Patent Publication Number: US-2009234436-A1

Title: Vascular anchor tethering system and method

Description:
BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     The present invention is directed generally to implant systems. 
     2. Description of the Related Art 
     For an implant system sized for insertion within a vascular area there are challenges in positioning and maintaining the implant in a desired location within the vascular area. These challenges can be further increased when the implant is sectioned into portions that need to be positioned relative to one another. Unintended movement of such portions, such as near or inside a heart organ, can lead to misalignment or undesired consequences. 
    
    
     
       BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING(S) 
         FIG. 1  is a perspective-fragmented view of an exemplary vascular area depicted as a bifurcated vasculature to receive a vascular anchoring system disclosed herein. 
         FIG. 1A  is a sectional fragmented view of the bifurcated vasculature of  FIG. 1  taken along the  1 A- 1 A line with fluid flow proceeding from a vascular trunk to a pair of first and second vascular branches. 
         FIG. 1B  is a sectional view of the vascular trunk of the bifurcated vasculature of  FIG. 1  taken along the  1 B- 1 B line. 
         FIG. 2  is a sectional fragmented view of the bifurcated vasculature of  FIG. 1  taken along the  2 - 2  line with fluid flow proceeding from the first and second vascular branches to the vascular trunk. 
         FIG. 3  is a perspective view of an exemplary first of a pair of two anchoring trunk sections of a first anchoring trunk member of the vascular anchoring system. 
         FIG. 4  is a sectional view of the first anchoring trunk section taken along the  4 - 4  line of  FIG. 3  and a sectional view of the bifurcated vasculature taken along the  4 - 4  line of  FIG. 1  with the first anchoring trunk section depicted as being inserted into the vascular trunk of the bifurcated vasculature. 
         FIG. 5  is a sectional view of the first anchoring trunk section taken along the  5 - 5  line of  FIG. 3  and a sectional view of the bifurcated vasculature taken along the  1 B- 1 B line of  FIG. 1  with the first anchoring trunk section depicted as being inserted into the vascular trunk of the bifurcated vasculature. 
         FIG. 6  is a perspective view of an exemplary second of the pair of the two anchoring sections of the first anchoring trunk member of the vascular anchoring system. 
         FIG. 7  is a sectional view of the second anchoring trunk section taken along the  7 - 7  line of  FIG. 6  and a sectional view of the bifurcated vasculature taken along the  4 - 4  line of  FIG. 1  with the second anchoring trunk section depicted as being inserted into the vascular trunk of the bifurcated vasculature. 
         FIG. 8  is a sectional view of the second anchoring trunk section taken along the  8 - 8  line of  FIG. 6  and a sectional view of the bifurcated vasculature taken along the  1 B- 1 B line of  FIG. 1  with the second anchoring trunk section depicted as being inserted into the vascular trunk of the bifurcated vasculature. 
         FIG. 9  is a perspective view of the first anchoring trunk member of the vascular anchoring system as having both the first anchoring trunk section and the second anchoring trunk section forming the first anchoring trunk member. 
         FIG. 10  is a sectional view of the first anchoring trunk member taken along the  10 - 10  line of  FIG. 9  and a sectional view of the bifurcated vasculature taken along the  4 - 4  line of  FIG. 1  with the first anchoring trunk member depicted as being inserted into the vascular trunk of the bifurcated vasculature. 
         FIG. 11  is a sectional view of the first anchoring trunk member taken along the  10 - 10  line of  FIG. 9  and a sectional view of the bifurcated vasculature taken along the  1 B- 1 B line of  FIG. 1  with the first anchoring trunk member depicted as being inserted into the vascular trunk of the bifurcated vasculature. 
         FIG. 12  is a perspective view of the first anchoring trunk member and a first anchoring branch member of the vascular anchoring system. 
         FIG. 13  is a perspective view of the vascular anchoring system showing both the first anchoring branch member and a second anchoring branch member. 
         FIG. 13A  is a top plan view of the vascular anchoring system. 
         FIG. 13B  is a side elevational view of the vascular system. 
         FIG. 14  is a front elevational view of the vascular anchoring system and a fragmented sectional view of the bifurcated vasculature of  FIG. 1  taken along the  1 A- 1 A line with the vascular anchoring system depicted as being inserted into the vascular trunk of the bifurcated vasculature. 
         FIG. 15  is a side elevational view of the vascular anchoring system and a fragmented sectional view of the bifurcated vasculature of  FIG. 1  taken along the  15 - 15  line with the vascular anchoring system depicted as being inserted into the vascular trunk of the bifurcated vasculature. 
         FIG. 16  is a front elevational view of the vascular anchoring system and a fragmented sectional view of the bifurcated vasculature of  FIG. 1  taken along the  1 A- 1 A line with the vascular anchoring system depicted as being inserted into the vascular trunk of the bifurcated vasculature. 
         FIG. 17  is a side elevational view of the vascular anchoring system and a fragmented sectional view of the bifurcated vasculature of  FIG. 1  taken along the  15 - 15  line with the vascular anchoring system depicted as being inserted into the vascular trunk of the bifurcated vasculature. 
         FIG. 18  is a perspective view of a second anchoring trunk member including a first component package. 
         FIG. 18A  is a perspective view of the exemplary second of the pair of the two anchoring sections of the first anchoring trunk member of the vascular anchoring system with the first component package. 
         FIG. 19  is a perspective view of a second vascular anchoring system having the second anchoring trunk member of  FIG. 18  with the first component package. 
         FIG. 20  is a perspective view of a third anchoring trunk member including the first component package and the second component package. 
         FIG. 20A  is a perspective view of the exemplary second of the pair of the two anchoring sections of the first anchoring trunk member of the vascular anchoring system with the first component package and the second component package. 
