Cook Medical Technologies LLC

Cook Incorporated

William A. Cook Australia Pty. Ltd.

The Cleveland Clinic Foundation

Chuter, Timothy

Timothy A Chuter

Blayne A Roeder

Alan R Leewood

Sharath Gopalakrishnamurthy

David Ernest Hartley

Michael Lawrence-Brown

Roy K Greenberg

Erik Edelbo Rasmussen

Jarin A Kratzberg

Steven Charlebois

Werner Dieter Ducke

William Kurt Dierking

Matthew S Huser

Richard Swift

David Douglas Grewe

Bent Oehlenschlaeger

David Brocker

Susan Morriss

Kim Mogelvang Jensen

John Luke Chuter

Steven J Charlebois

The present embodiments provide a medical device for implantation in a patient comprising a stent and a valve. The stent comprises a proximal region comprising a cylindrical shape having a first outer diameter in an expanded state, and a distal region comprising a cylindrical shape having a second outer diameter in the expanded state. The second outer diameter is greater than the first outer diameter. A proximal region of the valve is at least partially positioned within the proximal region of the stent, and the distal region of the valve is at least partially positioned within one of tapered and distal regions of the stent. When implanted, the proximal region of the stent and the proximal region of the valve are aligned with a native valve, and the distal region of the valve is distally spaced-apart from the native valve.

Stent structures for use with valve replacements

An implantable endoluminal prosthesis for replacing a damaged aortic valve is provided. In one embodiment, the prosthesis includes a balloon-expandable stent, a tubular conduit that extends into the ascending aorta, and a self-expanding stent. The tubular conduit extends across the balloon-expandable stent. The tubular conduit includes an artificial valve. The self-expanding stent extends across the tubular conduit into the ascending aorta. The balloon-expandable stent, the tubular conduit, and the self-expanding stent are coupled to provide unidirectional flow of fluid into the aorta and further into the coronary arteries. Also provided is a method for implanting the endoluminal prosthesis.

Aortic valve stent graft

The present embodiments provide a medical device for implantation in a patient-comprising a stent and a valve. The stent comprises a proximal region comprising a cylindrical shape having a first outer diameter in an expanded state, and a distal region comprising a cylindrical shape having a second outer diameter in the expanded state. The second outer diameter is greater than the first outer diameter. A proximal region of the valve is at least partially positioned within the proximal region of the stent, and the distal region of the valve is at least partially positioned within one of tapered and distal regions of the stent. When implanted, the proximal region of the stent and the proximal region of the valve are aligned with a native valve, and the distal region of the valve is distally spaced-apart from the native valve.

A device for delivering and deploying a prosthesis is described and comprises an elongate sheath having a sheath lumen and a delivery catheter slidably disposed within the sheath lumen. A deployment assist mechanism may be coupled to the delivery catheter and the sheath and configured to apply a retraction force to the delivery catheter and the sheath. Additional devices, systems, and methods of delivering and deploying a prosthesis are described.

Prosthesis delivery and deployment device

A stent graft delivery device () has a pull wire arrangement with a pull wire () fastened to the distal end of a nose cone dilator () and extending to a wire pull mechanism () for the pull wire associated with a handle () of the stent graft delivery device. The pull wire can be pulled by the wire pull mechanism to induce a curve in a guide wire catheter () distally of the nose cone dilator such that the proximal end of the delivery device more closely fits the shape of a portion of the vasculature of a patient into which the device is deployed.

Thoracic introducer

A stent graft introducer () which includes a handle arrangement which by telescopic movement of a slide or slide portions () into a handle portion () causes controlled sequential deployment of a stent graft (). Stops () ensure actions are carried out in a selected order. A sheath () of the introducer is fixed to a slide portion such that with retraction of the slide portion the sheath is withdrawn from a stent graft retained on the introducer and at a selected position trigger wires retaining the stent graft onto the introducer are also released. Interconnections between the slides and the handle are provided to prevent relative rotation and re-extension after full retraction.

