| 摘要 |
1. A prosthesis comprising two or more Z stents sutured to a graft comprising a bio-compatible material tube, wherein the two or more Z stents are attached to the inside surface of the bio-compatible material tube and at least one fenestration in the bio-compatible material tube corresponding to an intersecting artery opening. 2. A prosthesis according to claim 1 wherein there are more than two Z stents attached to the bio-compatible material tube. 3. A prosthesis according to claim 1 further including a further Z stent fastened to the bio-compatible material tube and extending proximally from the bio-compatible material tube. 4. A prosthesis according to any one preceding claim wherein at least one of the Z stents has caudally facing barbs thereon. 5. A prosthesis according to claim 3 wherein the proximally extending Z stent has caudally facing barbs thereon. 6. A prosthesis according to any one preceding claim wherein there are two or more fenestrations according to the number of intersecting arteries. 7. A prosthesis according to any one preceding claim wherein the or each fenestration includes one or more radiopaque markers defining a periphery of the fenestration. 8. A prosthesis according to any one preceding claim wherein the distal most of the Z stents includes a loop extending distally of the graft. 9. A prosthesis according to any one preceding claim further including a release mechanism for said prosthesis including one or more trigger wires wherein a portion of the bio-compatible material tube is folded longitudinally with the one or more trigger wires respectively threaded longitudinally through the bio-compatible material tube at the fold to retain the prosthesis in a partially compressed state. 10. A prosthesis according to any one preceding claim wherein at least one of the Z stents includes one or more shortened loops to enable location of the fenestrations as required. 11. The method according to claim 10 wherein there are more than two said Z stents attached to the bio-compatible material tube. 12. The method according to claim 10 wherein there are two or more than two fenestrations according to the number of intersecting arteries. 13. The method according to claim 10 wherein the radiopaque markers are gold or any other bio-compatible material which enables the marker to be visualised by X-ray or other methods. 14. A method for treating arterial disease at an intersection of two arteries, including the steps of: X-raying arteries to be treated so as to accurately determine the position of the intersection of the arteries; customising one or more fenestrations to a prosthesis comprising a selected length of a bio-compatible material tube; attaching radiopaque markers around the or each fenestrations; placing two or more Z stents into said bio-compatible material tube, bends in the Z stents being shortened if necessary in such a way so as not to cover the fenestrations; manually gathering a top Z stent, covering with the top Z stent with a top cap and holding the top cap in place with a trigger wire; stitching a trigger wire through a longitudinal fold in the bio-compatible material tube to narrow the diameter of said graft; thereby providing a customised fenestrated covered graft to be inserted into an artery to be treated. 15. A method as in Claim 14 further including the step of sewing a further Z stents to top ring of said bio-compatible material tube, such that the further Z stent extends proximally from the bio-compatible material tube. 16. The method as in claim 11 wherein the process of insertion of the graft includes the steps of: compressing the graft and placing it into a sheath which fits snugly around said top cap, said prosthesis, the Z stents and an obturator; inserting through a femoral artery in a groin said prosthesis using a delivery device which includes said top cap, said sheath, said obturator and guide wires; withdrawing said sheath to reveal said graft in semi-deployed position; positioning the prosthesis: partially withdrawing said sheath and obturator to enable insertion of angiography catheters and guide wires; inserting said angiography catheters and guide wires through a contralateral groin into the artery to be treated to provide manoeuvrability, and accurate positioning of the graft by positioning right and left angiography catheters and guide wires through the fenestrations into the intersecting arteries; releasing the trigger wire to provide full deployment of the said graft; withdrawing said angiography catheters; pushing up said sheath and obturator through said stent and docking with said top cap and fully withdrawing said delivery device; whereby the said fully deployed stent ensures the flow of blood at the intersection of the arteries to be treated. |
