US20050027347A1 - Endovascular graft joint and method for manufacture - Google Patents

Abstract

A joint and method for producing a joint in an endovascular graft. In one embodiment, a flap of a flexible material portion of an endovascular graft is folded about a portion of an expandable member to form a loop portion. The flap is secured in the loop configuration so that tensile force on the expandable member is transferred into a shear force on the fixed portion of the flap.

Description

RELATED APPLICATIONS
• This application is related to U.S. patent application Ser. No. ______ entitled “Method and Apparatus for Shape Forming Endovascular Graft Material”, by Chobotov, et al., U.S. patent application Ser. No. ______ entitled “Method and Apparatus for Manufacturing an Endovascular Graft Section”, by Chobotov et al., and U.S. patent application Ser. No. ______ entitled “Advanced Endovascular Graft”, by Chobotov et al. All of the above applications are commonly owned and were filed on even date herewith. All of the above applications are hereby incorporated by reference, each in their entirety.
BACKGROUND
• Embodiments of the device and method discussed herein relate to a system and method for manufacturing intracorporeal devices used to replace, strengthen, or bypass body channels or lumens of patients; in particular, those channels or lumens that have been affected by conditions such as abdominal aortic aneurysms.
• Existing methods of treating abdominal aortic aneurysms include invasive surgical methods with grafts used to replace the diseased portion of the artery. Although improvements in surgical and anesthetic techniques have reduced perioperative and postoperative morbidity and mortality, significant risks associated with surgical repair (including myocardial infarction and other complications related to coronary artery disease) still remain.
• Due to the inherent hazards and complexities of such surgical procedures, various attempts have been made to develop alternative repair methods that involve the endovascular deployment of grafts within aortic aneurysms. One such method is the non-invasive technique of percutaneous delivery of grafts and stent-grafts by a catheter-based system. Such a method is described by Lawrence, Jr. et al. in “Percutaneous Endovascular Graft: Experimental Evaluation”,Radiology(1987). Lawrence et al. describe therein the use of a Gianturco stent as disclosed in U.S. Pat. No. 4,580,568 to Gianturco. The stent is used to position a Dacron® fabric graft within the vessel. The Dacron® graft is compressed within the catheter and then deployed within the vessel to be treated.
• A similar procedure is described by Mirich et al. in “Percutaneously Placed Endovascular Grafts for Aortic Aneurysms: Feasibility Study,”Radiology(1989). Mirich et al. describe therein a self-expanding metallic structure covered by a nylon fabric, the structure being anchored by barbs at the proximal and distal ends.
• An improvement to percutaneously delivered grafts and stent-grafts results from the use of materials such as expanded polytetrafluoroethylene (ePTFE) for a graft body. This material, and others like it, have clinically beneficial properties. However, manufacturing a graft from ePTFE can be difficult and expensive. For example, it is difficult to bond ePTFE with conventional methods such as adhesives, etc. In addition, depending on the type of ePTFE, the material can exhibit anisotropic behavior. Grafts are generally deployed in arterial systems whose environments are dynamic and which subject the devices to significant flexing and changing fluid pressure flow. Stresses are generated that are cyclic and potentially destructive to interface points of grafts, particularly interface between soft and relatively hard or high strength materials.
• What has been needed is a method and device for manufacturing intracorporeal devices used to replace, strengthen or bypass body channels or lumens of a patient from ePTFE and similar materials which is reliable, efficient and cost effective.
SUMMARY
• An embodiment of the invention is directed to the formation of a joint between an connector member and a flexible material portion of an endovascular graft, or section thereof. A flap of the flexible material portion is fixed about at least a portion of the connector member such that tensile force imposed on the connector member is transferred into a shear component of force on the fixed portion of the flap. Such a configuration provides a high strength joint with a low profile or low cross sectional mass that will allow the graft to be compressed radially for flexible low profile percutaneous delivery to a body conduit of a patient. Such a joining method also provides for ease of manufacture of the graft. The connector member can be an annular connector member suitable for connection to an expandable.
• Another embodiment of the invention is directed to an endovascular graft or section thereof with a flexible material portion and a transversely or circumferentially oriented member secured to the flexible material portion with a joint. The joint includes at least one flap of the flexible material folded back to form a loop portion about the transversely or circumferentially oriented member. The flap is secured in the looped configuration. The flap for this embodiment and other embodiments discussed herein can be secured in the loop configuration by a variety of methods including adhesive bonding and thermomechanical compaction or seam formation. Thermomechanical compaction which can include seam formation is particularly useful when fusible material is used for the flexible material portion. The transversely or circumferentially oriented member may be a connector member, expandable stent, a portion of either of these or the like.
• An embodiment of a method for securing a transversely or circumferentially oriented member to a flexible material portion of an endovascular graft or section thereof is now described. A transversely or circumferentially oriented member is disposed in proximity to a flap in the flexible material portion of the endovascular graft, or section thereof. The flap is then folded over at least a portion of the transversely or circumferentially oriented member to form a loop portion of the flap about the transversely oriented member. The flap is then secured in a looped configuration. The transversely or circumferentially oriented member may be an expandable stent, a connector member configured to be secured to an expandable stent or other component of a stent graft device.
BRIEF DESCRIPTION OF THE DRAWINGS
• FIG. 1 illustrates a layer of fusible material being positioned onto a shape forming mandrel.
• FIG. 2 shows a first layer of fusible material disposed on a shape forming mandrel.
• FIG. 2A is a transverse cross sectional view of the first layer of fusible material and the shape forming mandrel ofFIG. 2 taken alonglines2A-2A inFIG. 2.
• FIG. 3 illustrates an additional layer of fusible material being deposited onto a shape forming mandrel.
• FIG. 4 shows the first layer of fusible material being trimmed by an instrument.
• FIG. 5 is a transverse cross sectional view of the layers of fusible material and shape forming mandrel ofFIG. 5 taken along lines5-5 ofFIG. 4.
• FIG. 6 illustrates additional layers of fusible material being deposited on the shape forming mandrel.
• FIG. 7 illustrates an inflation line being positioned on the first and additional layers of fusible material ofFIG. 6.
• FIGS. 7A and 7B illustrate the formation of the inflation line ofFIG. 7.
• FIG. 8 shows two expandable members positioned on the layers of fusible material ofFIG. 7.
• FIG. 9 illustrates the deposition of an adhesive or melt processible material adjacent a connector member of the graft body section under construction.
• FIG. 10 shows another additional layer of fusible material being deposited onto the graft body section.
• FIG. 11 illustrates excess fusible material being trimmed from the first end and second end of the graft body section adjacent the connector members.
• FIG. 12 is an elevational view of the graft body section with the fusible material trimmed away and removed.
• FIG. 13A is a side view from the right hand side of a five axis seam forming apparatus.
• FIG. 13B is a side view from the left hand side of a five axis seam forming apparatus.
• FIG. 13C is a front view of the five axis seam forming apparatus ofFIGS. 13A and 13B.
• FIG. 13D shows a stylus tip in contact with a transverse cross sectioned view of a cylindrical shape forming member with an axis of the stylus tip oriented at an angle with the tangent of the shape forming member at the point of contact therebetween.
• FIG. 13E illustrates a stylus tip in contact with a plurality of layers of fusible material in a substantially flat configuration with the longitudinal axis of the stylus tip at an angle with respect to a line which is orthogonal to the surface of the layers.
• FIG. 13F is a front view of the seam forming apparatus with a shape forming mandrel and a graft body section on the shape forming mandrel positioned in the chuck of the seam forming member mount system.
• FIG. 13G illustrates a distal extremity or tip of a stylus in contact with the layers of fusible material of the graft body section.
• FIG. 13H illustrates the tip of a stylus in contact with layers of fusible material of the graft body section, forming a seam in the layers.
• FIG. 14 shows inflation channels being formed in the layers of fusible material on the shape forming mandrel by the seam forming apparatus stylus tip.
• FIG. 15 shows the graft body section with the channel formation complete and pressurized fluid being injected into an inflatable channel network in order to expand the inflatable channels.
• FIG. 16A illustrates one half of an embodiment of a two-piece mold for use during expansion of the inflatable channels formed by the seam forming apparatus.
• FIG. 16B is an end view showing the shape forming mandrel and graft body section within both halves of the mold.
