Percutaneous endovascular apparatus for repair of aneurysms and arterial blockages

Abstract

An endovascular apparatus is provided for treating the effects of vascular disease including aneurysms and arterial blockages using a percutaneous, minimally invasive technique. In one embodiment the endovascular apparatus includes a tubular sleeve having a cranial end, a first caudal branch, and a second caudal branch such that the tubular sleeve is shaped like an upside down “Y.” The apparatus further includes at least one expandable attachment device attached to the tubular sleeve for securing the endovascular apparatus to an interior wall of a vessel.

1 - 18 . (canceled) 
     
     
         19 . An endovascular apparatus comprising:
 a tubular sleeve having a central lumen with a cranial end portion longitudinally separated from a caudal end portion, the cranial end portion including a cranial end opening and the caudal end portion including at least one caudal end opening; and   an expandable attachment device extending circumferentially around the cranial end portion of the tubular sleeve, the expandable attachment device including:
 a plurality of tubular segments including first and second segment openings and a tubular segment body, the tubular segment body including an acute angle forming a caudally-pointing tubular segment apex attached to the cranial end portion, the first and second segment openings being mutually circumferentially spaced and being oriented substantially in the cranial direction, and 
 a plurality of received segments including first and second segment ends and a received segment body, the received segment body including an acute angle forming a cranially-pointing received segment apex longitudinally spaced cranially from the cranial end opening, the first and second segment ends being mutually circumferentially spaced and being oriented substantially in the caudal direction, 
 wherein each first segment end is telescopically received into a second segment opening, and each second segment end is telescopically received into a first segment opening in an M configuration; 
   wherein the expandable attachment device includes alternating telescopically arranged tubular and received segments, with each tubular segment being circumferentially spaced from the circumferentially adjacent tubular segments by a circumferentially interposed received segment.   
     
     
         20 . The endovascular apparatus of  claim 19 , wherein the caudal end portion of the tubular sleeve includes a first caudal branch laterally separated from a second caudal branch, the first and second caudal branches each including a branch opening oriented in a caudal direction. 
     
     
         21 . The endovascular apparatus of  claim 20 , wherein the expandable attachment device is a first expandable attachment device, and wherein at least one of the first and second caudal branches includes a branch expandable attachment device extending circumferentially therearound and attached thereto. 
     
     
         22 . The endovascular apparatus of  claim 21 , wherein each branch expandable attachment device includes:
 a plurality of tubular segments including first and second segment openings and a tubular segment body, the tubular segment body including an acute angle forming a caudally-pointing tubular segment apex, the first and second segment openings being mutually circumferentially spaced and being oriented substantially in the cranial direction, and   a plurality of received segments including first and second segment ends and a received segment body, the received segment body including an acute angle forming a cranially-pointing received segment apex longitudinally spaced cranially from the tubular segments, the first and second segment ends being mutually circumferentially spaced and being oriented substantially in the caudal direction;   wherein each first segment end is telescopically received into a second segment opening, and each second segment end is telescopically received into a first segment opening in an M configuration.   
     
     
         23 . The endovascular apparatus of  claim 19 , wherein the expandable attachment device is a first expandable attachment device, and wherein the caudal end opening includes a caudal end expandable attachment device extending circumferentially around the caudal end portion of the tubular sleeve. 
     
     
         24 . The endovascular apparatus of  claim 23 , wherein the caudal end expandable attachment device includes:
 a plurality of tubular segments including first and second segment openings and a tubular segment body, the tubular segment body including an acute angle forming a caudally-pointing tubular segment apex, the first and second segment openings being mutually circumferentially spaced and being oriented substantially in the cranial direction, and   a plurality of received segments including first and second segment ends and a received segment body, the received segment body including an acute angle forming a cranially-pointing received segment apex longitudinally spaced cranially from the tubular segments, the first and second segment ends being mutually circumferentially spaced and being oriented substantially in the caudal direction;   wherein each first segment end is telescopically received into a second segment opening, and each second segment end is telescopically received into a first segment opening in an M configuration.   
     
     
         25 . The endovascular apparatus of  claim 19 , wherein the expandable attachment device is a first expandable attachment device, and the cranial end portion includes a second expandable attachment device located caudally of the first attachment device, the second expandable attachment device extending circumferentially around the tubular sleeve. 
     
