Bifurcated side-access intravascular stent graft

Abstract

A bifurcated intravascular stent graft comprises primary stent segments and a primary graft sleeve, forming a main fluid channel and having a side opening therethrough. An external graft channel formed on the primary graft sleeve has a first end communicating with the side opening and an open second end outside the primary graft sleeve, thereby providing a branch flow channel from the main channel out through the side opening and external graft channel. The primary stent segments and graft sleeve engage an endoluminal surface of a main vessel and form substantially fluid-tight seals. The stent graft further comprises a secondary stent graft, which may be positioned partially within the external graft channel, through the open second end thereof, and partially within a branch vessel. The secondary stent graft engages the inner surface of the external graft channel and the endoluminal surface of the branch vessel, thereby forming substantially fluid-tight seals.

What is claimed is: 
     
         1 . A stent graft comprising:
 a primary stent construct;   a primary graft coupled to the primary stent construct, the primary graft extending between a first end and a second end, the primary graft having an outer surface and an inner surface, the inner surface of the primary graft defining a primary fluid flow channel between the first end and the second end, the primary graft having a side opening into the primary flow channel between the first end and the second end; and   a secondary graft coupled lengthwise along an outer surface of the primary graft, the secondary graft defining an external graft channel extending along the outer surface of the primary graft such that the primary graft channel and the external graft channel extend in a common longitudinal direction, the external graft channel defining an external fluid flow channel communicating with the primary fluid flow channel through the side opening in the primary graft, the secondary graft including an end at least partially opening in a common direction with the first end or the second end of the primary graft, the end of the secondary graft being configured to couple with a branch member having a branch fluid flow channel to connect the branch fluid flow channel of the branch member to the primary fluid flow channel of the primary graft member through the side opening in the primary graft.   
     
     
         2 . The stent graft of  claim 1 , further comprising a secondary stent construct coupled to the secondary graft to maintain patency of the external graft channel. 
     
     
         3 . The stent graft of  claim 2 , wherein the secondary stent construct extends along a majority of the secondary graft. 
     
     
         4 . The stent graft of  claim 1 , further comprising a secondary stent construct configured to maintain patency of the end of the secondary graft that is configured to couple with a branch member. 
     
     
         5 . The stent graft of  claim 1 , wherein the secondary graft defines a raised surface relative to the outer surface of the primary graft. 
     
     
         6 . A bifurcated stent graft comprising:
 one or more stents;   a primary graft coupled to the one or more stents having a first end and a second end forming a primary fluid flow channel; and   one or more external graft channels formed by graft material coupled to an outer surface of the primary graft configured to communicate with the primary fluid flow channel through a side opening in the primary graft, the one or more external graft channels including an end at least partially opening in a common direction with the first end or the second end of the primary graft configured to accept a branch member and connect the branch member to the primary fluid flow channel through the side opening in the primary graft.   
     
     
         7 . The bifurcated stent graft of  claim 6 , wherein the one or more external graft channels form a second fluid flow channel that includes at least portion that extends along the outer surface of the primary graft. 
     
     
         8 . The bifurcated stent graft of  claim 7 , wherein the one or more external graft channels include a stent portion arranged at or adjacent to the end of the one or more external graft channels. 
     
     
         9 . The bifurcated stent graft of  claim 8 , wherein an outer surface of the one or more external graft channels is spaced apart from the outer surface of the primary graft. The bifurcated stent graft of  claim 9 , wherein the stent portion maintains the second fluid flow channel spaced apart from the outer surface of the primary graft. 
     
     
         11 . The bifurcated stent graft of  claim 6 , wherein the one or more stents include a first stent arranged at or adjacent to the first end of the primary graft and a second stent arranged at or adjacent the second end of the primary graft, the first stent and the second stent being configured to form substantially fluid-tight seals with an endoluminal surface of a vessel near the first end and the second end of the primary graft by engagement of the first stent and the second stent with the vessel. 
     
     
         12 . The bifurcated stent graft of  claim 6 , wherein the branch member is configured to communicate with a fluid volume that is substantially isolated from intravascular volumes both upstream and downstream of the primary graft. 
     
     
         13 . The bifurcated stent graft of  claim 6 , wherein the branch member includes a proximal end configured to form a substantially fluid-tight seal within the one or more externa channels and a distal end configured to form a substantially fluid-tight seal within a branch vessel. 
     
     
         14 . The bifurcated stent graft of  claim 6 , wherein the one or more external graft channels includes at least two external graft channels arranged at different longitudinal and circumferential positions along the outer surface of the primary graft. 
     
     
         15 . The bifurcated stent graft of  claim 14 , wherein the at least two external graft channels includes a first external graft channel having an end at least partially opening in a common direction with the first end or the second end of the primary graft and a second external graft channel having an end at least partially opening in a common direction with the first end or the second end of the primary graft, wherein the opening of the first external graft channel is spaced apart from the second external graft channel circumferentially about the outer surface of the primary graft. 
     