• FIG. 16C shows the graft body section and shape forming mandrel disposed within the mold cavity (with one half of the mold removed for clarity of illustration) with a fluid being injected into the inflatable channels of the graft body section in order to keep the inflatable channels in an expanded state during the fixing or sintering of the fusible material.
• FIG. 17 illustrates an outer layer or layers of fusible material being forced into the mold cavity of a portion of the mold by pressurized fluid as indicated by the dotted line.
• FIG. 18 is an elevational view in partial section of an embodiment of an inflatable endovascular graft of the present invention.
• FIG. 19 is an enlarged view of the graft ofFIG. 18 taken at the dashed circle indicated by numeral19 inFIG. 18.
• FIG. 20 is an enlarged view in section taken along lines20-20 inFIG. 18.
• FIG. 21 is a transverse cross sectional view of the graft ofFIG. 18 taken along lines21-21 inFIG. 18.
• FIG. 22 is a transverse cross sectional view of the graft ofFIG. 18 taken along lines22-22 inFIG. 18.
• FIG. 23 is a transverse cross sectional view of the graft ofFIG. 18 taken along lines23-23 inFIG. 18.
• FIG. 24 is an elevational view in longitudinal section of an embodiment of an endovascular graft having features of the invention.
• FIG. 25A is a transverse cross sectional view of a portion of the endovascular graft ofFIG. 24 taken alonglines25A-25A ofFIG. 24 which illustrates an embodiment of a joint between a transversely oriented member and flexible material portion of the endovascular graft.
• FIG. 25B is a perspective view of the joint ofFIG. 25A.
• FIG. 26 is a transverse cross sectional view of a portion of an endovascular graft which illustrates an embodiment of a joint between a transversely oriented member and flexible material portion of the endovascular graft.
• FIG. 27 is a transverse cross sectional view of a portion of an endovascular graft which illustrates an embodiment of a joint between a transversely oriented member and flexible material portion of the endovascular graft.
• FIG. 28 is a perspective view of a method for manufacturing an endovascular graft wherein a flap of a flexible material portion of the endovascular graft is being formed in a loop about a transversely oriented member.
• FIG. 29 is a perspective view of the endovascular graft ofFIG. 28 with a plurality of flaps of the flexible material portion of the endovascular graft being formed in loops about portions of the transversely oriented member.
• FIG. 30 illustrates a perspective view of the endovascular graft ofFIGS. 28 and 29 with an outer layer of flexible material disposed over the flap portions.
• FIG. 31 illustrates a tubular section of an endovascular graft having a first layer of flexible material and a second layer of flexible material wherein flaps of flexible material have been formed in the second layer of flexible material, formed in loop portions about transversely oriented members and secured in a looped configuration about the transversely oriented members.
DETAILED DESCRIPTION
• FIG. 1 illustrates a sheet offusible material10 stored on anelongate drum11. Thedrum11 is rotatable, substantially circular in transverse cross section and has a transverse dimension in thelongitudinal center12 that is greater than the transverse dimension of either end of the drum. The sheet offusible material10 is being rolled from the elongate drum in asingle layer13 onto an interior surface support means in the form of a cylindrical or tapered (conical) shape forming member ormandrel14 to form abody section15 of anendovascular graft16. Thebody section15 has aproximal end17 and adistal end18. For the purposes of this application, with reference to endovascular graft devices, theproximal end17 describes the end of the graft that will be oriented towards the oncoming flow of bodily fluid, usually blood, when the device is deployed within a conduit of a patient's body. Thedistal end18 of the graft is the end opposite the proximal end.
• A single layer offusible material13 is a term that generally refers to a sheet of material that is not easily separated by mechanical manipulation into additional layers. Theshape forming mandrel14 is substantially cylindrical in configuration, although other configurations are possible.Middle section20 ofmandrel14 shown inFIGS. 1-2 has a transverse dimension which is smaller than the transverse dimension of afirst end section21 and asecond end section22. The shape forming mandrel may have a firsttapered section23 at the first end and a secondtapered section24 at the second end. The sheet offusible material10 is shown being rolled off theelongate drum11 in the direction indicated by the arrow11A with thelead end25 of the first layer offusible material10 oriented longitudinally along an outside surface14A of theshape forming mandrel14.
• The fusible material in the embodiment illustrated inFIG. 1 is ePTFE that ranges from about 0.0005 to about 0.010 inch in thickness; specifically from about 0.001 to about 0.003 inch in thickness. The sheet being disposed or rolled onto theshape forming mandrel14 may range from about 2 to about 10 inches in width; specifically, from about 3 to about 7 inches in width, depending on the indication and size of the end product.
• TheePTFE material sheet10 inFIG. 1 is a fluoropolymer with a node and fibril composition with the fibrils oriented in primarily a uniaxial direction substantially aligned with the longitudinal axis ofshape forming mandrel14. Other nodal/fibril orientations of ePTFE could also be used for this layer, including multiaxially oriented fibril configurations or uniaxial material oriented substantially circumferentially aboutshape forming mandrel14 or at any desired angle between substantial alignment with the longitudinal axis and substantial alignment with a circumferential line about theshape forming mandrel14. Uniaxially oriented ePTFE materials tend to have greater tensile strength along the direction of fibril orientation, so fibril orientation can be chosen to accommodate the greatest stresses imposed upon the finished product for the particular layer, combination of layers, and portion of the product where such stress accommodation is needed.
• The layers of fusible material made of ePTFE are generally applied or wrapped in an unsintered state. By applying the ePTFE layers in an unsintered or partially sintered state, thegraft body section15, upon completion, can then be sintered or fixed as a whole in order to form a cohesive monolithic structure with all contacting surfaces of ePTFE layers achieving some level of interlayer adhesion. It may, however, be desirable to apply some layers of fusible material that have been pre-sintered or pre-fixed in order to achieve a desired result or to assist in the handling of the materials during the construction process. For example, it may be desirable in some embodiments to sinter thesingle layer13 of fusible material applied to theshape forming mandrel14 in order to act as a better insulator between theshape forming mandrel14, which can act as a significant heat sink, and subsequent layers of fusible material which may be welded by seam formation in some locations in order to create inflatable channels.
• The amount of expansion of the ePTFE material used for the construction of endovascular grafts and other devices can vary significantly depending on the desired characteristics of the material and the finished product. Typically, the ePTFE materials processed by the devices and methods discussed herein may have a density ranging from about 0.4 to about 2 grams/cc; specifically, from about 0.5 to about 0.9 grams/cc. The nodal spacing of the uniaxial ePTFE material may range from about 0.5 to about 200 microns; specifically, from about 5 to about 35 microns. The nodal spacing for multiaxial ePTFE material may range from about 0.5 to about 20 microns; specifically, from about 1 to about 2 microns.
• AlthoughFIG. 1 illustrates a layer of fusible material that is made of ePTFE, the methods described herein are also suitable for a variety of other fusible materials. Examples of other suitable fusible materials for endovascular graft construction and other applications include PTFE, porous PTFE, ultra high molecular weight polyethylene, polyesters, and the like.
• FIGS. 2 and 2A depict a first layer offusible material26 disposed on theshape forming mandrel14 with an overlappedportion27 of thefirst layer26 on itself. Aterminal end28 of thefirst layer26 is seen extending longitudinally along the length of theshape forming mandrel14. As the layer of fusible material is wrapped ontoshape forming mandrel14, some tension may be provided on the sheet of material by theelongate drum11. As a result of this tension and the flexible and conforming properties of the ePTFE material, the first layer ofmaterial26 conforms closely to the outer contour of theshape forming mandrel14 as is illustrated inFIG. 2.
• In some embodiments, it may be desirable to pass the tip of a seam forming tool or similar device (not shown) along the overlappedportion27 offirst layer26 in a longitudinal direction in order to form a seam (not shown) along the overlappedportion27 offirst layer26. A tool suitable for forming such a longitudinal seam is a soldering iron with a smooth, rounded tip that will not catch or tear the layer of fusible material. An appropriate operating temperature for the tip of such a tool may range from about 320 to about 550 degrees Celsius; specifically, from about 380 to about 420 degrees Celsius.
• FIG. 3 illustrates an additional layer offusible material30 being disposed or wrapped onto the first layer offusible material26 in a manner similar to that described above for thefirst layer26. Both uniaxial and multiaxial ePTFE may be used for thisadditional layer30. Alead end31 of the additional layer can be seen adjacent theterminal end28 of thefirst layer26. Tension on the additional layer offusible material30 helps to make theadditional layer30 conform to theshape forming mandrel14 as seen in the illustration. Although a singleadditional layer30 is shown inFIG. 3 as being disposed onto thefirst layer26, it is within the scope of the invention to wrap multipleadditional layers30 of fusible material in this step. We have found that wrapping twoadditional layers30 of multiaxial ePTFE onto thefirst layer26 helps to form a usefulgraft body section15.
