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  Endovascular graft with sensors design and attachment methodsUSPTO Application #: 20060200220Title: Endovascular graft with sensors design and attachment methods Abstract: A endovascular graft having sensing devices attached thereto to facilitate measurement of pertinent parameters within the vasculature into which the graft is implanted. Power sources and transmitters may be attached to the graft to facilitate transmission of measurements to a receiving device outside the patient's body. The sensing devices, may be electrically passive or integrated devices with measurement and transmission capability. The sensing devices may be attached to specific locations on the graft material or attached to the lumen, thereby providing pertinent parameters from critical points inside the vasculature, or may be dispersed over the surface of the graft material or within the lumen to provide a profile of pertinent parameters. The sensing devices may be attached to the graft material with one suture using a running stitch to minimize graft bulk and may be coated with a material to inhibit or control tissue growth. (end of abstract) Agent: Fulwider Patton - Los Angeles, CA, US Inventors: Peter S. Brown, Mark T. Lemere, Kimberly Barkman, Tim Kovac USPTO Applicaton #: 20060200220 - Class: 623001100 (USPTO) Related Patent Categories: Prosthesis (i.e., Artificial Body Members), Parts Thereof, Or Aids And Accessories Therefor, Arterial Prosthesis (i.e., Blood Vessel) The Patent Description & Claims data below is from USPTO Patent Application 20060200220. Brief Patent Description - Full Patent Description - Patent Application Claims
BACKGROUND OF THE INVENTION [0001] This invention relates to the treatment of body lumens and, more particularly, to the endovascular placement of a prosthetic graft within vasculature for the purpose of repairing the same. [0002] Ruptured abdominal aortic aneurysms (AAA) are a leading cause of death in the United States. Treatment options to repair AAA include conventional open surgery and implantation of an endovascular graft. Conventional open surgical repair of AAA involves major abdominal surgery with associated high rates of morbidity. Endovascular grafts have been developed to endoluminally bypass abdominal aortic aneurysms through minimally invasive surgery. Many patients that are unacceptable surgical risks for open repairs are eligible for endovascular graft implantation. Deployment of transfemoral, endovascular grafts to treat AAA is appealing for many reasons: avoidance of an abdominal incision, lack of aortic cross clamping, the potential for regional anesthesia, and a shortened hospital stay. [0003] Untreated AAA have been shown to continue to expand until rupture, with an associated high mortality rate. Implantation of endovascular grafts have also been associated with high complication rates, including perioperative death, conversion to open repair, the need for further intervention, the need for hemodialysis, a failure to cure the AAA, and wound complications. [0004] The inability to obtain or maintain a secure seal between the vessel wall and the endovascular graft is a complication unique to endovascular aneurysm exclusion. Because the term "leak" has been associated with aneurysm rupture following conventional surgery, the term "endoleak" has been proposed as a more definitive description of this complication. It is believed that persistent endoleaks result in continued aneurysm expansion, which may eventually lead to aneurysm rupture. Aneurysms that have been successfully excluded have shown a tendency towards a reduction in aneurysm diameter. Failure to properly exclude the aneurysm from systemic arterial blood pressure keeps the patient at risk of impending rupture. Endoleaks have been classified according to the source of the leaks. Current classifications of endoleaks include four categories. Type I endoleaks are "perigraft" or "graft-related" leaks that involve a persistent channel of blood flow due to inadequate or ineffective sealing at the ends of the endovascular graft, or between overlapping components of a modular system. Type II endoleaks are retrograde flow into the aneurysm sac from patent lumbar arteries, the inferior mesenteric artery, or other collateral vessels. Type III endoleaks result from fabric tears, graft disconnection, or graft disintegration. Finally, Type IV endoleaks are flow through the graft fabric associated with graft wall porosity or permeability. It has been recognized that preoperative patent side branches are not a good predictor of postoperative endoleaks. [0005] There have been a number of reported cases of aneurysm rupture following implantation of an endovascular graft. Some of the ruptures occurred in patients without a documented endoleak. [0006] A number of studies have focused on measurement of pressure within the aneurysm sac following implantation of an endovascular graft, both in the human patient, an animal model, or an in vitro model. Properly implanted endovascular grafts have been shown to reduce the pressure within the aneurysm sac while an endoleak, with or without detectable blood flow, continues to pressurize the sac at pressures equivalent to the systemic arterial pressure. Animal studies utilizing a predictable rupturing aneurysm model have shown that non-excluded aneurysms will rupture. Thrombosed aneurysm sacs may still receive pressurization