     
         26 . The endovascular apparatus of  claim 25 , wherein the second expandable attachment device includes:
 a plurality of tubular segments including first and second segment openings and a tubular segment body, the tubular segment body including an acute angle forming a caudally-pointing tubular segment apex, the first and second segment openings being mutually circumferentially spaced and being oriented substantially in the cranial direction, and   a plurality of received segments including first and second segment ends and a received segment body, the received segment body including an acute angle forming a cranially-pointing received segment apex longitudinally spaced cranially from the tubular segments, the first and second segment ends being mutually circumferentially spaced and being oriented substantially in the caudal direction,   wherein each first segment end is telescopically received into a second segment opening, and each second segment end is telescopically received into a first segment opening in an M configuration; and   wherein at least a portion of the plurality of tubular segments and the plurality of received segments are attached to the tubular sleeve at a location longitudinally caudally spaced from the first expandable attachment device.   
     
     
         27 . The endovascular apparatus of  claim 19 , wherein the plurality of tubular segments and the plurality of received segments are each selectively collapsible in the circumferential direction to selectively and reversibly reduce a total circumference of the expandable attachment device from an expanded apparatus condition to a collapsed apparatus condition. 
     
     
         28 . The endovascular apparatus of  claim 19 , wherein the plurality of tubular segments and the plurality of received segments are collectively selectively collapsible in the longitudinal direction to selectively and reversibly telescope a total length of the endovascular apparatus from an extended apparatus condition to a retracted apparatus condition. 
     
     
         29 . The endovascular apparatus of  claim 22 , wherein the plurality of tubular segments and the plurality of received segments are each selectively collapsible in the circumferential direction to selectively and reversibly reduce a total circumference of the expandable attachment device from an expanded apparatus condition to a collapsed apparatus condition. 
     
     
         30 . The endovascular apparatus of  claim 22 , wherein the plurality of tubular segments and the plurality of received segments are collectively selectively collapsible in the longitudinal direction to selectively and reversibly telescope a total length of the endovascular apparatus from an extended apparatus condition to a retracted apparatus condition. 
     
     
         31 . The endovascular apparatus of  claim 24 , wherein the plurality of tubular segments and the plurality of received segments are each selectively collapsible in the circumferential direction to selectively and reversibly reduce a total circumference of the expandable attachment device from an expanded apparatus condition to a collapsed apparatus condition. 
     
     
         32 . The endovascular apparatus of  claim 24 , wherein the plurality of tubular segments and the plurality of received segments are collectively selectively collapsible in the longitudinal direction to selectively and reversibly telescope a total length of the endovascular apparatus from an extended apparatus condition to a retracted apparatus condition. 
     
     
         33 . The endovascular apparatus of  claim 26 , wherein the plurality of tubular segments and the plurality of received segments are each selectively collapsible in the circumferential direction to selectively and reversibly reduce a total circumference of the expandable attachment device from an expanded apparatus condition to a collapsed apparatus condition. 
     
     
         34 . The endovascular apparatus of  claim 26 , wherein the plurality of tubular segments and the plurality of received segments are collectively selectively collapsible in the longitudinal direction to selectively and reversibly telescope a total length of the endovascular apparatus from an extended apparatus condition to a retracted apparatus condition. 
     
     
         35 . An endovascular apparatus comprising:
 a tubular sleeve having a central lumen with a cranial end portion longitudinally separated from a caudal end portion, the cranial end portion including a cranial end opening and the caudal end portion including at least one caudal end opening; and   an expandable attachment device extending circumferentially around the cranial end portion of the tubular sleeve, the expandable attachment device including:
 a plurality of fixation components positioned about the perimeter of the expandable attachment device, 
 a plurality of circumferentially extending arms, each arm being used to attach each fixation component to a circumferentially adjacent fixation component, and 
 at least one M spring including four angularly attached M segments, the M segments being arranged in a zig-zag configuration to form one inboard apex and two outboard apices, the M spring having two circumferentially spaced M free ends, each M spring being interposed between two selected adjacent fixation components with the M free ends each being attached to a different one of the two selected adjacent fixation components; 
   wherein the M springs are graft expanders operative to hold the tubular sleeve open.   
     
     
         36 . The endovascular apparatus of  claim 35 , wherein the caudal end portion of the tubular sleeve includes a first caudal branch laterally separated from a second caudal branch, the first and second caudal branches each including a branch opening oriented in a caudal direction. 
     
     
         37 . The endovascular apparatus of  claim 36 , wherein the expandable attachment device is a first expandable attachment device, and wherein at least one of the first and second caudal branches includes a branch expandable attachment device extending circumferentially therearound and attached thereto. 
     
