Surgery – Instruments – Means for inserting or removing conduit within body
Patent
1998-08-17
2000-04-04
Smith, Jeffrey A.
Surgery
Instruments
Means for inserting or removing conduit within body
A61F 206
Patent
active
060455578
DESCRIPTION:
BRIEF SUMMARY
FIELD OF THE INVENTION
The present invention relates to a method for positioning an intraluminal graft into a bifurcated artery and to a catheter for use in that method.
BACKGROUND ART
It is well known that through disease, arteries of humans are susceptible to the development of distended sacs known as aneurysms which are susceptible to rupture. Traditionally, aneurysms are treated by radical surgical intervention. This approach is risky for the patient and is, in many cases, not feasible due to other pre-existing disease states in the patient. More recently there have been a number of proposals for the intraluminal placement of an intraluminal graft bridging the aneurysms and thereby isolating an active arterial duct from the aneurysmal sac. One such arrangement is described in Australian Patent Application No. 78035/94.
Difficulties arise in the placement of such intraluminal grafts when the aneurysm extends from a single artery into one or more divergent arteries. In this case a so called "trouser graft" must be used. In such a graft a single tubular body bifurcates into two smaller tubular bodies. The intention being that the single tubular body is placed in the single artery and the two smaller tubular bodies are respectively placed in the two divergent arteries (for example, see U.S. Pat. No. 5,360,443 to Barone). In practice it has proven very difficult to effectively place a trouser graft.
The present invention relates to a new method and catheter designed to facilitate the placement of an intraluminal graft in a bifurcating artery.
DISCLOSURE OF THE INVENTION
In a first aspect the present invention comprises a delivery catheter comprising: catheter, the body having at a first end, disposed adjacent to the first end of the elongate catheter, a tubular portion, and at a second end a bifurcation into first and second tubular graft extensions, the elongate catheter extending up the first tubular graft extension and into the tubular portion; and first tubular graft extension and projecting in a second different direction into the second tubular graft extension.
In another aspect, the present invention consists of a method for positioning an intraluminal graft into a branching vessel within a patient's body, the vessel comprising a single pre-branching vessel branching into a pair of post-branching vessels, the method comprising: graft having a body having at a first end a tubular portion and a second end that is bifurcated into first and second tubular graft extensions, there being positioned within the first intraluminal graft a guidewire which extends in a first direction through the first tubular graft extension and projects in a second different direction into the second tubular graft extension; second tubular graft extension within the pre-branching vessel and expanding that graft until at least the first end thereof expands into contact with a circumferential wall of the pre-branching vessel; direction until it extends into the other of the post-branching vessels; and downstream end, into the other of the post-branching vessels and, utilising the guidewire, or another guidewire positioned in its place, moving the second intraluminal graft until its upstream end is within or surrounds the second tubular graft extension and its downstream end is within the other of the post-branching vessels and causing the upstream end of the second intraluminal graft to form fluid conveying engagement with the second tubular graft extension.
The catheter and method according to this invention preferably utilise balloon expandable grafts made according to the disclosure of Australian Patent Application No. 78035/94, the contents thereof are incorporated herein by reference. The elongate catheter can have an inflatable balloon at or adjacent one end with the intraluminal graft disposed about the balloon. Other suitable balloon expandable or self-expandable stents or grafts could be used in carrying out the present invention.
In a preferred embodiment of the invention, the intraluminal grafts that are positi
REFERENCES:
patent: 4994071 (1991-02-01), MacGregor
patent: 5562726 (1996-10-01), Chuter
patent: 5609627 (1997-03-01), Goicoechea et al.
patent: 5628783 (1997-05-01), Quiachon et al.
White Geoffrey H.
Yu Weiyun
Baxter International Inc.
Canter Bruce M.
Gluck Peter Jon
Robert Eduardo C.
Smith Jeffrey A.
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