Medical grafting methods and apparatus

• US 20020087181A1
• Filed: 02/28/2002
• Published: 07/04/2002
• Est. Priority Date: 11/07/1996
• Status: Abandoned Application

• Current Assignee: St Jude Medical ATG Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: St Jude Medical Cardiovascular Group Incorporated
• Inventors: Sullivan, Daniel J., Mazzocchi, Rudy, Bachinski, Thomas J., Goldsteen, David S.
• Application Number:
  US10/090,121
• Publication Number:
  US 20020087181A1
• Time in Patent Office: Days
• US Class Current: 606/185
• 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 delivering and installing a new length of tubing between two sections of a patient'"'"'s existing body organ tubing and at least partly outside of that existing structure. For example, the new length of tubing may be for the purpose of providing the patient with a coronary bypass. The new tubing may be an artificial graft, a natural graft (harvested elsewhere from the patient), or both. The new tubing is delivered to and installed at the operative site primarily by working through the patient'"'"'s existing tubular body organ structure. This avoids the need for any significant surgery on the patient. The artificial grafts may have shapes other than tubular. Certain procedural and apparatus aspects of the invention have uses other than in connection with grafting in general or tubular grafting in particular.

Claims

1. A guided punch, comprising:

a sharp, extendible guide wire; and

a hollow punch mechanism adapted to ride on the guide wire, wherein said guide wire is adapted to extend from said punch.

2. A punch according to claim 1, wherein said punch is a rotating punch.

3. A punch according to claim 1, wherein said punch is an axially moving punch.

4. An anastomotic connector, comprising:

a cylinder-like body; and

at least one set of spikes, coupled to said body by twisting joints.

5. A connector according to claim 4, wherein said twisting joints comprise at least one torsion bar.

6. A connector according to claim 4, wherein said twisting joints comprise at least one bend area.

7. A medical graft delivery system, comprising:

a tubular element for delivering a graft through a bore thereof and having a delivery end, said end being prone to distortion; and

at least one collar removably encircling said delivery end, which collar prevents said distortion.

8. A system according to claim 7, wherein said tube comprises weakened portions at or adjacent said delivery end.

9. A system according to claim 7, comprising an anastomotic connector preloaded in said delivery end and applying outward forces against said end.

10. A system according to any of claims 7-9, wherein said at least one collar comprises at least two collars.

11. A method of sealing an opening between two blood conduit lips, comprising:

providing a clip;

first retracting a first lip into said clip; and

second retracting a second lip into said clip.

12. A method according to claim 11, comprising closing said clip to seal said opening.

13. A method according to claim 12, wherein closing comprises releasing said clip to selfdeform.

14. A method according to claim 12, wherein closing comprises plastically deforming said clip.

15. A method according to any of claims 11-14, wherein said two lips are lips of different conduits.

16. A method according to any of claims 11-14, wherein at least one of the conduits comprises a blood vessel.

18. A connector according to claim 17, wherein said collapsing portion buckles.

19. A connector according to claim 17, wherein said collapsing portion twists.

20. A connector according to claim 17, wherein said collapsing portion folds out.

17. A reducing profile anastomotic connector, comprising:

a ring section;

a spikes section comprises a plurality of spikes, wherein said spikes section defines a collapsing portion, for axial collapsing of said spikes section.

21. A connector according to any of claims 17-20, wherein said collapsing portion selfdeforms.

22. A connector according to any of claims 17-20, wherein said collapsing portion plastically deforms.