from a sealed endoleak and this continued pressurization keeps the aneurysm at risk for rupture. [0007] Current methods of patient follow-up include arteriography, contrast-enhanced spiral computed tomography (CT), duplex ultrasonography, abdominal X-ray, and intravascular ultrasound. All of these methods are costly and involve invasive procedures with associated morbidity that may need to be performed in a hospital. None of the imaging methods are completely successful in detecting endoleaks. Therefore, the potential exists for an endoleak to go undetected until eventual rupture. An increase in aneurysm diameter is detectable, and should be considered an indication of endoleak. To avoid aneurysm rupture an increase in aneurysm diameter must be detected in a timely fashion to identify patients in need of corrective endovascular procedures. [0008] An endovascular graft with the ability to measure pressure within the aneurysm sac and provide feedback to the physician could provide acute confirmation of a procedure and identify those patients with persistent pressurization of their aneurysm, and subsequent risk of rupture. Some physicians are advocating that the follow-up examinations of AAA patients focus on pressure measurements, but that this is not currently clinically feasible. Furthermore, follow-up examinations may be performed in the physician's office as opposed to a hospital. Moreover, clinicians will have a new method to study the pathology of post-endovascularly treated AAA disease. [0009] Accordingly, there exists a need for an endovascular graft that facilitates non-invasive measurement of pressure, as well as other pertinent parameters, within the aneurysm sac and along the endovascular graft itself as a means for confirming the success of a procedure as well as identifying patients at risk for aneurysm rupture after the endovascular graft is implanted. [0010] However, providing devices on an endovascular graft to facilitate the measurement of pertinent parameters poses problems. The measurement device increases bulk, which can significantly effect the delivery profile of the endovascular graft and increase the force necessary to deploy the device, such as jacket or release wire retraction forces. Increased bulk is a significant issue for an endovascular graft. Furthermore, attachment of measurement devices to an endovascular graft may require sutures and the suture knots not only provide increased bulk, but are also potential graft wear points. Additionally, tissue growth around a measuring device attached to an implanted endovascular graft may interfere with its function and inaccurate data may result. The present invention addresses these problems and other needs. SUMMARY OF THE INVENTION [0011] Briefly and in general terms, the present invention is embodied in an endovascular graft with sensors attached thereto. The endovascular graft has the ability to be delivered endovascularly and measure pertinent parameters within the lumen in which it is implanted. The endovascular graft has the ability to transmit data about intra-lumen parameters to an external monitoring device. Confirmation of a successful implant procedure is quickly and easily obtained. Patient follow-up is less costly (conducted in the physician office), non-invasive, and more accurate, allowing prompt intervention in those patients most at risk for acute AAA rupture. The invention would also allow for more frequent patient follow-up, increasing the potential to diagnose and treat aneurysms at risk before acute rupture. [0012] In one aspect of the invention, a modular endovascular graft having a main body component and one or more limb components is provided. One or more sensors are attached to the limb component(s). By attaching at least one sensor near the superior end of the limb component and sizing the main body component such that the sensor is adjacent to the aneurysm sac when the endovascular graft is implanted, measurement of pertinent parameters within the aneurysm sac is facilitated. The meaning of the term "adjacent" as used herein encompasses the sensor being located within the aneurysm sac or at a location where the parameters or properties being detected indicate conditions within the aneurysm sac. Measurements of pertinent parameters within the aneurysm sac may allow early confirmation of a successful procedure and identification of areas of the patient's vasculature at risk for aneurysm rupture, thrombus formation, infection, inflamation or other anomalies without the need for invasive procedures. [0013] An antenna or other data transmitter and a power source also may be attached to the limb component adjacent to the aneurysm sac, allowing a physician or technician to monitor graft and vessel health without the need for an invasive procedure. The transmitter transmits measurements made by the sensors to a receiver located outside the patient's body. With the main body component unencumbered with sensors, transmitters or power sources, the bulk of the main body component is minimized and thereby, catheter diameter, jacket retraction and deployment complications are kept to a minimum. [0014] In another aspect of the invention, an endovascular graft is provided that has attached thereto at least one integrated sensor/transmitter device capable of measuring a pertinent parameter and transmitting the measurements to an external monitoring device. Although having more bulk than a