         FIG. 21A  is a sectional view of the third anchoring trunk member taken along the  21 A- 21 A line of  FIG. 20  and a sectional view of the bifurcated vasculature taken along the  4 - 4  line of  FIG. 1  with the third anchoring trunk member depicted as being inserted into the vascular trunk of the bifurcated vasculature. 
         FIG. 21B  is a sectional view of the third anchoring trunk member taken along the  21 B- 21 B line of  FIG. 20  and a sectional view of the bifurcated vasculature taken along the  1 B- 1 B line of  FIG. 1  with the third anchoring trunk member depicted as being inserted into the vascular trunk of the bifurcated vasculature. 
         FIG. 22  is a perspective view of a third vascular anchoring system having the third anchoring trunk member of  FIG. 20  with the first component package and the second component package. 
         FIG. 23  is a front elevational view of the third vascular anchoring system version. 
         FIG. 24  is a front elevational view of the third vascular anchoring system and a fragmented sectional view of the bifurcated vasculature of  FIG. 1  taken along the  1 A- 1 A line with the third vascular anchoring system depicted as being inserted into the vascular trunk of the bifurcated vasculature. 
         FIG. 25  is a side elevational view of the third vascular anchoring system and a fragmented sectional view of the bifurcated vasculature of  FIG. 1  taken along the  15 - 15  line with the vascular anchoring system depicted as being inserted into the vascular trunk of the bifurcated vasculature. 
         FIG. 26  is a front elevational view of the third vascular anchoring system and a fragmented sectional view of the bifurcated vasculature of  FIG. 1  taken along the  1 A- 1 A line with the third of the vascular anchoring system depicted as being inserted into the vascular trunk of the bifurcated vasculature. 
         FIG. 27  is a side elevational view of the third vascular anchoring system and a fragmented sectional view of the bifurcated vasculature of  FIG. 1  taken along the  15 - 15  line with the third of the vascular anchoring system depicted as being inserted into the vascular trunk of the bifurcated vasculature. 
         FIG. 28  is a sectional fragmented view of the bifurcated vasculature of  FIG. 1  taken along the  1 A- 1 A line and a front elevational fragmented view of a first catheter end external to the bifurcated vasculature with a first end of the deployment tether extending therefrom and a second catheter end inserted into the vascular trunk. 
         FIG. 29  is a sectional view of the second catheter end and a front elevational view of the third vascular anchoring system coupled with a second end of the deployment tether shown as inserted into the second catheter end. 
         FIG. 30  is a sectional fragmented view of the bifurcated vasculature of  FIG. 1  taken along the  1 A- 1 A line and a front elevational fragmented view of the second catheter end inserted into the vascular trunk with a portion of the third vascular anchoring system extending therefrom by a first amount and the first catheter end external to the bifurcated vasculature with the first end of the deployment tether extending therefrom by a first diminished amount. 
         FIG. 31  is a sectional fragmented view of the bifurcated vasculature of  FIG. 1  taken along the  1 A- 1 A line and a front elevational fragmentary view of the second catheter end inserted into the vascular trunk with a portion of the third vascular anchoring system extending therefrom by a second amount and the first catheter end external to the bifurcated vasculature with the first end of the deployment tether extending therefrom by a second diminished amount. 
         FIG. 32  is an enlarged view of the front elevational fragmentary view of the second catheter end with the portion of the third vascular anchoring system extending therefrom by the second amount and the first catheter end with the first end of the deployment tether extending therefrom by the second diminished amount of  FIG. 31 . 
         FIG. 33  is a sectional fragmented view of the bifurcated vasculature of  FIG. 1  taken along the  1 A- 1 A line and a front elevational fragmentary view of the second catheter end inserted into the vascular trunk with the third vascular anchoring system extending therefrom by a fully extended amount and coupled with the second end of the deployment tether extending therefrom by a first extended amount and the first catheter end external to the bifurcated vasculature with the first end of the deployment tether extending therefrom by a third diminished amount. 
         FIG. 34  is an enlarged view of the front elevational fragmentary view of the second catheter end of  FIG. 31  with the third vascular anchoring system fully extended therefrom shown coupled with the second end of the deployment tether extending therefrom. 
         FIG. 35  is an enlarged fragmentary view of the third vascular anchoring system fully extended from the catheter and coupled with the second end of the deployment tether extended from the second catheter end and an enlarged fragmentary view of the first catheter end with the first end of the deployment tether extended therefrom. 
         FIG. 36  is an enlarged fragmentary view of the third vascular anchoring system fully extended from the catheter and partially coupled with the second end of the deployment tether extended from the second catheter end with the deployment tether lock pin member uncoupled from the deployment tether hook member and an enlarged fragmentary view of the first catheter end with the first end of the deployment tether extended therefrom. 
         FIG. 37  is an enlarged fragmentary view of the third vascular anchoring system fully extended from the catheter and uncoupled from the second end of the deployment tether, which is extended from the second catheter end and an enlarged fragmentary view of the first catheter end with the first end of the deployment tether extended therefrom. 
         FIG. 38  is a sectional view of an exemplary heart region as the vascular area with a front elevational view of the third vascular anchoring system fully extended from the catheter into a pulmonary artery, engaging with the associated left and right pulmonary arteries and shown coupled with the deployment tether before being fully deployed. 
         FIG. 39  is a sectional perspective view of a first alternative implementation of the deployment tether to include an alignment conduit. 
         FIG. 40  is an enlarged fragmentary perspective view of the alignment conduit of  FIG. 39  before engagement of the vascular anchoring system. 
