Intraluminal prosthesis attachment systems and methods

• US 20040093057A1
• Filed: 11/29/2002
• Published: 05/13/2004
• Est. Priority Date: 11/28/2001
• Status: Active Grant

• Current Assignee: Aptus Endosystems Inc. (Medtronic Plc)
• Original Assignee: Aptus Endosystems Inc. (Medtronic Plc)
• Inventors: Bolduc, Lee, Kaganov, Alan L.
• Granted Patent: US 8,075,570 B2
• Time in Patent Office: Days
• US Class Current: 623/1.11
• 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 2017/0647 having one single leg, e.g. tacks
• CPC Class Codes: A61B 2017/0649 Coils or spirals
• 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 2/89 the wire-like elements comprising two or more adjacent rings flexibly connected by separate members
• CPC Class Codes: A61F 2/95 Instruments specially adapted for placement or removal of stents or stent-grafts
• CPC Class Codes: A61F 2002/065 Y-shaped blood vessels
• CPC Class Codes: A61F 2002/075 the stent being loosely attached to the graft material, e.g. by stitching

Abstract

Systems and method implant prostheses in the body. The systems and methods provide permanent attachment of the prosthesis in the body. The prosthesis can comprise, e.g., an endovascular graft, which can be deployed without damaging the native blood vessel in either an arterial or a venous system. The endovascular graft can comprise, e.g., a radially expanding vascular stent and/or a stent-graft. The graft can be placed in the vasculature, e.g., to exclude or bridge an aneurysm, for example, an abdominal aortic aneurysms. The graft desirably adapts to changes in aneurysm morphology and repairs the endovascular aneurysm. The fastening systems and methods can be deployed through the vasculature and manipulated from outside the body, to deliver a fastener to attach the graft to the vessel wall.

Claims

1. A fastener applier for a prosthesis comprising:

a drive mechanism sized and configured to be releasably coupled to the fastener to deploy the fastener into the prosthesis, and

an actuator for the drive mechanism including a sensing mechanism that enables operation of the drive mechanism in response to a force sensed at or near the fastener.

2. A fastener applier according to claim 1

wherein the sensing mechanism disables operation of the drive mechanism when force sensed is less than a predetermined magnitude.

3. A fastener applier according to claim 1

wherein the sensing mechanism includes a switch assembly that is actuated in response to force sensed at or near the fastener.

7. A fastener applier according to claim 1 or 4

wherein the drive mechanism includes a carrier for the fastener.

8. A fastener applier according to claim 7

wherein the carrier receives a single fastener at a time.

9. A fastener applier according to claim 1 or 4

wherein the drive mechanism is magnetically coupled to the fastener.

10. A fastener applier according to claim 9

wherein the drive mechanism is magnetically coupled to a single fastener at a time.

11. A fastener applier according to claim 1 or 4

wherein the drive mechanism is mechanically coupled to the fastener.

12. A fastener applier according to claim 11

wherein the drive mechanism is mechanically coupled to a single fastener at a time.

13. A fastener applier according to claim 1 or 4

wherein the drive mechanism rotates the fastener for deployment.

14. A fastener applier according to claim 1 or 4

further including a catheter body sized and configured for deployment in a targeted body region, and

wherein at least a portion of the drive mechanism is carried by the catheter body.

15. A fastener applier according to claim 14

wherein the catheter body includes a distal end, and

wherein the sensing mechanism includes a component extending distally beyond the distal end of the catheter body.

16. A fastener applier according to claim 15

wherein the component includes a carrier for the fastener.

17. A fastener applier according to claim 15

wherein the component includes a force sensing probe.

18. A fastener applier according to claim 1 or 4

further including a catheter body sized and configured for intraluminal passage, and

wherein at least a portion of the drive mechanism is carried by the catheter body for deployment in a targeted endovascular region.

19. A fastener applier according to claim 18

wherein the catheter body includes a distal end, and

wherein the sensing mechanism includes a component extending distally beyond the distal end of the catheter body.

20. A fastener applier according to claim 19

wherein the component includes a carrier for the fastener.

21. A fastener applier according to claim 19

wherein the component includes a sensing probe.

4. A fastener applier for a prosthesis comprising:

a drive mechanism sized and configured to be releasably coupled to the fastener to deploy the fastener into the prosthesis, and

an actuator for the drive mechanism including a sensing mechanism that enables operation of the drive mechanism in response to contact sensed with a surface at or near the fastener.

