Endovascular graft having a cannulation pocket

Patent metadata

Field	Value
Publication number	US-9642732-B2
Application number	US-201514887960-A
Country	US
Kind code	B2
Filing date	Oct 20, 2015
Priority date	Jul 3, 2013
Publication date	May 9, 2017
Grant date	May 9, 2017

Abstract

A stent graft for placement in a lumen of a patient is disclosed. The stent graft comprises: a main tubular body of a biocompatible graft material having a main lumen, the main tubular body having a proximal end and a distal end; a side arm extending from the main tubular body, the side arm having a side arm lumen, the side arm lumen being in fluid communication with the main lumen through a side arm opening in the main tubular body; and a cannulation pocket. The pocket comprises: an exit aperture positioned opposite the side arm opening; an entry aperture longitudinally spaced from the entry aperture in a direction toward the distal end of the main tubular body; and a wall, the wall laterally spaced from the main lumen so as to provide a guide surface for a cannula fed through the entry aperture.

First claim

The invention claimed is:

1. A stent graft for placement in a lumen of a patient, the stent graft comprising:
a main tubular body of a biocompatible graft material having a main lumen, the main tubular body having a proximal end, a distal end, and a side wall between the proximal end and the distal end;
a side arm extending from a first fenestration in the side wall of the main tubular body on one side of the main body, the side arm having a side arm lumen;
a second fenestration in the side wall of the main body positioned opposite the first fenestration, the second fenestration providing an exit aperture for a medical instrument;
a third fenestration in the side wall of the main body spaced distally from the second fenestration, the third fenestration providing an entry aperture for the medical instrument; and
a cannulation pocket adjacent to and outside the lumen of the main body, the cannulation pocket enclosing the second and third fenestrations and providing an enclosed space, the cannulation pocket having a guide surface for the medical instrument;
wherein the guide surface of the pocket is configured to guide the medical instrument from the entry aperture to the exit aperture and into the main lumen of the main tubular body.

2. The stent graft of claim 1 , wherein the cannulation pocket is comprised of graft material.

3. The stent graft of claim 1 , wherein the guide surface is configured to facilitate guiding of the medical instrument from the main lumen of the main tubular body into the side arm lumen.

4. The stent graft of claim 1 , wherein the side arm is at an acute angle to the main tubular body such that the side arm lumen extends laterally and distally from the main tubular body.

5. The stent graft of claim 4 , further comprising an external self-expanding stent which extends around both the main tubular body and a portion of the side arm, the stent configured to expand such that the main lumen and the side arm lumen are each biased open allowing fluid to flow freely there-through.

6. The stent graft of claim 1 , further comprising a temporary diameter reduction constraint arrangement, the arrangement comprising:
a release wire; and
at least one loop of thread engaged with the release wire and engaged around a distal portion of the main body to a location circumferentially spaced a selected distance away from the release wire, and drawn tight and tied to itself to reduce the distal portion of the main body.

7. The stent graft of claim 1 , wherein the stent graft comprises a distal sealing portion configured to seal against a wall of a body vessel and wherein the third fenestration is disposed proximally above the sealing portion.

8. The stent graft of claim 1 , wherein the medical instrument is a guidewire.

9. The stent graft of claim 1 , wherein the medical instrument is a delivery device with a side arm extension graft.

10. A stent graft for placement in a lumen of a patient, the stent graft comprising:
a main tubular body of a biocompatible graft material having a main lumen, the main tubular body having a proximal end, a distal end, and a side wall between the proximal end and the distal end;
a side arm extending from a first fenestration in the side wall of the main tubular body on one side of the main body, the side arm having a side arm lumen;
a second fenestration in the side wall of the main body positioned opposite the first fenestration, the second fenestration providing an exit aperture for a medical instrument;
a cannulation pocket adjacent to and outside the lumen of the main body, the cannulation pocket providing an enclosed space extending from the distal end of the main tubular body to proximal of the second fenestration, the cannulation pocket having a distal opening adjacent to the distal end of the main tubular body providing an entry aperture for the medical instrument, and a guide surface for the medical instrument;
wherein the guide surface of the pocket is configured to guide the medical instrument from the entry aperture to the exit aperture and into the main lumen of the main tubular body.

11. The stent graft of claim 10 , further comprising a self-expanding stent disposed about the distal end of the main tubular body.

12. The stent graft of claim 11 , wherein the self-expanding stent is configured to close the distal opening of the cannulation pocket upon expansion of the self-expanding stent.

13. The stent graft of claim 10 , wherein the cannulation pocket is comprised of graft material.

14. The stent graft of claim 10 , wherein the guide surface is configured to facilitate guiding of the medical instrument from the main lumen of the main tubular body into the side arm lumen.

15. The stent graft of claim 10 , wherein the side arm is at an acute angle to the main tubular body such that the side arm lumen extends laterally and distally from the main tubular body.

16. The stent graft of claim 15 , further comprising an external self-expanding stent which extends around both the main tubular body and a portion of the side arm, the stent configured to expand such that the main lumen and the side arm lumen are each biased open allowing fluid to flow freely there-through.

17. The stent graft of claim 10 , further comprising a temporary diameter reduction constraint arrangement, the arrangement comprising:
a release wire; and
at least one loop of thread engaged with the release wire and engaged around a distal portion of the main body to a location circumferentially spaced a selected distance away from the release wire, and drawn tight and tied to itself to reduce the distal portion of the main body.

18. The stent graft of claim 10 , wherein the medical instrument is a guidewire.

19. The stent graft of claim 1 , wherein the medical instrument is a delivery device with a side arm extension graft.

20. A stent graft assembly for placement in a lumen of a patient, the stent graft assembly comprising a stent graft and a pre-loaded medical instrument, the stent graft comprising:
a main tubular body of a biocompatible graft material having a main lumen, a proximal end, a distal end, a side wall of graft material between the proximal end and the distal end, a side arm extending from the side wall on one side of the main tubular body, and a fenestration in the side wall substantially opposite the side arm providing,
a cannulation pocket attached to and adjacent the side wall of the main tubular body, the cannulation pocket providing an enclosed space enclosing a portion of the side wall and the fenestration, the cannulation pocket having a guide surface configured to guide a medical instrument from an entry aperture disposed distally of the fenestration into the enclosed space of the cannulation pocket to the fenestration and into the main lumen main tubular body;
wherein the pre-loaded guidewire is loaded on a delivery device with the stent graft and, in the pre-loaded state, extends through the entry aperture, into the enclosed space of the cannulation pocket, substantially along the guide surface, through the fenestration, into the lumen of the main body, and into the side arm lumen.

Assignees

• Cook Medical Technologies Llc

Inventors

• Barrand Zoe

Classifications

• A61F2002/065

  Y-shaped blood vessels · CPC title

• A61F2/954 Primary

  for placing stents or stent-grafts in a bifurcation · CPC title

• A61F2002/061

  provided with means for allowing access to secondary lumens · CPC title

• A61F2230/0069

  cylindrical · CPC title

• A61F2002/077

  having means to fill the space between stent-graft and aneurysm wall, e.g. a sleeve · CPC title