         FIG. 41  is an enlarged fragmentary perspective view of the alignment conduit of  FIG. 39  as engaged with the vascular anchoring system. 
         FIG. 42  is a sectional perspective view of an alternative engagement portion of the alignment conduit of  FIG. 39 . 
         FIG. 43  is an enlarged fragmentary perspective view of the alternative engagement portion of  FIG. 42 . 
     
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
     As described herein vascular anchoring systems are used to position an implant in a vascular area such as a bifurcated vasculature with relatively high fluid flow, for instance, in an area of a pulmonary artery with associated left and right pulmonary arteries. 
     As shown in  FIG. 1  an exemplary vascular area is depicted as a bifurcated vasculature  10  to receive versions of the vascular anchoring system disclosed herein. The bifurcated vasculature  10  is shown in  FIG. 1A  has having a vascular trunk  12  that extends longitudinally approximately along a dimensional axis Z and splits into a first vascular branch  14  and a second vascular branch  16 . For illustrative purposes the vascular trunk  12  has been depicted in the Figures including  FIGS. 1A and 1B  with labels as having four distal surface locations of a distal trunk surface portion  17 : a first distal surface location  17   a , a second distal surface location  17   b , a third distal surface location  17   c , and a fourth distal surface location  17   d  and as having four proximate surface locations of a proximate trunk surface portion  18 : a first proximate surface location  18   a , a second proximate surface location  18   b , a third proximate surface location  18   c , and a fourth proximate surface location  18   d , which will be used herein to describe placement of portions of the vascular anchoring systems. 
     The distal trunk surface portion  17  is farther along the dimensional Z-axis from the first vascular branch and the second vascular branch than the proximate trunk surface portion  18 . Those surface locations labeled sharing like ending letters, such as the first distal surface location  17   a  and the first proximate surface location  18   a , are substantially spaced from one another substantially along the longitudinal direction of the dimensional axis Z. 
     The first distal surface location  17   a  is positioned substantially directly across from the third distal surface location  17   c , which have substantially the same longitudinal position along the dimensional Z axis. The second distal surface location  17   b  is positioned substantially directly across from the fourth distal surface location  17   d , which have substantially the same longitudinal position along the dimensional Z-axis. The positions of the second distal surface location  17   b  and the fourth distal surface location  17   d  are farther from the first vascular branch  14  and the second vascular branch  16  along the dimensional Z axis than the positions of the first distal surface location  17   a  and the third distal surface location  17   c  are to the first vascular branch  14  and the second vascular branch  16 . 
     The first proximate surface location  18   a  is positioned substantially directly across from the third proximate surface location  18   c , which have substantially the same longitudinal position along the dimensional Z-axis. The second proximate surface location  18   b  is positioned substantially directly across from the fourth proximate surface location  18   d , which have substantially the same longitudinal position along the dimensional Z-axis. The positions of the second proximate surface location  18   b  and the fourth proximate surface location  18   d  are closer to the first vascular branch  14  and the second vascular branch  16  along the dimensional Z axis than the positions of the first proximate surface location  18   a  and the third proximate surface location  18   c  are to the first vascular branch  14  and the second vascular branch  16 . 
     The first vascular branch  14  is shown in  FIG. 1A  to have a first branch proximate surface  22 , a first branch distal surface  24 , and a first branch interior  26 . The first branch proximate surface  22  is relatively closer along the dimensional axis Z to the vascular trunk  12  than the first branch distal surface  24 . The second vascular branch  16  has a second branch proximate surface  28 , a second branch distal surface  30 , and a second branch interior  32 . The second branch proximate surface  28  is relatively closer along the dimensional axis Z to the vascular trunk  12  than the second branch distal surface  30 . 
     The vascular trunk  12 , the first vascular branch  14 , and the second vascular branch  16  join at a vascular intersection  33 . The vascular intersection  33  has a first proximate intersection surface  34 , a second proximate intersection surface  36 , and a distal intersection surface  38 . Between the vascular trunk  12  and the first vascular branch  14  lays the first proximate intersection surface  34 . Between the vascular trunk  12  and the second vascular branch  16  lays the second proximate intersection surface  36 . Farther from the vascular trunk  12  along the longitudinal dimension Z lays the distal intersection surface  38 . 
     The intersection surfaces serve to bound an intersection  33  that is positioned between the vascular trunk  12  and the first vascular branch  14 , and the second vascular branch  16 . The bifurcated vasculature  10  is shown in  FIG. 1A  as generally having fluid flow from the vascular trunk  12  to the first vascular branch  14  and the second vascular branch  16  with vascular trunk divergent fluid flow  42 , first vascular branch divergent fluid flow  44 , and second vascular branch divergent fluid flow  46 . The bifurcated vasculature  10  is shown in  FIG. 2  as generally having fluid flow from the first vascular branch  14  and the second vascular branch  16  to the vascular trunk  12  with first vascular branch convergent fluid flow  48 , second vascular branch convergent fluid flow  50 , and vascular trunk convergent fluid flow  52 . 
     A first anchoring trunk section  100  is shown in  FIG. 3  as having a first longitudinal member  102  with a first end  102   a  and a second end  102   b  and a second longitudinal member  104  spaced apart in juxtaposition therefrom with a first end  104   a  and a second end  104   b . As shown in  FIG. 3 , both the first longitudinal member  102  and the second longitudinal member  104  extend substantially in the direction of the dimensional axis Z 100 . Extending between the first end  102   a  of the first longitudinal member  102  and the first end  104   a  of the second longitudinal member  104  is a first convex arch  106  with a first apex  106   a . It is an object of this invention that the anchoring trunk section  100  be constructed so that it is flexible and compliant to the vessel wall, so that it neither damages the vessel wall nor restricts natural vessel wall motion. The shape of the trunk section  100  shown in  FIG. 3  is chosen to provide these features. 
