MEDICAL GRAFTING METHODS AND APPARATUS

• US 20010041931A1
• Filed: 05/28/1999
• Published: 11/15/2001
• Est. Priority Date: 11/07/1996
• Status: Active Grant

• Current Assignee: St Jude Medical ATG Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Robert R. Jackson
• Inventors: SULLIVAN, DANIEL J., MAZZOCCHI, RUDY, BACHINSKI, THOMAS J., GOLDSTEEN, DAVID S.
• Granted Patent: US 6,302,905 B1
• Time in Patent Office: Days
• US Class Current: 623/1.23
• CPC Class Codes: A61B 1/0058 using shape-memory elements
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 17/221 Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions surgical snare instruments A61B17/32056
• CPC Class Codes: A61B 17/32056 Surgical snare instruments for removing or smashing calculi A61B2017/2212; tonsillotomes A61B17/26
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/1107 for blood vessels
• CPC Class Codes: A61B 2017/1135 End-to-side connections, e.g. T- or Y-connections Y-shaped blood vessel prostheses A61F2002/065
• CPC Class Codes: A61B 2017/1139 Side-to-side connections, e.g. shunt or X-connections
• CPC Class Codes: A61B 2017/2212 having a closed distal end, e.g. a loop
• CPC Class Codes: A61B 2017/2939 Details of linkages or pivot points
• CPC Class Codes: A61B 2090/306 using optical fibres
• CPC Class Codes: A61B 2090/3614 using optical fibre
• CPC Class Codes: A61F 2/06 Blood vessels
• 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 2/90 characterised by a net-like or mesh-like structure
• CPC Class Codes: A61F 2/95 Instruments specially adapted for placement or removal of stents or stent-grafts
• CPC Class Codes: A61F 2/954 for placing stents or stent-grafts in a bifurcation
• CPC Class Codes: A61F 2/958 : Inflatable balloons for placing stents or stent-grafts
• CPC Class Codes: A61F 2002/061 : provided with means for allowing access to secondary lumens
• CPC Class Codes: A61F 2002/065 : Y-shaped blood vessels
• CPC Class Codes: A61F 2002/3008 : radio-opaque, e.g. radio-opaque markers
• CPC Class Codes: A61F 2002/30092 : using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2002/826 : more than one stent being applied sequentially
• CPC Class Codes: A61F 2002/8486 : provided on at least one of the ends
• CPC Class Codes: A61F 2210/0014 : using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2240/001 : Designing or manufacturing processes
• CPC Class Codes: A61F 2250/0098 : radio-opaque, e.g. radio-opaque markers
• CPC Class Codes: A61M 2025/0293 : Catheter, guide wire or the like with means for holding, centering, anchoring or frictionally engaging the device within an artificial lumen, e.g. tube natural lumen, e.g. vessels A61M25/04
• CPC Class Codes: A61M 2025/1052 : for temporarily occluding a vessel for isolating a sector
• CPC Class Codes: A61M 25/0041 : pre-formed, e.g. specially adapted to fit with the anatomy of body channels urethral catheters A61F2/04
• CPC Class Codes: A61M 25/0108 : using radio-opaque or ultrasound markers
• CPC Class Codes: A61M 25/0133 : Tip steering devices
• CPC Class Codes: A61M 25/0147 : with movable mechanical means, e.g. pull wires
• CPC Class Codes: A61M 25/0152 : with pre-shaped mechanisms, e.g. pre-shaped stylets or pre-shaped outer tubes
• CPC Class Codes: A61M 25/04 : in the body, e.g. expansible A61M25/10, A61M16/0488 take precedence
• CPC Class Codes: A61M 25/09025 : with sliding mandrils
• CPC Class Codes: Y10S 623/903 : Blood vessel

Abstract

Methods and apparatus for making an anastomotic connection between tubular fluid conduits in a patient. A connector may provided having an annular structure configured for placement partially within one of the tubular fluid conduits and for annular enlargement by expansion of an expandable structure positioned within an interior portion of the connector. The connector may be configured for plastic annular enlargement, and have members with free end portions that are configured to penetrate a wall of the tubular fluid conduits at locations that are annularly spaced around the connection. A portion of the connector may be selectively deflected radially out from a remainder of the connector in response to expansion of the expandable structure disposed inside the connector. An axial portion of the connector may be adapted for insertion within an axial end of a first one of the tubular fluid conduits, and an axial portion of the connector may be adapted for insertion through an opening in a wall of a second one of the tubular fluid conduits.

Claims

1. A connector for use in making an anastomotic connection between tubular fluid conduits in a patient comprising an annular structure configured for placement partially within one of the tubular fluid conduits and for annular enlargement by expansion of an expandable structure positioned within an interior portion of the connector.

2. The connector defined in

claim 1

, comprising members having free end portions that are configured to penetrate a wall of a first one of the tubular fluid conduits at locations that are annularly spaced around the connection.

