Blood vessel prosthesis and delivery apparatus

Abstract

A prosthesis delivery apparatus, a method of delivering a prosthesis, and a prosthesis are provided. The prosthesis ( 3 ) is for delivering to the branch region of the ascending aorta ( 1 ) and the right and left coronary arteries ( 12, 13 ), and it comprises a main conduit ( 33 ) and first and second branch conduits ( 31, 32 ). The branch conduits ( 31, 32 ) are or locating in the right and left coronary arteries ( 12, 13 ) respectively upon moving from a first position in which they are located in the main conduit ( 33 ) to a second position in which they project out from the main conduit ( 33 ). The branch conduits ( 31, 32 ) turn inside out as the move from the first position to the second position.

1 . Prosthesis delivery apparatus for delivering a prosthesis to the branch region of the ascending aorta and the right and left coronary arteries, the apparatus comprising:
 a prosthesis comprising a main conduit and first and second branch conduits,   a first guide wire for inserting in the ascending aorta such that it extends through the ascending aorta into the right coronary artery; and   a second guide wire for inserting in the ascending aorta such that it extends through the ascending aorta into the left coronary artery;   wherein the prosthesis is arranged such that:   the first and second branch conduits are movable along the first and second guide wires to the branch region, and   the first branch conduit is movable from a first position in which it projects inside the main conduit, to a second position in which it projects out from the main conduit for location in the right coronary artery, the first branch conduit being arranged to turn inside out as it moves from the first position to the second position, and   the second branch conduit is movable from a first position in which it projects inside the main conduit to a second position in which it projects out from the main conduit for location in the left coronary artery, the second branch conduit being arranged to turn inside out as it moves from the first position to the second position.   
   
   
       2 . The delivery apparatus of  claim 1 , comprising one or more actuators for moving the first and second branch conduits from the first to the second position. 
   
   
       3 . The delivery apparatus of  claim 2 , comprising one or more actuators for moving the first branch and second branch conduits along the first and second guide wires to the branch region. 
   
   
       4 . The delivery apparatus of  claim 3 , wherein the same actuators are used to move the first branch and second branch conduits along the first and second guide wires to the branch region and to move the first and second branch conduits from the first to the second position. 
   
   
       5 . The delivery apparatus of  claim 2 , wherein the actuators are push rods. 
   
   
       6 . The delivery apparatus of  claim 5 , wherein the push rods are slidably mounted on the guide wires. 
   
   
       7 . The delivery apparatus of  claim 1 , wherein the first and/or second guide wire comprises an identifying mark or shape. 
   
   
       8 . The delivery apparatus of  claim 1 , wherein the first and/or second guide wire is configured for insertion into the ascending aorta percutaneously. 
   
   
       9 . The delivery apparatus of  claim 1 , wherein the prosthesis is configured for insertion into the ascending aorta percutaneously. 
   
   
       10 . The delivery apparatus of  claim 1 , wherein the prosthesis is expandable from a collapsed state to an expanded state. 
   
   
       11 . The delivery apparatus of  claim 10 , comprising a delivery casing for holding the prosthesis in a collapsed state during delivery of the prosthesis to the branch region. 
   
   
       12 . The delivery apparatus of  claim 11 , wherein the prosthesis is arranged to expand automatically upon removal of the delivery casing. 
   
   
       13 . The delivery apparatus of  claim 1 , further comprising one or more stents for securing the prosthesis in place at the branch region. 
   
   
       14 . A prosthesis for locating at the branch region of the ascending aorta and the right and left coronary arteries, the prosthesis comprising a main conduit and first and second branch conduits, the first branch conduit being for locating in the right coronary artery and the second branch conduit being for locating in the left coronary artery, wherein:
 the first branch conduit is movable from a first position in which it projects inside the main conduit to a second position in which projects out from the main conduit in order for it to locate in the right coronary artery, the first branch conduit being arranged to turn inside out as it moves from the first position to the second position, and   the second branch conduit is movable from a first position in which it projects inside the main conduit to a second position in which projects out from the main conduit in order for it to locate in the left coronary artery, the second branch conduit being arranged to turn inside out as it moves from the first position to the second position.   
   
   
       15 . The prosthesis of  claim 14 , wherein the main conduit comprises a first end which defines an opening, a second end which defines an opening and a side wall extending between the first and second ends of the main conduit, the first and second branch conduits being mounted to the side wall of the main conduit. 
   
   
       16 . The prosthesis of  claim 15 , wherein the first and/or second branch conduits are configured to be movable along respective first and second guide wires. 
   
   
       17 . The prosthesis of  claim 14 , wherein the first and/or second branch conduits have an engagement surface at one end for engaging one or more actuators for moving the branch conduits from the first to the second position. 
   
   
       18 . The prosthesis of  claim 14 , wherein the prosthesis is expandable from a collapsed state to an expanded state. 
   
   
       19 . The prosthesis of  claim 18 , further comprising a removable delivery casing for holding the prosthesis in the collapsed state. 
   
   
       20 . The prosthesis of  claim 14 , wherein the first and second branch conduits are mounted to opposing flanks of the sidewall of the main conduit. 
   
   
       21 . The prosthesis of  claim 14 , wherein the main conduit, and first and second branch conduits are one-piece. 
   
   
       22 . The prosthesis of  claim 14 , wherein the first and/or second branch conduit comprises a fixing means for fixing the branch conduit in the coronary artery. 
   
   
       23 . The prosthesis of  claim 22 , wherein the fixing means for fixing the first and/or second branch conduit is a stent. 
   
   
       24 . The prosthesis of  claim 14 , wherein the main conduit comprises one or more fixing means for fixing the first and/or second end of the main conduit to the wall of the ascending aorta. 
   
   
       25 . The prosthesis of  claim 24 , wherein the fixing means for fixing the first and/or second end of the main conduit is a stent. 
   
   
       26 . (canceled) 
   
   
       27 . (canceled) 
   
   
       28 . A method for delivering a prosthesis to the branch region of the ascending aorta and the right and left coronary arteries, the prosthesis comprising a main conduit and first and second branch conduits, the method comprising the steps of:
 inserting a first guide wire in the ascending aorta such that it extends through the ascending aorta into the right coronary artery;   inserting a second guide wire in the ascending aorta such that it extends through the ascending aorta into the left coronary artery.   moving the prosthesis to the branch region by moving the first branch conduit along the first guide wire and the second branch conduit along the second guide wire; and   moving the first branch conduit along the first guide wire from a first position in which it projects inside the main conduit to a second position in which it projects out from the main conduit, to locate the first branch conduit in the right coronary artery, the first branch conduit turning inside out as it moves from the first position to the second position;   moving the second branch conduit along the second guide wire from a first position in which it projects inside the main conduit to a second position in which it projects out from the main conduit, to locate the second branch conduit in the left coronary artery, the second branch conduit turning inside out as it moves from the first position to the second position.   
   
   
       29 . The method of  claim 28 , wherein one or more actuators are used for moving the first branch and second branch conduits along the first and second guide wires to the branch region. 
   
   
       30 . The method of  claim 29 , wherein one or more actuators are used for moving the first and second branch conduits from the first to the second position. 
   
   
       31 . The method of  claim 29 , wherein the same actuators are used to move the first branch and second branch conduits along the first and second guide wires toward the branch region
 and to move the first and second branch conduits from the first to the second position.   
   
   
       32 . The method of  claim 29 , wherein the actuators are push rods. 
   
   
       33 . The method of  claim 32 , wherein the push rods are slidably mounted on the guide wires. 
   
   
       34 . The method of  claim 28 , wherein the first and/or second guide wire comprises an identifying mark or shape. 
   
   
       35 . The method of  claim 28 , wherein the first and/or second guide wire is inserted into the ascending aorta percutaneously. 
   
   
       36 . The method of  claim 28 , wherein the prosthesis is inserted into the ascending aorta percutaneously. 
   
   
       37 . The method of  claim 28 , wherein the prosthesis is expanded from a collapsed state to an expanded state at the branch region. 
   
   
       38 . The method of  claim 37 , wherein a delivery casing is provided for holding the prosthesis in a collapsed state during delivery of the prosthesis to the branch region. 
   
   
       39 . The method of  claim 38 , wherein the prosthesis expands automatically upon removal of the delivery casing. 
   
   
       40 . The method of  claim 28 , wherein one or more stents are used to secure the prosthesis at the branch region.