Endovascular aneurysm repair system

• US 20030100943A1
• Filed: 10/15/2002
• Published: 05/29/2003
• Est. Priority Date: 11/28/2001
• Status: Active Grant

• Current Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Original Assignee: Aptus Endosystems Inc. (Medtronic Plc)
• Inventors: Bolduc, Lee
• Granted Patent: US 6,960,217 B2
• Time in Patent Office: Days
• US Class Current: 623/1.35
• 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 17/072 for applying a row of staples in a single action , e.g. the staples being applied simultaneously
• CPC Class Codes: A61B 17/10 for applying or removing wound clamps, e.g. containing only one clamp or staple A61B17/076 takes precedence; containing multiple wound clamps A61B17/068; Wound clamp magazines containers, packaging elements or packages specially adapted for particular articles or with special means for dispensing contents B65D83/00, B65D85/00
• CPC Class Codes: A61B 2017/00292 mounted on or guided by flexible, e.g. catheter-like, means
• CPC Class Codes: A61B 2017/00778 Operations on blood vessels A61B2017/22097, A61B2017/320741 take precedence
• CPC Class Codes: A61B 2017/0646 for insertion into cartillege, e.g. meniscus
• CPC Class Codes: A61B 2017/0649 Coils or spirals
• 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 2/848 having means for fixation to the vessel wall, e.g. barbs
• CPC Class Codes: A61F 2/90 characterised by a net-like or mesh-like structure
• 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 2002/067 modular
• CPC Class Codes: A61F 2002/075 the stent being loosely attached to the graft material, e.g. by stitching
• CPC Class Codes: Y10S 623/903 Blood vessel

Abstract

Method and apparatus for implanting radially expandable prostheses in the body lumens rely on tacking or anchoring of the prostheses with separately introduced fasteners. The prostheses may be self-expanding or balloon expandable. After initial placement, a fastener applier system is introduced within the expanded prostheses to deploy a plurality of fasteners at at least one prosthesis end, usually as each end of the prosthesis. The fasteners are usually helical fasteners which are delivered from a helical track in the fastener applier by rotation with a rotator wire. The fasteners will be applied singly, typically in circumferentially spaced-apart patterns about the interior of each end of the prosthesis.

Claims

1. A method for implanting a radially expandable prosthesis in a body lumen, said method comprising:

expanding at least one scaffold of the prosthesis at an implantation site within the body lumen; and

introducing a plurality of fasteners through the prosthesis in the region of the scaffold to anchor the scaffold in place.

2. A method as in claim 1, wherein the scaffold is elastic and expanding comprises releasing the scaffold from constraint to permit the scaffold to self expand at the implantation site.

3. A method as in claim 1, wherein the scaffold is malleable and expanding comprises applying a radially expansive force within the scaffold to cause expansion.

4. A method as in claim 1, wherein expanding comprises expanding at least to scaffolds at spaced apart locations on the prosthesis

5. A method as in claim 1, wherein expanding comprises expanding at least three spaced apart prostheses on the prosthesis.

6. A method as in claim 1, wherein expanding comprises expanding a scaffold structure that spans the entire length of the prosthesis.

7. A method as in claim 1, wherein the prosthesis comprises a fabric covering at least a portion of the scaffold, wherein introducing comprises introducing at least some of the fasteners through the fabric but not through the scaffold.

8. A method as in claim 1, wherein the prosthesis comprises a fabric covering at least a portion of the scaffold, wherein introducing comprises introducing at least some of the fasteners over elements of the scaffold.

9. A method as in claim 1, wherein the fasteners are helical penetrating fasteners.

10. A method as in claim 9, wherein the introducing step comprises introducing single fasteners in a circumferentially spaced-apart pillar on the inner wall of the prosthesis.

11. A method as in claim 10, wherein introducing comprises introducing from two to 12 helical fasteners at each region where the fasteners are placed.

12. An intraluminal fastener applier comprising:

a tubular body with a deflectable distal end;

a stabilizer configured to engage a blood vessel wall to hold the distal end of tubular body in place;

a control handle at a proximal end of the tubular body having controls to separately deflect the distal end, and deploy the stabilizer that holds the deflected distal end in place;

and means to advance a fastener from the distal end into the blood vessel wall engaged by the distal end.

13. An intraluminal fastener applier as in claim 12, wherein the fastener advancing means comprises a fastener delivery device which is introducable through the tubular body and which carries at least one fastener.

14. An intraluminal fastener applier as in claim 13, wherein the fastener delivery device comprises a flexible shaft which carries a single helical fastener at its distal end and a means for rotating and advancing the helical fastener to penetrate tissue.

15. An intraluminal fastener as in claim 14, wherein the flexible shaft has a helical track which carries the helical fastener and a rotator wire that engages and rotates the helical fastener to cause advancement from the distal end of the body.

16. A method for implanting a radially expandable prosthesis at a target site in a body lumen, said method comprising:

advancing a guidewire from a remote access site to the target site;

introducing a prosthesis deployment catheter over the guidewire to the target site;

deploying the prosthesis from the deployment catheter at the target site;

exchanging the deployment catheter for an intraluminal fastener applier over the guidewire; and

introducing from the intraluminal fastener applier a plurality of fasteners through the prosthesis to anchor the prosthesis.

17. A method as in claim 16, wherein the prosthesis is self-expanding and deploying comprises releasing the prosthesis from constraint to permit the prosthesis to self-expand at the target site.

18. A method as in claim 16, wherein the prosthesis is malleable and expanding comprises applying a radially expansive force within the prosthesis to cause expansion.

19. A method as in claim 16, wherein a single fastener is applied from the intraluminal fastener applier and the applier is withdrawn from the vasculature and a new fastener loaded on the catheter before returning the applier to the target location.