• FIG. 4 shows an optional step in which the first and additional layers offusible material26 and30 which form thegraft body section15 under construction are trimmed byknife edge32 or a similar tool which is pressed against the layers of material and moved circumferentially about theshape forming mandrel14.FIG. 5 is a transverse cross sectional view of theshape forming mandrel14 andgraft body section15 ofFIG. 5 taken along lines5-5 inFIG. 4. The overlappedportion27 of thefirst layer26 and an overlappedportion33 of theadditional layer30 of fusible material can be seen. It may be desirable to create a longitudinal seam in the overlappedportion33 of theadditional layer30 in a manner similar to that of thefirst layer26 discussed above using the same or similar tools.
• FIG. 6 illustrates aproximal end wrap34 of fusible material being applied to theadditional layer30 ofgraft body section15, preferably under some tension. We have found it useful to haveend wrap34 be uniaxial ePTFE, with the fibrils of the end wrap material oriented circumferentially about theshape forming mandrel14, although other orientations and types of ePTFE are possible. The end wrap material may have a thickness ranging from about 0.0005 to about 0.005 inch; specifically, from about 0.001 to about 0.002 inch. The width of the end wrap material may range from about 0.25 to about 2.0 inch; specifically, from about 0.5 to about 1.0 inch. One or more layers of end wrap34 (in any desired orientation) may be built up onto theproximal end17 ofgraft body section15 onshape forming mandrel14. The additional end wrap layer or layers34 may be applied in a manner similar to that of thefirst layer26 andadditional layers30 as discussed above.
• FIG. 7 showsgraft body section15 with theend wrap layer34 completed with aninflation line36 disposed on or near thedistal end18 ofgraft body section15. Theinflation line36 may be constructed as shown inFIGS. 7A and 7B of ePTFE by wrapping one or more layers of the material about acylindrical mandrel37. Alongitudinal seam38 can then be formed in an overlapped portion of the layers by passing the tip of aseam forming tool39 along the overlapped portion of the first layer in a longitudinal direction in order to form aseam38 along the overlapped portion of the layers of theinflation line36. A tool suitable for forming such a longitudinal seam is a soldering iron with a smooth rounded tip that will not catch or tear the layer of fusible material; operating temperatures for the tip may range as previously discussed. Alternatively, theinflation line36 may be formed using an ePTFE extrusion placed over a mandrel.
• Onceseam38 is formed ininflation line36, the fusible material ofinflation line36 may can be fixed or sintered by heating to a predetermined temperature for a predetermined time. For embodiments of theinflation line36 made of ePTFE, the layers are sintered by bringing the layered assembly to a temperature ranging from about 335 to about 380 degrees Celsius (for unsintered material) and about 320 to about 380 degrees Celsius (for sintering material that was previously sintered) and then cooling the assembly to a temperature ranging from about 180 to about 220 degrees Celsius. Theinflation line36 may then be removed frommandrel37 and disposed on agraft body assembly40 as shown inFIG. 7. Theinflation line36 may be pre-fixed or pre-sintered to avoid having the inner surfaces of theinflation line36 stick together during the construction and processing of the graft and possibly block theinflation line36.
• InFIG. 8, expandable members in the form of aproximal connector member41 and adistal connector member42 have been disposed onto thegraft body section15 towards the respective graft body sectionproximal end17 anddistal end18. Theproximal connector member41 is an elongate flexible metal element configured as a ring, with the ring having a zig-zag or serpentine pattern around the circumference of the ring. Thedistal connector member42 can have a similar configuration; note the feature of this element in which anextended apex44 is disposed overinflation line36 to further stabilizegraft section15. This configuration allows theconnector members41 and42 to be radially constrained and radially expanded while maintaining a circular ring configuration. The embodiment of theconnector members41 and42 shown inFIG. 8 may be constructed of any suitable biocompatible material; most suitable are metals, alloys, polymers and their composites known to have superelastic properties that allow for high levels of strain without plastic deformation, such as nickel titanium (NiTi). Other alloys such as stainless steel may also be used.Connector members41 and42 shown are also configured to be self-expanding from a radially constrained state. The serpentine pattern of theconnector members41 and42 is disposed over base layers of the graft body section as areconnector elements43 which are disposed oncertain apices44 of the serpentine pattern of theconnector members41 and42. The embodiments of theconnector members41 and42 shown inFIG. 8 have been shape formed to lie substantially flat against the contour of the outer surface of theshape forming mandrel14. Although the embodiment ofFIG. 8 illustratesconnector members41 and42 being disposed upon thegraft body section15, expandable members including stents or the like may be used in place of theconnector members41 and42.
• An optional adhesive or melt-processible material such as FEP or PFA may be deposited adjacent theconnector members41 and42 prior to the addition of additional layers of fusible material to thegraft body section15, as is shown inFIG. 9. Materials such as FEP or PFA can help the layers of fusible material to adhere to theconnector members41 and42, to inflation line36 (in the case of distal member42), and to each other. In addition, such material may serve to provide strain relief betweenconnector members41 and42 and the adhered or bonded layers of fusible material (and inflation line36) adjacent the wire of theconnector members41 and42. It has been determined that one of the areas of greatest concentrated stress within an endovascular structure such as that described herein, when deployed within a dynamic biological system, such as an artery of a human patient, is at the junction between theconnector members41 and42 andgraft body section15. Therefore, it may be desirable to include materials such as FEP or PFA or some other form of strength enhancement or strain relief in the vicinity of this junction.
• An outeroverall wrap layer50 may thereafter be applied to thegraft body section15 andconnector members41 and42 as shown inFIG. 10. The outeroverall wrap layer50 can include one, two, three or more layers of multiaxial ePTFE, usually about 2 to about 4 layers, but uniaxial ePTFE other suitable fusible materials, fibril orientation and layer numbers could also be used. The outeroverall wrap layer50 is most usefully applied under some tension in order for the layer or layers to best conform to the outer contour of theshape forming mandrel14 andgraft body section15. When theouter layer50 comprises multiaxial ePTFE, there is generally no substantially preferred orientation of nodes and fibrils within the microstructure of the material. This result in a generally isotropic material whose mechanical properties, such as tensile strength, are generally comparable in all directions (as opposed to significantly different properties in different directions for uniaxially expanded ePTFE). The density and thickness of the multiaxial material can be the same as or similar to those dimensions discussed above.
• Although not shown in the figures, we have found it useful to add one or more-optional cuff-reinforcing layers prior to the addition of anoverall wrap layer50 as discussed below in conjunction withFIG. 10. Typically this cuff-reinforcing layer is circumferentially applied to graftbody section15 at or near the graft body sectionproximal end17 so to provide additional strength to the graft body sectionproximal end17 in those designs in which a proximal cuff (and possibly a proximal rib) are used. Typically the graft experiences larger strains during fabrication and in service in the region of the proximal cuff, especially if a larger cuff is present. This optional cuff-reinforcing layer typically is multiaxial ePTFE, although uniaxial ePTFE and other materials may be used as well. We have found effective a cuff-reinforcing layer width from about 20 to about 100 mm; specifically, about 70 mm. Functionally, however, any width sufficient to reinforce the proximal end ofgraft body section15 may be used.
• Once the additional layer or layers of fusible material and additional graft elements such as theconnector members41 and42 andinflation line36 have been applied, any excess fusible material may be trimmed away from theproximal end17 anddistal end18 ofgraft body section15.FIG. 11 illustrates one or more layers of fusible material being trimmed from theproximal end17 anddistal end18 of thegraft body section15 so as to leave theconnector members41 and42 embedded between layers of fusible material but with theconnector elements43 exposed and adistal end51 of theinflation line36 exposed as shown inFIG. 12. Once the fusible material has been trimmed from theproximal end17 and thedistal end18, as discussed above, an additional process may optionally be performed on theproximal end17,distal end18 or both the proximal end anddistal end17 and18. In this optional process (not shown in the figures), theouter wrap50 is removed from a portion of theconnector members41 and42 so as to expose a portion of theconnector members41 and42 and the additional layer offusible material30 beneath theconnector member42 and theproximal end wrap34 beneathconnector member41. Once exposed, one or more layers of the additional layer or layers30 orproximal end wrap34 may have cuts made therein to form flaps which can be folded back over therespective connector members42 and41 and secured to form a joint (not shown). One or more layers of fusible material can then be disposed over such a joint to provide additional strength and cover up the joint. The construction of such a joint is discussed in copending U.S. Patent Application “Endovascular Graft Joint and Method for Manufacture” by Chobotov et al. which has been incorporated by reference herein.
