# US 2019/0314136 A1 · Branch graft system with adjustable openings > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2019/0314136 A1 - Document ID: US20190314136A1 - Status: Published application - Kind: A1 - Application number: 15/950,405 - Filed: 2018-04-11 - Published: 2019-10-17 - Earliest claimed: 2018-04-11 - Assignees: Cook Medical Technologies LLC - Applicants: Cook Medical Technologies LLC - Inventors: Blayne A. Roeder - Web page: https://patentgrep.com/patent/US20190314136A1 ## CPC - A61F 2/07: Stent-grafts - A61F 2/958: Inflatable balloons for placing stents or stent-grafts - A61F 2002/061: {provided with means for allowing access to secondary lumens} - A61F 2002/067: {modular} - A61F 2220/0016: with sharp anchoring protrusions, e.g. barbs, pins, spikes - A61F 2220/0025: Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements - A61F 2220/0033: made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit - A61F 2230/0006: circular - A61F 2230/0008: elliptical or oval - A61F 2230/0013: Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped - A61F 2230/0034: D-shaped - A61F 2250/0006: for adjusting angular orientation - A61F 2250/0007: for adjusting length - A61F 2250/0008: for adjusting a position by translation along an axis or two perpendicular axes - A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C) ## Abstract The present embodiments describe a multi-component endograft having a first endograft with first and second wall openings, a second endograft with a third wall opening, a third endograft with a fourth wall opening, where during an adjustment state the second and third endografts are independently adjustable, both vertically along a longitudinal axis and rotationally relative to the longitudinal axis, (1) while keeping the perimeter of the third wall opening primarily encompassed by the perimeter of the first wall opening and (2) while keeping the perimeter of the fourth wall opening primarily encompassed by the perimeter of the second wall opening. ## Claims ### Claim 1 A multi-component endograft, comprising: a first endograft comprising, a first tubular main body portion having a first proximal end with a first proximal opening, a first distal end with a first distal opening, and a first lumen extending therebetween along a longitudinal axis, first and second wall openings through a wall of the first tubular main body portion and having first and second perimeters, respectively, in fluid communication with the first lumen; a second endograft comprising, a second tubular main body portion having a second proximal end with a second proximal opening, a second distal end with a second distal opening, and a second lumen extending therebetween, a third wall opening through a wall of the second tubular main body portion having a third perimeter in fluid communication with the second lumen; a third endograft comprising, a third tubular main body portion having a third proximal end with a third proximal opening, a third distal end with a third distal opening, and a third lumen extending therebetween, a fourth wall opening through a wall of the third tubular main body portion having a fourth perimeter in fluid communication with the third lumen; and wherein the first, second, and third endografts are constructed and dimensioned such that in an adjustment state where the second and third endografts are both within the lumen of the first endograft, the second and third endografts are independently adjustable, both vertically along the longitudinal axis and rotationally relative to the longitudinal axis, while keeping the third perimeter of the third wall opening primarily encompassed by the first perimeter of the first wall opening and while keeping the fourth perimeter of the fourth wall opening primarily encompassed by the second perimeter of the second wall opening. ### Claim 2 (depends on 1) The multi-component endograft of claim 1, further comprising: a fifth wall opening through the wall of the first tubular main body portion and having a fifth perimeter in fluid communication with the first lumen; a sixth wall opening through a wall of the second tubular main body portion having a sixth perimeter in fluid communication with the second lumen; a seventh wall opening through a wall of the third tubular main body portion having a seventh perimeter in fluid communication with the third lumen; wherein the sixth perimeter at least partially overlaps with the seventh perimeter to form a combined perimeter, and wherein the first, second, and third endografts are constructed and dimensioned such that in the adjustment state, the second and third endografts are independently adjustable, both vertically along the longitudinal axis and rotationally relative to the longitudinal axis, while keeping the fifth perimeter of the fifth wall opening primarily encompassed by the combined perimeter of the sixth and seventh wall openings. ### Claim 3 (depends on 2) The multi-component endograft of claim 2, further comprising an eighth wall opening through the wall of the first tubular main body portion and having an eighth perimeter in fluid communication with the first lumen. ### Claim 4 (depends on 1) The multi-component endograft of claim 1, wherein the third and fourth wall openings are fenestrations. ### Claim 5 (depends on 1) The multi-component endograft of claim 1, wherein at least one of the third and fourth wall openings is a scalloped opening. ### Claim 6 (depends on 2) The multi-component endograft of claim 2, wherein the sixth and seventh wall openings are scalloped openings. ### Claim 7 (depends on 3) The multi-component endograft of claim 3, wherein the eighth wall opening is a scalloped opening. ### Claim 8 (depends on 3) The multi-component endograft of claim 3, wherein the eighth wall opening is a branch. ### Claim 9 (depends on 1) The multi-component endograft of claim 1, wherein the third and fourth wall openings face in opposite directions relative to one another. ### Claim 10 (depends on 2) The multi-component endograft of claim 2, wherein the fifth wall opening is proximal to the third and fourth wall openings. ### Claim 11 (depends on 3) The multi-component endograft of claim 3, wherein the eighth wall opening is proximal to the fifth wall opening. ### Claim 12 (depends on 1) The multi-component endograft of claim 1, wherein the second proximal end