STENT GRAFT SYSTEM AND A METHOD FOR COUPLING STENT GRAFTS AS A STENT GRAFT SYSTEM

Abstract

A stent graft system (1) with a first stent graft (2) expandable in respect of a diameter, and with at least a second stent graft (3). The first stent graft (2) at least in some areas has a tubular net structure (4) which, in an expanded mode, has a net structure (4) with substantially round annular meshes (5). The at least second stent graft (3) has, at a distal end (6), outwardly extending barbs (7) via which the at least second stent graft (3) can be coupled to the first stent graft (2) in the expanded mode. The distal end (6) of the at least second stent graft (3) passes through a round annular mesh (5) of corresponding diameter and, with its outwardly extending barbs (7), engages on the round annular mesh (5). Also, a method for coupling stent grafts as a stent graft system.

Claims

1. A stent graft system (1) having an expandable diameter first stent graft (2) and at least one second stent graft (3), the first stent graft (2) comprising, at least in regions, a tubular mesh structure (4) having in an expanded mode a mesh structure (4) with substantially circular annular loops (5), the at least second stent graft (3) having at a distal end (6) outwardly projecting barbs (7), via which the at least second stent graft (3) can be coupled to the first stent graft (2) in the expanded mode, wherein the at least second stent graft (3) pierces with the distal end (6) a circular, annular loop (5) corresponding to its own diameter and engages with the respective outwardly projecting barbs (7) on the circular annular loop (5).

2. The stent graft system (1) according to claim 1, wherein the first stent graft (2) is coated with a layer (8), in particular a polymer, such as polytetrafluoroethylene (PTFE).

3. The stent graft system according to claim 2, wherein a material of the mesh structure (4) of the first stent graft (2) is a shape-memory alloy, preferably Nitinol.

4. The stent graft system according to claim 1, wherein the mesh structure (4) of the first stent graft (2) is enmeshed with non-resorbable suture material (9).

5. A method for coupling stent grafts as stent graft system according to claim 1, comprising the steps: inserting the expandable diameter first stent graft (2) in a non-expanded mode into a blood vessel, expanding the first stent graft (2) with formation of substantially circular annular loops (5) at least in areas in the mesh structure (4), introducing the at least second stent graft (3) through another blood vessel or a plurality of second stent grafts (3) through one or more further blood vessels by moving the respective distal end (6) of the respective second stent graft (3) in the direction the first stent graft (2), preferably by a respective guide catheter (10), piercing a respective substantially circular annular loop (5) in the mesh structure (4) of the first stent graft (2) by a respective distal end (6) of the second stent graft (3), coupling to the respective distal end (6) to the respective substantially circular annular loops (5) in the mesh structure (4) of the first stent graft (2) by mechanically pulling behind and engaging the barbs (7) in the respective circular, annular loop (5).

6. The method of coupling stent graft as a stent graft system according to claim 1, comprising the steps of: inserting the expandable diameter first stent graft (2) in a non-expanded mode into a blood vessel, expanding the first stent graft (2) with formation of substantially circular annular loops (5) at least in areas in the mesh structure (4), introducing the at least second stent graft (3) through another blood vessel or a plurality of second stent grafts (3) through one or more further blood vessels by moving the respective distal end (6) of the respective second stent graft (3) in the direction the first stent graft (2), preferably by a respective laser guided catheter (11), perforating the respective layer (8) of the first stent graft (3) by the respective laser guided catheter (11), piercing a respective substantially circular annular loop (5) in the mesh structure (4) of the first stent graft (2) by a respective second stent graft (3) at its respective distal end (6), coupling the respective distal end (6) to the respective substantially circular annular loop (5) in the mesh structure (4) of the first stent graft (2) by mechanically pulling behind and engaging the barbs (7) into the respective circular annular loop (5).

