Endospan Ltd.

Dan Raz Ltd.

Mtex Cardio Ag

Yaniv Marmur

Alon Shalev

Ricardo David Roman

Andrea Guidotti

Amir Raz

Dan Raz

David Zarbatany

Nir Shalom Nae

Or Zigelboim

Karl Heinz Kuck

Ori Nissan

Zeev Geva

Monica Tocchi

Tzachi Tziler

Idan Tobis

Michael Butscheid

An endovascular stent-graft is provided, including a plurality of circumferential strut members disposed at respective axial positions along a self-curving longitudinal portion thereof. Each of the circumferential strut members is shaped so as to define a plurality of proximal peaks. When the stent-graft is unconstrained in a radially-expanded state, for at least one of the circumferential strut members, a first set of the proximal peaks of the circumferential strut member, which includes at least a circumferentially-closest one of the proximal peaks to an outermost curve of the self-curving longitudinal portion, are bent radially inward at least an average angle of 20 degrees toward a central longitudinal axis of the self-curving longitudinal portion, and a second set of the proximal peaks of the circumferential strut member are not bent radially inward by at least an average angle of 20 degrees toward the central longitudinal axis. Other embodiments are also described.

Self-curving stent-graft

A stent-graft () comprises strut members () and a graft member (), which is fixed to the strut members (). The strut members () and the graft member () are arranged so as to define, when the stent-graft () is in a radially-expanded state: a main tube (), which is shaped so as to define a main lumen (); and a lateral tube (), which (a) has (i) a distal end () and (ii) a proximal end () that is joined to a lateral wall () of the main tube () at a junction (), (b) is shaped so as to define a lateral lumen () that is in fluid communication with the main lumen (), and (c) defines a central longitudinal axis (). The strut members () that define the lateral tube () are shaped so as to define two to four non-contiguous arcuate members (), which (a) are centered around the central longitudinal axis (), and (b) collectively subtend at least 150 degrees around the central longitudinal axis ().

Endovascular stent-graft with fatigue-resistant lateral tube

An elongate delivery shaft assembly () includes an outer covering shaft () and an inner support shaft (). When the delivery shaft assembly () is unconstrained and a stent-graft () is removably constrained in a radially-compressed delivery state along a distal end portion () of the delivery shaft assembly (), radially between the outer covering shaft () and the inner support shaft (): (a) the delivery shaft assembly () is shaped so as to define a self-orienting portion (), which (i) is shaped so as to define at least proximal and distal curved portions (A,B), the proximal curved portion (A) disposed more proximal than the distal curved portion (B), and (ii) at least one point of inflection () on a central longitudinal axis () of the delivery shaft assembly () longitudinally between the proximal and the distal curved portions (A,B), and (b) respective smallest radii of curvature of the proximal and the distal curved portions (A,B), measured at the central longitudinal axis (), are each between 2.5 and 12 cm.

Self-orienting endovascular delivery system

An endovascular system includes an elongate delivery shaft assembly, which, when a stent-graft is removably constrained in a radially-compressed delivery state along a distal end portion of the delivery shaft assembly, is shaped so as to define a self-orienting portion, which is shaped so as to define (a) at least proximal and distal curved portions, the proximal curved portion disposed more proximal than the distal curved portion, and (b) at least one point of inflection on a central longitudinal axis of the delivery shaft assembly longitudinally between the proximal and the distal curved portions. Upon positioning of a distal tip of the system near a bifurcation of a brachiocephalic artery from an aortic arch, the self-orienting portion automatically rotationally orients itself in the aortic arch to a rotational orientation in which an inferior lateral opening of the stent-graft faces upstream in the aortic arch. Other embodiments are also described.

A stent-graft () comprises strut members () and a graft member (), which is fixed to the strut members (). The strut members () and the graft member () are arranged so as to define, when the stent-graft () is in a radially-expanded state: a main tube (), which is shaped so as to define a main lumen (); and a lateral tube (), which (a) has (i) a distal end () and (ii) a proximal end () that is joined to a lateral wall () of the main tube () at a junction (), (b) is shaped so as to define a lateral lumen () that is in fluid communication with the main lumen (), and (c) defines a central longitudinal axis (). The strut members () that define the lateral tube () are shaped so as to define two to four non-contiguous arcuate members (), which (a) are centered around the central longitudinal axis (); and (b) collectively subtend at least 150 degrees around the central longitudinal axis ().

