Fenestration template for endovascular repair of aortic aneurysms
View Patent ↗To provide simple yet accurate stent graft fenestration, a patient-specific fenestration template is used as a guide for graft fenestration. To generate the fenestration template, a patient's medical imaging data such as CT scan data may be used to generate a 3-D digital model of an aorta lumen of the patient. The aorta lumen may encompass one or more branch vessels, which may be indicated on the 3-D digital model. Based on the 3-D digital model or a segment thereof, the fenestration template may be generated, for example, using 3-D printing technology. The fenestration template may include one or more holes or openings that correspond to the one or more branch vessels. To fenestrate a stent graft, the fenestration template is coupled to the stent graft so that the holes or openings on the fenestration template indicate the fenestration locations.
1. A method of fenestrating an aortic graft using a patient-specific fenestration template, the aortic graft comprising a plurality of stents and a graft material disposed on the plurality of stents, the method comprising:
causing imaging data to be taken of a portion of a patient's blood vessel, the portion of the patient's blood vessel having a branch blood vessel extending from the portion of the patient's blood vessel;
causing the patient-specific fenestration template to be generated based on the imaging data, the patient-specific fenestration template having a wall defining a lumen, the wall of the template defining an aperture corresponding to the location of the branch blood vessel;
inserting the aortic graft into the lumen of the patient-specific fenestration template; and
generating a fenestration in the graft material.
2. The method of claim 1 , wherein the patient-specific fenestration template has a diameter approximately the same as the diameter of the patient's blood vessel.
3. The method of claim 1 , wherein the patient-specific fenestration template has a diameter greater than the diameter of the patient's blood vessel.
4. The method of claim 3 , wherein the diameter of the patient-specific fenestration template is up to 20% greater than the diameter of the patient's blood vessel.
5. The method of claim 1 , further comprising:
causing the patient-specific fenestration template to be sterilized prior to inserting the aortic graft into the lumen of the patient-specific fenestration template.
6. The method of claim 1 , wherein the imaging data is acquired using at least one of x-ray radiology, computed tomography, computed axial tomography, ultrasound, magnetic resonance imaging, and position emission tomography.
7. The method of claim 1 , wherein the portion of the patient's blood vessel is a portion of the patient's aorta.
8. The method of claim 7 , wherein the branch blood vessel is a renal artery.
9. The method of claim 1 , wherein the patient-specific fenestration template is generated using additive manufacturing.
10. The method of claim 1 , wherein the patient-specific fenestration template is generated using three-dimensional printing.
11. The method of claim 1 , further comprising:
identifying a location to generate the fenestration in the graft material based at least in part on the aperture of the patient-specific fenestration template.
12. The method of claim 11 , further comprising:
marking the location to generate the fenestration.
13. The method of claim 1 , further comprising:
moving the patient-specific fenestration template with respect to the aortic graft to avoid positioning the aperture over a stent strut.
14. The method of claim 1 , further comprising:
marking the fenestration with a radio-opaque marker.
15. A method comprising:
receiving imaging data representative of a portion of a patient's aorta, the portion of the patient's aorta having a first branch blood vessel extending from the aorta and a second branch blood vessel extending from the aorta;
generating a three-dimensional digital model of the portion of the patient's aorta, the first branch blood vessel, and the second branch blood vessel; and
generating a patient-specific fenestration template based on the three-dimensional digital model, the patient-specific fenestration template having a first marker corresponding to the location of the first branch blood vessel, and a second marker corresponding to the location of the second branch blood vessel;
wherein the patient-specific fenestration template is a flat sheet configured to be wrapped around a portion of an aortic raft to allow a user to identify a first fenestration location in the aortic graft corresponding to the first marker, and a second fenestration location in the aortic graft corresponding to the second marker.
16. The method of claim 15 , wherein the first branch blood vessel is a renal artery.
17. The method of claim 16 , wherein the second branch blood vessel is a renal artery.
18. The method of claim 15 , further comprising:
causing the patient-specific fenestration template to be sterilized.
19. The method of claim 15 , wherein the patient-specific fenestration template is movable between a first configuration, in which the patient-specific fenestration template is a substantially flat sheet, and a second configuration in which the patient-specific fenestration template is configured to be disposed around a portion of the aortic graft.
20. The method of claim 19 , wherein the patient-specific fenestration template is tubular in the second configuration.
21. A method of generating a patient-specific aortic graft, the method comprising:
causing imaging data to be taken of a portion of a patient's aorta, the portion of the patient's aorta having a branch blood vessel extending from the aorta;
causing a fenestration template to be generated based on the imaging data, the fenestration template having a marker corresponding to the location of the branch blood vessel;
providing an aortic graft, the aortic graft including a plurality of stents and a graft material disposed on the plurality of stents;
coupling the aortic graft to the fenestration template;
identifying a location to generate a fenestration in the aortic graft based at least in part on the marker of the fenestration template;
moving the fenestration template with respect to the aortic graft to avoid positioning the marker over a stent strut; and
generating the fenestration in the aortic graft.
22. The method of claim 21 , wherein coupling the fenestration template to the aortic graft includes positioning the aortic graft at least partially inside a lumen defined by the fenestration template.
23. The method of claim 21 , wherein coupling the fenestration template to the aortic graft includes positioning the fenestration template at least partially inside a lumen of the aortic graft.
24. The method of claim 21 , further comprising:
reinforcing the fenestration.
25. The method of claim 21 , further comprising:
marking the location of the fenestration.
26. The method of claim 25 , wherein the location of the fenestration is marked with a radio-opaque marker.