Devices, systems, and methods for endovascular staple and/or prosthesis delivery and implantation

• US 10,194,905 B2
• Filed: 08/24/2016
• Issued: 02/05/2019
• Est. Priority Date: 11/28/2001
• Status: Expired due to Fees

• Current Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Original Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Inventors: Bolduc, Lee, Jen, Jimmy
• Primary Examiner(s): Louis, Richard G
• Application Number:
  US15/246,271
• Publication Number:
  US 20160361058A1
• Time in Patent Office: 895 Days
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 2017/00296 mounted on an endoscope
• CPC Class Codes: A61B 2017/00336 with a protective sleeve, e.g. retractable or slidable
• CPC Class Codes: A61B 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/00734 battery operated
• CPC Class Codes: A61B 2017/0649 Coils or spirals
• CPC Class Codes: A61B 2017/0688 Packages or dispensers for surgical staplers
• CPC Class Codes: A61B 50/30 Containers specially adapted for packaging, protecting, dispensing, collecting or disposing of surgical or diagnostic appliances or instruments for wound clamps A61B17/10; for ligaturing clips A61B17/122; packages or dispensers for surgical gloves or finger-stalls A61B42/40
• CPC Class Codes: A61B 50/3001 for sharps
• CPC Class Codes: A61B 6/481 involving the use of contrast agents
• CPC Class Codes: A61F 2/0095 Packages or dispensers for prostheses or other implants for intraocular lenses A61F2/1691; for dental surgery A61C19/02
• CPC Class Codes: A61F 2/064 with special features to facilitate anastomotic coupling anastomosis of natural blood vessels A61B17/11
• CPC Class Codes: A61F 2/07 Stent-grafts
• CPC Class Codes: A61F 2/852 Two or more distinct overlapping stents
• CPC Class Codes: A61F 2/89 the wire-like elements comprising two or more adjacent rings flexibly connected by separate members
• CPC Class Codes: A61F 2/9517 handle assemblies therefor
• CPC Class Codes: A61F 2/954 for placing stents or stent-grafts in a bifurcation
• CPC Class Codes: A61F 2/966 with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
• CPC Class Codes: A61F 2002/061 provided with means for allowing access to secondary lumens
• CPC Class Codes: A61F 2002/067 : modular
• CPC Class Codes: A61F 2002/075 : the stent being loosely attached to the graft material, e.g. by stitching
• CPC Class Codes: A61F 2002/30617 : Visible markings for adjusting, locating or measuring
• CPC Class Codes: A61F 2002/8486 : provided on at least one of the ends
• CPC Class Codes: A61F 2002/9511 : the retaining means being filaments or wires
• CPC Class Codes: A61F 2220/0066 : stapled
• CPC Class Codes: A61F 2220/0075 : sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2250/0063 : Nested prosthetic parts
• CPC Class Codes: A61F 2250/0097 : Visible markings, e.g. indicia
• CPC Class Codes: A61M 25/0108 : using radio-opaque or ultrasound markers
• CPC Class Codes: A61M 25/0147 : with movable mechanical means, e.g. pull wires
• CPC Class Codes: A61M 25/09 : Guide wires

Abstract

Devices, systems, and methods for implanting expandable prostheses in the body lumens rely on stapling or anchoring the prostheses with separately introduced fasteners. The prostheses may be self-expanding or balloon expandable, and may include a single lumen or more than one lumen. After initial placement, a stapling system is introduced within the expanded prosthesis to deploy a plurality of fasteners to at least one prosthesis end. The stapling system may apply a force to the prosthesis to modify the shape of the prosthesis to conform to the shape of the vessel wall. The stapling system can be deflected in one or more distinct steerable segments. A lumen extension or lumens may be coupled to the prosthesis to extend the reach of the prosthesis within the implantation site. Fasteners may also be applied to the lumen extensions.

Claims

1. A steerable guide catheter comprising:

one and only one guide tube having a length and defining an open interior lumen, the lumen adapted for accommodating passage of an operative endovascular tool, the one guide tube comprising a first steerable segment and a second steerable segment at a distal end region of the one guide tube, and an integrated handle assembly comprising;

a first rotational deflector knob coupled to the first steerable segment of the one guide tube to apply a deflecting force to bend the first steerable segment of the one guide tube, the first rotational deflector knob adapted to bend the first steerable segment in a first articulated position, and a second rotational deflector knob coupled to the second steerable segment of the guide tube to apply a deflecting force to bend the second steerable segment of the one guide tube, the second rotational deflector knob adapted to bend the second steerable segment in a second articulated position, the lumen extending through the first rotational deflector knob and the second rotational deflector knob.

2. A steerable guide catheter according to claim 1:

wherein the second articulated position is different than the first articulated position.

3. A steerable guide catheter according to claim 1:

further including an operative tool that applies one or more fasteners to tissue.

4. The steerable guide catheter of claim 1 wherein the first rotational deflector knob and the second rotational deflector knob are located at opposite ends of the integrated handle assembly.

5. The steerable guide catheter of claim 4 wherein the integrated handle assembly further comprises a control handle between the first rotational deflector knob and the second rotational deflector knob.

6. The steerable guide catheter of claim 1 further comprising:

a first deflecting means directly coupling the first rotational deflector knob to the first steerable segment; and

a second deflecting means directly coupling the second rotational deflector knob to the second steerable segment.

7. The steerable guide catheter of claim 6 wherein the first deflecting means and the second deflecting means are selected from the group consisting of steering wires and pull cords.