A method for treating a subject includes providing an endovascular system that includes a stent-graft and an elongate delivery shaft assembly. When the delivery shaft assembly is unconstrained and the stent-graft is removably constrained along a distal end portion of the delivery shaft assembly, the delivery shaft assembly is shaped so as to define a self-orienting portion, which is shaped so as to define at least proximal and distal curved portions. The delivery shaft assembly is transvascularly introduced into a descending aorta of the subject and a distal end of the delivery shaft assembly is advanced to an aortic arch, such that the self-orienting portion assumes a desired rotational orientation in the aortic arch. While the distal end of the delivery shaft assembly is positioned in the aortic arch, the stent-graft is released from the distal end portion of the delivery shaft assembly. Other embodiments are also described.

An endovascular prosthesis includes a stent-graft and an external coagulation inducer. The stent-graft includes a first portion of structural strut members and a first portion of a graft member, which, when the endovascular prosthesis is unconstrained in a radially-expanded state, together are shaped so as to define a blood-carrying tubular structure defining a lumen. The external coagulation inducer includes an extra-luminal skirt, which includes a second portion of the structural strut members and a second portion of the graft member, and is configured to assume: (i) when the endovascular prosthesis is removably disposed in a delivery sheath, a radially-compressed delivery state, in which the structural strut members of the first portion do not coincide with the structural stent members of the second portion, and (ii) when the endovascular prosthesis is unconstrained, a radially-expanded state, in which the extra-luminal skirt extends radially outward from an external surface of the stent-graft.

Stent-grafts systems with skirt

A deployment system () includes an inner shaft (), removably disposed in a self-expanding stent-graft (), and shaped so as to define (a) at least one conduit therealong (), which is (i) not coaxial with the inner shaft (), and (ii) shaped so as to define at least first () and second enclosed longitudinal segments (), and (b) a restraining longitudinal portion () that is longitudinally disposed between the first () and second enclosed longitudinal segments (). The deployment system () is configured such that (a) when a restraining wire () thereof is removably disposed in the first () and second enclosed longitudinal segments (), a portion () of the restraining wire () disposed alongside the restraining longitudinal portion () prevents full radial expansion of a longitudinal portion () of the stent-graft () by physically engaging the stent-graft longitudinal portion (), and (b) when the restraining wire () has been withdrawn from at least the first enclosed longitudinal segment (), the restraining wire () does not prevent the full radial expansion of the stent-graft longitudinal portion ().

Stent system with radial-expansion locking

An endovascular system () includes an endovascular implant () and a delivery tool (). The implant () is configured to assume a radially-compressed delivery state, and a radially-expanded deployment state. The delivery tool () includes a proximal main delivery catheter (), having a distal portion () in which the implant () is disposed while in the radially-compressed delivery state; and a distal restraining assembly (), which includes a restraining-assembly tubular shaft () disposed distal to the proximal main delivery catheter (). The distal restraining assembly () is configured to assume an engaged state, in which the distal restraining assembly () prevents proximal displacement of the implant () relative to the distal restraining assembly (), and a disengaged state, in which the distal restraining assembly () allows proximal displacement of the implant () relative to the distal restraining assembly (). Other embodiments are also described.

Minimization of stent-graft migration during implantation

A generally tubular stent-graft () has distal and proximal stent-graft ends () and includes a generally tubular support element () and a covering element (). When the stent-graft () is unconstrained in a radially-expanded state: (1) the covering and support elements () are shaped so as to together define a lateral fenestration () having distal and proximal fenestration ends (), (2) a perimeter (P) of the distal stent-graft end () equals at least 200% of a perimeter (P) of the proximal stent-graft end (), and (3) the stent-graft () includes a dissection-reinforcement axial portion (), which (a) has a proximal dissection-reinforcement end () that is disposed no more than 20 mm proximal to the proximal fenestration end (), (b) extends along the stent-graft for a distance equal to between 5% and 32% of a greatest perimeter of the stent-graft () distally to the distal fenestration end (), and (c) has a radial strength that is at least 10% greater than an average radial strength of the entire stent-graft (). Other embodiments are also described.

Multi-component stent-graft system for aortic dissections

A closure includes a panel closing against a frame. A set of abutment surfaces for supporting the panel against applied forces is completed by a displaceable abutment block which selectively assumes an engaged state disposed between an abutment surface of the panel and an abutment surface of a strike jamb. The geometry of engagement is such that forces acting on the abutment block opposing opening of the panel are primarily compressive forces. Certain implementations additionally, or alternatively, employ abutment blocks for locking along the lintel or the threshold of the opening.

Growing community of inventors

Yokneam Moshava, Israel

Yaniv Marmur