Single puncture bifurcation graft deployment system
View Patent ↗The present invention relates to the endoluminal repair of abdominal aortic aneurysms at the aortic and iliac bifurcation. In particular, a deployment system and graft are disclosed for deploying the bifurcated graft within both iliac branches, as well as the aortic trunk, from a single vascular access.
1. A method of transluminally deploying a bifurcation graft at the bifurcation of a main vessel into a first and second branch vessels, comprising:
providing a bifurcation graft having a main portion, a first branch portion, and a second branch portion, the bifurcation graft supported by a single delivery catheter with the main portion, the first branch and the second branch portion constrained in a radially compressed state by one or, the main portion having a diameter greater than a diameter of the first branch portion or the second branch portion;
introducing distally the delivery catheter and the bifurcation graft through a first access site in the first or second branch vessel;
transluminally advancing the bifurcation graft to the bifurcation;
manipulating the delivery catheter to position the bifurcation graft such that the main portion is in the main vessel, the first branch portion is positioned at least partially in the first branch vessel, and the second branch portion is positioned at least partially in the second branch vessel;
proximally retracting the bifurcation graft until the bifurcation of the graft is positioned in contact with the bifurcation between the first and second branch vessels, wherein the bifurcation of the graft is the juncture of the first branch portion and the second branch portion;
expanding the main, first branch and second branch portions from their radially compressed states; and
withdrawing the delivery catheter and each of the one or more restraints through the first access site;
wherein the bifurcation prevents distal migration of the bifurcation graft.
2. The method of claim 1 , wherein the main vessel is the aorta artery, the first branch vessel is the ipsilateral iliac artery and the second branch vessel is the contralateral iliac artery.
3. The method of claim 1 , wherein the step of proximally retracting the bifurcation graft until the bifurcation of the graft is positioned on the bifurcation between the first and second branch vessels comprises positioning the second branch portion on the bifurcation between the first and second branch vessels.
4. The method of claim 3 , wherein the bifurcation graft is introduced through the first access site and into the first branch vessel.
5. The method of claim 1 , wherein the step of expanding the main, first branch and second branch portions from their radially compressed states comprises expanding the main portion before the first and second branch portions.
6. The method of claim 1 , wherein the step of expanding the first branch portion is accomplished by removing a tubular restraining sheath from around the first branch portion.
7. The method of claim 6 , wherein the removing step comprises axially displacing the restraining sheath from the first branch portion.
8. The method of claim 1 , wherein the second branch portion comprises a wire support formed from a memory metal alloy.
9. The method of claim 8 , wherein the second branch portion is expanded by heating the wire support.
10. The method of claim 1 , wherein the second branch portion comprises a peelable sheath.
11. The method of claim 1 , wherein the step of expanding the second branch portion is accomplished by removing a peelable sheath from the second branch portion.
12. The method of claim 11 , wherein the peelable sheath is removed by proximally retracting a release wire.
13. The method of claim 1 , wherein the second branch portion comprises a self-expandable wire support.
14. The method of claim 13 , wherein the second branch portion is restrained in a radially compressed state by a biodegradable adhesive.
15. The method of claim 1 , wherein the step of expanding the second branch portion is accomplished by removing a restraining sheath from around the second branch portion.
16. The method of claim 15 , wherein the restraining sheath is tubular.
17. The method of claim 15 , wherein the restraining sheath is removed by distally advancing the restraining sheath.
18. The method of claim 15 , wherein the removing step comprises tearing the restraining sheath.
19. The method of claim 15 , wherein the removing step comprises axially displacing the restraining sheath relative to the second branch portion.
20. The method of claim 1 , wherein the step of expanding the second branch portion is accomplished by applying an electrical current thereto.
21. The method of claim 1 , wherein the second branch portion is expanded from its radially compressed state by axially displacing an elongate release element attached to a second branch portion restraint.