• Once thegraft body section15 has been trimmed, the entireshape forming mandrel14 andgraft body section15 assembly is moved to aseam forming apparatus52 illustrated inFIGS. 13A-13H. Thisseam forming apparatus52 has abase53 and avertical support platform54 which extends vertically upward from the back edge of thebase53. Amount system55 is secured to thebase53 and for the embodiment shown in the figures, consists of a motordrive chuck unit56 secured to ariser57 and alive center unit58 secured to ariser59. Bothrisers57 and59 are secured to the base53 as shown. The axis ofrotation55A of thechuck60 of the motordrive chuck unit56 and the axis ofrotation55B of thelive center61 of thelive center unit58 are aligned or concentric as indicated by dashedline55C. A motor is mechanically coupled to thechuck60 of the motordrive chuck unit56 and serves to rotate thechuck60 in a controllable manner.
• Avertical translation rack62 is secured to thevertical support platform54 and extends from the base53 to the top of thevertical support platform54. Avertical car63 is slidingly engaged on thevertical translation rack62 and can be moved along thevertical translation rack62, as shown byarrows63A, in a controllable manner by a motor and pinion assembly (not shown)-secured to thevertical car63. Ahorizontal translation rack64 is secured to thevertical car63 and extends from the left side of thevertical car63 to the right side of thevertical car63. Ahorizontal car65 is slidingly engaged on thehorizontal translation rack64 and can be moved along thehorizontal rack64, as shown byarrow64A, in a controllable manner by a motor and pinion assembly (not shown) which is secured to thehorizontal car65.
• Astylus rotation unit66 is slidingly engaged with a secondhorizontal translation rack65A disposed on thehorizontal car65 and can be moved towards and away from thevertical car63 andvertical support platform54 in a controllable manner as shown byarrow66A. Astylus rotation shaft67 extends vertically downward from thestylus rotation unit66 and rotates about an axis as indicated by dashedline67B andarrow67A in a controllable manner. Astylus mount68 is secured to the bottom end of therotation shaft67 and has amain body portion69 and astylus pivot shaft70. Astylus housing71 is rotatably secured to thestylus mount68 by thestylus pivot shaft70. Atorsion spring72 is disposed between the proximal end of thestylus housing73 and thestylus mount68 and applies a predetermined amount of compressive, or spring-loaded force to theproximal end73 of thestylus housing71. This in turn determines the amount of tip pressure applied by adistal extremity80 of astylus tip75 disposed at thedistal end section78 of the stylus79 (which is in turn secured to thedistal end section76 of the stylus housing71).
• Thebase53 ofseam forming apparatus52 is secured to acontrol unit housing77 which contains one or more power supplies, a CPU, and a memory storage unit that are used in an automated fashion to control movement between thegraft body15 section and thestylus tip75 in the various degrees of freedom therebetween. The embodiment of theseam forming apparatus52 described above has five axes of movement (or degrees of freedom) between an object secured to thechuck60 andlive center61 and thestylus tip75; however, it is possible to have additional axes of movement, such as six, seven, or more. Also, for some configurations and seam forming processes, it may be possible to use fewer axes of movement, such as two, three, or four. In addition, any number of configurations may be used to achieve the desired number of degrees of freedom between thestylus79 and the mounted device. For example, additional axes of translation or rotation could be added to the mount system and taken away from thestylus rotation unit66. Although the embodiment of theshape forming mandrel14 shown inFIGS. 1-17 is cylindrical, a five axis or six axis seam forming apparatus has the capability and versatility to accurately create seams of most any desired configuration on a shape forming member or mandrel of a wide variety of shapes and sizes. For example, a “Y” shaped mandrel suitable for generating a bifurcated graft body section could be navigated by the five axis seam forming apparatus illustrated herein, as well as other shapes. Finally,seam forming apparatus52 illustrated herein is but one of a number of devices and configurations capable of achieving the seams of the present inventions.
• FIG. 13D illustrates an enlarged view of astylus tip75 applied to a rotatingcylindrical surface86B with the surface rotating in a counterclockwise direction as indicated byarrow86A. The cylindrical surface can support one or more layers of fusible material (not shown) between thedistal extremity80 of thestylus tip75 and thesurface86B which require seam to be formed therein. Thestylus tip75 has a longitudinal axis that forms anangle86 with a tangent to the surface of the cylindrical surface indicated by dashedline87. Although not necessary, we have found it useful to have the object in contact with thestylus tip75 rotating or moving in a direction as show inFIG. 13D, relative toangle86 in order to prevent chatter of the configuration or distortion of fusible material on thesurface86A. In one embodiment,angle86 may range from about 5 to about 60 degrees; specifically, from about 10 to about 20 degrees. It is also useful if thedistal extremity80 of thestylus tip75 has a smooth surface and is radiused. A suitable radius for one embodiment may range from about 0.01 to about 0.030 inch; specifically, from about 0.015 to about 0.02 inch.
• FIG. 13E shows a similar relationship between astylus tip75 andhard surface81.Surface81 may have one or more layers of fusible material (not shown) disposed thereon betweendistal extremity80 andsurface81. Alongitudinal axis75A ofstylus tip75 forms anangle86 with the dashedline89 that is parallel to surface81.Angle88 in this embodiment should range from about 5 to about 60 degrees; specifically, from about 10 to about 20 degrees, so to ensure smooth relative motion betweensurface81 andtip75. Thesurface81 is shown moving relative to thestylus tip75 in the direction indicated byarrow81A.
• The pressure exerted by theextremity80 ofstylus tip75 on the material being processed is another parameter that can affect the quality of a seam formed in layers of fusible material. In one embodiment in which the stylus tip is heated, the pressure exerted by thedistal extremity80 of thestylus tip75 may range from about 100 to about 6,000 pounds per square inch (psi); specifically, from about 300 to about 3,000 psi. The speed of theheated stylus75 relative to the material being processed, such as that ofgraft body section15, may range from about 0.2 to about 10 mm per second, specifically, from about 0.5 to about 1.5 mm per second. The temperature of thedistal extremity80 of theheated stylus tip75 in this embodiment may range from about 320 to about 550 degrees Celsius; specifically, about 380 to about 420 degrees Celsius.
• Seam formation for ePTFE normally occurs by virtue of the application of both heat and pressure. The temperatures at the tip of theheated stylus75 during such seam formation are generally above the melting point of highly crystalline ePTFE, which may range be from about 327 to about 340 degrees Celsius, depending in part on whether the material is virgin material or has previously been sintered). In one embodiment, the stylus tip temperature for ePTFE welding and seam formation is about 400 degrees Celsius. Pressing such aheated tip75 into the layers of ePTFE against a hard surface such as the outside surface of the shape forming mandrel) compacts and heats the adjacent layers to form a seam with adhesion between at least two of, if not all, the layers. At the seam location and perhaps some distance away from the seam, the ePTFE generally transforms from an expanded state with a low specific gravity to a non-expanded state (i.e., PTFE) with a relatively high specific gravity. Some meshing and entanglement of nodes and fibrils of adjacent layers of ePTFE may occur and add to the strength of the seam formed by thermal-compaction. The overall result of a well-formed seam between two or more layers of ePTFE is adhesion that can be nearly as strong or as strong as the material adjacent the seam. The microstructure of the layers may change in the seam vicinity such that the seam will be impervious to fluid penetration.
• It is important to note that a large number of parameters determine the proper conditions for creating the fusible material seam, especially when that material is ePTFE. Such parameters include, but are not limited to, the time thestylus tip75 is in contact with the material (or for continuous seams, the rate of tip movement), the temperature (of thetip extremity80 as well as that of the material, theunderlying surface81, and the room), tip contact pressure, the heat capacity of the material, the mandrel, and the other equipment, the characteristics of the material (e.g. the node and fibril spacing, etc.), the number of material layers present, the contact angle between thetip extremity80 and the material, the shape of theextremity80, etc. Knowledge of these various parameters is useful in determining the optimal combination of controllable parameters in forming the optimal seam. And although typically a combination of heat and pressure is useful in forming an ePTFE seam, under proper conditions a useful seam may be formed by pressure at ambient temperature (followed by elevation to sintering temperature); likewise, a useful seam may also be formed by elevated temperature and little-to-no applied pressure.
