Hybrid graft for therapy of aortic pathology and associated method
Vascular devices and methods for addressing aortic pathologies are provided that facilitate hemostasis at the junctions of the ends of the device with the native aorta or other vessels to minimize or eliminate the risk of endoleaks. One or both ends of the device may include inner and outer skirts that are configured to receive a section of native blood vessel therebetween. The outer skirt may be flared in some cases or rolled up prior to placement at and engagement with the blood vessel to provide clearance for joining the blood vessel to the inner skirt of the device, such as via sutures. Once engaged, the outer skirt is disposed such that the blood vessel is between the inner and outer skirts. Devices and associated methods are also described that allow endografts to be deployed and engaged with an end of the device in areas with insufficient landing zones.
1. A vascular device for treating a target site within a body lumen, wherein the vascular device is configured for placement between first and second sections of a patient's native blood vessel, the vascular device comprising:
a first end configured to be attached to the first section of the native blood vessel;
a second end configured to be attached to the second section of the native blood vessel; and
a lumen extending between the first and second ends, wherein the lumen is defined by a wall,
wherein the wall splits proximate at least one of the first or second ends to form an inner skirt and an outer skirt, wherein the outer skirt at least partially surrounds the inner skirt, and wherein the inner and outer skirts are spaced from each other and are thereby configured to receive a portion of the respective section of the native blood vessel within the space formed between the inner and outer skirts for attaching the respective end of the vascular device to the respective section of the native blood vessel,
wherein the inner skirt is configured to be attached to the respective section of the native blood vessel and the outer skirt is configured to be placed against an outer surface of the attachment between the inner skirt and the respective section of the native blood vessel, such that the respective section of the native blood vessel is disposed between the inner skirt and the outer skirt, and
wherein the outer skirt is longer than the inner skirt.
2. The vascular device of claim 1 , wherein an outer surface of the inner skirt is configured to be disposed adjacent an inner surface of the respective section of the native blood vessel and an inner surface of the outer skirt is configured to be disposed adjacent an outer surface of the respective section of the native blood vessel.
3. The vascular device of claim 1 , wherein each end of the vascular device comprises an inner skirt and an outer skirt configured to receive a portion of the respective section of the native blood vessel therebetween for attaching the respective end of the vascular device to the respective section of the native blood vessel.
4. The vascular device of claim 1 , wherein the inner skirt is configured to be sutured to the respective section of the native blood vessel and the outer skirt is configured to promote hemostasis for minimizing endoleaks proximate the respective end.
5. The vascular device of claim 1 , wherein each of the inner and outer skirts extends away from a central axis defined by the vascular device, thereby forming a flare.
6. The vascular device of claim 1 , wherein the outer skirt is configured to be moved between a first position and a second position, wherein in the first position the outer skirt is biased toward a rolled configuration, such that an outer surface of the inner skirt is exposed for receiving the respective section of native blood vessel, and in the second position the outer skirt is biased toward an extended configuration, such that an inner surface of the outer skirt is disposed opposite the outer surface of the inner skirt, thereby engaging the respective section of native blood vessel therebetween.
7. The vascular device of claim 6 , wherein in the second position the outer skirt is configured to apply pressure in a direction toward the inner skirt.
8. A vascular device for treating a target site within a body lumen, wherein the vascular device is configured for placement between first and second sections of a patient's native blood vessel, the vascular device comprising:
a first end configured to be attached to the first section of the native blood vessel;
a second end configured to be attached to the second section of the native blood vessel; and
a lumen extending between the first and second ends, wherein the lumen is defined by a wall,
wherein the wall splits proximate at least one of the first or second ends to form an inner skirt and an outer skirt, wherein the outer skirt at least partially surrounds the inner skirt, and wherein the inner and outer skirts are spaced from each other and are thereby configured to receive a portion of the respective section of the native blood vessel within the space formed between the inner and outer skirts for attaching the respective end of the vascular device to the respective section of the native blood vessel,
wherein the inner skirt is configured to be attached to the respective section of the native blood vessel and the outer skirt is configured to be placed against an outer surface of the attachment between the inner skirt and the respective section of the native blood vessel, such that the respective section of the native blood vessel is disposed between the inner skirt and the outer skirt, and
wherein one of the first or second ends is configured to receive an endograft therein.
9. A vascular device for treating a target site within a body lumen comprising:
a primary tubular structure comprising a wall defining a first end, a second end, and a primary lumen extending between the first and second ends;
a secondary tubular structure disposed within the primary lumen of the primary tubular structure, wherein part of the wall defining the primary tubular structure comprises a wall extension that extends into the primary lumen to define the secondary tubular structure, wherein the secondary tubular structure comprises a secondary lumen, wherein the secondary tubular structure is configured to receive an endograft via the secondary lumen and is configured to serve as a landing zone for the endograft, and wherein at least a portion of an outer surface of the wall extension of the secondary tubular structure is spaced from an inner surface of the primary tubular structure and defines a chamber therebetween; and
at least one debranching limb extending from a portion of the primary tubular structure defined by the wall in the area of the chamber, opposite the wall extension, such that blood is able to through each debranching limb via the chamber to a corresponding branch vessel and is able to flow through the secondary lumen to points downstream,
wherein at least one of the first or second ends of the primary tubular structure comprises an inner skirt and an outer skirt configured to receive a portion of a respective section of a native blood vessel therebetween for attaching the respective end of the primary tubular structure to the respective section of the native blood vessel.
10. The vascular device of claim 9 , wherein a portion of the secondary tubular structure is integral to the primary tubular structure.
11. The vascular device of claim 9 , wherein at least a portion of the secondary tubular structure comprises a nitinol mesh.