Expandable supportive branched endoluminal grafts

Abstract

An endoluminal graft which is both expandable and supportive is provided in a form suitable for use in a branched body vessel location. The graft expands between a first diameter and a second, larger diameter. The support component is an expandable stent endoprosthesis. A liner is applied to the endoprosthesis in the form of a compliant wall material that is porous and biocompatible in order to allow normal cellular invasion upon implantation, without stenosis, when the expandable and supportive graft is at its second diameter. The supportive endoluminal graft is preferably provided as a plurality of components that are deployed separately at the branching body vessel location, one of which has a longitudinal seam defining leg portions within which the other components fit in a telescoping manner.

1 - 42 . (canceled) 
   
   
       43 . An endoluminal support device comprising:
 a radially-expandable, bifurcated support, the support including:   a first support portion, and   a second support portion including a first lobe and a second lobe, and a longitudinal isthmus between the first lobe and the second lobe,   the first and second lobes having smaller diameters than the first portion; and   a liner coupled to the radially-expandable, bifurcated support,   wherein the endoluminal support device has an uninterrupted cross-section over its entire length.   
   
   
       44 . The endoluminal support device of  claim 43 , wherein the liner is coupled to an interior side of the radially-expandable, bifurcated support. 
   
   
       45 . The endoluminal support device of  claim 43 , wherein the liner is coupled to an exterior side of the radially-expandable, bifurcated support. 
   
   
       46 . The endoluminal support device of  claim 43 , wherein each of the first and second lobes is adapted to receive a branch support. 
   
   
       47 . A branching endovascular prosthesis comprising:
 a radially expandable support, the support including:   a distal support portion comprising at least one expandable circumferential portion, and   a proximal support portion including a first lobe and a second lobe separated from the first lobe by an isthmus, and   a bifurcated liner coupled to the distal support portion and to the proximal support portion,   wherein the branching endovascular prosthesis has an uninterrupted cross-section over its entire length.   
   
   
       48 . The prosthesis of  claim 47 , wherein the bifurcated liner is coupled to an interior side of the distal support portion and to an interior side of the proximal support portion. 
   
   
       49 . The prosthesis of  claim 47 , wherein the bifurcated liner is coupled to an exterior side of the distal support portion and to an exterior side of the proximal support portion. 
   
   
       50 . The prosthesis of  claim 47 , wherein the prosthesis is self expanding. 
   
   
       51 . A branching endovascular prosthesis comprising:
 a distal support portion comprising at least one radially expandable portion;   a proximal support portion coupled to the distal support portion, the proximal support portion including a first radially expandable lobe and a second radially expandable lobe separated from the first lobe by an isthmus; and   a bifurcated liner coupled to the distal support portion and to the proximal support portion,   wherein the branching endovascular prosthesis has an uninterrupted cross-section over its entire length.   
   
   
       52 . The prosthesis of  claim 51 , wherein the bifurcated liner is coupled to an interior side of the distal support portion and to an interior side of the proximal support portion. 
   
   
       53 . The prosthesis of  claim 51 , wherein the bifurcated liner is coupled an exterior side of the distal support portion and to an exterior side of the proximal support portion. 
   
   
       54 . A branching endoluminal prosthesis comprising:
 a liner and a radially expandable support coupled to said liner;   wherein said liner comprises:   a main body having a proximal portion and a distal portion, said proximal portion including a main lumen, and said distal portion including a first branch having a first lumen extending to a first distal end, and a second branch having a second lumen extending to a second distal end, the first and second branch lumens being in communication with the main lumen and extending through said distal portion to define a bifurcation extending to said first and second distal ends; and   wherein said support comprises:   a distal support portion disposed over said distal portion of said main body, said distal support portion comprising at least one expandable circumferential portion defining a first lobe supporting said first branch, a second lobe supporting said second branch, and opposed indentations to support and separate said first and second branches,   wherein said branching endoluminal prosthesis has an uninterrupted cross-section over its entire length.   
   
   
       55 . The branching endoluminal prosthesis of  claim 54  wherein said support further comprises an expandable proximal circumferential portion supporting said proximal portion of said main body. 
   
   
       56 . The branching endoluminal prosthesis of  claim 54  further comprising an attachment mechanism which couples said distal support to said distal portion of said main body of said liner. 
   
   
       57 . The branching endoluminal prosthesis of  claim 56  wherein said attachment mechanism attaches said first lobe and a portion of each indentation to the first branch. 
   
   
       58 . The branching endoluminal prosthesis of  claim 57  wherein said attachment mechanism attaches said second lobe and a portion of each indentation to the second branch.