• For example, we have created seams in ePTFE that formed an intact, inflatable cuff by the use of a clamshell mold that presented an interference fit on either side of a cuff zone for the ePTFE. The application of pressure alone without using an elevated temperature prior to sintering formed a seam sufficient to create a working cuff.
• FIG. 13F depicts a front view of theseam forming apparatus52 with ashape forming mandrel14 secured to thechuck60 and thelive center unit58. The distal extremity of theheated stylus tip75 is in contact with thegraft body section15 which is disposed on theshape forming mandrel14. Thechuck60 is turning theshape forming mandrel14 andgraft body section15 in the direction indicated by thearrow60A to form aseam81 between the layers of fusible material of thegraft body section15.
• FIGS. 13G and 13H illustrate an enlarged view of theheated stylus tip75 in contact with thegraft body section15 in the process of creating one oremore seams81 which are configured to form elongateinflatable channels82 in thegraft body section15. The term “inflatable channels” may generally be described herein as a substantially enclosed or enclosed volume between layers of fusible material on a graft or graft section, and in some embodiments, in fluid communication with at least one inlet port for injection of inflation material. The enclosed volume of an inflatable channel or cuff may be zero if the inflatable cuff or channel is collapsed in a non-expanded state. The enclosed volume of an inflatable channel may or may not be collapsible during compression or compacting of thegraft body section15.
• FIG. 13H is an enlarged view in section of thedistal extremity80 of theheated stylus tip75 in contact with layers of fusible material ofgraft body section15. The layers of fusible material are being heated and compressed to form abond15A therebetween. The seam forming apparatus can position thedistal extremity80 at any desired location on thegraft body section15 by activation of one or more of the five motors controlled by the components in thecontrol unit housing77. Each of the five motors controls relative movement betweengraft body section15 anddistal extremity80 in one degree of freedom. Thus, thedistal extremity80 may be positioned above the surface of thegraft body section15, as shown inFIG. 13C, and brought to an appropriate temperature for seam formation, as discussed above, by resistive heating or any other appropriate method. Onceextremity80 has reached the target temperature, it can be lowered by activation of the motor which controls movement of the vertical car. Theextremity80 can be lowered and horizontally positioned by other control motors until it contacts the graft body section in a desired predetermined position ongraft body section15, as shown inFIG. 13F.
• Oncedistal extremity80 makes contact withgraft body section15 with the proper amount of pressure, it begins to form a seam between the layers of the fusible material of the graft body section as shown inFIG. 13H. The pressure or force exerted by theextremity80 on the graft body section may be determined by the spring constant and amount of deflection oftorsion spring72 shown inFIGS. 13A and 13B; generally, we have found a force at theextremity80 ranging from about 0.2 to about 100 grams to be useful. As the seam formation process continues, the surface ofgraft body section15 may be translated with respect to thedistal extremity80 while desirably maintaining a fixed, predetermined amount of pressure between thedistal extremity80 and the layers of fusible material of the graft body section. The CPU (or an equivalent device capable of controlling the components of apparatus52) of thecontrol unit housing77 may be programmed, for instance, a mathematical representation of the outer surface contour of any known shape forming member or mandrel.
• The CPU is thereby able to control movement of the five motors ofapparatus52, so thatdistal extremity80 may follow the contour of the shape forming member while desirably exerting a fixed predetermined amount of pressure the layers of fusible material disposed between thedistal extremity80 and the shape forming member. While seam formation is taking place, the pressure exerted by thedistal extremity80 on the shape forming member may be adjusted dynamically. Theextremity80 may also be lifted off the graft body section and shape forming member in locations where there is a break in the desired seam pattern. Oncedistal extremity80 is positioned above the location of the starting point of the next seam following the break, theextremity80 may then be lowered to contact the layers of fusible material, reinitiating the seam formation process.
• Use of theseam forming apparatus52 as described herein is but one of a number of ways to create the desired seams in thegraft body section15 of the present invention. Any suitable process and apparatus may be used as necessary and the invention is not so limited. For instance, seams may also be formed in agraft body section15 by the use of a fully or partially heated clamshell mold whose inner surfaces contain raised seam-forming extensions. These extensions may be configured and preferentially or generally heated so that when the mold halves are closed over agraft body section15 disposed on a mandrel, the extensions apply heat and pressure to the graft body section directly under the extensions, thereby “branding” a seam in the graft body section in any pattern desired and in a single step, saving much time over the technique described above in conjunction withseam forming apparatus52.
• If the fusible material comprises ePTFE, it is also possible to infuse or wick an adhesive (such as FEP or PFA) or other material into the ePTFE layers such that the material flows into the fibril/node structure of the ePTFE and occupies the pores thereof. Curing or drying this adhesive material will mechanically lock the ePTFE layers together through a continuous or semi-continuous network of adhesive material now present in and between the ePTFE layers, effectively bonding the layers together.
• FIG. 14 illustrates a substantially completed set ofseams81 formed in the layers of fusible material of thegraft body section15, which seams forminflatable channels82.FIG. 15 illustratesgraft body section15 as fluid (such as compressed gas) is injected into theinflation line36 and in turn into theinflatable channel network84 ofbody section15, as shown by arrow84A. The fluid is injected to pre-stress theinflatable channels82 ofbody section15 and expand them outward radially. The fluid may be delivered or injected through an optional elongate gas containment means having means for producing a permeability gradient in the form of a manifold orpressure line85. Thepressure line85 shown inFIG. 15 has a configuration with an input (not shown) located outside the inflation line and a plurality of outlet apertures or orifices (not shown) that may be configured to provide an even distribution of pressure within theinflatable channel network84. Other fluid injection schemes and configurations are of course possible.
• Because ePTFE is a porous or semi-permeable material, the pressure of exerted by injected fluids such as pressurized gas tends to drop off or diminish with increasing distance away from the outlet apertures or orifices (not shown) of manifold orpressure line85. Therefore, in some embodiments,pressure line85 may comprise apertures or orifices (not shown) which, when disposed ingraft body section15, progressively increases in size as one moves distally along the pressure line towards theproximal end17graft body section15 in order to compensate for a drop in pressure both within theinflatable channel network84 and within the manifold orpressure line85 itself.
• Once some or all of theinflatable channels82 have been pre-expanded or pre-stressed, thegraft body section15 and shape formingmandrel assembly89 may then be positioned within an outer constraint means in the form of a mold to facilitate the inflatable channel expansion and sintering process. One half of amold90 suitable for forming an embodiment of agraft body section15 such as that shown inFIG. 15 is illustrated inFIG. 16A. A moldhalf body portion91 is one of two pieces ofmold90. A mold similar tomold90 could be made from any number of mold body portions configured to fit together. For example, amold90 could be designed from three, four, five or more mold body portions configured to fit together to form a suitablemain cavity portion93 for maintaining the shape ofgraft body section15 during channel expansion and sintering. For certain configurations, a one-piece mold may be used.
• Mold body portion91 has acontact surface92 and amain cavity portion93.Main cavity portion93 has an inside surface contour configured to match an outside surface contour of the graft body section with the inflatable channels in an expanded state.Optional exhaust channels92A may be formed incontact surface92 and provide an escape flow path for pressurized gas injected into theinflatable channel network84 during expansion of theinflatable channels82.
• Themain cavity portion93 of theFIGS. 16A-16B embodiment is substantially in the shape of a half cylinder withcircumferential channel cavities94 for forming the variousinflatable channels82 ofgraft body section15.Cavity93 has a first taperedportion95 at theproximal end96 ofmold90 and a second taperedportion97 at the molddistal end98.FIG. 16B shows an end view ofmold90 with the twomold body portions91 and100 pressed together with the assembly of thegraft body section15 andshape forming mandrel14 disposedmold cavity93.
• FIG. 16C shows the assembly of thegraft body section15 andshape forming mandrel14 disposed withinmold90, with the circumferentialinflatable channels82 of thegraft body section15 aligned with thecircumferential channel cavities94 of themain cavity portion93. Onemold body portion100 ofmold90 is not shown for the purpose of clarity of illustration. A pressurized fluid indicated as being delivered or injected into manifold orpressure line85 byarrow85A.