     
         38 . The endovascular apparatus of  claim 37 , wherein each branch expandable attachment device includes:
 a plurality of fixation components positioned about the perimeter of the expandable attachment device;   a plurality of circumferentially extending arms, each arm being used to attach each fixation component to a circumferentially adjacent fixation component; and   at least one M spring including four angularly attached M segments, the M segments being arranged in a zig-zag configuration to form one inboard apex and two outboard apices, the M spring having two circumferentially spaced M free ends, each M spring being interposed between two selected adjacent fixation components with the M free ends each being attached to a different one of the two selected adjacent fixation components;   wherein the M springs are graft expanders operative to hold the tubular sleeve open.   
     
     
         39 . The endovascular apparatus of  claim 35 , wherein the expandable attachment device is a first expandable attachment device, and wherein the caudal end opening includes a caudal end expandable attachment device extending circumferentially around the caudal end portion of the tubular sleeve. 
     
     
         40 . The endovascular apparatus of  claim 39 , wherein the caudal end expandable attachment device includes:
 a plurality of fixation components positioned about the perimeter of the expandable attachment device;   a plurality of circumferentially extending arms, each arm being used to attach each fixation component to a circumferentially adjacent fixation component; and   at least one M spring including four angularly attached M segments, the M segments being arranged in a zig-zag configuration to form one inboard apex and two outboard apices, the M spring having two circumferentially spaced M free ends, each M spring being interposed between two selected adjacent fixation components with the M free ends each being attached to a different one of the two selected adjacent fixation components;   wherein the M springs are graft expanders operative to hold the tubular sleeve open.   
     
     
         41 . The endovascular apparatus of  claim 35 , wherein at least the arms and the M springs of the expandable attachment device are selectively collapsible in the circumferential direction to selectively and reversibly reduce a total circumference of the expandable attachment device from an expanded apparatus condition to a collapsed apparatus condition. 
     
     
         42 . The endovascular apparatus of  claim 38 , wherein at least the arms and the M springs of the expandable attachment device are selectively collapsible in the circumferential direction to selectively and reversibly reduce a total circumference of the expandable attachment device from an expanded apparatus condition to a collapsed apparatus condition. 
     
     
         43 . The endovascular apparatus of  claim 40 , wherein at least the arms and the M springs of the expandable attachment device are selectively collapsible in the circumferential direction to selectively and reversibly reduce a total circumference of the expandable attachment device from an expanded apparatus condition to a collapsed apparatus condition. 
     
     
         44 . The endovascular apparatus of  claim 35 , wherein at least one M spring is located directly adjacent to an exterior surface of the tubular sleeve. 
     
     
         45 . The endovascular apparatus of  claim 38 , wherein at least one M spring is located directly adjacent to an exterior surface of the tubular sleeve. 
     
     
         46 . The endovascular apparatus of  claim 40 , wherein at least one M spring is located directly adjacent to an exterior surface of the tubular sleeve. 
     
     
         47 . The endovascular apparatus of  claim 35 , wherein at least one M spring is located directly adjacent to an interior surface of the tubular sleeve. 
     
     
         48 . The endovascular apparatus of  claim 38 , wherein at least one M spring is located directly adjacent to an interior surface of the tubular sleeve. 
     
     
         49 . The endovascular apparatus of  claim 40 , wherein at least one M spring is located directly adjacent to an interior surface of the tubular sleeve. 
     
     
         50 . The endovascular apparatus of  claim 35 , wherein at least one circumferentially extending arm is a telescoping arm having a plurality of segments in slideable contact with one another. 
     
     
         51 . The endovascular apparatus of  claim 38 , wherein at least one circumferentially extending arm is a telescoping arm having a plurality of segments in slideable contact with one another. 
     
     
         52 . The endovascular apparatus of  claim 40 , wherein at least one circumferentially extending arm is a telescoping arm having a plurality of segments in slideable contact with one another. 
     
     
         53 . The endovascular apparatus of  claim 50 , wherein each of the M free ends of a selected M spring is attached to a different segment of a selected arm. 
     
     
         54 . The endovascular apparatus of  claim 51 , wherein each of the M free ends of a selected M spring is attached to a different segment of a selected arm. 
     
     
         55 . The endovascular apparatus of  claim 52 , wherein each of the M free ends of a selected M spring is attached to a different segment of a selected arm. 
     
     
         56 . The endovascular apparatus of  claim 35 , wherein a plurality of M segments of a single M spring are telescoping arms. 
     
     
         57 . The endovascular apparatus of  claim 38 , wherein a plurality of M segments of a single M spring are telescoping arms. 
     
     
         58 . The endovascular apparatus of  claim 40 , wherein a plurality of M segments of a single M spring are telescoping arms