Puncturable and resealable graft
Implantable grafts, particularly for arteriovenous access that may be punctured by an object such as a needle and, following removal of the object, will reseal the resulting hole to the extent of reducing fluid leakage through the graft at the puncture site to an amount less than would be typical for a conventional graft. More particularly, the grafts comprise three layers; an inner layer of implantable graft material such as ePTFE, a middle layer of self sealing elastomeric material such as silicone, and an outer layer of implantable graft material such as ePTFE. Following manufacture, the tubular form of the three-layer graft is everted to put substantially the entire wall thickness of the elastomeric material layer under circumferential compression.
1. An implantable stent-graft having a diametrically compacted, insertion profile and a diametrically expanded, deployed profile, the stent-graft comprising:
a stent having a tubular shape; and
a graft secured to the stent, the graft including,
an outer tubular member formed of a graft material, the outer tubular member defining an inner surface, an outer surface, and a thickness between the inner and outer surfaces, an entirety of the thickness being under circumferential tension;
an inner tubular member formed of a graft material, the inner tubular member defining an inner surface, an outer surface, and a thickness between the inner and outer surfaces, an entirety of the thickness of the inner tubular member being under radial compression by the outer tubular member; and
an elastomeric coating between the inner and outer tubular members, an entirety of the thickness of the elastomeric coating being under radial compression by the outer tubular member around the circumference of the elastomeric coating, wherein the outer tubular member is secured to the inner tubular member by the elastomeric coating;
wherein the stent is secured on the outer surface of the outer tubular member, on the inner surface of the inner tubular member, on one or both ends of the graft, between the inner and outer surface of the outer tubular member, or between the inner and outer surface of the inner tubular member; and
wherein the graft has a puncture characteristic that includes leakage of the graft stopping entirely after about 2 seconds after being punctured with a 16 gauge dialysis needle at an angle of about 45 degrees while pressurized with room temperature water at 2.5 psi (17.2 KPa).
2. The stent-graft of claim 1 , wherein the insertion profile corresponds to a maximum diameter of about 13 French.
3. The stent-graft of claim 1 , wherein the stent is configured as a self-expanding stent.
4. The stent-graft of claim 1 , wherein the stent is configured as a balloon expandable stent.
5. The stent-graft of claim 1 , wherein the graft material of the inner tubular member includes ePTFE material.
6. The stent-graft of claim 1 , wherein the graft material of the outer tubular member includes ePTFE material.
7. The stent-graft of claim 1 , wherein the elastomeric coating includes silicone material.
8. The stent-graft of claim 1 , wherein the elastomeric coating includes a fluoroelastomer material.
9. The stent-graft of claim 1 , wherein the elastomeric material is a copolymer of tetrafluoroethylene and polyalkylvinylether.
10. The stent-graft of claim 1 , wherein the elastomeric material is a polyurethane.
11. The stent-graft of claim 1 , wherein the thickness of the graft has an overall wall thickness of greater than 0 mm and less than 0.40 mm.
12. An implantable stent-graft having a diametrically compacted, insertion profile and a diametrically expanded, deployed profile, the stent-graft comprising:
a stent having a tubular shape; and
a graft secured to the stent, the graft having a thickness of 0.40 mm or less, but greater than 0 mm and having a puncture characteristic that includes leakage of the graft stopping entirely after about 2 seconds after being punctured with a 16 gauge dialysis needle at an angle of about 45 degrees while pressurized with room temperature water at 2.5 psi (17.2 KPa), the graft including,
an outer tubular member formed of a graft material, the outer tubular member defining an inner surface, an outer surface, and a thickness between the inner and outer surfaces;
an inner tubular member formed of a graft material, the inner tubular member defining an inner surface, an outer surface, and a thickness between the inner and outer surfaces; and
an elastomeric coating between the inner and outer tubular members, at least a portion of the thickness of the elastomeric coating being under radial compression by the outer tubular member, wherein the outer tubular member is secured to the inner tubular member by the elastomeric coating;
wherein the stent is secured on the outer surface of the outer tubular member, on the inner surface of the inner tubular member, on one or both ends of the graft, between the inner and outer surface of the outer tubular member, or between the inner and outer surface of the inner tubular member.
13. The stent-graft of claim 12 , wherein the stent is configured as a self-expanding stent.
14. The stent-graft of claim 12 , wherein the stent is configured as a balloon expandable stent.
15. The stent-graft of claim 12 , wherein at least one of the inner tubular member includes ePTFE material and the outer tubular member includes ePTFE material.
16. The stent-graft of claim 12 , wherein the elastomeric coating includes silicone material.
17. The stent-graft of claim 12 , wherein the elastomeric coating includes a fluoroelastomer material.
18. The stent-graft of claim 12 , wherein the elastomeric material is a copolymer of tetrafluoroethylene and polyalkylvinylether.
19. The stent-graft of claim 12 , wherein the elastomeric material is a polyurethane.
20. An implantable medical device having a diametrically compacted, insertion profile and a diametrically expanded, deployed profile, the medical device comprising:
a support structure having a tubular shape; and
a cover secured to the support structure, the cover including,
an outer tubular member formed of a graft material, the outer tubular member defining an inner surface, an outer surface, and a thickness between the inner and outer surfaces, an entirety of the thickness being under circumferential tension;
an inner tubular member formed of a graft material, the inner tubular member defining an inner surface, an outer surface, and a thickness between the inner and outer surfaces, an entirety of the thickness of the inner tubular member being under radial compression by the outer tubular member around the circumference of the inner tubular member; and
an elastomeric coating between the inner and outer tubular members, an entirety of the thickness of the elastomeric coating being under radial compression by the outer tubular member, wherein the outer tubular member is secured to the inner tubular member by the elastomeric coating;
wherein the cover has a puncture characteristic that includes leakage of the cover stopping entirely after about 2 seconds after being punctured with a 16 gauge dialysis needle at an angle of about 45 degrees while pressurized with room temperature water at 2.5 psi (17.2 KPa).
21. The implantable medical device of claim 20 , wherein the insertion profile corresponds to a maximum diameter of about 13 French.
22. The implantable medical device of claim 20 , wherein the support structure is configured to be self-expanding.
23. The implantable medical device of claim 20 , wherein the support structure is configured to be balloon expandable.
24. The implantable medical device of claim 20 , wherein the graft material of the inner tubular member includes ePTFE material.
25. The implantable medical device of claim 20 , wherein the graft material of the outer tubular member includes ePTFE material.
26. The implantable medical device of claim 20 , wherein the elastomeric coating include silicone material.
27. The implantable medical device of claim 20 , wherein the elastomeric coating includes a fluoroelastomer material.
28. The implantable medical device of claim 20 , wherein the elastomeric material is a copolymer of tetrafluoroethylene and polyalkylvinylether.
29. The implantable medical device of claim 20 , wherein the elastomeric material is a polyurethane.
30. The implantable medical device of claim 20 , wherein the thickness of the cover has an overall wall thickness of greater than 0 mm and less than 0.40 mm.