APPARATUS AND METHOD OF PLACEMENT OF A GRAFT OR GRAFT SYSTEM
Some embodiments relate to endoluminal prostheses having a first stent portion and a second stent portion, a main graft body comprising first, second, and third portions, the second portion having a cross-sectional size that is significantly larger than a cross-sectional size of the first or third portions, and also significantly larger than a cross-sectional size of the target vessel. In some embodiments, the first portion of the main graft body can be attached to the first stent portion and the third portion of the main graft body can be attached to the second stent portion. The prostheses can be configured such that the second portion of the main graft body is not directly attached to the first stent portion, the second stent portion, or any other internal support structure. In some embodiments, one or more openings can be formed in the second portion of the main graft body.
1 . An endoluminal prosthesis, comprising:
a first stent portion and a second stent portion;
a main graft body comprising a first portion, a second portion, and a third portion, the second portion having a cross-sectional size that is significantly larger than a cross-sectional size of the first portion or the third portion, and also significantly larger than a cross-sectional size of the target vessel; and
one or more openings formed in the second portion of the main graft body;
wherein:
the first portion of the main graft body is attached to the first stent portion and wherein the third portion of the main graft body is attached to the second stent portion; and
the second portion of the main graft body is not directly attached to the first stent portion, the second stent portion, or any other internal support structure.
2 . The endoluminal prosthesis of claim 1 , wherein the cross-sectional size of the second portion is approximately 30% larger than the cross-sectional size of the target vessel.
3 . The endoluminal prosthesis of claim 1 , wherein the cross-sectional size of the second portion is from approximately 20% to approximately 40% larger than the cross-sectional size of the target vessel.
4 . The endoluminal prosthesis of claim 1 , wherein the main graft body comprises two openings formed in the second portion of the main graft body.
5 . The endoluminal prosthesis of claim 1 , wherein two openings are formed in the second portion of the main graft body, the two openings being separated by an angle between approximately 130 degrees and approximately 170 degrees.
6 . The endoluminal prosthesis of claim 5 , wherein the two openings are separated by approximately 150 degrees.
7 . The endoluminal prosthesis of claim 1 , wherein the main the first portion of the main graft body defines a generally tubular shape.
8 . The endoluminal prosthesis of claim 1 , wherein the main graft body comprises one or more cutouts in the first portion thereof.
9 . The endoluminal prosthesis of claim 1 , further comprising a branch graft supported by the main graft body and advanced through one of the openings.
10 . The endoluminal prosthesis of claim 9 , further comprising a bare or covered stent advanceable through the branch graft.
11 . The endoluminal prosthesis of claim 1 , wherein the main graft body is bifurcated.
12 . The endoluminal prosthesis system of claim 1 , wherein the main graft body is formed from a bi-directionally expanded, layered PTFE material.
13 . The endoluminal prosthesis of claim 1 , wherein the main graft body further comprises at least one radiopaque suture or marker attached thereto.
14 . The endoluminal prosthesis of claim 1 , wherein the second portion is located between the first and third portions.
15 . The endoluminal prosthesis of claim 1 , wherein the first and second stent portions are interconnected by one or more connectors spanning at least the second portion of the graft.
16 . The endoluminal prosthesis of claim 15 , wherein the end portions of the one or more connectors are slidably supported by the first and second stent portions.
17 . The endoluminal prosthesis of claim 1 , wherein a distance between end portions of the main graft body is greater than a distance between opposing end portions of the first stent portion and the second stent portion.
18 . An endoluminal prosthesis, comprising:
a main graft body comprising a first portion, a second portion, and a third portion, the second portion having a cross-sectional size that is significantly larger than a cross-sectional size of the first portion or the third portion, and also significantly larger than a cross-sectional size of the target vessel; and
one or more openings formed in the second portion of the main graft body;
wherein:
the first portion of the main graft body is radially supported by a first support member;
the third portion of the main graft body is radially supported by a second support member; and
the second portion of the main graft body is free of radial support from a stent or other prosthetic device.
19 . The endoluminal prosthesis of claim 18 , wherein the first and second support members are connected by generally axially oriented struts.