     The first apex  106   a  is positioned along the dimensional axis Z 100  farther away from the second end  102   b  of the first longitudinal member  102  and the second end  104   b  of the second longitudinal member  104  than the first end  102   a  of the first longitudinal member is from the second end  102   b  and than the first end  104   a  of the second longitudinal member is from the second end  104   b . Extending between the second end  102   b  of the first longitudinal member  102  and the second end  104   b  of the second longitudinal member  104  is a second convex arch  108  with a second apex  108   a . The second apex  108   a  is positioned along the dimensional axis Z 100  farther away from the first end  102   a  of the first longitudinal member  102  and the first end  104   a  of the second longitudinal member  104  than the second end  102   b  of the first longitudinal member is from the first end  102   a  and than the second end  104   b  of the second longitudinal member is from the first end  104   a.    
     Although the first anchoring trunk section  100  may be used singly or in combination with other components, for illustrative purposes it is described herein in conjunction with other portions of vascular anchoring systems.  FIGS. 4 and 5  depict what the first anchoring trunk section  100  would look like if it were placed alone inside of the vascular trunk  12  in a first position  100   a . As shown in  FIG. 4 , the first longitudinal member  102  and the second longitudinal member  104  extend along the distal trunk surface portion  17  and the proximate trunk surface portion  18 . The second convex arch  108  is shaped to substantially abut adjacent to the vascular trunk  12  extending substantially from the first proximate surface location  18   a  (where the second end  102   b  of the first longitudinal member  102  would be positioned) through the second proximate surface location  18   b  (where the second apex  108   a  would be positioned) on to the third proximate surface location  18   c  (where the second end  104   b  of the second longitudinal member  104  would be positioned). 
     As shown in  FIG. 5 , the first convex arch  106  is shaped to substantially abut adjacent to the vascular trunk  12  extending substantially from the first distal surface location  17   a  (where the first end  102   a  of the first longitudinal member  102  would be positioned) through the second distal surface location  17   b  (where the first apex  106   a  would be positioned) on to the third distal surface location  17   c  (where the first end  104   a  of the second longitudinal member  104  would be positioned). 
     A second anchoring trunk section  110  is shown in  FIG. 6  as having a first longitudinal member  112  with a first end  112   a  and a second end  112   b  and a second longitudinal member  114  spaced apart in juxtaposition therefrom with a first end  114   a  and a second end  114   b . As shown in  FIG. 6 , both the first longitudinal member  112  and the second longitudinal member  114  extend substantially in the same direction as a dimensional axis Z 110 . Extending between the first end  112   a  of the first longitudinal member  112  and the first end  114   a  of the second longitudinal member  114  is a first convex arch  116  with a first apex  116   a . The first apex  116   a  is positioned along the dimensional axis Z 110  farther away from the second end  112   b  of the first longitudinal member  112  and the second end  114   b  of the second longitudinal member  114  than the first end  112   a  of the first longitudinal member is from the second end  112   b  and than the first end  114   a  of the second longitudinal member is from the second end  114   b.    
     Extending between the second end  112   b  of the first longitudinal member  112  and the second end  114   b  of the second longitudinal member  114  is a second convex arch  118  with a second apex  118   a . The second apex  118   a  is positioned along the dimensional axis Z 110  farther away from the first end  112   a  from the first longitudinal member  112  and the first end  114   a  of the second longitudinal member  114  than the second end  112   b  of the first longitudinal member  112  is from the first end  112   a  and the second end  114   b  of the second longitudinal member  114  is from the first end  114   a.    
     Although the second anchoring trunk section  110  may be used singly or in combination with other components, for illustrative purposes it is described herein in conjunction with other portions of vascular anchoring systems.  FIGS. 7 and 8  depict what the second anchoring trunk section  110  would look like if it were placed alone inside of the vascular trunk  12  in a first position  110   a . As shown in  FIG. 7 , the second convex arch  118  is shaped to substantially abut adjacent to the vascular trunk  12  extending substantially from the first proximate surface location  18   a  (where the second end  112   b  of the first longitudinal member  112  would be positioned) through the fourth proximate surface location  18   d  (where the second apex  118   a  would be positioned) on to the third proximate surface location  18   c  (where the second end  114   b  of the second longitudinal member  114  would be positioned). 
     As shown in  FIG. 8 , the first convex arch  116  is shaped to substantially abut adjacent to the vascular trunk  12  extending substantially from the first distal surface location  17   a  (where the first end  112   a  of the first longitudinal member  112  would be positioned) through the fourth distal surface location  17   d  (where the first apex  116   a  would be positioned) on to the third distal surface location  17   c  (where the first end  114   a  of the second longitudinal member  114  would be positioned). 
     As shown in  FIG. 9 , the first anchoring trunk section  100  and the second anchoring trunk section  110  combine to form a first anchoring trunk member  119 . The first longitudinal member  102  of the first anchoring trunk section  100  is integral with the first longitudinal member  112  of the second anchoring trunk section  110 . The first apex  106   a  of the first anchoring trunk section  100  is spaced apart from the first apex  116   a  of the second anchoring trunk section  110 . The second apex  108   a  of the first anchoring trunk section  100  is spaced apart from the second apex  118   a  of the second anchoring trunk section  110 . Aspects include that the anchoring trunk member  119  be self-aligning when it is deployed into the vascular trunk  12 . The anchoring trunk member  119  shown in  FIG. 9  is self-aligning in yaw and pitch. Other aspects include that the anchoring trunk member  119  be self-expanding when it is deployed into the vascular trunk  12 , to accommodate variations in vessel size and shape between individual subjects. Further aspects include that the anchoring trunk member  119  have a clear bore nearly as large as the vascular trunk into which it is deployed, to provide both for unobstructed fluid flow and to allow for passage of catheters, such as Swan-Ganz catheters, or other medical devices, that may be inserted into the vascular trunk. 