• FIG. 17 illustrates by the phantom lines how theouter layers94A of circumferentialinflatable channel82 of the fusible material of agraft body section15 are expanded into thecircumferential channel cavity94 ofmold cavity93. The direction of the expansion of theouter layers94A to the position indicated by the phantom lines is indicated byarrow94B. A cross sectional view of theseams83 of the circumferentialinflatable channel82 is shown inFIG. 17 as well.
• While the graft body section network ofinflatable channels84 is in an expanded state by virtue of pressurized material being delivered or injected intopressure line85, the entire assembly may be positioned within an oven or other heating device (not shown) in order to bring the fusible material ofgraft body section15 to a suitable temperature for an appropriate amount of time in order to fix or sinter the fusible material. In one embodiment, the fusible material is ePTFE and the sintering process is carried out by bringing the fusible material to a temperature of between about 335 and about 380 degrees Celsius; specifically, between about 350 and about 370 degrees Celsius. The mold may then be cooled and optionally quenched until the temperature of the mold drops to about 250 degrees Celsius. The mold may optionally further be quenched (for handling reasons) with ambient temperature fluid such as water. Thereafter, the twohalves91 and100 ofmold90 can be pulled apart, and the graft assembly removed.
• The use ofmold90 to facilitate the inflatable channel expansion and sintering process is unique in that themold cavity portion93 acts as a backstop to the graft body section so that during sintering, the pressure created by the injected fluid that tends to expand the inflatable channels outward is countered by the restricting pressure exerted by the physical barrier of the surfaces defining themold cavity93. In general terms, therefore, it is the pressure differential across the inflatable channel ePTFE layers that in part defines the degree of expansion of the channels during sintering. During the sintering step, the external pressure exerted by the mold cavity surface competes with the fluid pressure internal to the inflatable channels (kept at a level to counteract any leakage of fluid through the ePTFE pores at sintering temperatures) to provide an optimal pressure differential across the ePTFE membrane(s) to limit and define the shape and size of the inflatable channels.
• Based on this concept, we have found it possible to use alternatives to a mold in facilitating the inflatable channel expansion process. For instance, it is possible inject the channel network with a working fluid that does not leak through the ePTFE pores and to then expand the network during sintering in a controlled manner, without any external constraint. An ideal fluid would be one that could be used within the desired ePTFE sintering temperature range to create the necessary pressure differential across the inflatable channel membrane and the ambient air, vacuum, or partial vacuum environment so to control the degree of expansion of the channels. Ideal fluids are those that possess a high boiling point and lower vapor pressure and that do not react with ePTFE, such as mercury or sodium potassium. In contrast, the network ofinflatable channels84 can also be expanded during the fixation process or sintering process by use of vapor pressure from a fluid disposed within the network ofinflatable channels84. For example, the network ofinflatable channels84 can be filled with water or a similar fluid prior to positioning assembly in the oven, as discussed above. As the temperature of thegraft body section15 and network ofinflatable channels84 begins to heat, the water within the network ofinflatable channels84 begins to heat and eventually boil. The vapor pressure from the boiling water within the network ofinflatable channels84 will expand the network ofinflatable channels84 provided the vapor is blocked at theinflation line85 or otherwise prevented from escaping the network of inflatable channels.
• FIG. 18 shows an elevational view in partial longitudinal section of anendovascular graft assembly105 manufactured by the methods and with the apparatus described above.Endovascular graft assembly105 comprises agraft body section108 with aproximal end106, adistal end107, and circumferentially orientedinflatable channels111 shown in an expanded state. A longitudinalinflatable channel116 fluidly communicates with the circumferentialinflatable channels111.
• An expandable member in the form of aproximal connector member112 is shown embedded between proximal end wrap layers113 of fusible material. An expandable member in the form of adistal connector member114 is likewise shown embedded between distal end wrap layers115 of fusible material. Theproximal connector member112 anddistal connector member114 of this embodiment are configured to be secured or connected to other expandable members which may include stents or the like, which are not shown. In the embodiment ofFIG. 18, such a connection may be accomplished viaconnector elements117 of the proximal anddistal connector members112 and114, which extend longitudinally outside of the proximal and distal end wrap layers113 and115 away from thegraft body section108.
• TheFIG. 18 embodiment of the present invention featuresjunction118 between the distal end wrap layers115 of fusible material and the layers of fusible material of adistal end121 of the graft assemblymain body portion122. There is likewise ajunction123 between the proximal end wrap layers113 and the layers of fusible material of aproximal end124 of the graft assemblymain body portion122. Thejunctions118 and123 may be tapered, with overlapping portions that are bound by sintering or thermomechanical compaction of the end wrap layers113 and115 and layers of themain body portion122. Thisjunction123 is shown in more detail inFIG. 19.
• InFIG. 19, six proximal end wrap fusible material layers113 are disposed between three fusible materialinner layers125 and three fusible materialouter layers126 of the main body portionproximal end124.
• FIG. 20 illustrates a sectional view of a portion of thedistal connector member114 disposed within the distal end wrap layers115 of fusible material.Connector member114 is disposed between threeouter layers127 of fusible material and threeinner layers128 of fusible material.Optional seams127A, formed by the methods discussed above, are disposed on either side ofdistal connector member114 and mechanically capture theconnector member114.FIG. 21 likewise is a transverse cross sectional view of theproximal connector member112 embedded in the proximal end wrap layers113 of fusible material.
• FIG. 22 illustrates a transverse cross section of the longitudinalinflatable channel116 formed betweenmain body portion122outer layers131 and themain body portion122inner layers132.FIG. 23 is a transverse cross section of graftmain body portion122 showing a circumferentialinflatable channel111 in fluid communication with longitudinalinflatable channel116. The circumferentialinflatable channel111 is formed between theouter layers131 of fusible material ofmain body portion122 andinner layers132 of fusible material ofmain body portion122.
• FIG. 24 shows anendovascular graft assembly205 having agraft body section208 with aproximal end206, adistal end207, and circumferentialinflatable channels211 shown in an expanded state. Aproximal connector member212 is embedded between proximal end wrap layers213 of flexible material. Adistal connector member214 is embedded between distal end wrap layers215 of flexible material. Theproximal connector member212 anddistal connector member214 are configured to be connected to other expandable members or stents (not shown). A longitudinalinflatable channel216 is disposed in fluid communication with the circumferentialinflatable channels211 and extends longitudinally along thegraft body section208.Connector elements217 of the proximal anddistal connector members212 and214 extend longitudinally outside of the proximal and distal end wrap layers213 and215 away from thegraft body section208.
• There is ajunction218 between the distal end wrap layers offlexible material215 and the layers of flexible material of adistal end221 of amain body portion222 of thegraft assembly205. There is also ajunction223 between the proximal end wrap layers213 and the layers of flexible material of aproximal end224 of themain body portion222 of thegraft assembly205. Thejunctions218 and223 may be tapered junctions with overlapping portions as shown.Junctions218 may be secured by sintering or thermomechanical compaction of the junction if the flexible material consists of a fusible material or the like.
• FIG. 25A illustrates a transverse cross section of a portion of thedistal connector member214 disposed within the distal end wrap layers offlexible material215 and secured to the end wrap layers by a joint230.Joint230 includesdistal connector member214, or portion thereof, disposed within aloop portion231 of a second layer offlexible material232. Theloop portion231 of the second layer offlexible material232 is formed by aflap233 which has been folded back about thedistal connector member214 in a looped configuration and secured to a portion of the second layer of flexible material at asecured portion234.
• A first layer offlexible material235 is disposed inside and upon aninner surface236 of the second layer offlexible material232 and continues distally to thedistal end207 of thegraft body section208. A third layer offlexible material237 is disposed upon anoutside surface238 of the second layer offlexible material232 and extends distally to thedistal end207 of thegraft body section208. The first layer offlexible material235 and third layer offlexible material237 contact each other and are bonded or secured to each other distal of joint230.
