Branch grafting device and method

Abstract

An endoluminal stent graft deployment system useful for deployment of a limb of a branched stent graft ( 16 ) into a blind vessel. The branched stent graft has a main body ( 16 ) and a limb ( 19 ) extending from the body. The branched stent graft is mounted on a deployment device which has a separate deflecting guide wire ( 14 ) extending into the limb. The method of deploying the branched stent graft into a blind vessel in a human or animal body includes the step of releasing the limb from the deployment device, extending the guide wire from the limb into the blind vessel, manipulating the deployment device by withdrawing the deployment device slightly to cause the limb to enter the blind vessel assisted by the guide wire and releasing the stent graft from the deployment device.

What is claimed is:  
     
         1 . An endoluminal stent graft deployment system adapted for deployment of a limb of a branched stent graft into a blind vessel, the deployment system comprising a deployment device having a distal end and a proximal end and including the branched stent graft releasably retained thereon at the proximal end thereof; an inner sheath slidably and coaxially mounted on the deployment device, the branched stent graft having a main body and a limb extending therefrom, the limb extending distally from a bifurcation in the main body, the branched stent graft being mounted on the deployment device with a deployment catheter passing through the main body, the inner sheath enclosing the main body up to distally of the bifurcation, and a separate deflecting wire guide extending into the limb from the distal end.  
     
     
         2 . An endoluminal stent graft deployment system as in  claim 1  further including an outer sheath slidably and coaxially mounted on the inner sheath and enclosing the entire stent graft.  
     
     
         3 . An endoluminal stent graft deployment system as in  claim 2  further including an anchor wire arrangement extending between the inner and outer sheaths and extending to and fastened to the main body of the stent graft adjacent to the bifurcation.  
     
     
         4 . An endoluminal stent graft deployment system as in  claim 1  wherein the separate deflecting wire guide includes a guide wire arrangement extending through the limb and extending distally therefrom to assist with directing the limb into the blind vessel.  
     
     
         5 . An endoluminal stent graft deployment system as in  claim 1  wherein the deployment device includes a guide wire catheter mounted coaxially and movably within a deployment catheter, the guide wire catheter extending to a nose cone and the branched stent graft releasably retained distally of the nose cone.  
     
     
         6 . An endoluminal stent graft deployment system as in  claim 1  further including a diameter reducing arrangement on at least part of the main body of the stent graft.  
     
     
         7 . An endoluminal stent graft deployment system as in  claim 1  further including a diameter reducing arrangement on the limb of the stent graft.  
     
     
         8 . An endoluminal stent graft deployment system as in  claim 6  or  7  wherein the diameter reducing arrangement includes ties around the main body or limb of the stent graft to reduce the diameter of the stent graft or limb from a deployed diameter to a compressed diameter and a trigger wire arrangement to release the ties to allow the main body or limb of the stent graft to expand to the deployed diameter.  
     
     
         9 . An endoluminal stent graft deployment system as in  claim 8  wherein the trigger wire arrangement includes a trigger wire release arrangement at the distal end of the deployment device and adapted to remain outside the patient during deployment.  
     
     
         10 . An endoluminal stent graft deployment system as in  claim 1  wherein the branched stent graft comprises a tubular body and self expanding stents at at least the proximal and distal ends of the main body and at the distal end of the limb.  
     
     
         11 . An endoluminal stent graft deployment system as in  claim 1  wherein the separate deflecting guide wire catheter extending to the limb includes a guide wire and a guide wire sheath, the guide wire being movable within the guide wire sheath from outside the patient during deployment.  
     
     
         12 . An endoluminal stent graft deployment system as in  claim 1  wherein the limb includes on an outer surface thereof fibres extending therefrom to improve adhesion to the vessel wall.  
     
     
         13 . An endoluminal stent graft deployment system as in  claim 3  wherein the anchor wire arrangement includes an anchor wire and an anchor release wire and the anchor release wire extending to an anchor wire release arrangement at the distal end of the deployment device that is adapted to remain outside the patient during deployment.  
     