     The first anchoring trunk member  119  is shown in  FIG. 10  for illustration purposes as how the first anchoring trunk member would be positioned inside of the vascular trunk  12  in a first position  119   a  as a sectional view of the first anchoring trunk member taken along the  10 - 10  line of  FIG. 9  and a sectional view of the bifurcated vasculature taken along the  4 - 4  line of  FIG. 1 . The first anchoring trunk member  119  is shown in  FIG. 11  for illustration purposes as how the first anchoring trunk member would be positioned inside of the vascular trunk  12  in the first position  119   a  as a sectional view of the first anchoring trunk member taken along the  11 - 11  line of  FIG. 9  and a sectional view of the bifurcated vasculature taken along the  1 B- 1 B line of  FIG. 1 . 
     The first anchoring trunk member  119  is shown in  FIG. 12  as integrated with a first anchoring branch member  120 . The first anchoring branch member  120  has an end portion  120   a , a first saddle side portion  120   b , a second saddle side portion  120   c , a first open side portion  120   d , a second open side portion  120   e , a first open end portion  120   f , and a second open end portion  120   g . The depicted first anchoring branch  120  is constructed as a frame structure to include the saddle end portion  120   a , the first saddle side portion  120   b , and the second saddle side portion  120   c , which are integrally formed as a saddle-frame portion  120   h  shaped like an outline of a portion of a saddle surface of negative Gaussian curvature. The first anchoring trunk member  119  can stabilize an alignment with a vascular trunk or other such trunk for yaw and pitch movements, but a branch member, such as the first anchoring branch member  120 , is needed for stabilizing alignment with a vascular trunk or other trunk for roll movements. 
     The first open side portion  120   d  extends from the first saddle side portion  120   b  to couple with the second convex arch  108  through the first open end portion  120   f  and thereby couples with the first longitudinal member  102  of the first anchoring trunk section  100 . The second open side portion  120   e  extends from the second saddle side portion  120   c  to couple with the second convex arch  118  through the second open end portion  120   g  and thereby couples with the first longitudinal member  112  of the second anchoring trunk section  110 . 
     A first vascular anchoring system  121  is shown in  FIGS. 13A and 13B  and better shown in  FIG. 13  as having the first anchoring trunk member  119  integrated with the first anchoring branch member  120  and a second anchoring branch member  122 . The second anchoring branch member  122  has an end portion  122   a , a first saddle side portion  122   b , a second saddle side portion  122   c , a first open side portion  122   d , a second open side portion  122   e , a first open end portion  122   f , and a second open end portion  122   g . The depicted first anchoring branch  122  is constructed as a frame structure to include the saddle end portion  122   a , the first saddle side portion  122   b , and the second saddle side portion  122   c , which are integrally formed as a saddle-frame portion  122   h  shaped like an outline of a portion of a saddle surface of negative Gaussian curvature. Aspects include that the anchoring trunk member  121  be self-aligning when it is deployed into the vascular trunk  12 . The anchoring trunk member  121  shown in  FIG. 13  is self-aligning in yaw and pitch as a result of its anchoring trunk sections  100  and  110 , and is self-aligning in roll and in axial location within the vascular trunk  12  as a result of its anchoring branch members  120  and  122 . 
     The first open side portion  122   d  extends from the first saddle side portion  122   b  to couple with the second convex arch  108  through the first open end portion  122   f  and thereby couples with the second longitudinal member  104  of the first anchoring trunk section  100 . The second open side portion  120   e  extends from the second saddle side portion  122   c  to couple with the second convex arch  118  through the second open end portion  122   g  and thereby couples with the second longitudinal member  114  of the second anchoring trunk section  110 . 
     The first vascular anchoring system  121  is shown in  FIGS. 14 and 15  being located in a first position  121   a  within the bifurcated vasculature  10 . Fluid flow in the bifurcated vasculature  10  does not substantially effect positioning of the first vascular anchoring system  121  so has not been depicted in  FIG. 14 ,  FIG. 15 , and following. The first anchoring branch member  120  is located generally within the first branch interior  26  of the first vascular branch  14 . The saddle end portion  120   a  and parts of the first saddle side portion  120   b  and the second saddle side portion  120   c  of the saddle frame portion  120   h  of the second anchoring branch member  120  is adjacent the first branch proximate surface  22  of the first vascular branch  14 . 
     In the first position  121   a  of the first vascular anchoring system  121 , the first anchoring trunk member  119  is located in the first position  119   a . The first anchoring branch member  120  is located generally within the first branch interior  26  of the first vascular branch  14 . The saddle end portion  120   a  and parts of the first saddle side portion  120   b  and the second saddle side portion  120   c  of the saddle frame portion  120   h  of the second anchoring branch member  120  is adjacent the first branch proximate surface  22  of the first vascular branch  14 . 
     The second anchoring branch member  122  is located generally within the second branch interior  32  of the second vascular branch  16 . The saddle end portion  122   a  and parts of the first saddle side portion  122   b  and the second saddle side portion  122   c  of the saddle frame portion  122   h  of the second anchoring branch member  122  is adjacent the second branch proximate surface  28  of the second vascular branch  16 . 
