Stent/graft assembly

Abstract

A stent/graft assembly includes a tubular graft connected in substantially end-to-end relationship with a generally tubular stent.

What is claimed is: 
     
         1 . An endovascular stent graft assembly for repairing a section of a blood vessel that has an aneurysm, the blood vessel having first and second relatively healthy sections adjacent and on opposite ends of the aneurysm, the assembly comprising:
 a tubular stent configured to contact a first relatively healthy section of the blood vessel, the stent having opposite first and second axial ends;   a graft having a first axial end and a tubular portion adjacent the first axial end configured to contact the first relatively healthy section of the blood vessel; and   the graft being connected to the second axial end of the stent by a plurality of axially projecting extensions mounted at circumferentially spaced apart locations on at least one of the stent or the graft, each of the plurality of axially projecting extensions comprising a radially extending surface remote from its respective mounting location and configured to achieve a substantially fixed connection between the stent and the graft without overlap between the stent and the graft;   wherein the substantially fixed connection without overlap enables a smaller cross-section than a connection with overlap so that the assembly can be introduced more easily into the blood vessel.   
     
     
         2 . The endovascular stent graft assembly of  claim 1 , wherein the substantially fixed connection without overlap is a non-abutting connection comprising an axial gap between the stent and the graft. 
     
     
         3 . The endovascular stent graft assembly of  claim 1 , comprising a plurality of axially projecting extensions mounted on the graft and extending beyond the first axial end of the graft. 
     
     
         4 . The endovascular stent graft assembly of  claim 1 , wherein at least one of the radially extending surfaces comprises a barb or a hook. 
     
     
         5 . The endovascular stent graft assembly of  claim 1 , wherein the graft and the second axial end of the stent are secured by a plurality of circumferentially spaced apart structures each selected from the group consisting of a fuse, stitch, wire, or suture. 
     
     
         6 . The endovascular stent graft assembly of  claim 5 , wherein the plurality of circumferentially spaced apart structures secure the stent to the graft pre-operatively. 
     
     
         7 . The endovascular stent graft assembly of  claim 5 , wherein the plurality of circumferentially spaced apart structures are releasable. 
     
     
         8 . The endovascular stent graft assembly of  claim 1 , wherein each of the plurality of axially projecting extensions is connected at its respective circumferential location by a fuse. 
     
     
         9 . The endovascular stent graft assembly of  claim 1 , wherein the graft and the second axial end of the stent are affixed at a plurality of circumferentially spaced apart locations by a structure selected from the group consisting of a wire and a hook. 
     
     
         10 . The endovascular stent graft assembly of  claim 9 , wherein the graft and the second axial end of the stent are affixed by a wire at a plurality of circumferentially spaced apart locations. 
     
     
         11 . The endovascular stent graft assembly of  claim 6 , wherein each of the plurality of axially projecting extensions comprises a radially extending surface and a wire. 
     
     
         12 . An endovascular stent graft assembly for repairing a section of a blood vessel that has an aneurysm, the blood vessel having first and second relatively healthy sections adjacent and on opposite ends of the aneurysm, the assembly comprising:
 a stent having opposite first and second axial ends;   a one piece bifurcated graft having a first axial end and two free ends remote from the first axial end and at least one flexible wall portion disposed between the first axial end and the two free ends, substantially the entirety of the flexible wall portion being unsupported by any underlying metallic framework prior to deployment in the blood vessel; and   a plurality of hooking fasteners configured to connect the stent to the bifurcated graft at a plurality of circumferentially spaced apart locations to achieve a non-abutting connection with a gap between the first axial end of the bifurcated graft and the second axial end of the stent;   each hooking fastener comprising an axially projecting extension from a mounting point on at least one of the graft or the stent, each axially projecting extension further comprising a radially projecting extension remote from the mounting point; and   wherein the plurality of circumferentially spaced apart hooking fasteners securely maintains the gap between the stent and the bifurcated graft without overlap to enable a smaller cross-section than a connection with overlap so that the assembly can be introduced more easily into the blood vessel.   
     