Controlled sequential deployment

A stent graft for endovascular introduction into the pararenal region of the descending aorta. The stent graft has an elongate tubular body () with a proximal portion (), a distal portion () of a diameter less than the proximal portion and a tapered central portion (). A notional transverse clock face on the tubular body has 12 o'clock at a notional anterior longitudinal datum line. The stent graft has a scalloped cut out () centered at about 12:30 o'clock and a fenestration () at about 12:00 o'clock in the proximal portion and first and second fenestration assemblies which can be low profile side arms at about 2:15 o'clock and about 10:00 o'clock in the tapered central portion. The tapered central portion can have an arcuate side wall () so that the tapered portion has an outer face which is concave.

Pararenal stent graft

A stent graft for use in a medical procedure to treat a dissection of a patient's ascending thoracic aorta. The stent graft includes bare alignment stents at least at a proximal end, and often with a stent at both ends, each stent having opposing sets of curved apices, where the curved section of one broader set of apices has a radius of curvature that is greater than the curved section of the other narrower set of apices. The proximal stent is flared in a manner such that its broad apices occupy a larger circumference around the stent than do its narrower apices, where this flared feature provides for anchoring engagement near the aortic root in a manner not interfering with the coronary arteries or the aortic valve.

Low profile non-symmetrical bare alignment stents with graft

Assembly for controlled sequential stent graft deployment

A stent graft () has a tubular body () of a biocompatible material and at least one fenestration (). The or each fenestration has a tubular side branch stitched into it with a portion of the tubular side branch extending within the tubular body and a portion of the tubular side branch extending exteriorly of the tubular body. The stitching by which the tubular side branch is mounted into the fenestration extends circumferentially and diagonally from one end of the tubular side branch to the other such that the tubular side branch extends from the tubular body at an angle thereto. The tubular side branch has a resilient ring around at least one and preferably both ends thereof and a self expanding stent in between them. The tubular side branch can have a circumferential linear portion () at an inner end to engage against the inner wall () of the tubular body. The tubular side branch can have a stent made from a single wire forming a first ring (), a second ring (), the second ring defining a plane which is substantially parallel to and spaced axially apart from the plane of the first ring and a number of helical wire portions () extending between the first and second ring. Preferably the wire is a shape memory wire such as Nitinol&#x2122; wire.

Side branch stent graft construction

A transluminal arrangement for positioning a prosthesis assembly at an aneurysm in the bifurcated lumen of the aorta and the common iliac arteries extending therefrom. The prosthesis assembly includes a bifurcated endovascular graft having a main body and ipsilateral and contralateral limbs extending therefrom. The assembly also includes main, ipsilateral, and contralateral spring assemblies each having a compressed state. When released from its compressed state, each spring expands a portion of the graft to substantially conform that portion of the graft to the wall of the bifurcated lumen. The transluminal arrangement comprises an elongated member extending through the main and ipsilateral bores of the graft and includes attachment sutures and an inner catheter extending therethrough for temporarily attaching the main and ipsilateral spring assemblies to the elongated member. An outer sheath contains the attached prosthesis assembly, whereas stent boots consisting of short length sheaths contain the ipsilateral and contralateral spring assemblies. A control limb delivery catheter and attachment sutures maintain the contralateral graft limb and spring assembly in the stent boot for placement in the contralateral iliac artery.

Expandable transluminal graft prosthesis for repair of aneurysm

A transluminal grafting system for grafting a prosthesis to the wall of a lumen includes a tubular graft provided with spring assemblies and anchoring barbs. The prosthesis is mounted on an apertured tubular carrier and a central control means is inserted into the bore of the apertured carrier. Mooring loops are attached to the prosthesis, pass through the apertures of the tubular carrier, and engage the central control means. An introducer sheath covers the system for smooth insertion into a lumen. When the graft has been positioned, the central control means maintains the axial position of the prosthesis. When the introducer sheath is pulled, the prosthesis is exposed and the spring assemblies return to an expanded state and anchor the graft against the internal wall of the lumen.

Growing community of inventors

San Francisco, CA, United States of America

Timothy A Chuter