     The first vascular anchoring system  121  is shown in  FIGS. 16 and 17  as being located in a second position  121   b  within the bifurcated vasculature  10 , which may be different than the first position  121   a  due to size differences between particular instances of the bifurcated vasculature  10  or size differences between particular instances of the first vascular anchoring system  121 . In the second position  121   b  of the first vascular anchoring system  121 , the first anchoring trunk member  119  is shifted slightly relative to the first position  119   a  to be partially positioned into the intersection  33  of the bifurcated vasculature  10 . The first saddle side portion  120   b  and the second saddle side portion  120   c  of the first anchoring branch member  120  and the first saddle side portion  122   b  and the second saddle side portion  122   c  of the second anchoring branch member  122  are shown as touching the first branch distal surface  24  and the second branch distal surface  30 , respectively. 
     A second anchoring trunk member  123  is shown in  FIG. 18  as having a first component package  124  with a first elongated enclosure  126  having a first attachment point  126   a , a second attachment point  126   b , a third attachment point  126   c , a fourth attachment point  126   d , an outward facing exterior surface  126   e , and an inward facing exterior surface  126   f . For the second anchoring trunk member  123 , the first longitudinal member  102  of the first anchoring trunk section  100  engages with the first elongated enclosure  126  at the first attachment point  126   a  and the third attachment point  126   c  near the first end  102   a  and the second end  102   b , respectively. In some implementations, the first longitudinal member  102  can extend the length of the first elongated enclosure  126  whereas in other implementations, the first longitudinal member  102  can include two pieces with the first elongated enclosure extending therebetween. Some implementations only use a portion of the second anchoring trunk member  123  as shown in  FIG. 18A  having the exemplary second of the pair of the two anchoring sections of the first anchoring trunk member  119  and the first component package  124 . 
     The first longitudinal member  112  of the second anchoring trunk section  110  engages with the first elongated enclosure  126  at the second attachment point  126   b  and the fourth attachment point  126   d  near the first end  112   a  and the second end  112   b , respectively. In some implementations, the first longitudinal member  112  can extend the length of the first elongated enclosure  126  whereas in other implementations, the first longitudinal member  112  can include two pieces with the first elongated enclosure extending therebetween. The second anchoring trunk member  123  is shown in  FIG. 19  as being integrated with the first anchoring branch member  120  and the second anchoring branch member  122  as a second vascular anchoring system  127  in a manner similar to that described above for the first vascular anchoring system  121 . 
     A third anchoring trunk member  128  is shown in  FIG. 20  as having the first component package  124  and a second component package  129  with a second elongated enclosure  130  having a first attachment point  130   a , a second attachment point  130   b , a third attachment point  130   c , and a fourth attachment point  130   d , an outward facing exterior surface  130   e , and an inward facing exterior surface  130   f . For the third anchoring trunk member  128 , the second longitudinal member  104  of the first anchoring trunk section  100  engages with the second elongated enclosure  130  at the first attachment point  130   a  and the third attachment point  130   c  near the first end  104   a  and the second end  104   b , respectively. Some implementations only use a portion of the third anchoring trunk member  128  as shown in  FIG. 20A  having the exemplary second of the pair of the two anchoring sections of the first anchoring trunk member  119  and the first component package  124  and the second component package  129 . 
     In some implementations, the second longitudinal member  104  can extend the length of the second elongated enclosure  130  whereas in other implementations, the second longitudinal member  104  can include two pieces with the second elongated enclosure extending therebetween. The second longitudinal member  114  of the second anchoring trunk section  110  engages with the second elongated enclosure  130  at the second attachment point  130   b  and the fourth attachment point  130   d  near the first end  114   a  and the second end  114   b , respectively. In some implementations, the second longitudinal member  104  can extend the length of the second elongated enclosure  130  whereas in other implementations, the second longitudinal member  104  can include two pieces with the second elongated enclosure extending therebetween. 
     The third anchoring trunk member  128  is shown in  FIG. 21A  for illustration purposes as how the first anchoring trunk member would be positioned inside of the vascular trunk  12  in a first position  128   a  as a sectional view of the third anchoring trunk member taken along the  21 A- 21 A line of  FIG. 20  and a sectional view of the bifurcated vasculature taken along the  4 - 4  line of  FIG. 1 . As shown in  FIG. 21A , portions of the first longitudinal member  102  and the second longitudinal member  104  of the of the first anchoring trunk section  100 , portions of the first longitudinal member  112  and the second longitudinal member  114  of the second anchoring trunk section  110 , the outward surface  126   e  of the first elongated enclosure  126 , and the outward surface  130   e  of the second elongated enclosure  126  extend along the distal trunk surface portion  17  and the proximate trunk surface portion  18 . The second convex arch  118  is shaped to substantially abut adjacent to the vascular trunk  12  extending substantially from the first proximate surface location  18   a  (where the second end  112   b  of the first longitudinal member  112  would be positioned) through the fourth proximate surface location  18   d  (where the second apex  118   a  would be positioned) on to the third proximate surface location  18   c  (where the second end  114   b  of the second longitudinal member  114  would be positioned). 
     The third anchoring trunk member  128  is shown in  FIG. 21B  for illustration purposes as how the first anchoring trunk member would be positioned inside of the vascular trunk  12  in the first position  128   a  as a sectional view of the first anchoring trunk member taken along the  21 B- 21 B line of  FIG. 20  and a sectional view of the bifurcated vasculature taken along the  1 B- 1 B line of  FIG. 1 . As shown in  FIG. 21B , the first convex arch  116  is shaped to substantially abut adjacent to the vascular trunk  12  extending substantially from the first distal surface location  17   a  (where the first end  112   a  of the first longitudinal member  112  would be positioned) through the fourth distal surface location  17   d  (where the first apex  116   a  would be positioned) on to the third distal surface location  17   c  (where the first end  114   a  of the second longitudinal member  114  would be positioned). 
