Tandem modular endograft

1. A modular endovascular graft assembly comprising:

a main elongate tubular graft body having a proximal open end and an opposed distal open end, defining a graft body wall having a proximal portion, a medial portion, a distal portion and an open lumen therein between;

a proximal expansion anchor disposed at or secured to a proximal neck portion disposed at the proximal end of the graft body wall;

a first and second elongate tubular stent-graft extensions percutaneously disposed into the distal end of the tubular graft body, the first and second stent-graft extensions having respective proximal open ends and opposed distal open ends, defining graft body walls having a proximal portions, medial portions, distal portions and open lumens therein between;

wherein the first and second elongate tubular stent-graft extensions comprise a tubular stent securably disposed between a graft liner and a graft cover, the stent comprising an undulating wire having opposed first and second ends and being helically wound into a plurality of approximate circumferential windings to define a stent wall, the undulating wire having a plurality undulations defined by peaks and valleys with peaks of adjacent approximate circumferential windings being separated by a distance (X), and peaks of one circumferential winding being substantially aligned with peaks of an adjacent winding;

wherein the proximal portions of the first and second stent-graft extensions are configured to be deployable into the distal portion of the main graft body;

wherein an adjacent peak and an adjacent valley of said undulating wire has a peak height (Y) from an apex of said adjacent peak to a base of said adjacent valley;

wherein a ratio of the distance between adjacent peaks to the peak height (X/Y) at the proximal portions of the first and second stent-graft extensions is about 0.1 or less than 0.1;

wherein the open lumen of the main tubular graft has approximately or substantially circular cross-section having a main diameter;

wherein the first and second stent-graft extensions are self-expanding or balloon-expandable;

wherein the open lumens of the proximal portions of the first and second stent-graft extensions have cross-sections having first and second dimensions, respectively, where the sum of the first and second dimensions is greater than the main diameter, prior to being percutaneously disposed into the distal end of the tubular graft body;

wherein, in combination, the proximal portions of the first and second stent-graft extensions are conformable to the shape of the open lumen of the main graft body;

wherein the open lumens of the proximal portions of the first and second stent-graft extensions have substantially D-shaped cross-sections as a result of self-expansion or balloon expansion against each other and the main graft lumen after being percutaneously disposed into the distal end of the tubular graft body and are configured to prevent flow of bodily fluid between outer proximal portions of the first and second stent-graft extensions and the open lumen of the main tubular graft; and

wherein the main graft body wall further comprises: at least one circumferential inflatable channel disposed towards the proximal portion of the graft body wall near the proximal open end of the main tubular graft body and distally prior the proximal neck portion; and a plurality of circumferential inflatable channels disposed towards the distal portion of the graft body wall near the distal open end of the main tubular graft body, the at least one of the plurality of circumferential inflatable channels disposed toward the distal portion of the graft body causing the first and second stent-graft extensions to be secured to each other and to the graft body wall when the at least one of the plurality of circumferential inflatable channels disposed toward the distal portion of the graft body is in an inflated state.

2. The assembly of claim 1 , comprising at least one circumferential inflatable channel in fluid communication with the single longitudinal inflatable fill channel and disposed towards the proximal portion of the graft body, said at least one circumferential inflatable channel in fluid communication with a plurality of circumferential inflatable channels disposed towards the distal portion of the graft body.

3. The assembly of claim 2 , further comprising an inflation material for inflating the at least one circumferential inflatable channel disposed towards the proximal portion of the graft body and the plurality of circumferential inflatable channels disposed towards the distal portion of the graft body, the inflation material delivered to the at least one circumferential inflatable channel from the single longitudinal inflatable fill channel.

4. The assembly of claim 3 , wherein the inflation material is an in vivo curable material.

5. The assembly of claim 1 , wherein the graft liner comprises at least one layer of porous PTFE having no discemable node and fibril structure.

6. The assembly of claim 1 , wherein the graft covering comprises at least one layer of porous PTFE having no discemable node and fibril structure.

7. The assembly of claim 1 , wherein the graft body wall of the main tubular graft comprises at least one layer of porous PTFE having no discemable node and fibril structure.