20 . The endoluminal prosthesis of claim 19 , wherein the second portion of the main graft body has no attachment points to the support members or struts.
21 . An endoluminal prosthesis, comprising:
a main graft body comprising a first portion, a second portion, and a third portion, the entirety of the second portion having a cross-sectional size that is significantly larger than a cross-sectional size of the first portion or the third portion, and also significantly larger than a cross-sectional size of the target vessel;
a support member positioned within the main graft body, the support member having a first support portion, a second support portion, and a third support portion; and
one or more openings formed in the second portion of the main graft body;
wherein:
the first portion of the main graft body is attached to the first support portion of the support member at a first number of attachment points;
the second portion of the main graft body is attached to the second support portion of the support member at a second number of attachment points;
the third portion of the main graft body is attached to the third support portion of the support member at a third number of attachment points; and
the third number of attachment points is less than the first number of attachment points and the third number of attachment points.
22 . The endoluminal prosthesis of claim 21 , wherein the second support portion comprises one or more connecting members that connect the first and third support portions, and the second portion of the main graft body is attached to the connecting members.
23 . The endoluminal prosthesis of claim 21 , wherein the cross-sectional size of the second portion is from approximately 20% to approximately 40% larger than the cross-sectional size of the target vessel.
24 . The endoluminal prosthesis of claim 21 , wherein two openings are formed in the second portion of the main graft body, the two openings being separated by an angle between approximately 130 degrees and approximately 170 degrees.
25 . The endoluminal prosthesis of claim 21 , wherein the second portion is located between the first and third portions.
26 . The endoluminal prosthesis of claim 21 , wherein a distance between end portions of the main graft body is greater than a distance between opposing end portions of the first support portion and the second support portion.
27 . A method of deploying an endoluminal prosthesis, comprising:
advancing a catheter supporting the endoluminal prosthesis therein through a patient's vasculature to a target vessel location, wherein:
the prosthesis has a main graft body comprising a first portion, a second portion, and a third portion; and
the second portion of the main graft body has a cross-sectional size that is significantly larger than a cross-sectional size of the first portion and the third portion, and also significantly larger than a cross-sectional size of the target vessel;
advancing one or more catheters through one or more fenestrations formed in the main graft body and into one or more branch vessels in the patient's vasculature;
at least partially expanding at least the second portion of the main graft body; and
substantially aligning the one or more fenestrations formed within the second portion of the main graft body with the one or more branch vessels by moving the one or more fenestrations in a circumferential and/or axial direction toward an ostium of the one or more branch vessels.
28 . The method of deploying an endoluminal prosthesis of claim 27 , wherein at least partially expanding at least a portion of the prosthesis comprises removing a radial restraint surrounding the prosthesis and permitting the prosthesis to self-expand.
29 . The method of deploying an endoluminal prosthesis of claim 27 , wherein the first portion of the main graft body is attached to the first stent portion and wherein the third portion of the main graft body is attached to the second stent portion; and the second portion of the main graft body is not directly attached to the first stent portion, the second stent portion, or any other internal support structure.
30 . The method of deploying an endoluminal prosthesis of claim 27 , wherein the cross-sectional size of the second portion is approximately 30% larger than the cross-sectional size of the target vessel.
31 . The method of deploying an endoluminal prosthesis of claim 27 , wherein the cross-sectional size of the second portion is from approximately 20% to approximately 40% larger than the cross-sectional size of the target vessel.
32 . The method of deploying an endoluminal prosthesis of claim 27 , wherein two openings are formed in the second portion of the main graft body, the two openings being separated by an angle between approximately 130 degrees and approximately 170 degrees.
33 . The method of deploying an endoluminal prosthesis of claim 32 , wherein the two openings are separated by approximately 150 degrees.
34 . The method of deploying an endoluminal prosthesis of claim 27 , further comprising advancing a bare or covered stent through the one or more fenestrations.
35 . The method of deploying an endoluminal prosthesis of claim 27 , wherein the first and second stent portions are interconnected by one or more connectors spanning at least the second portion of the graft.