     
         14 . A method of deploying a limb of a branched stent graft into a blind vessel in a human or animal body, the branched stent graft being mounted on a deployment device, the branched stent graft having a main body and a limb extending therefrom, the limb extending distally from a bifurcation in the main body, the method including the steps of: 
 deploying the deployment device into a vessel from which the blind vessel extends;    releasing a limb of the main body of the branched stent graft from the deployment device such that the limb extends laterally and distally;    extending a guide wire from the limb into the blind vessel;    manipulating the deployment device by withdrawing the deployment device slightly to cause the limb to enter the blind vessel assisted by the guide wire, and    releasing the branched stent graft from the deployment device.    
     
     
         15 . An endoluminal stent graft deployment system adapted for deployment of a limb of a branched stent graft into a blind vessel, the deployment system comprising a deployment device having a distal end and a proximal end and including the branched stent graft releasably retained thereto at the proximal end thereof; an inner sheath slidably and coaxially mounted on the deployment device, an outer sheath slidably and coaxially mounted on the inner sheath, the branched stent graft having a main body and a limb extending therefrom, the limb extending distally from a bifurcation in the main body, the branched stent graft being mounted on the deployment device in an annular recess thereon, with a deployment catheter passing through the main body, the inner sheath enclosing the main body up to distally of the bifurcation, the outer sheath enclosing the entire stent graft and extending proximally of the annular recess, and an anchor wire arrangement extending between the inner and outer sheaths and extending to and fastened to the main body adjacent to the bifurcation.  
     
     
         16 . An endoluminal stent graft deployment system as in  claim 15  further including a guide wire arrangement extending through the limb and extending distally therefrom to assist with directing the limb into the blind vessel.  
     
     
         17 . An endoluminal stent graft deployment system as in  claim 15  wherein the deployment device includes a guide wire catheter mounted coaxially within a deployment catheter, the guide wire catheter extending to a nose cone and the annular recess being between the nose cone and the deployment catheter.  
     
     
         18 . An endoluminal stent graft deployment system as in  claim 15  further including a diameter reducing arrangement on at least part of the main body of the stent graft.  
     
     
         19 . An endoluminal stent graft deployment system as in  claim 15  further including a diameter reducing arrangement on the limb of the stent graft.  
     
     
         20 . An endoluminal stent graft deployment system as in  claim 18  wherein the diameter reducing arrangement includes ties around the stent graft to reduce the diameter of the stent graft from a deployed diameter to a compressed diameter and a trigger wire arrangement to release the ties to allow the stent graft to expand to the deployed diameter.  
     
     
         21 . An endoluminal stent graft deployment system as in  claim 20  wherein the trigger wire arrangement includes a trigger wire release arrangement at the distal end of the deployment device that is adapted to remain outside the patient during deployment.  
     
     
         22 . An endoluminal stent graft deployment system as in  claim 15  wherein the branched stent graft comprises a tubular body and self expanding stents at at least the proximal and distal ends of the main body and at the distal end of the limb.  
     
     
         23 . An endoluminal stent graft deployment system as in  claim 16  wherein the guide wire arrangement extending to the limb includes a guide wire and a guide wire catheter, the guide wire being movable within the guide wire catheter from outside the patient during deployment.  
     
     
         24 . An endoluminal stent graft deployment system as in  claim 15  wherein the branched stent graft comprises a tubular body and self expanding stents at at least the proximal and distal ends of the main body and at the distal end of the limb.  
     
     
         25 . An endoluminal stent graft deployment system as in  claim 16  wherein the guide wire arrangement extending to the limb includes a guide wire and a guide wire catheter, the guide wire being movable within the guide wire catheter from outside the patient during deployment.  
     
     
         26 . An endoluminal stent graft deployment system as in  claim 15  wherein the anchor wire arrangement includes an anchor wire and an anchor release wire and the anchor release wire extending to an anchor wire release arrangement at the distal end of the deployment device that is adapted to remain outside the patient during deployment.  
     
     
         27 . An endoluminal stent graft deployment system adapted for endoluminal deployment of a stent graft, the deployment system including a deployment device having a distal end and a proximal end and including the stent graft releasably retained thereon at the proximal end thereof, characterized by a releasable anchor wire arrangement extending from the distal end of the deployment device and engaging the stent graft to thereby anchor the stent graft during manipulation of the deployment device or another deployment device through the stent graft.