3. The connector defined in

claim 1

, wherein the free end portions of the members are configured to penetrate a wall of a second one of the tubular fluid conduits at locations that are annularly spaced around the connection.

4. The connector defined in

claim 1

wherein the connector is configured for plastic annular enlargement.

5. The connector defined in

claim 1

, wherein a portion of the connector is configured for selective deflection radially out from a remainder of the connector in response to expansion of the expandable structure disposed inside the connector.

6. The connector defined in

claim 1

, wherein an axial portion of the connector is adapted for insertion within an axial end of a first one of the tubular fluid conduits, and an axial portion of the connector is adapted for insertion through an opening in a wall of a second one of the tubular fluid conduits.

7. The connector defined in

claim 6

, wherein the axial portion of the connector adapted for insertion through an opening in the wall of the second one tubular fluid conduit is further adapted for selective deflection radially out from a remainder of the connector in response to expansion of the expandable structure disposed inside the connector.

8. The connector defined in

claim 7

, wherein the portions of the connector are configured to resist withdrawal from the side wall of the at least one tubular body fluid conduit after the deflection radially out from a remainder of the connector.

9. Apparatus for inserting a connector to make a connection between tubular fluid conduits in a patient comprising:

the connector as defined in

claim 1

; and

a radially expandable structure configured for disposition within the interior portion of the connector.

10. The apparatus defined in

claim 9

, wherein the expandable structure is adapted for passage into and along a lumen of the patient'"'"'s tubular fluid conduit.

11. The apparatus defined in

claim 9

, wherein the expandable structure is configured for control remotely from outside the patient'"'"'s body.

12. The apparatus defined in

claim 8

, wherein the radially expandable structure comprises an inflatable annular balloon portion.

13. The apparatus defined in

claim 10

further comprising:

a longitudinal guide structure insertable longitudinally into and along the first tubular fluid conduit and having an end portion insertable into an opening in the second tubular fluid conduit.

14. The apparatus defined in

claim 13

wherein the expandable structure defines an axial lumen therethrough to pass the expandable structure coaxially over the longitudinal structure.

15. The apparatus defined in

claim 10

further comprising:

a tubular member configured to annularly surround a portion of the connector.

16. The method defined in

claim 15

wherein the tubular member is further configured for reciprocation axially with respect to the connector.

17. A method for making an anastomotic connection between a tubular fluid conduit and a patient'"'"'s tubular body structure, comprising:

providing a connector having an annular structure configured for annular enlargement;

positioning an axial portion of the connector in the tubular fluid conduit and an axial portion of the connector in the tubular body structure; and

enlarging the connector with an expandable structure disposed within an interior portion of the connector.

18. The method defined in

claim 17

, wherein the step of providing a connector further comprises providing free end portions on the connector, the method further comprising:

penetrating a wall of the tubular fluid conduit with the free end portions at locations on the tubular fluid conduit that are annularly spaced around the connection.

19. The method defined in

claim 17

, wherein the step of providing a connector further comprises providing free end portions on the connector, the method further comprising:

penetrating a wall of the tubular body structure with the free end portions at locations on the tubular body structure that are annularly spaced around the connection.

20. The method defined in

claim 17

, wherein the step of enlarging the connector comprises plastically annularly enlarging the connector.

21. The method defined in

claim 17

, wherein the step of enlarging the connector comprises selectively radially deflecting out a portion of the connector from a remainder of the connector.

22. The method defined in

claim 17

, wherein the step of positioning an axial portion of the connector in the tubular fluid conduit and an axial portion of the connector in the tubular body structure comprises inserting an axial portion of the connector within an axial end of the tubular fluid conduits, and inserting an axial portion of the connector through an opening in a wall of tubular body structure.

23. The method defined in

claim 17

, further comprising:

before the step of positioning an axial portion of the connector in the tubular fluid conduit and an axial portion of the connector in the tubular body structure, passing the tubular fluid conduit into and along a lumen of the tubular body structure.

24. The method defined in

claim 17

, wherein the step of enlarging the connector with an expandable structure disposed within an interior portion of the connector comprises remotely controlling the expandable structure from outside the patient'"'"'s body.

25. The method defined in

claim 17

, further comprising:

before the step of enlarging the connector with an expandable structure disposed within an interior portion of the connector, passing a portion of the expandable structure into and along a lumen of the tubular body structure to a location within the interior portion of the connector.

26. The method defined in

claim 25

, further comprising:

before the step of passing a portion of the expandable structure into and along a lumen of the tubular body structure, inserting a longitudinal guide structure longitudinally into and along the tubular fluid conduit and further into an opening in the tubular body structure.

27. The method defined in

claim 26

, wherein the expandable structure defines a lumen extending axially therethrough, and wherein the step of passing a portion of the expandable structure into and along a lumen of the tubular body structure comprises passing the expandable structure coaxially over the longitudinal structure.