Aortic prosthesis delivery system and method of use
A stent graft for treating an arterial aneurysm includes loops fixed to struts of stents, wherein the struts define distal and proximal apices. The ends of a ligature can be linked by a wire in a stent graft delivery system that threads anchor loops longitudinally spanning ends of the ligature to maintain the stent in a radially constricted position during delivery to the aneurysm. A delivery system and method for implanting a stent graft prosthesis includes and employs a torque component at a distal end of the stent graft prosthesis, whereby following advancement of the stent graft to a surgical site in a constrained or partially constrained configuration, torque is applied to the torque component to rotationally align the stent graft about a longitudinal axis of the stent graft, followed by deployment of the stent graft in correct rotational alignment. A delivery system and method of its use includes an apex capture assembly, a leg clasp, and a leg stop for capturing a stent graft during orientation and stabilization at an implantation site of a surgical site.
1 . A stent graft, comprising:
a) a luminal graft component having a proximal open end and a distal open end;
b) a plurality of stents distributed longitudinally along the luminal graft component, at least one of the stents having struts that are joined to define proximal and distal apices;
c) a plurality of fenestrations, wherein each fenestration is nested between respective struts of adjacent stents;
d) at least one loop secured to at least one of the struts; and
e) at least one ligature extending through the at least one loop, each ligature traversing the struts of at least one of the stents and passing around one of the plurality of fenestrations, wherein each ligature includes ends that, when linked, at least partially radially constrict each corresponding stent.
2 . An aortic prosthetic system, comprising:
a) a luminal stent graft component having a proximal end and a distal end;
b) at least one stent at the luminal graft component, the at least one stent having struts that are joined to define proximal apices and distal apices;
c) a plurality of fenestrations, wherein each fenestration is nested between respective struts of adjacent stents;
d) at least one loop secured to at least one of the struts;
e) a ligature that extends through the loop, traverses a plurality of the struts of the at least one stent to which the loop is attached, and passes around one of the plurality of fenestrations, the ligature defining ends that, when linked, constrain the at least one stent against outward radial expansion to thereby constrict the at least one stent.
3 . The aortic prosthesis system of claim 2 , further including a wire that extends longitudinally along the luminal graft component and links the ends of the ligature to thereby constrict the at least one stent.
4 . The aortic prosthetic system of claim 3 , wherein the ligature has a first end and a second end, and extends around a circumference of the luminal graft component, and through at least a portion of the at least one loop, whereby linkage of the first and second ends causes the ligature to traverse the struts at the at least one loop and constricts outward radial expansion of the at least one stent.
5 . The aortic prosthetic system of claim 4 , wherein the ligature defines a ligature loop at each of the first and the second ends, whereby the first end and the second end can be linked at the ligature loop by the wire.
6 . The aortic prosthetic system of claim 5 , wherein the ligature is a hoop that is collapsed to thereby define a first end and a second end, and extends through at least a portion of the at least one loop, whereby linkage of the first end and the second end causes the ligature to traverse the struts at the at least one loop and constricts outward radial expansion of the at least one stent.
7 . The aortic prosthetic system of claim 6 , including a plurality of loops at a plurality of struts of the at least one stent.
8 . The aortic prosthetic system of claim 7 , wherein the plurality of loops includes at least one pair of loops at a pair of struts that join to form at least one proximal apex or distal apex, whereby constriction of the struts by the ligature causes the at least one pair of loops at the struts to be closer together than the distance between the at least one pair of loops in the absence of constriction of the ligature.
9 . The aortic prosthetic system of claim 8 , wherein the luminal graft component defines a fenestration between two adjoining struts of the at least one stent, and wherein the at least one pair of loops are at the adjoining struts distal to a distal end of the fenestration or proximal to a proximal end of the fenestration, whereby the ligature constricts the at least one stent without obstructing the fenestration.
10 . The aortic prosthetic system of claim 9 , further including a second pair of loops at the pair of struts, wherein the second pair of loops span the fenestration, and further including a loop at the luminal graft component between the at least one pair of loops distal to a distal end of the fenestration or proximal to the proximal end of the fenestration, wherein the ligature extends through the at least one pair of loops at the luminal graft component and constricts the fenestration without obstructing the fenestration, and whereby the luminal graft component at the fenestration is supported between the struts to which the at least one pair of loops are fixed.
11 . The aortic prosthetic system of claim 10 , wherein the ends of the ligature are linked radially apart from the fenestration.
12 . The aortic prosthetic system of claim 11 , further including loops at adjoining struts that define apices proximal to the distal apex nesting the fenestration, or that define apices distal to the proximal apex nesting the fenestration.