8. The assembly of claim 1 , wherein the proximal expansion anchor is a metallic member.

9. The assembly of claim 8 , wherein the metallic member comprises a super elastic nitinol (NiTi) alloy.

10. The assembly of claim 1 , wherein the proximal expansion anchor is a dual stage member where a first crown portion having a first number of crowns and a second crown portion having a second number of crowns, where the first number of crowns may be the same as or different from the second number of crowns.

11. The assembly of claim 1 , wherein the ratio of the distance between adjacent peaks to the peak height (X/Y) at the distal portions of the first and second stent-graft extensions is about 0.5 or greater than 0.5.

12. The assembly of claim 1 , wherein the ratio of the distance between adjacent peaks to the peak height (X/Y) at the medial portions of the first and second stent-graft extensions is from about 0.1 to about 0.5.

13. The assembly of claim 1 , wherein the peak height (Y) of the first and second stent-graft extensions is from about one fifth to about one half of a diameter of the first and second stent-graft extensions.

14. The assembly of claim 1 , wherein the stent-graft extensions are self-expanding.

15. A modular endovascular graft assembly comprising:

a main elongate tubular graft body having a proximal open end and an opposed distal open end, defining a graft body wall having a proximal portion, a medial portion, a distal portion and an open lumen therein between;

the graft body wall comprising a proximal neck portion disposed at the proximal end; the graft body wall comprising at least one proximal circumferential inflatable channel disposed towards the proximal portion of the graft body wall near the proximal open end of the main tubular graft body and distally prior the proximal neck portion;

the graft body wall comprising a plurality of distal circumferential inflatable channels disposed towards the distal portion of the graft body wall near the distal open end of the main tubular graft body;

a proximal expansion anchor disposed at or secured to the proximal neck portion of the graft body wall;

a first and second elongate tubular stent-graft extensions separate from the main graft body, percutaneously disposed into the distal end of the tubular graft body, the first and second stent-graft extensions having respective proximal open ends and opposed distal open ends, defining graft body walls having a proximal portions, medial portions, distal portions and open lumens therein between;

wherein the first and second elongate tubular stent-graft extensions comprise a tubular stent securably disposed between a graft liner and a graft cover, the stent comprising an undulating wire having opposed first and second ends and being helically wound into a plurality of approximate circumferential windings to define a stent wall, the undulating wire having a plurality undulations defined by peaks and valleys with peaks of adjacent approximate circumferential windings being separated by a distance (X), and peaks of one circumferential winding being substantially aligned with peaks of an adjacent winding;

wherein the proximal portions of the first and second stent-graft extensions are configured to be deployable into the distal portion of the main graft body, and at least one of the distal circumferential inflatable channels causes the first and second stent-graft extensions to be secured to each other and to the main graft body when the at least one of the distal circumferential inflatable channels is in an inflated state;

wherein the first and second stent-graft extensions are self-expanding or balloon-expandable;

wherein an adjacent peak and an adjacent valley of said undulating wire has a peak height

(Y) from an apex of said adjacent peak to a base of said adjacent valley;

wherein a ratio of the distance between adjacent peaks to the peak height (X/Y) at the proximal portions of the first and second stent-graft extensions is about 0.1 or less than 0.1; and

wherein, the proximal portions of the first and second stent-graft extensions are conformable to the shape of the open lumen of the main graft body, and have substantially D-shaped cross-sections as a result of self-expansion or balloon expansion against each other and the main graft lumen after being percutaneously disposed into the distal end of the tubular graft body and are configured to prevent flow of bodily fluid between outer proximal portions of the first and second stent-graft extensions and the open lumen of the main tubular graft.

16. The assembly of claim 15 , wherein the plurality of distal circumferential inflatable channels provide structural rigidity to the distal portion when the plurality of distal circumferential inflatable channels are in an inflated state.

17. The assembly of claim 15 , wherein the plurality of proximal circumferential inflatable channels provide structural rigidity to the proximal portion when the plurality of proximal circumferential inflatable channels are in an inflated state.