of the second endograft fits together with the third proximal end of the third endograft to form an interference fit with a circular cross-section. ### Claim 13 (depends on 1) The multi-component endograft of claim 1, wherein the second proximal end of the second endograft and the third proximal end of the third endograft are “D” shaped. ### Claim 14 (depends on 1) The multi-component endograft of claim 1, wherein the second proximal end of the second endograft and the third proximal end of the third endograft are “yin-yang” shaped. ### Claim 15 (depends on 1) The multi-component endograft of claim 1, wherein at least one of the second proximal end of the second endograft or the third proximal end of the third endograft further comprises at least one hook. ### Claim 16 (depends on 15) The multi-component endograft of claim 15, wherein the hook latches to the first endograft. ### Claim 17 (depends on 15) The multi-component endograft of claim 15, wherein the hook latches to at least one of the second or third endografts. ### Claim 18 A multi-component endograft, comprising: a first endograft comprising, a first tubular main body portion having a first proximal end with a first proximal opening, a first distal end with a first distal opening, and a first lumen extending therebetween along a longitudinal axis, first and second wall openings through a wall of the first tubular main body portion and having first and second perimeters, respectively, in fluid communication with the first lumen; a second endograft comprising, a second tubular main body portion having a second proximal end with a second proximal opening, a second distal end with a second distal opening, and a second lumen extending therebetween, a third wall opening through a wall of the second tubular main body portion having a third perimeter in fluid communication with the second lumen; a third endograft comprising, a third tubular main body portion having a third proximal end with a third proximal opening, a third distal end with a third distal opening, and a third lumen extending therebetween, a fourth wall opening through a wall of the third tubular main body portion having a fourth perimeter in fluid communication with the third lumen; and wherein the first, second, and third endografts are constructed and dimensioned such that the second and third endografts are independently vertically adjustable along the longitudinal axis within the lumen of the first endograft between a first state and a second state different from the first state, wherein in both the first and second states the first perimeter of the first wall opening surrounds the third perimeter of the third wall opening and the second perimeter of the second wall opening surrounds the fourth perimeter of the fourth wall opening. ### Claim 19 A method of deploying a multi-component endograft, comprising: guiding a first endograft to a first anatomical target, the first endograft comprising, a first tubular main body portion having a first proximal end with a first proximal opening, a first distal end with a first distal opening, and a first lumen extending therebetween along a longitudinal axis, first and second wall openings through a wall of the first tubular main body portion and having first and second perimeters, respectively, in fluid communication with the first lumen; expanding the first endograft such that it forms a seal at the first anatomical target; guiding a second endograft to a second anatomical target within the lumen of the first endograft, the second endograft comprising, a second tubular main body portion having a second proximal end with a second proximal opening, a second distal end with a second distal opening, and a second lumen extending therebetween, a third wall opening through a wall of the second tubular main body portion having a third perimeter in fluid communication with the second lumen; guiding a third endograft to a third anatomical target within the lumen of the first endograft, the third endograft comprising, a third tubular main body portion having a third proximal end with a third proximal opening, a third distal end with a third distal opening, and a third lumen extending therebetween, a fourth wall opening through a wall of the third tubular main body portion having a fourth perimeter in fluid communication with the third lumen; wherein the first, second, and third endografts are constructed and dimensioned such that in an adjustment state where the second and third endografts are both within the lumen of the first endograft, the second and third endografts are independently adjustable, both vertically along the longitudinal axis and rotationally relative to the longitudinal axis, while keeping the third perimeter of the third wall opening primarily encompassed by the first perimeter of the first wall opening and while keeping the fourth perimeter of the fourth wall opening primarily encompassed by the second perimeter of the second wall opening; and expanding the second and third endografts such that they form an interference fit with one another and the first endograft. ### Claim 20 (depends on 19) The method of deploying the multi-component endograft of claim 19, wherein the first tubular main body portion further comprises a fifth wall opening through the wall of the first tubular main body portion and having a fifth perimeter in fluid communication with the first lumen, wherein the second tubular main body portion further comprises a sixth wall opening through a wall of the second tubular main body portion having a sixth perimeter in fluid communication with the second lumen; wherein the third tubular main body portion further comprises a seventh wall opening through a wall of the third tubular main body portion having a seventh perimeter in fluid communication with the third lumen, wherein the sixth perimeter at least partially overlaps with the seventh perimeter to form a combined perimeter, and wherein the first, second, and third endografts are constructed and dimensioned such that in the adjustment state, the second and third endografts are independently adjustable, both vertically along the longitudinal axis and rotationally relative to the longitudinal axis, while keeping the fifth perimeter of the fifth wall opening primarily encompassed by the combined perimeter of the sixth and seventh wall openings.