     The third anchoring trunk member  128  is shown in  FIGS. 22 and 23  as being integrated with the first anchoring branch member  120  and the second anchoring branch member  122  as a third vascular anchoring system  131  in a manner similar to the first vascular anchoring system  127 . 
     The third vascular anchoring system  131  is shown in  FIGS. 24 and 25  being located in a first position  131   a  within the bifurcated vasculature  10 . Fluid flow in the bifurcated vasculature  10  does not substantially effect positioning of the third vascular anchoring system  131  so has not been depicted in  FIG. 24 ,  FIG. 25 , and following. The first anchoring branch member  120  is located generally within the first branch interior  26  of the first vascular branch  14 . The saddle end portion  120   a  and parts of the first saddle side portion  120   b  and the second saddle side portion  120   c  of the saddle frame portion  120   h  of the second anchoring branch member  120  is adjacent the first branch proximate surface  22  of the first vascular branch  14 . 
     In the first position  131   a  of the third vascular anchoring system  131 , the third anchoring trunk member  128  is located in the first position  128   a . The first anchoring branch member  120  is located generally within the first branch interior  26  of the first vascular branch  14 . The saddle end portion  120   a  and parts of the first saddle side portion  120   b  and the second saddle side portion  120   c  of the saddle frame portion  120   h  of the second anchoring branch member  120  is adjacent the first branch proximate surface  22  of the first vascular branch  14 . 
     The second anchoring branch member  122  is located generally within the second branch interior  32  of the second vascular branch  16 . The saddle end portion  122   a  and parts of the first saddle side portion  122   b  and the second saddle side portion  122   c  of the saddle frame portion  122   h  of the second anchoring branch member  122  is adjacent the second branch proximate surface  28  of the second vascular branch  16 . 
     The third vascular anchoring system  131  is shown in  FIGS. 26 and 27  as being located in a second position  131   b  within the bifurcated vasculature  10 , which may be different than the first position  131   a  due to size differences between particular instances of the bifurcated vasculature  10  or size differences between particular instances of the first vascular anchoring system  131 . In the second position  131   b  of the third vascular anchoring system  131 , the third anchoring trunk member  128  is shifted slightly relative to the first position  128   a  to be partially positioned into the intersection  33  of the bifurcated vasculature  10 . The first saddle side portion  120   b  and the second saddle side portion  120   c  of the first anchoring branch member  120  and the first saddle side portion  122   b  and the second saddle side portion  122   c  of the second anchoring branch member  122  are shown as touching the first branch distal surface  24  and the second branch distal surface  30 , respectively. 
     A catheter  132  with a first end  132   a  and a second end  132   b  is shown in  FIG. 28  with the second end  132   b  being inserted into the vascular trunk  12  of the bifurcated vasculature  10 . The first end  132   a  of the catheter  132  is shown with a first end  134   a  of a deployment tether  134  protruding therefrom. The deployment tether  134  includes a pinning member  136  with a first end  136   a  and a hooking member  138  with a first end  138   a . The first end  136   a  of the pinning member  136  and the first end  138   a  of the hooking member  138  are depicted as comprising the first end  134   a  of the deployment tether  134 . The pinning member  136  and the hooking member  138  can be made of a double-wire construction such as depicted. A clamp  140  or other device can be used to couple the pinning member  136  and the hooking member  138  together, as shown, when the catheter  132  is being inserted into the vascular trunk  12 . Aspects include that the pinning member  136  and the hooking member  138  function to provide the operator with complete control over the axial and roll positions of the vascular anchoring system relative to the catheter tip  132   b . The catheter tip  132   b  provides yaw and pitch control of the vascular anchoring system relative to the catheter  132  axis. The combined degree of control over the vascular anchoring system results in a deployment that is largely unaffected by the blood flowing past the device in the vascular trunk  12 . 
     A second end  134   b  of the deployment tether  134  is shown inside a portion of the catheter  132  at the second end  132   b  in  FIG. 29  as having a second end  136   b  of the pinning member  136  and a second end  138   b  of the hooking member  138 , which are depicted to couple with the third vascular anchoring system  131 . Although the third vascular anchoring system  131  is depicted as being deployed by the catheter  132 , the catheter  132  can similarly deploy other versions, such as the first vascular anchoring system  121  and the second vascular anchoring system  127 . 
     Once the catheter  132  is positioned inside of the vascular trunk  12 , the third vascular anchoring system  131  can be deployed into the bifurcated vasculature  10 . A partial stage of deployment is shown in  FIG. 30  having the first end  134   a  of the deployment tether  134  being pushed a first amount into the first catheter end  132   a  resulting in the first anchoring branch member  120  and the second anchoring branch member  122  being fully extended and the third anchoring trunk member  128  partially extended from the second catheter end  132   b  into the vascular trunk  12 . The third vascular anchoring system  131  is shown in  FIGS. 31 and 32  as being further deployed by the first end  134   a  of the deployment tether  134  being pushed a second amount greater than the first amount into the first catheter end  132   a  resulting in further extending of the third vascular anchoring system  131  from the second catheter end  132   b  with portions of the first component package  124  and the second component package  129  having exited from the catheter  132 . 
     The third vascular anchoring system  131  is shown in  FIGS. 33-35  as being further deployed by the first end  134   a  of the deployment tether  134  being pushed a third amount greater than the second amount into the first catheter end  132   a  resulting in the third vascular anchoring system  131  being fully extended from the second catheter end  132   b  into the bifurcated vasculature  10 .  FIG. 35  also better shows the second end  136   b  of the hooking member  136  having a hook  138   c  with an eyelet  138   d  that the second end  136   b  of the pinning member  136  extends therethrough to couple the second end of the pinning member to the second end of the hooking member thereby locking the coupling of the hook of the hooking member with the loop  116   b  of the first convex arch  116  of the second trunk section  110  of the third anchoring trunk member  128  of the third vascular anchoring system  131 . 