     
         16 . The bifurcated stent graft of  claim 9 , wherein the first external graft channel is spaced apart from the second external graft channel longitudinally along the outer surface of the primary graft. 
     
     
         17 . A bifurcated stent graft comprising:
 a primary stent graft coupled to the one or more stents having a first end and a second end forming a primary fluid flow channel; and   two or more secondary stent grafts formed by graft material coupled to an outer surface of the primary stent graft, each of the two or more secondary stent graft being spaced apart from one another circumferentially about the outer surface of the primary graft and configured to communicate with the primary fluid flow channel through a corresponding side opening in the primary graft to accept a branch member and connect the branch member to the primary fluid flow channel through the side opening in the primary graft.   
     
     
         17 . The bifurcated stent graft of  claim 17 , wherein the two or more secondary stent grafts are spaced apart longitudinally along the outer surface of the primary stent graft. 
     
     
         18 . The bifurcated stent graft of  claim 17 , wherein the two or more secondary stent grafts each form secondary fluid flow channels that include at least portion of each of the secondary fluid flow channels that extend along the outer surface of the primary stent graft. 
     
     
         19 . The bifurcated stent graft of  claim 18 , wherein the two or more secondary stent grafts each include a stent portion arranged at or adjacent to the end of the secondary stent grafts. 
     
     
         20 . The bifurcated stent graft of  claim 19 , wherein an outer surface of each of the secondary stent grafts are spaced apart from the outer surface of the primary stent graft. 
     
     
         21 . An endoprosthesis for repair of a damaged portion of an aorta, the endoprosthesis comprising:
 a primary graft coupled to the a first stent at a first end of the primary graft and a second stent arranged at a second end of the primary graft, the primary graft having an outer surface configured to engage a tissue wall of the aorta and an inner surface configured to define a primary fluid flow lumen between the first end and the second end, the primary graft having a side opening into the primary flow lumen between the first end and the second end; and   an external graft channel extending along the outer surface of the primary graft, defining an external fluid flow channel communicating with the primary fluid flow channel through the side opening in the primary graft extending substantially in a common longitudinal direction as the primary flow lumen, the secondary graft including an end section at least partially opening in a common direction with the first end or the second end of the primary graft; and   a branch member having a branch fluid flow channel configured to engage the end section of the external graft channel and to connect the branch fluid flow channel of the branch member to the primary fluid flow channel of the primary graft member through the side opening in the primary graft.   
     
     
         22 . The endoprosthesis of  claim 21 , wherein the primary graft is configured to substantially isolate the damaged portion of the aorta from intravascular fluid pressure and the branch member is configured to allow blood flow to a branch vessel. 
     
     
         23 . The endoprosthesis of  claim 21 , wherein the branch member is configured to extend within the external graft channel external to the primary flow lumen. 
     
     
         24 . The endoprosthesis of  claim 21 , wherein the branch member is configured to engage with the section of the external graft channel in a fluid tight arrangement. 
     
     
         25 . A method of deploying a stent graft within a vessel, the method comprising:
 arranging an endoprosthesis within the vessel, the endoprosthesis including a primary stent construct, a primary graft coupled to the primary stent construct, the primary graft extending between a first end and a second end, the primary graft having an outer surface and an inner surface, the inner surface of the primary graft defining a primary fluid flow channel between the first end and the second end, the primary graft having a side opening into the primary flow channel between the first end and the second end, and a secondary graft coupled lengthwise along an outer surface of the primary graft, the secondary graft defining an external graft channel extending along the outer surface of the primary graft such that the primary graft channel and the external graft channel extend in a common longitudinal direction, the external graft channel defining an external fluid flow channel communicating with the primary fluid flow channel through the side opening in the primary graft, the secondary graft including an end at least partially opening in a common direction with the first end or the second end of the primary graft; and   engaging a first end portion of a branch member with the end of the secondary graft, the branch member having a branch fluid flow channel to connect the branch fluid flow channel of the branch member to the primary fluid flow channel of the primary graft member through the side opening in the primary graft; and   arranging a second end portion of the branch member within a branch vessel extending from the vessel.   
     
     
         26 . The method of  claim 25 , wherein the primary graft is configured to substantially isolate the damaged portion of the aorta from intravascular fluid pressure and the branch member is configured to allow blood flow to a branch vessel. 
     
     
         27 . The method of  claim 25 , wherein the branch member is configured to extend within the external graft channel external to the primary flow lumen. 
     
     
         29 . The method of  claim 25 , wherein the branch member is configured to engage with the section of the external graft channel in a fluid tight arrangement.