Sleeves for expandable medical devices

Abstract

The present disclosure describes treatment of the vasculature of a patient with an expandable implant. The implant is constrained to a reduced delivery profile for delivery within the vasculature by at least one sleeve. The implant may be constrained to other diameters, such as an intermediate configuration having a diameter larger than the delivery profile and smaller than the deployment diameter. The sleeves may be expanded, allowing for expansion of the diameter of the expandable implant, by disengaging a coupling member from the sleeve or sleeves from outside of the body of the patient. The expandable implant may comprise a number of side branch fenestrations or fenestratable portions.

1 . A device for treating a vessel comprising:
 an expandable stent graft having a main lumen and a target portion;   a primary sleeve wrapped circumferentially around the expandable stent graft, wherein the primary sleeve comprises a sheet of material having first and second major surfaces and a plurality of openings extending from the first major surface to the second major surface; and   a primary coupling member cooperating with the openings for releasably coupling portions of the sheet to one another to constrain the expandable stent graft in a collapsed configuration,   wherein the primary sleeve includes a lateral opening proximate to the target portion.   
     
     
         2 . The device of  claim 1 , wherein the target portion comprises a side branch fenestration. 
     
     
         3 . The device of  claim 1 , wherein the target portion comprises a fenestratable portion that is punctured to form a side branch fenestration. 
     
     
         4 . The device of  claim 1 , wherein the primary sleeve constrains the expandable stent graft in the collapsed configuration for delivery within the vessel. 
     
     
         5 . The device of  claim 1 , wherein upon release of the primary sleeve, the target portion is exposed between opposing edges of the sheet of material. 
     
     
         6 . The device of  claim 1 , wherein edges of the first and second major surfaces through which the plurality of openings extend comprise radiopaque markers. 
     
     
         7 . The device of  claim 1 , wherein the target portion includes a drug eluting element. 
     
     
         8 . The device of  claim 4 , further comprising a secondary coupling member, wherein the secondary coupling member constrains the expandable stent graft in an intermediate configuration, the intermediate configuration comprising a diameter larger than the diameter of the collapsed configuration and smaller than the diameter of the expandable stent graft in an unconstrained diameter. 
     
     
         9 . A device for treatment of a vessel comprising:
 an expandable implant having a main lumen and at least one target portion;   at least two sheets of material, each wrapped circumferentially around the expandable implant forming at least two adjacent tubes;   each tube having at least one tube end adjacent to another tube end;   each sheet having first and second major surfaces and a plurality of openings extending from the first major surface to the second major surface; and   a coupling member cooperating with the openings for releasably coupling portions of each sheet together to constrain the expandable implant in a collapsed configuration.   
     
     
         10 . The device of  claim 9 , wherein upon disengagement of the coupling member and expansion of the expandable implant, the at least one target portion is positioned between one tube end and the other adjacent tube end. 
     
     
         11 . The device of  claim 9 , further comprising a primary sleeve extending around the at least two sheets of material and the expandable implant for constraining the device to a collapsed configuration suitable for endoluminal delivery. 
     
     
         12 . The device of  claim 9 , wherein the at least two sheets of material limit expansion of the device to an intermediate configuration, in which the diameter of the expandable implant is larger than the collapsed configuration suitable for endoluminal deployment and smaller than the expandable implant in an unconstrained diameter. 
     
     
         13 . The device of  claim 9 , wherein at least two of the sheets of material have two opposed longitudinally extending edges. 
     
     
         14 . The device of  claim 13 , wherein the target portion is disposed between the opposed longitudinally extending edges. 
     
     
         15 . The device of  claim 9 , wherein the target portion comprises a side branch fenestration. 
     
     
         16 . The device of  claim 9 , wherein at least one edge of at least one of the sheets of material comprises a radiopaque material. 
     
     
         17 . The device of  claim 9 , wherein the target portion comprises a fenestratable portion. 
     
     
         18 . The device of  claim 9 , wherein the target portion comprises a therapeutic agent eluting element disposed beneath at least one of the sheets of material such that once the coupling member of the at least one of the sheets of material has been disengaged a therapeutic agent is exposed. 
     
     
         19 . A device for treatment of a vessel comprising:
 an expandable implant having a main lumen and at least one target portion;   at least two sleeves;   a collapsed configuration, wherein each of the at least two sleeves comprise a sheet of material wrapped circumferentially around the expandable implant forming a tube having at least one tube end adjacent to another tube end; each sheet having first and second major surfaces and a plurality of openings extending from the first major surface to the second major surface; and a coupling member cooperating with the openings for releasably coupling portions of each sheet together to constrain the expandable implant in a collapsed configuration; and   an expanded configuration, wherein upon disengagement of the coupling member, the expandable implant is expanded and the at least one target portion is positioned between one tube end and the other adjacent tube end.   
     
     
         20 . The device of  claim 19  further comprising:
 an intermediate configuration, wherein the device further comprises a primary sleeve surrounding the expandable implant and at least two sleeves, wherein upon the of the primary sleeve the expandable implant expands to an intermediate configuration which is greater than the diameter of the collapsed configuration and less than the diameter of the expanded configuration.