Intravascular folded tubular endoprosthesis

Abstract

A bifurcated or straight intravascular folded tubular member is deliverable percutaneously or by small cutdown to the site of a vascular lesion. Its inserted state has a smaller nondeployed diameter and a shorter nondeployed length. The intravascular tubular member has a folded tubular section that is unfolded following insertion into the blood vessel. The length of the intravascular folded tubular member is sized in situ to the length of the vessel lesion without error associated with diagnostic estimation of lesion length. The folded tubular member is self-expandable or balloon-expandable to a larger deployed diameter following delivery to the lesion site. An attachment anchor can be positioned at the inlet or outlet ends of the intravascular folded tubular member to prevent leakage between the tubular member and the native vessel lumen and to prevent migration of the tubular member. The attachment anchor has a short axial length to provide a more focal line of attachment to the vessel wall. Such attachment is valuable in attaching to a short aortic neck in the treatment of abdominal aortic aneurysm. The attachment anchor can have barbs which are held in a protected conformation during insertion of the tubular member and are released upon deployment of the attachment anchor. The intravascular tubular member can be formed of woven multifilament polymeric strands with metallic strands interwoven along with them. Double weaving is incorporated to prevent leakage at crossover points.

1 - 34 . (canceled) 
   
   
       35 . A wall structure for a cylindrical member that is deliverable to the site of a lesion within a tubular vessel of the body, the cylindrical member having a nondeployed state and capable of undergoing an expansion deformation to a deployed state with a larger diameter, said wall structure comprised of;
 A. one or more hinges and one or more struts,   B. said hinges being adapted to bend substantially only in the direction of the hinge width,   C. said struts having a strut width that is greater than a strut radial dimension wherein said strut is unable to bend substantially in the direction of the strut width and is adapted to flex elastically and not substantially plastically in the radial direction.   
   
   
       36 . The wall structure of  claim 35  wherein the said hinges provide a plastic deformation of a material as said hinges deform during the expansion deformation. 
   
   
       37 . The wall structure of  claim 36  wherein said struts formed of said material are adapted to bend elastically in the radial direction due to an external crush force and return to the original shape upon removal of the crush force, thereby providing a cylindrical member that is adapted to be balloon expandable but not plastically crushable. 
   
   
       38 . The wall structure of  claim 35  wherein said hinges have an expansion yield force in the direction of said hinge width and said struts have an outward crush elastic force in the radial direction that are uncoupled from each other thereby allowing these forces to be adjusted independently from each other. 
   
   
       39 . The wall structure of  claim 35  wherein said hinges provide an elastic expansion force in the direction of said hinge width that is uncoupled from a crush elastic force provided by said struts in a radial direction. 
   
   
       40 . A cylindrical wall structure for use within a tubular vessel of the body, deliverable to a site that requires a supporting structure, said cylindrical wall structure having the ability to exert an expansion force outward that is transmitted toward the tubular vessel wall, said cylindrical wall structure further having an independent ability to tolerate a temporarily applied external crush force by becoming oval in shape and then returning back to its approximate initial shape upon removal of the external force, said tubular wall structure comprised of;
 A. hinges and struts that are interconnected within said cylindrical wall structure,   B. said struts having a width enough greater than the width of said hinges such that the struts do not contribute significantly to the expansion force that is predominantly determined by said hinges,   C. said hinges having a radial dimension enough greater than the radial dimension of said struts such that the hinges do not contribute significantly to the elastic crush resistance force that is predominantly determined by said struts.   
   
   
       41 . The method of use for a cylindrical member that is deliverable to the site of a lesion within a tubular vessel of the body, the cylindrical member having a nondeployed state and capable of undergoing an expansion deformation to a deployed state of larger diameter, the method comprising; providing a wall structure with hinges and struts, said hinges being adapted to be unable to bend substantially in the radial direction; said struts being adapted to be substantially unbendable in the direction of the strut width and adapted to flex elastically and not significantly plastically in the radial direction; whereby said cylindrical member is thereby adapted to reversibly form an oval shape during a crush deformation. 
   
   
       42 . The method of use of  claim 41  wherein at least some of said hinges bend plastically in the direction of the hinge width during the expansion deformation thereby adapting said cylindrical member to be balloon expandable while said struts adapt said cylindrical member to not be plastically crushable. 
   
   
       43 . The method of  claim 41  wherein the hinge width is made wider to increase the force required to pivot the hinge. 
   
   
       44 . The method of  claim 41  wherein said hinge has a hinge length that is decreased to cause a relatively elastic material to bend plastically within a relatively small amount of rotation. 
   
   
       45 . The method of  claim 41  wherein said hinge has a hinge length that is increased to cause a relatively plastic material to bend elastically throughout a relatively large amount of rotation. 
   
   
       46 . The method of  claim 41  wherein the hinge radial dimension is increased beyond that which is necessary to prevent the strut from causing said hinge to flex in the radial direction, thereby providing an increase the force required to pivot the hinge. 
   
   
       47 . The method of  claim 41  wherein the strut radial dimension is made thicker to increase the force required to flex said strut in the radial direction. 
   
   
       48 . The method of  claim 41  wherein the strut radial dimension is decreased to reduce the force required to flex said strut in the radial direction, and adapt said strut when formed from a relatively plastic material to bend elastically throughout a relatively large degree of flexing in the radial direction. 
   
   
       49 . The method of  claim 41  wherein said strut width is made wider than that which is necessary to prevent bending in the direction which said hinges pivot, thereby providing an increase in the force required to flex said strut in the radial direction. 
   
   
       50 . The method of  claim 41  wherein said strut has a strut length that is increased to cause said strut when formed from a relatively plastic material to bend elastically throughout a relatively large degree of flexing in the radial direction. 
   
   
       51 . The method of  claim 41  wherein the hinge width and hinge radial dimension of any of said hinges, and the strut width and strut radial dimension of any of said struts are adapted to have different hinge width and hinge radial dimension than another of said hinges and different strut width and strut radial dimension than another of said struts.