sensor, the integrated sensor/transmitter device has less total bulk than a sensor and independent transmitter device, thereby facilitating less total bulk for the endovascular graft. [0015] Furthermore, the integrated sensor/transmitter device may be designed to allow one or more "satellite" sensors, having no function other than measurement, to be connected thereto. A single integrated sensor/transmitter device and smaller "satellite" sensors facilitate a smaller total bulk than multiple integrated sensor/transmitter devices. Attaching the integrated sensor/transmitter at a central location such as the graft crotch and "satellite" sensors at various locations on the endovascular graft facilitates measurement and transmission to an external monitoring device of pertinent parameters at multiple locations along the endovascular graft and within the lumen. The "satellite" sensors allow a complete profile of pertinent parameters to be obtained and may provide more accurate identification of anomalies. Measurement of pertinent parameters at multiple locations along the endovascular graft or within the aneurysm sac may allow early detection of a defective seal between endovascular graft components, graft wear or changes in aneurysm geometry. The smaller "satellite" sensors may also allow pertinent parameters to be measured from locations on the endovascular graft where local graft bulk is a constraint of the design, such as the graft contra limb or near the superior attachment system that holds the graft in the patient's aorta. [0016] Additionally, it is contemplated that "satellite" sensors may be attached directly to the lumen of a patient. The integrated sensor/transmitter device also may be attached directly to the lumen or attached to an implanted endovascular graft. [0017] Moreover, it is contemplated that passive devices, or monuments, which perform no sensing function may be attached to the implanted endovascular graft or directly attached to the aneurysm sac. By tracking the location of the monuments with a monitoring device, changes in the position of the endovascular graft within the lumen or changes in the geometry of the tissue outside the endovascular graft may be detected without the problems of encapsulation or thrombus isolation associated with the measurement of pertinent parameters. Such changes may provide early detection of endovascular graft displacement or aneurysm re-dilation due to an endoleak. [0018] Sensors with pressure measurement capability may be used to detect pressure changes in the aneurysm sac indicative of graft failure or endoleak due to an inadequate seal between the endovascular graft and the vasculature. Sensors with temperature measurement capability may be used to detect temperature differentials associated with "hot spots" related to inflamation, infection or thrombus formation in the vessel. Sensors with the capability to measure oxygen and other blood constituents such as enzymes, proteins, and nutrients, may be used to detect minute blood flow indicative of endoleak. Sensors with the capability to measure electrical potential or magnetic fields may be used to detect differences in potential associated with areas of the vessel at risk for thrombus formation. Sensors also may be provided to facilitate other sensing applications such as blood oxymetry, blood glucose, blood or fluid flow, biochemical or hormonal balance, blood chemistry, positional data, dynamic displacement data, ocular pressure, respiration, electro physiology, tissue stress, venous return and body acoustics. [0019] In yet another aspect of the invention, sensors are attached to an endovascular graft using one continuous suture. Starting at one location on the sensor, a running stitch around the sensor is used to attach the sensor to the graft fabric, thereby minimizing the number of knots necessary for attachment, in this case a single knot. It is contemplated that the running stitch may start at any location on the sensor depending on the location of the sensor on the endovascular graft. Minimizing the number of knots is advantageous because knots are potential graft wear points and add bulk. Additionally, a single knot attachment design may allow the sensor to be placed close to the graft crotch due to the lack of a knot at the end closest the crotch. [0020] In an additional aspect of the invention, the sensors may be covered in a coating that either inhibits tissue growth or promotes a known or controlled amount and/or type of tissue growth. Because tissue growth may interfere with the ability of a sensor to perform its measurement function, inhibiting tissue growth or restricting tissue growth to a known type and/or amount may increase the reliability of measurements obtained. [0021] The invention is applicable to all applications of endovascular grafts to treat aneurysmal segments of blood vessels. Furthermore, the invention and methods disclosed herein may be applied any time it is desired to measure intra-luminal parameters in a non-invasive manner. It is contemplated that the invention may be used with all shapes of endovascular grafts known within the art. [0022] Other features and advantages of the present invention will become apparent from the following detailed description taken in conjunction with the accompanying drawings, which illustrate, by way of example, the principles of the invention. Continue reading... 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