Percutaneous bypass graft and securing system
First Claim
1. A system for implanting a bypass graft, including:
- a tissue dilating member having at its distal end a tissue dilating tip that converges in a distal direction;
a tissue puncturing tool supported within the dilating member and extending in the distal direction from the dilating tip, said tool adapted to puncture a tissue wall to form an orifice enlargeable by the dilating tip; and
a graft comprising a substantially fluid impervious graft wall with first, second and third spaced apart regions of the wall having respective first, second and third openings formed through the graft wall;
wherein the graft is adapted to be removably mounted on the dilating member in which the dilating member extends through the first and third openings, with the first opening disposed near the dilating tip and the third opening disposed proximally of the first opening so to enable use of the dilating member to insert the first region of the graft wall into a first orifice in the tissue wall for fixation of the first region therein; and
wherein the graft further is slideable relative to the dilating member to permit a proximal withdrawal of the dilating member from the first region after said fixation, and further to allow an insertion of the dilating member into the second opening for securing the second region of the graft wall within a second orifice in the tissue wall whereby the graft provides a fluid flow conduit between the first orifice and the second orifice; and
a closure mechanism for closing the third opening, following withdrawal of the dilating member from the graft.
4 Assignments
0 Petitions
Accused Products
Abstract
A bypass graft incorporates fixation mechanisms at its opposite ends, for securing these ends to different locations along a blood vessel, or alternatively to different locations wherein one of the locations is a different vessel or an organ defining a cavity. Mechanical fixation features such as collets or grommets can be employed, enhanced by delivery of an electrical current sufficient to heat surrounding tissue to form a thermal bond. A graft deployment system includes a tissue dilator and a needle for perforating tissue, mounted coaxially within the dilator. Intralumenal systems further include a catheter for containing the dilator.
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Citations
67 Claims
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1. A system for implanting a bypass graft, including:
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a tissue dilating member having at its distal end a tissue dilating tip that converges in a distal direction;
a tissue puncturing tool supported within the dilating member and extending in the distal direction from the dilating tip, said tool adapted to puncture a tissue wall to form an orifice enlargeable by the dilating tip; and
a graft comprising a substantially fluid impervious graft wall with first, second and third spaced apart regions of the wall having respective first, second and third openings formed through the graft wall;
wherein the graft is adapted to be removably mounted on the dilating member in which the dilating member extends through the first and third openings, with the first opening disposed near the dilating tip and the third opening disposed proximally of the first opening so to enable use of the dilating member to insert the first region of the graft wall into a first orifice in the tissue wall for fixation of the first region therein; and
wherein the graft further is slideable relative to the dilating member to permit a proximal withdrawal of the dilating member from the first region after said fixation, and further to allow an insertion of the dilating member into the second opening for securing the second region of the graft wall within a second orifice in the tissue wall whereby the graft provides a fluid flow conduit between the first orifice and the second orifice; and
a closure mechanism for closing the third opening, following withdrawal of the dilating member from the graft. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. A system for deploying a bypass graft, comprising:
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an elongate and flexible carrier having a proximal end and a distal end, insertable by the distal end for intralumenal movement toward a selected site along a body lumen while the proximal end remains outside of the body;
a tissue perforating mechanism proximate the distal end, positionable at a first location near the selected site and operable from the proximal end of the carrier to form a first opening through tissue at the first location, and further positionable at a second location near the selected site and operable to form a second opening through tissue at the second location;
a graft guide supported by the carrier and disposed near said distal end and movable into a guiding position in which the graft guide extends from the first location through the first opening to the second location and through the second opening;
a tubular graft adapted to be mounted to the carrier for movement along the carrier; and
a graft controller operable to move the graft, when so mounted, distally along the carrier toward the graft guide and distally along the graft guide when the guide is in the guiding position to a bypass location in which the graft extends from the first location to the second location and further extends through the first and second openings. - View Dependent Claims (9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19)
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20. A process for translumenally deploying a bypass graft, comprising:
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advancing an elongate catheter intralumenally toward a selected site along a body lumen;
with a distal end of the catheter near the selected site, forming a first opening through a tissue wall defining the body lumen via a tissue perforating mechanism mounted near a distal end of the catheter;
advancing the tissue perforating mechanism through the first opening to a location spaced apart from the first opening, then using the mechanism to form a second opening through tissue at said location;
advancing a graft guide distally through the first opening to said location and then through the second opening;
with the graft guide so positioned, advancing a tubular graft along the guide via a graft controller to a bypass location in which the graft extends from the first opening to the second opening and through the first and second openings, forming a bypass conduit in fluid communication with the body lumen; and
while maintaining the graft in said bypass position, proximally withdrawing the catheter, the tissue perforation mechanism and the graft guide. - View Dependent Claims (21, 22, 23, 24, 25, 26, 27, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 44, 45, 46, 47, 49, 50, 51, 52, 67)
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28. An anastomotic connector comprising:
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a collet having a tubular portion with a proximal end and a distal end, and at least one radially self-expanding collet member disposed on the tubular portion distal end.
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42. An anastomotic connector comprising:
at least one encircling member having a distal end attachable to the graft, a proximal end attachable to the graft and configured to expand into and contact the interior of a vessel or organ wall. - View Dependent Claims (43)
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48. A system for deploying and securing at least one end of a bypass graft to a vessel or organ, comprising:
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a tissue perforator;
a tissue dilator;
a tubular carrier adapted for insertion into a vessel lumen, over the dilator and through an opening in the vessel lumen;
a connector attached to one end of a bypass graft adapted to compress into a reduced outer diameter in response to an external force and adapted to expand into an expanded outer diameter upon removal of the external force.
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53. A system for securing a bypass graft to at least one vessel comprising:
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a tubular member having a first end, a second end, and a passageway defining an inner lumen extending between those ends;
a first connector attached to the first end of the tubular member;
a second connector attached to the second end of the tubular member;
a delivery mechanism adapted for producing a first opening at a first vessel wall location and a second opening at a second vessel wall location, expanding said first opening and said second opening, and maintaining said first opening and said second opening in an expanded orientation;
wherein the first connector and tubular member are adapted to be inserted as a single unit through the first opening; and
wherein the first connector and second connector are configured to secure the tubular member to the first and second vessel wall locations, respectively. - View Dependent Claims (54, 55, 56, 57, 58, 59, 60, 61, 62, 63)
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64. A method for creating an anastomosis between a tubular member and a mammalian vessel or organ segment, comprising:
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positioning an end of the tubular member having a self-expanding connector attached thereto near the mammalian vessel or organ segment;
penetrating a wall of the vessel or organ segment to create an opening in said wall;
expanding the opening and advancing a distal portion of the connector through said opening such that the distal portion enters an interior of said vessel or organ segment and self-expands into an expanded configuration and the distal portion directly contacts an inner surface of the vessel or organ segment wall without further penetrating the wall. - View Dependent Claims (65, 66)
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Specification