7. The method of coupling stent graft as a stent graft system according to claim 1, comprising the steps of: inserting the expandable diameter first stent graft (2) in a non-expanded mode into a blood vessel, expanding the first stent graft (2) with formation of substantially circular annular loops (5) at least in areas in the mesh structure (4), introducing the at least second stent graft (3) through another blood vessel or a plurality of second stent grafts (3) through one or more further blood vessels by moving the respective distal end (6) of the respective second stent graft (3) in the direction the first stent graft (2), preferably by a respective laser guided catheter (11), perforating the respective layer (8) of the first stent graft (3) by the respective laser guided catheter (11), piercing a respective substantially circular annular loop (5) in the mesh structure (4) of the first stent graft (2) by a respective second stent graft (3) at its respective distal end (6), coupling the respective distal end (6) to the respective substantially circular annular loop (5) in the mesh structure (4) of the first stent graft (2) by mechanically pulling behind and engaging the barbs (7) in the respective circular annular loop (5) enmeshed with non-resorbable suture material (9).

Description

[0044] In the following an embodiment of the invention will be described in detail with reference to the drawings accompanying the description of the figures, which are intended to illustrate the invention and are not to be considered as limiting:

[0045] In the drawings:

[0046] FIGS. 1 to 3 show an inventive stent graft system in the course of installation;

[0047] FIGS. 4 to 6 show a detail view of the distal end of the second stent graft during the installation process;

[0048] FIGS. 7 and 8 show detail view of the first stent graft before and after the expansion;

[0049] FIGS. 1 to 3 show an aortic arch in aortic arch aneurysm/A-dissection with the introduced stent graft system 1 according to the invention.

[0050] The stent graft system 1 in this embodiment consists of a first stent graft 2 and a second stent graft 3, the first stent graft 2 being inserted into the aortic arch.

[0051] Under fluoroscopy in a hybrid OR, the aortic arch is completely displayed on the basis of CT angiography so that work can be done accordingly.

[0052] Process steps: [0053] advancing ABLE-stent graft 1 and the laser catheter supraaortal; [0054] bilateral access cervical to the common carotid artery; [0055] bilateral access to the common femoral artery; [0056] installation of an arterio-arterial shunt AFC-ACC bds., if necessary with flow control and extracorporeal circulation pump; [0057] open antegrade positioning system inserted into the ACC bds. and introduction of Terumo guide wire with laser catheter, for example a TurboElite 23 manufactured by Spectranetics, Colorado, USA into the aortic arch under video display control; [0058] puncture and antegrade positioning system insertion into the brachial artery and introduction of Terumo guide wire with laser catheter to the aortic arch under video display control; [0059] open antegrade positioning system insert in the aortic arch unilateral femoral and placement under video display

[0060] The stent graft system 1 is correspondingly completed by coupling the second stent graft 3 to the first stent graft 2 by hooking the barbs 7 of the second stent graft 3 in the first stent graft 2.

[0061] The individual elements of the stent graft system 1 can be found in the corresponding list of reference numerals.

[0062] In FIG. 2 is shown: [0063] the deployment of the aortic stent graft, the first stent graft 2, optionally with rapid pacing; [0064] docking of the laser catheter to the circular configured branch areathe coincidental meeting with a loop 5, for example a Nitinol loop junction, the mesh structure 4 and laser perforation of the PTFE cover of the first stent graft 2 by means of low energy and high repetition rate; [0065] wire presentation in the lumen of the aortic arch.

[0066] In FIG. 3 the dilatation of the grafts and the completion of the procedure is shown: [0067] dilatation of the stent grafts; [0068] overview angiography; [0069] pulling out of shunt/extracorporeal circulation.

[0070] In FIGS. 4 to 6 of the insertion and locking operation of the second stent graft 3 in the first stent graft 2 is shown.

[0071] Here, a laser-assisted supra aortic branching occurs. In this case, the application of common branch stents into the ASL and ACC takes place on the left, in the brachiocephalic trunk the implants of an iliac side branch. The branched stent diameter is adapted to the the circles of the lumen with minimal oversizing. The barbs 7 on the distal stent ends 6 are anchored in the continuous suture cover of, for example, Nitinol struts.

[0072] FIGS. 7 and 8 show the first stent graft 2 prior to deployment (FIG. 7) and after deployment (FIG. 8). In the unfolded state, at least circle-like loops 5 are formed, which can be pierced by the second stent graft 3.

LIST OF REFERENCE NUMBERS

[0073] 1 stent graft system [0074] 2 first stent graft [0075] 3 second stent graft [0076] 4 network structure [0077] 5 loop [0078] 6 distal end of a second stent graft [0079] 7 barb [0080] 8 layer [0081] 9 suture material [0082] 10 guide catheter [0083] 11 laser guide catheter