• Flap233 may be secured to the second layer offlexible material232 by a variety of suitable methods including adhesive bonding, thermomechanical compaction (including, e.g., seam formation, sintering, welding) or the like. Thesecured portion234 may also be secured or bonded to the adjacent first layer offlexible material235 and third layer offlexible material237 by the same or similar methods. The joint230 is particularly strong and resistant to forces tending to pull thedistal connector member214 in a distal direction against the end wrap layers215 being pulled in a proximal direction. The tensile forces of such stress will be distributed into a shear load on the secured portion of theflap233 which is bonded over a surface area which is large relative to the surface area of the corresponding portion of thedistal connector member214.
• FIG. 25B illustrates the joint230 from outside thegraft assembly205 with the third layer offlexible material237 not shown to more clearly illustrate the construction ofjoint230.FIG. 25B showsflap233 secured to the second layer offlexible material232 at thesecured portion234 which extends across the majority offlap233 as indicated by brackets and hatch lines inFIG. 25B. Theloop portion231 is disposed about the corresponding portion of thedistal connector member214. A void241 is shown whereflap233 has been cut from the second layer offlexible material232 against the first layer offlexible material235.
• FIG. 26 shows an alternative embodiment of a joint245, similar in some respects to the joint230 ofFIG. 24, between a transversely oriented member such as aconnector member246 and end wrap layers offlexible material247. Theconnector member246 is disposed within aloop portion248 of a third layer offlexible material249 which is formed by aflap251 that is folded back upon the third layer offlexible material249 about theconnector member246.Flap251 is secured to the third layer offlexible material249 over asecured portion252. Anadditional flap253 formed from a second layer offlexible material254 is folded back about theconnector member246,loop portion248,flap251 andsecured portion252.Additional flap253 is secured toflap251 and third layer offlexible material254 at an additionalsecured portion255.
• Proximal ofadditional flap253, a fourth layer offlexible material258 is disposed outside and upon anoutside surface261 of the second layer offlexible material254 and continues distally to thedistal end207 of thegraft body section208. Proximal of joint245, a first layer offlexible material256 is disposed upon aninside surface257 of the second layer offlexible material254 and extends distally to thedistal end207 of thegraft body section208. Distal of joint245, first layer offlexible material256 and fourth layer offlexible material258 contact each other and are bonded or secured to each other.
• Such a nested joint configuration creates a doublelayered loop portion262 which can increase the tensile strength of joint245 by providing athicker loop portion262 which is more resilient to dynamic repetitive loads imposed on the joint. Such a configuration could be extended to include any number of nested loop portions, including 3, 4, 5 or more layers of flexible material formed into aloop portion248 about a transversely oriented member such asconnector member246.
• In the embodiment depicted inFIGS. 25A and 25B, theflap233 formed from the second layer offlexible material249 is secured primarily to the same second layer offlexible material249. However,FIG. 27 illustrates an alternative embodiment of a joint265 between aconnector member266 and end wrap layers offlexible material267.Joint265 has aflap268 formed from a third layer offlexible material271 which is folded back on itself about theconnector member266.Flap268 is secured to a second layer offlexible material272 which is disposed between theflap268 and the third layer offlexible material271.Flap268 is secured to the second layer offlexible material272 over asecured portion273. Proximal offlap268, a first layer offlexible material274 is disposed upon aninner surface275 of the second layer offlexible material272 and continues distally to thedistal end207 of thegraft body section208. Proximal of joint265, a fourth layer offlexible material276 is disposed upon anoutside surface277 of the third layer offlexible material271 and extends distally to thedistal end207 of thegraft body section208. Distal of joint265, the first layer offlexible material274 and fourth layer offlexible material276 contact each other and are bonded or secured to each other distal of the joint265.
• Referring toFIG. 28, an endovasculargraft body section280 having a generally tubular configuration and aproximal end section281 which includes proximal end wrap layers offlexible material282 is shown. A circumferentially oriented member configured as aconnector member283 is disposed about the proximal end wrap layers offlexible material282 and includes aring member284 configured in a serpentine pattern andconnector elements285 extending proximally from thering member284 past aproximal end286 of thegraft body section280.
• A second layer offlexible material287 having a tubular configuration is disposed upon anoutside surface288 of a first layer offlexible material289 which also has a generally tubular shape. A third layer offlexible material291 is disposed upon anoutside surface292 of the second layer offlexible material287. The third layer offlexible material291 haslongitudinal slits293 formed in aproximal section294 thereof that extend from theproximal end286 of thegraft body section280 toring member284. Afirst flap295 formed from the third layer offlexible material291 is shown positioned against theouter surface292 of the second layer offlexible material287. In order to form a loop portion, thefirst flap295 will be folded back on itself in the direction indicated by thearrow296. Asecond flap297 is shown folded back on itself in a loop configuration about thering member284 of theconnector member283 to form aloop portion298.
• InFIG. 29, a plurality offlaps298 are shown folded back toform loop portions299 about thering member284 of theconnector member283 andsuch flaps298 have been folded over the substantial circumference of thering member284.Flaps298 are then secured to the third layer offlexible material291 oversecured portions300 by any of the methods discussed above. Onceflaps298 are secured, a fourth layer offlexible material301 is disposed upon anouter surface302 of the third layer offlexible material291, theflaps298, theloop portions299 and theconnector member283 as shown inFIG. 30. For some embodiments of an endovasculargraft body section280, the number offlaps298 that are disposed about aconnector member283 can be from about 2 to about 24 flaps. For certain embodiments, theflaps298 may vary in size from about 1 to about 25 square millimeters.
• The fourth layer offlexible material301 extends to theproximal end286 ofgraft body section280 and may be secured in place by adhesive bonding, sintering, welding, thermomechanical compaction or any other suitable means. In some embodiments, the fourth layer offlexible material301 may be disposed only over the joint303 of thegraft body section280. Such a joint303 secures theconnector member283 to the proximal end wrap layers282 ofgraft body section280 with a joint303 that is highly resistant to tensile forces between those components. When the fourth layer offlexible material301 is secured in place, aninside surface304 of the fourth layer offlexible material301 may be secured to anoutside surface305 of theflaps298 in order to further lock theflaps298 in the loop configuration and further strengthen the joint303 between theconnector member283 and the end wrap layers282 ofgraft body section280.
• FIG. 31 shows agraft section310 having a generally tubular configuration. A second layer offlexible material311 is disposed upon anoutside surface312 of a first layer offlexible material313, with both layers having a generally tubular configuration. A first transversely orientedmember314 in the form of a metallic rod is disposed within aloop portion315 of aflap316. Theflap316 is formed from a portion of the second layer offlexible material311 folded back about the first transversely orientedmember314 and is secured to the second layer offlexible material311 over asecured portion318 to form a joint320.
• Joint320 is particularly resistant to tensile forces imposed upon the first transversely orientedmember314 in the direction of thearrows321. A second transversely orientedmember322 in the form of a metallic rod is disposed within aloop portion323 of aflap324.Flap324 is formed from a portion of the second layer offlexible material311 folded back about the second transversely orientedmember322 and is secured to the second layer offlexible material311 over asecured portion326 to form a joint327.Joint327 is particularly resistant to tensile forces imposed upon the first transversely oriented member in the direction of thearrows328.
• FIG. 31 illustrates that the load of any particular tensile force may be dissipated by a joint having certain features of the invention depending on the configuration and orientation of the flap and secured portion of the flap. In the embodiment shown inFIG. 31, opposing tensile forces could be imposed on the first transversely orientedmember314 and the second transversely orientedmember322 and adequately distributed over the respectivesecured portions318 and326 to the extent that the flexible material of theloop portions315 and323 of therespective joints320 and327 would likely fail prior to the bond at the respectivesecured portions318 and326, depending on the relative tensile strength inherent in the flexible material of the second layer offlexible material311. This will generally hold true forjoints320 and327 made with ePTFE, both uniaxial and multiaxial, as the flexible material layer wherein the secured portion is secured by thermomechanical compaction.
• While particular forms of embodiments of the invention have been illustrated and described, it will be apparent that various modifications can be made without departing from the spirit and scope of the invention. Accordingly, it is not intended that the invention be limited, except as by the appended claims.

