Patent Application
20240325137
This invention relates to implantable medical devices specifically vascular prosthesis in endovascular aneurysm repair applications.
Aneurysms of the aorta occurring in the abdominal region are repaired by placement of a prosthetic graft typically made from woven tubes of suitable synthetic materials. The technique of endovascular repair is when the aneurysm is bridged with vascular endograft which is placed intraluminally. A number of prior art patents disclose a variety of catheter-based implantation apparatus and methods directed to securing an endovascular prothesis, see U.S. Patent Publication 2005/0090843 that uses attached elements implanted in the vessel wall.
A stent graft delivery system access conduit can be seen in U.S. Pat. No. 10,849,774 that provides a delivery system with integral aneurysm sac conduit for introducing material for treating endoleaks.
A multi-fabric endovascular stent graph is claimed in U.S. Pat. No. 10,952,884 which includes a flexible stent member and a tubular fluid flow guide.
A device and method for magnetic tissue support is disclosed in U.S. Pat. No. 8,398,703 wherein a metallic component and magnetic component used to allow to interact through body tissue so as to provide external support of the tissue.
A magnetic stent is illustrated in U.S. Pat. No. 6,673,104 as an implantable medical device for intralumenal support of a body lumen where a portion of the device is comprised of a magnetic material.
Finally, a movable magnetic for magnetically guided catheters is disclosed in U.S. Pat. No. 8,532,743 having flexible tubing with a movable magnet in the proximal end and a movable magnet repositioned to an internal magnet fluid to position the guide and distal end of the flexible tubing.
A method and device to assist in guiding an ablation laser for targeted fenestration within an implanted vascular endoprosthesis for endovascular aneurysm repair by providing a magnetically enable guide sheath with a magnetic enabled arterial stent in the proximal end of the supply artery for magnetic attraction and alignment of the guide sheath through the vascular endoprosthesis stent wall. The so-aligned magnetic sheath helps deploy the laser for precise access aperture formation in the vascular endoprosthesis stent graft assuring precise alignment into the target artery for the subsequent placement of the covered stent.
Referring to
The surgical method of the invention provides precise magnetic guidance for subsequent use of the ablation laser 12 by a guide sheath 17 within which the ablation laser 12 is tracked. The guide sheath 17 having a manipulative elongated configuration with integral magnetic end portion 18 of a geometry to enable its directed magnetic pole properties with a ring configuration, in this example, as best seen in
The integration and placement therefore of the magnetic end portion 19A will be compliant with the radial expansion properties of the stent and may therefore be segmented as an example so illustrated on the expanding body 19B of the stent as hereinbefore described.
The procedural aspects of the surgical technique of the invention therefore require placement of the magnetic enabled target stent 19 directly in a target artery 20 which in this example may be the renal artery along the abdominal aorta wherein such juxta renal aneurysms, as noted, are difficult to repair due to the complexities of the anatomy and the difficulty therefore of locating the orifice of the target vessel once the aortic stent graft 13 has been deployed. The target stent 19 is so positioned by standard catheter deployment techniques so as to be within the target vessel and flush to the aortic wall and the endovascular stent graft 13. The target stent 19 is oriented with the magnetic enabled end portion 19A towards the endovascular stent graft 13 or the proximal end of the target vessel 19, in this example, having a plurality of directional stabilization barbs 21 formed circumferentially on the stent's outer surface S so as to engage within the artery's interior wall 20A. This orientation and retainment will prevent longitudinal movement of the target stent 19 which may occur during the endovascular procedure due to the magnetic attraction and engagement as will be described in detail hereinafter.
The positional placement of the endovascular stent graft 13 is by traditional endovascular methods using a delivery system inserted into an artery and then positioned within the aorta aneurysm 14 and released from the delivery system and expanded in place.
Correspondingly, the ablation laser 12 and guide sheath 17 may use the catheter placement method, not shown, for introduction into the endovascular graft 13, as noted. The inclusion of magnetic enabled guide sheath 17 will assist in the subsequent alignment of the ablation laser 12 against the endovascular stent graft wall 13A by magnetic attraction to the already positioned magnetic target stent 19 within the target artery 20 as hereinbefore described. The ablation laser 12 is used to create a fenestration at 21 in the endovascular stent graft wall 13A in alignment with the target stent 19 that subsequently allows for a cover stent 22 to be secured from the endovascular graph opening at 22 into the target stent 19 as will be well understood by those skilled in the surgical art as best seen in
It will thus be seen that a new and novel endovascular method 10 and apparatus assembly 11 for remote guidance and alignment for precise laser fenestration 21 has been illustrated and described and it will be apparent to those skilled in the art that various changes and modifications may be made thereto without departing from the spirit of the invention. Therefore I claim:
