Methods and apparatus for treating a type 2 endoleak from within an endoluminal stent graft

Abstract

A repair device includes a first elongate member, a second elongate member, and a seal member. The first elongate member includes a proximal end portion and a distal end portion and defines a lumen therebetween. The second elongate member includes a proximal end portion and a distal end portion and is movably disposed within the lumen. The distal end portion of the second elongate member is configured to puncture an endoluminal stent graft disposed within an artery of a patient and to be inserted, at least partially, into an aneurysm sac. The seal member is releasably coupled to the distal end portion of the first elongate member. The seal member is configured to be coupled to the endoluminal stent graft to seal an opening formed by the distal end portion of the second elongate member.

What is claimed is: 
     
         1 . An apparatus comprising:
 a first elongate member having a proximal end portion and a distal end portion and defining a lumen therebetween;   a second elongate member movably disposable within the lumen of the first elongate member, the second elongate member having a distal end portion configured to puncture an endoluminal stent graft disposed within an artery of a patient and be inserted at least partially within an aneurysm sac; and   a seal member releasably coupled to the distal end portion of the first elongate member, the seal member configured to be coupled to the endoluminal stent graft to seal an opening formed by the distal end portion of the second elongate member in the endoluminal stent graft.   
     
     
         2 . The apparatus of  claim 1 , wherein the second elongate member includes a cannula defining a lumen and a trocar movably disposable within the lumen of the cannula, the trocar having a distal end configured to puncture the endoluminal stent graft, the lumen of the cannula configured to communicate an agent into the aneurysm sac. 
     
     
         3 . The apparatus of  claim 1 , wherein the seal member includes a one-way valve, the distal end portion of the second elongate member configured to be inserted through the one-way valve to puncture the endoluminal stent graft. 
     
     
         4 . The apparatus of  claim 1 , wherein the lumen is a first lumen, the first elongate member includes a second lumen, the apparatus further comprising:
 at least one push rod movably disposed within the second lumen of the first elongate member and configured to releasably couple the seal member to the first elongate member.   
     
     
         5 . The apparatus of  claim 1 , wherein the lumen is a first lumen, the first elongate member includes a second lumen, the apparatus further comprising:
 a push rod movably disposed within the second lumen of the first elongate member; and   a coupling member including a coupling portion configured to threadably couple the seal member to a coupling portion of the push rod.   
     
     
         6 . The apparatus of  claim 1 , the lumen is a first lumen, the first elongate member includes a second lumen, the apparatus further comprising:
 a push rod movably disposed within the second lumen of the first elongate member; and   a coupling member including a first coupling portion configured to couple the seal member to the push rod and a second coupling portion configured to couple the seal member to the endoluminal stent graft.   
     
     
         7 . The apparatus of  claim 1 , further comprising:
 a coupling member including a coupling portion configured to couple the seal member to the endoluminal stent graft, the coupling portion having a biased coil configuration when unconstrained.   
     
     
         8 . The apparatus of  claim 1 , further comprising:
 a delivery device configured to be received within the lumen of the first elongate member and to communicate a sealing agent into the aneurysm sac.   
     
     
         9 . An apparatus, comprising:
 a first elongate member having a proximal end portion and a distal end portion and defining a lumen therebetween, the first elongate member configured to be inserted within an artery of a patient;   a second elongate member disposed within the lumen of the first elongate member;   a seal member configured to be releasably coupled to the second elongate member; and   a coupling member including a first coupling portion configured to releasably couple the seal member to the second elongate member and a second coupling portion configured to couple to the seal member to an endoluminal stent graft disposed within the artery of the patient, the second coupling portion having a first constrained configuration when disposed within a lumen of the seal member and a biased second configuration when moved outside of the lumen of the seal member, the biased configuration configured to couple the seal member to the endoluminal stent graft.   
     
     
         10 . The apparatus of  claim 9 , wherein the first coupling portion of the coupling member is configured to releasably and threadably couple the seal member to the second elongate member. 
     
     
         11 . The apparatus of  claim 9 , wherein the second coupling portion of the coupling member has a coil shape when in its second configuration. 
     
     
         12 . The apparatus of  claim 9 , wherein the lumen of the first elongate member is a first lumen, the first elongate member defining a second lumen, the apparatus further comprising:
 a third elongate member movably disposable within the second lumen, the second elongate member including a cannula defining a lumen and a trocar movably disposable within the lumen of the cannula, the trocar having a distal end configured to puncture the endoluminal stent graft.   
     
     
         13 . The apparatus of  claim 9 , wherein the lumen of the first elongate member is a first lumen, the first elongate member defining a second lumen, the apparatus further comprising:
 a third elongate member movably disposable within the second lumen, the third elongate member including a cannula defining a lumen and a trocar movably disposed within the lumen of the cannula,   the seal member including a valve, the trocar having a distal end configured to be inserted through the valve and through the endoluminal stent graft to form an opening in the endoluminal stent graft.   
     
     
         14 . The apparatus of  claim 9 , wherein the lumen of the first elongate member is a first lumen, the first elongate member defining a second lumen, the apparatus further comprising:
 a third elongate member configured to be received within the second lumen, the third elongate member configured to communicate a sealing agent into the aneurysm.   
     
     
         15 . The apparatus of  claim 9 , wherein the first elongate member is configured to be moved between a first configuration in which the distal end portion of the first elongate member is substantially linear and a second configuration in which the distal end portion of the first elongate member is disposed at an angle relative to a remaining portion of the first elongate member.