining struts of the distal apex, and extending between the distal apex and the carrier such that the distal end of the proximal stent is pulled toward the carrier from the interior of the tube of graft material,
wherein each of the plurality of loops of the second constraining member engage one or more of the trigger wire release mechanisms.

11. The introducer of claim 10 , wherein the first constraining mechanism constrains the proximal end of the proximal stent at at least three points to form at least three lobes.

12. The introducer of claim 11 , wherein the first constraining mechanism comprises a loop of thread at each point with each loop of thread engaging one of the points and engaging the carrier.

13. The introducer of claim 10 , wherein the plurality of lengths that extend about the external surface each extend over a strut of a first distal apex, across a span of graft material between a next adjacent distal apex, and over a strut of the next adjacent distal apex.

14. The introducer of claim 10 , where the plurality of loops includes at least three equally spaced loops about the interior of the stent graft.

15. A stent graft for deployment in a curved lumen, including:
a graft material providing an inner lumen;
a plurality of stents located longitudinally along the graft material, the plurality of stents comprising a proximal stent located at a proximal end of the stent graft and disposed entirely within the inner lumen of the graft material, the proximal stent having a proximal end and a distal end and proximal apices and distal apices;
the plurality of stents having an expanded circumference and a constrained circumference;
a first constraining mechanism engaging the proximal apices of the proximal stent, and configured to constrain the proximal end of the proximal stent at the constrained cir

Assignees

• Cook Medical Technologies Llc

Inventors

• Kölbel Tilo
• Rasmussen Erik E
• Oehlenschlaeger Bent
• Jensen Kim Moegelvang

Classifications

• A61F2002/9517

  Human Necessities · mapped topic

• A61F2002/9505

  having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument · CPC title

• A61F2002/9511

  the retaining means being filaments or wires · CPC title

• A61F2230/0067

  conical · CPC title

• A61F2/95

  Instruments specially adapted for placement or removal of stents or stent-grafts · CPC title