Claims (25)

1-37. (Canceled)

38. A method for securing a transversely oriented member to a flexible material portion of an endovascular graft or section thereof comprising:

a) disposing the transversely oriented member in proximity to a flap in a flexible material portion of an endovascular graft or section thereof;

b) folding the flap over at least a portion of the transversely oriented member to form a looped portion of the flap about the transversely oriented member; and

c) securing the flap in the looped configuration.

39. The method ofclaim 38 wherein the flap is comprised of a portion of a layer of flexible material and the flap is secured to the layer of flexible material.

40. The method ofclaim 38 wherein the flap is secured in the looped configuration with adhesive.

41. The method ofclaim 38 wherein the flap is comprised of a portion of a first layer of flexible material and the flap secured to a portion of a second layer of flexible material.

42. The method ofclaim 38 wherein the flexible material comprises ePTFE.

43. The method ofclaim 42 wherein the flap is secured in the looped configuration by thermomechanical compaction.

44. The method ofclaim 42 wherein the flap is secured in the looped configuration with FEP or PFA.

45. The method ofclaim 42 wherein the ePTFE material of the flap is sintered after being secured in the looped configuration.

46. A method for securing a circumferentially oriented member to a flexible material portion of an endovascular graft or section thereof comprising:

a) disposing a circumferentially oriented member in proximity to a flap in a flexible material portion of an endovascular graft or section thereof;

b) folding the flap over at least a portion of the circumferentially oriented member to form a looped portion of the flap about the circumferentially oriented member; and

c) securing the flap in the looped configuration.

47. The method ofclaim 46 wherein the flap is comprised of a portion of a layer of flexible material and the flap is secured to the layer of flexible material.

48. The method ofclaim 46 wherein the flap is secured in the looped configuration with adhesive.

49. The method ofclaim 46 wherein the flap is comprised of a portion of a first layer of flexible material and the flap secured to a portion of a second layer of flexible material.

50. The method ofclaim 46 wherein the flexible material comprises ePTFE.

51. The method ofclaim 50 wherein the flap is secured in the looped configuration by thermomechanical compaction.

52. The method ofclaim 50 wherein the flap is secured in the looped configuration with FEP or PFA.

53. The method ofclaim 50 wherein the ePTFE material of the flap is sintered after being secured in the looped configuration.

54. A method for securing an expandable member to a flexible material portion of an endovascular graft or section thereof comprising:

a) disposing the expandable member in proximity to a flap in a flexible material portion of an endovascular graft or section thereof;

b) folding the flap over at least a portion of the expandable member to form a looped portion of the flap about the expandable member; and

c) securing the flap in the looped configuration.

55. The method ofclaim 54 wherein the flap comprises a portion of a layer of flexible material and the flap is secured to the layer of flexible material.

56. The method ofclaim 54 wherein the flap is secured in the looped configuration with adhesive.

57. The method ofclaim 54 wherein the flap comprises a portion of a first layer of flexible material and the flap secured to a portion of a second layer of flexible material.

58. The method ofclaim 54 wherein the flexible material comprises ePTFE.

59. The method ofclaim 58 wherein the flap is secured in the looped configuration by thermomechanical compaction.

60. The method ofclaim 58 wherein the flap is secured in the looped configuration with FEP or PFA.

61. The method ofclaim 58 wherein the ePTFE material of the flap is sintered after being secured in the looped configuration.

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