# US 8,771,336 B2 · Endoluminal prosthesis comprising a valve replacement and at least one fenestration > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 8,771,336 B2 - Document ID: US8771336B2 - Status: Granted - Kind: B2 - Application number: 13/335,115 - Filed: 2011-12-22 - Published: 2012-08-02 - Granted: 2014-07-08 - Earliest claimed: 2010-08-21 - Assignees: Cook Medical Technologies LLC - Applicants: Blayne A. Roeder - Inventors: Blayne A. Roeder - Web page: https://patentgrep.com/patent/US8771336B2 ## CPC - A61F 2/07: Stent-grafts - A61F 2/89: the wire-like elements comprising two or more adjacent rings flexibly connected by separate members - A61F 2002/061: {provided with means for allowing access to secondary lumens} - A61F 2002/075: {the stent being loosely attached to the graft material, e.g. by stitching} - A61F 2002/821: {Ostial stents} - A61F 2002/9511: {the retaining means being filaments or wires} - A61F 2230/005: Rosette-shaped, e.g. star-shaped - A61F 2230/0054: V-shaped - A61F 2230/0067: conical - A61F 2250/0039: differing in diameter - A61F 2250/0071: breakable or frangible - 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 An endoluminal prosthesis comprises a graft having a tubular body comprising proximal and distal ends, and a valve replacement disposed between the proximal and distal ends of the graft. At least one stent is coupled to the graft and has a contracted delivery state and an expanded state for maintaining patency within a portion of the graft. At least one fenestration is disposed in a sidewall of the graft at a location distal to the valve replacement. In one embodiment, the at least one fenestration is pivotable in any direction away from an axis perpendicular to a longitudinal axis of the prosthesis. ## Claims ### Claim 1 An endoluminal prosthesis comprising: a graft having a tubular body comprising proximal and distal ends; a valve replacement disposed between the proximal and distal ends of the graft; at least one stent coupled to the graft, the at least one stent having a contracted delivery state and an expanded state for maintaining patency within a portion of the graft; at least one fenestration disposed in a sidewall of the graft at a location distal to the valve replacement; a first perimeter having a first diameter and surrounding the at least one fenestration; a band of flexible material attached to and surrounding the first perimeter and having a flexible frame; and a second perimeter attached to and surrounding the band of flexible material and having a second diameter greater than the first perimeter diameter; where the band of material has a first diameter substantially the same as the first perimeter diameter and a second diameter substantially the same as the diameter of the second perimeter, and where the diameter of the band of material decreases in a direction away from the surface of the graft from the second perimeter to the first perimeter, wherein the band of material is configured to independently move between an interior surface of the graft and an exterior surface of the graft, and wherein the flexible frame extends about a surface of the band from the first perimeter to the second perimeter. ### Claim 2 (depends on 1) The endoluminal prosthesis of claim 1 wherein the at least one fenestration is pivotable in any direction away from an axis perpendicular to a longitudinal axis of the prosthesis. ### Claim 3 (depends on 1) The endoluminal prosthesis of claim 1 wherein the band of material has a concave or convex orientation relative to the surface of the graft. ### Claim 4 (depends on 1) The endoluminal prosthesis of claim 1 wherein first and second fenestrations are disposed in the graft at locations between about 90 and about 270 degrees apart. ### Claim 5 (depends on 4) The endoluminal prosthesis of claim 4 further comprising a first branch vessel prosthesis extending between the first fenestration and a right coronary artery in a deployed state, and a second branch vessel prosthesis extending between the second fenestration and a left coronary artery in the deployed state. ### Claim 6 (depends on 1) The endoluminal prosthesis of claim 1 wherein first and second z-stents are coupled to the graft such that the distal apices of the first stent are aligned with the proximal apices of the second stent, and the at least one fenestration is positioned between a proximal apex of the first stent and a distal apex of the second stent. ### Claim 7 (depends on 1) The endoluminal prosthesis of claim 1 wherein the valve replacement comprises an artificial valve having a tricuspid shape. ### Claim 8 (depends on 1) The endoluminal prosthesis of claim 1 wherein the valve replacement is located at the proximal end of the graft, and one or more barbs extend radially outward from the proximal end of the graft. ### Claim 9 An endoluminal prosthesis comprising: a graft having a tubular body comprising proximal and distal ends; a valve replacement disposed between the proximal and distal ends of the graft; at least one stent coupled to the graft, the at least one stent having a contracted delivery state and an expanded state for maintaining patency within a portion of the graft; at least one fenestration disposed in a sidewall of the graft and pivotable in any direction away from an axis perpendicular to a longitudinal axis of the prosthesis; a first perimeter having a first diameter and surrounding the at least one fenestration; a band of flexible material attached to and surrounding the first perimeter and having a flexible frame; and a second perimeter attached to and surrounding the band of flexible material and having a second diameter greater than the first perimeter diameter; where the band of material has a first diameter substantially the same as the first perimeter diameter and a second diameter substantially the same as the diameter of the second perimeter, and where the diameter of the band of material decreases in a direction away from the surface of the graft from the second perimeter to the first perimeter, wherein the band of material is configured to independently move between an interior surface of the graft and an exterior surface of the graft, and wherein the flexible frame extends about a surface of the band from the first perimeter to the second perimeter. ### Claim 10 (depends on 9) The endoluminal prosthesis of claim 9 where the at least one fenestration is disposed at a location distal to the valve replacement. ### Claim 11 (depends on 9) The endoluminal prosthesis of claim 9 wherein the band of material has a concave or convex orientation relative to the surface of the graft. ### Claim 12 (depends on 9) The endoluminal prosthesis of claim 9 wherein first and second fenestrations are disposed in the graft at locations between about 90 and about 270 degrees apart. ### Claim 13 An endoluminal prosthesis comprising: a graft having a tubular body comprising proximal and distal ends; a valve replacement disposed between the proximal and distal ends of the graft; at least one stent coupled to the graft, the at least one stent having a contracted delivery state and an expanded state for maintaining patency within a portion of the graft; first and second fenestrations disposed in the graft at locations between about 90 and about 270 degrees apart; a first branch vessel prosthesis extending between the first fenestration and a right coronary artery in a deployed state, and a second branch vessel prosthesis extending between the second fenestration and a left coronary artery in the deployed state; a first perimeter having a first diameter and surrounding the first fenestration; a band of flexible material attached to and surrounding the first perimeter and having a flexible frame; and a second perimeter attached to and surrounding the band of flexible material and having a second diameter greater than the first perimeter diameter; where the band of material has a first diameter substantially the same as the first perimeter diameter and a second diameter substantially the same as the diameter of the second perimeter, and where the diameter of the band of material decreases in a direction away from the surface of the graft from the second perimeter to the first perimeter, wherein the band of material is configured to independently move between an interior surface of the graft and an exterior surface of the graft, and wherein the flexible frame extends about a surface of the band from the first perimeter to the second perimeter. ### Claim 14 (depends on 13) The endoluminal prosthesis of claim 13 wherein the first and second fenestrations are disposed at a location distal to the valve replacement. ### Claim 15 (depends on 13) The endoluminal prosthesis of claim 13 wherein each of the first and second fenestrations are pivotable in any direction away from an axis perpendicular to a longitudinal axis of the prosthesis. ### Claim 16 (depends on 13) The endoluminal prosthesis of claim 13 wherein the valve replacement comprises an artificial valve having a tricuspid shape.