Debranching visceral stent grant and methods for use
A visceral double-barreled main body stent graft and methods for its use, the stent graft comprises, a main body stent graft having distal and proximal ends, the main body stent graft's length ranges from about 100-120 mm and diameter at the proximal end ranges from about 30-45 mm, first and second lumens defined at the main body stent graft's distal end, the first lumen's diameter ranges from about 18-20 mm, the second lumen's diameter ranges from about 16-18 mm, the first and second lumens have about the same length from about 50-70 mm, the first lumen is secured to the second lumen along a shared length, and the main body stent graft defines a tubular wall that is contiguous with the first and second lumens such that any fluid entering the main body must exit through one of the first or second lumens.
1. A debranching stent graft comprising:
a first bifurcated stent graft having a first bifurcation defining a first leg and a second leg each extending away from the first bifurcation, wherein the first bifurcated stent graft has a distal end and a proximal end, and wherein a diameter of the proximal end of the first bifurcated stent graft is greater than each of a diameter of the first leg and a diameter of the second leg, and wherein a length of the first leg of the first bifurcated stent graft is equal to a length of the second leg of the first bifurcated stent graft;
an extension stent graft having a distal end and a proximal end, wherein the distal end of the extension stent graft is coupled to the proximal end of the first bifurcated stent graft;
a second bifurcated stent graft having a second bifurcation defining a first leg and a second leg, wherein the second bifurcated stent graft has a distal end and a proximal end, wherein the first leg of the second bifurcated stent graft is coupled to the proximal end of the extension stent graft; and
a main body stent graft having a distal end and a proximal end, wherein the distal end of the main body stent graft is coupled to the proximal end of the second bifurcated stent graft.
2. The debranching stent graft of claim 1 , further comprising:
a second extension stent graft having a distal end and a proximal end, wherein the proximal end of the second extension stent graft is coupled to the second leg of the first bifurcated stent graft.
3. The debranching stent graft of claim 1 , wherein the diameter of the proximal end of the first bifurcated stent graft ranges from about 14 mm to about 18 mm, wherein the diameter of the first leg of the first bifurcated stent graft ranges from about 8 mm to about 12 mm, wherein the diameter of the second leg of the first bifurcated stent graft ranges from about 6 mm to about 10 mm, wherein a distance from the proximal end of the first bifurcated stent graft to the distal end of the first leg and the second leg is in the range from about 50 mm to about 120 mm, wherein the diameter of the first leg of the first bifurcated stent graft is about 2 mm greater than the diameter of the second leg of the first bifurcated stent graft, and wherein the length of the first leg of the first bifurcated stent graft and the length of the second leg of the first bifurcated stent graft are each a minimum of about 30 mm.
4. The debranching stent graft of claim 3 , wherein the diameter of the first leg of the first bifurcated stent graft is about 10 mm and the diameter of the second leg of the first bifurcated stent graft is about 8 mm.
5. The debranching stent graft of claim 3 , wherein the diameter of the first bifurcated stent graft at the proximal end is about 16 mm.
6. The debranching stent graft of claim 3 , wherein a distance from the proximal end of the first bifurcated stent graft to the bifurcation is in the range from about 30 mm to about 90 mm.
7. The debranching stent graft of claim 1 , wherein the distal end of the extension stent graft is coupled to the proximal end of the first bifurcated stent graft via passive fixation, wherein the first leg of the second bifurcated stent graft is coupled to the proximal end of the extension stent graft via passive fixation, and wherein the distal end of the main body stent graft is coupled to the proximal end of the second bifurcated stent graft via passive fixation.
8. The debranching stent graft of claim 1 , wherein the first leg of the second bifurcated stent graft is configured to be positioned entirely within an aneurysmal sac.
9. The debranching stent graft of claim 1 , wherein both the distal end of the extension stent graft and the proximal end of the extension stent graft are configured to be positioned entirely within an aneurysmal sac.
10. A method for placement of a debranching stent graft, the method comprising:
introducing a guidewire into a non-diseased tissue of an aorta of a patient;
loading a delivery catheter containing a main body stent graft onto the guidewire;
moving the delivery catheter along the guidewire and introducing the delivery catheter into the non-diseased tissue of the aorta via arterial access;
deploying the main body stent graft into the non-diseased tissue of the aorta;
loading a second delivery catheter containing a second bifurcated stent graft onto a proximal end of the guidewire;
moving the second delivery catheter along the guidewire and introducing the second delivery catheter into the main body stent graft via arterial access;
deploying the second bifurcated stent graft such that a proximal end of the second bifurcated stent graft is in a distal end of the main body stent graft, a first leg of the second bifurcated stent graft extends within an aneurysmal sac, and a second leg of the second bifurcated stent graft extends within one of a left common iliac artery or a right common iliac artery;
introducing a second guidewire into one of the left common iliac artery or the right common iliac artery through the first leg of the second bifurcated stent graft via arterial access;
loading a third delivery catheter containing an extension stent graft onto the second guidewire;
moving the third delivery catheter along the second guidewire and introducing the third delivery catheter into the first leg of the second bifurcated stent graft via arterial access;
deploying a proximal end of the extension stent graft into the first leg of the second bifurcated stent graft;
loading a fourth delivery catheter containing a first bifurcated stent graft onto a proximal end of the second guidewire;
moving the fourth delivery catheter along the second guidewire and introducing the fourth delivery catheter into a distal end of the extension stent graft via arterial access; and
deploying a proximal end of the first bifurcated stent graft into a distal end of the extension stent graft such that a first leg of the first bifurcated stent graft is positioned within one of a left external iliac artery or a right external iliac artery.
11. The method of claim 10 , further comprising:
introducing a third guidewire into one of the left common iliac artery or the right common iliac artery through a second leg of the first bifurcated stent graft via arterial access;
loading a fifth delivery catheter containing a second extension stent graft onto a proximal end of the third guidewire;
moving the fifth delivery catheter along the third guidewire and introducing the fifth delivery catheter into the second leg of the first bifurcated stent graft via arterial access; and
deploying a proximal end of the second extension stent graft into the second leg of the first bifurcated stent graft such that the second extension stent graft is positioned in one of a left internal iliac artery or a right internal iliac artery.