     Once the third vascular anchoring system  131  is fully extended from the catheter  132 , the clamp  140  is opened thereby uncoupling the pinning member  136  from the hooking member  138 . The first end  136   a  of the pinning member  136  can then be pulled back away from the first end  132   a  of the catheter  132  thereby moving the second end  136   b  of the pinning member  136  out of the eyelet  138   d  of the hook  138   c  and unlocking the coupling of the hook with the loop as shown in  FIG. 36 . The hook  138   c  of the hooking member  138  can then be unhooked from the loop  116   b  of the third anchoring trunk member  128  to uncouple the third vascular anchoring system  131  from the deployment tether  134  as shown in  FIG. 37 . With the deployment tether  134  uncoupled from the third vascular anchoring system  131 , the catheter  132  can be removed from the bifurcated vasculature  10  as shown in  FIGS. 24-27 . 
     An exemplary implementation of the third vascular anchoring system  131  is shown in  FIG. 38  where the catheter  132  has been inserted into a pulmonary artery as the vascular trunk  12 . The third vascular anchoring system  131  is shown engaging with the pulmonary artery as the vascular trunk  12 , the left pulmonary artery of the heart as the first vascular branch  14  and the right pulmonary artery of the heart as the second vascular branch  16 . 
     A first alternative implementation of the deployment tether  134  is shown being positioned inside of an alignment conduit  150 , which includes a straight portion  152 , a flex portion  154 , and an engagement portion  156  having notches  158 . In some implementations the straight portion  152  and the flex portion  154  are formed from a common tube in which a portion of the tube is further processed to result in the flex portion such as through molding, crumpling, or other. Alternatively, the flex portion  154  can be formed from a helical metal wire winding such as with 300 series stainless steel. The coil wire for implementations of the flex portion  154  can be round or flat depending upon the bending characteristics desired for the flex portion. 
     The engagement portion  156  can also be made from a stainless steel, such as 300 series stainless, and be joined to the flex portion by laser welding. The notches  158 , better shown in  FIG. 40 , are used to engage the engagement portion  156  of the alignment conduit  150  with the third anchoring trunk member  128  as shown in  FIG. 41 . Before engagement of the notches  158  with the third anchoring trunk member  128 , some versions of the flex portion  154  can be rather limp, but with engagement, a certain amount of rigidity is imparted by the deployment tether  134  to the alignment conduit  150  in general and the flex portion in particular so that anchoring trunk member can be rotated about an axis  159  positioned coaxial with the alignment conduit. The capability to rotate the third anchoring trunk member  128  about the axis  159  can assist in properly placing the third anchoring member inside of the bifurcated vasculature  10 . Rotational alignment could be performed through the aid of visualization with fluoroscopy. 
     An alternative engagement portion  160  of the alignment conduit  150  is shown in  FIG. 42  to include a first aperture  162  with the pinning member  136  therethrough and a second aperture  164  with the hooking member  138  therethrough to provide engagement of the alignment conduit  150  with the third anchoring trunk member  128  when the deployment tether  134  is engaged with the third anchoring trunk member. 
     From the foregoing it will be appreciated that, although specific embodiments of the invention have been described herein for purposes of illustration, various modifications may be made without deviating from the spirit and scope of the invention. For instance, the members, sections, and portions of the vascular anchoring systems can be formed as a multi-piece construction or as a single integrated piece construction. In some implementations, the vascular anchoring systems, including trunk member portions and tether portions, can be formed from a nitinol alloy wire as a wire frame structure whereas other implementations can use other metal alloys, polymeric materials, and/or radiopacifying material. If a radiopacifying material is used it can be from gold, platinum, silver, tantalum, iridium, rhodium, and mixtures and alloys thereof. In some implementations, the radiopacifying material is one component of a mixture containing a polymer. Uses of a radiopacifying material can include positioning a radiopaque marker band on a tether wire for identification and visualization of the tether wire through x-ray techniques. 
     It is know that the large arteries have two distinct interrelated major functions including a low resistance blood distribution conduit to the peripheral organs, named conduit function, and a smoothing of pressure and flow pulsatility, in order to transform it into an almost continuous arteriolo-capillary flow and pressure, named the buffer function. Implementations are made to be highly resilient and compliant to accommodate a wide range of sizes of patients without resorting to models of varying sizes and to allow for size change of the vasculature since the pulmonary artery distends significantly between systole and diastole due in part to the buffer function described above. Just as the vessel wall is compliant so that it can store some energy from the heart and then sustain blood flow between heart contractions, implementations are also highly compliant, so that it does not disrupt this normal function of the vessel wall. 
     If instead the vessel wall is made stiffer by implanting other than highly compliant implementations, it is possibly that a patient&#39;s heart disease may be made worse through implantation of the implementations because the heart will have to contract harder and faster to pump the same amount of blood with less sustained flow between contractions. In this sense implementations are a sort of opposite in a sense to a conventional stent since an objective of a stent is to hold a vessel open, a stent is not high compliant but instead rather stiff to eliminate a good portion of vessel wall motion. In contrast to a stent, each of the implementations is highly compliant to maintain normal motion and buffer function of a vessel in which the implementation is implant. Furthermore, some portions of the vascular anchoring systems were described as using arches; however, other shaped members can be used instead. As shown, in its expanded state, the trunk member of the anchoring system can have a clear bore that allows for free passage of catheters and other medical devices to be inserted into or through the vascular trunk. Accordingly, the invention is not limited except as by the appended claims.