5. A fastener applier according to claim 4

wherein the sensing mechanism disables operation of the drive mechanism in the absence of contact sensed.

6. A fastener applier according to claim 4

wherein the sensing mechanism includes a switch assembly that is actuated in response to contact sensed at or near the fastener.

22. A fastener sized and configured for singular deployment in tissue comprising

a fastener body having a distal end for penetrating tissue in response to a force and a proximal end for releasably coupling the fastener body to a force applier, and

a stop structure associated with the proximal end to prevent over-penetration of the fastener body into tissue.

23. A fastener according to claim 22

wherein the fastener body comprises a helical coil having an interior diameter, and

wherein the stop structure comprises a leg of the coil that extends substantially across the entire interior diameter.

24. A fastener according to claim 23

wherein the leg mechanically couples the fastener body to the force applier.

25. A fastener according to claim 22

wherein the fastener body comprises a helical coil having an interior diameter, and

wherein the stop structure comprises a cap that extends substantially across the entire interior diameter.

26. A fastener according to claim 25

wherein the cap includes a fitting to engage the force applier.

27. A fastener according to claim 25

wherein the cap includes a material that is magnetized.

28. A fastener according to claim 25

wherein the cap includes a material that is attracted to a magnetized material.

29. A fastener according to claim 22

wherein the stop structure couples the fastener body to the force applier.

30. A fastener according to claim 29

wherein the stop structure includes a material that is magnetized.

31. A fastener according to claim 29

wherein the stop structure includes a material that is attracted to a magnetized material.

32. A fastener according to claim 29

wherein the stop structure mechanically couples the fastener body to the force applier.

33. A fastener according to claim 22

wherein the fastener body comprises a helical coil.

34. A system for applying a fastener to a prosthesis within a body comprising

a fastener comprising a body having a distal end for penetrating tissue in response to a force and proximal end,

a drive mechanism sized and configured to be releasably coupled to the proximal end of the fastener body to apply force, and

an actuator for the drive mechanism including a sensing mechanism that enables operation of the drive mechanism in response to at least one of force sensed at or near the distal end of the fastener body, or (ii) contact sensed with a surface at or near the distal end of the fastener body.

35. A system according to claim 34

wherein the fastener includes a stop structure associated with the proximal end to prevent over-penetration of the fastener body into tissue.

36. A system according to claim 34

wherein the drive mechanism is sized and configured to be releasably coupled to a single fastener at a time.

37. A system according to claim 34

further including a catheter body sized and configured for deployment in a targeted body region, and

wherein at least a portion of the drive mechanism is carried by the catheter body.

38. A system according to claim 34

further including a catheter body sized and configured for intraluminal passage, and

wherein at least a portion of the drive mechanism is carried by the catheter body for deployment in a targeted endovascular region.

39. A system for applying a fastener to a prosthesis within a body comprising

a fastener comprising a body having a distal end for penetrating tissue in response to a force and proximal end that includes a stop structure to prevent over-penetration of the fastener body into tissue, and

a drive mechanism sized and configured to be releasably coupled to the stop structure to apply force.

40. A system according to claim 39

wherein the drive mechanism is sized and configured to be releasably coupled to a single fastener at a time.

41. A system according to claim 39

further including a catheter body sized and configured for deployment in a targeted body region, and

wherein at least a portion of the drive mechanism is carried by the catheter body.

42. A system according to claim 39

further including a catheter body sized and configured for intraluminal passage, and

wherein at least a portion of the drive mechanism is carried by the catheter body for deployment in a targeted endovascular region.

43. A prosthesis comprising

a prosthesis body,

a fastener assembly integrally carried by the prosthesis body, the assembly including at least one fastener deployable into tissue in response to force applied by a force applier, and

a tracking wire coupled to the fastener to guide the force applier into operative contact with the fastener.

44. A prosthesis comprising

a prosthesis body, and

a fastener assembly integrally carried by the prosthesis body, the assembly including at least one fastener deployable into tissue in response to non-rotational force applied by a force applier.

45. A prosthesis according to claim 44

further including a tracking wire coupled to the fastener to guide the force applier into operative contact with the fastener.

46. A fastener sized and configured for singular deployment in tissue comprising

a fastener body having a distal end for penetrating tissue in response to a force and proximal end for releasably coupling the fastener body to a force applier, and

a tracking wire coupled to the proximal end to guide the force applier into operative contact with the fastener.