     
         13 . The endovascular stent graft assembly of  claim 12 , further comprising at least one second subsequently deployed graft configured to connect to the bifurcated graft at one of its free ends. 
     
     
         14 . The endovascular stent graft assembly of  claim 13 , further comprising at least one second stent configured to support the second graft. 
     
     
         15 . The endovascular stent graft assembly of  claim 14 , wherein the second stent is an internal stent disposed in an interior of the bifurcated graft post deployment with the second graft. 
     
     
         16 . The endovascular stent/graft assembly of  claim 15 , wherein the second stent is an internal stent configured for insertion at least partly into the interior of the bifurcated graft after the first stent and the bifurcated graft are inserted into the blood vessel. 
     
     
         17 . An endovascular stent/graft assembly for repairing a section of a blood vessel that has an aneurysm, the blood vessel having first and second relatively healthy sections adjacent and on opposite ends of the aneurysm, the assembly comprising:
 a substantially tubular stent having opposite first and second axial ends;   a graft having first axial and second axial ends and a flexible wall portion there between, substantially the entirety of the flexible wall portion being unsupported by any metallic framework;   an annular member incorporated into the graft in proximity to its first axial end and configured to keep the graft open during deployment without encircling the stent;   a plurality of axial extensions projecting from at least one of the stent or the graft toward the other at a plurality of circumferentially spaced apart locations;   and a hook having a curved or angular surface projecting radially from each axial extension and configured to connect the graft and the second axial end of the stent at the plurality of circumferentially spaced-apart axial projections to maintain a substantially end-to-end axial non-abutting connection without overlap between the stent and the graft; and   wherein the connection without overlap enables a smaller cross-section than a connection with overlap so that the assembly can be introduced more easily into the blood vessel.   
     
     
         18 . The endovascular stent/graft assembly of  claim 17 , comprising a plurality of circumferentially spaced apart wires configured to securely connect the graft and the stent. 
     
     
         19 . The endovascular stent/graft assembly of  claim 18 , wherein each of the plurality of circumferentially spaced apart wires comprises a hook configured to affix the stent to the graft. 
     
     
         20 . The endovascular stent/graft assembly of  claim 17 , wherein each of the plurality of axial extensions comprises a radially extending segment and a curved or angled surface. 
     
     
         21 . The endovascular stent/graft assembly of  claim 17 , wherein each of the plurality of axial extensions comprises a segment extending radially so as to releasably hook on a circumferentially disposed portion or element. 
     
     
         22 . The endovascular stent/graft assembly of  claim 21 , wherein the segment extending radially comprises a surface forming an angle with a surface of the axial extension. 
     
     
         23 . The endovascular stent/graft assembly of  claim 17 , further comprising at least one of a stitch, wire, or suture configured to secure the graft to the stent at a plurality of circumferentially spaced apart locations. 
     
     
         24 . The endovascular stent/graft assembly of  claim 17 , further comprising of a wire configured to secure the graft to the stent at a plurality of circumferentially spaced apart locations. 
     
     
         25 . The endovascular stent/graft assembly of  claim 17 , wherein at least one of the plurality of axial extensions is fused or bonded to the stent or to the graft. 
     
     
         26 . The endovascular stent/graft assembly of  claim 25 , wherein at least one of the axial extensions is incorporated into the graft. 
     
     
         27 . The endovascular stent/graft assembly of  claim 18 , wherein the plurality of circumferentially spaced apart wires are configured to securely connect the graft and the stent and maintain a non-abutting connection between the stent and the graft with a gap between the stent and the graft. 
     
     
         28 . The endovascular stent/graft assembly of  claim 27 , wherein the plurality of wires are disposed at least partially in the gap between the stent and the graft. 
     
     
         29 . The endovascular stent/graft assembly of  claim 26 , wherein each of the plurality of axial extensions from the graft extends beyond the first axial end of the graft.