Methods and apparatus for deploying conformed structures in body lumens

• US 20060009784A1
• Filed: 07/07/2004
• Published: 01/12/2006
• Est. Priority Date: 07/07/2004
• Status: Active Grant

• Current Assignee: Takai Hospital Supply Co., Ltd.
• Original Assignee: Percutaneous Systems Inc.
• Inventors: Huang, Alexander L., Behl, Robert S.
• Granted Patent: US 7,462,183 B2
• Time in Patent Office: Days
• US Class Current: 606/113
• 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 2017/2217 single wire changing shape to a gripping configuration

Abstract

Occluding structures may be created within a body lumen by advancing a length of material distally through the body lumen. By drawing a distal location on the advanced length of material in a proximal direction, the material may be compacted into a structure which at least partially occludes the lumen. The occluding structure may be used for a variety of purposes, including removing obstructions from the body lumen, such as kidney stones from the ureter; providing hemostasis in a blood vessel; providing occlusion of a fallopian tube; temporary constraint of stone fragments in the urinary tract; capture or restraint of clot in blood vessels; and the like. Apparatus for performing the method may comprise a length of material attached at its distal end to tubular guide or other advancement member. Tensioning members may also be provided for collapsing and compacting the length of material within the body lumen.

Claims

1. A method for compacting a structure in a body lumen, said method comprising:

advancing a length of material distally in the body lumen; and

drawing a distal location on the advanced length of material proximally to compact the material into a structure which at least partially occludes the body lumen.

2. A method as in claim 1, wherein the length of material is advanced distally past an obstruction in the body lumen and drawn proximally against the obstruction.

3. A method as in claim 2, further comprising pulling the compacted material against the obstruction to reposition the obstruction within the body lumen.

4. A method as in claim 3, wherein the obstruction is withdrawn from the body lumen.

5. A method as in claim 2, wherein the compacted structure prevents the obstruction from moving distally.

6. A method as in any one of claims 2 to 5, wherein the body lumen is a ureter, cystic duct, or common bile duct, and the obstruction comprises one or more stones.

7. A method as in claim 6, wherein the body lumen is a ureter and the length of material is advanced from urinary bladder into the ureter and past the kidney stone(s).

8. A method as in claim 7, further comprising directing energy to disrupt the kidney stone(s) while engaged by the compacted material.

9. A method as in claim 1, wherein the body lumen is a blood vessel.

10. A method as in claim 9, wherein the length of material is advanced distally past an obstruction and drawn proximally to remove the obstruction.

11. A method as in claim 9, wherein the compacted material provides substantially complete hemostasis.

12. A method as in claim 1, wherein advancing comprises introducing the length of material within a tubular guide.

13. A method as in claim 12, wherein the tubular guide and the length of material are introduced simultaneously.

14. A method as in claim 12, wherein the tubular guide is positioned first and the length of material introduced after the tubular guide has been positioned.

15. A method as in any one of claims 12 to 14, wherein the tubular guide is at least partially retracted to expose the length of material within the body lumen before drawing the distal location of the length of material proximally.

16. A method as in any one of claims 15, wherein drawing comprises pulling on a tension member attached to a distal end of the length of material.

17. A method as in claim 16, wherein the tension member is embedded in the length of material.

18. A method as in claim 1, wherein advancing comprises introducing a tubular guide through the body lumen, wherein the length of material everts over a distal end of the tube as the tube is introduced.

19. A method as in claim 13, wherein the length of material is a sleeve which emerges from an interior of the tubular guide and covers an exterior of tubular guide as the sleeve everts.

20. A method as in any one of claims 18 and 19, wherein the length of material has a tension member attached to a distal location on the length of material and wherein drawing the length of material comprises pulling on the tension member after the length of material has been released from the tubular guide into the body lumen.

21. A method as in claim 20, wherein the tension member extends from the length of material and is disposed within the interior of the tubular guide.

22. A method as in claim 20, wherein the tension member is embedded in the length of material.

23. A method as in claim 20, further comprising at least partially withdrawing the tubular guide in the proximal direction after the length of material has been released.

24. A method as in claim 1, wherein advancing comprises distally advancing an advancement member attached to a distal location on the length of material, wherein the length of material is pulled through the body lumen by distal advancement of the advancement member.

25. A method as in claim 24, further comprising detaching the advancement member from the length of material and then pulling proximally on a tension member attached to a distal location on the length of material.

26. A method as in claim 25, wherein the tension member is embedded within the length of material so that the material compacts about on the tension member as the member is pulled proximally.

27. A method as in claim 26, further comprising distally advancing the tension member to reverse compaction of the length of material.

28. A method as in claim 24, wherein drawing to compact the length of material comprises pulling proximally on the advancement member.

29. A method as in claim 24, further comprising distally advancing the advancement member to reverse compaction of the length of material.

30. A method as in claim 27 or 29, wherein entrapped stone fragments or other substances are released from the compacted material as compaction is reversed.

31. A method as in claim 1, wherein the length of material comprises a strip, sleeve, ribbon, or tube.

32. A method as in claim 31, wherein the material is selected from the group consisting of polymer films, woven fabrics, non-woven fabrics, and composites and laminates thereof.

33. A method as in claim 31 or 32, wherein the length of material has fold structures which impart a preferred folding pattern upon drawing in the proximal direction.

34. Apparatus for deploying a conformal structure in a body lumen, said apparatus comprising,

a length of material;

and

a tension member attached to a distal location on the length of material, said tension member adapted to compact the material into an occluding structure when the member is pulled proximally relative to the length of material when present in a body lumen.

35. Apparatus as in claim 34, wherein the length of material comprises a strip, sleeve, ribbon, or tube.

36. Apparatus as in claim 35, wherein the material is selected from the group consisting of polymer films, woven fabrics, non-woven fabrics, and composites and laminates thereof.

37. Apparatus as in any of claims 34-36, wherein the tension member is embedded within the length of material.

38. Apparatus as in claim 35, wherein the tension member penetrates the length of material at multiple spaced-apart locations along the length.

39. Apparatus as in claim 36, wherein the length of material has fold structures between at least some of the spaced-apart locations.

40. Apparatus as in any one of claims 34-36, wherein the tension member is positioned in a plurality of connecting loops disposed at multiple spaced-apart locations along the length of material.

41. Apparatus as in any one of claims 34-36, wherein the tension member is positioned in substantially continuous passage formed in or on the length of material.

42. Apparatus as in any one of claims 34-36, wherein the tension member comprises a filament woven into the length of material.

43. Apparatus as in any one of claims 34-36, wherein the tension member is attached only at a distal end of the length of material.

44. Apparatus as in any one of claims 34-36, wherein the tension member has sufficient column strength to advance the length of material distally in the body lumen.

45. Apparatus as in claim 44, wherein the tension member comprises a guide wire structure.

46. Apparatus as in any of claims 34-36, further comprising an advancement member coupled to the length of material.

47. Apparatus as in claim 46, wherein a distal location on the length of material is frangibly attached to a distal location on the advancement member.

48. Apparatus as in claim 46, wherein the advancement member comprises a wire.

49. Apparatus as in claim 46, wherein the advancement member comprises a tubular guide.

50. Apparatus as in claim 49, wherein the length of material is disposed in a lumen of the tubular guide so that the material is deployed by everting from a distal end of the guide as the guide is advanced through the body lumen.

51. Apparatus as in claim 49, wherein the length of material is disposed to be separately passed through a lumen of the tubular guide.