Endovascular aneurysm repair systems and methods

• US 20080065189A1
• Filed: 10/30/2007
• Published: 03/13/2008
• 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 8,083,752 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 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

Systems and methods introduce a tissue fastener applier to apply tissue-piercing fasteners to a prosthesis sequentially along a path established by the directing device that, between fastener applications, is manipulated into orientation with different desired fastening sites, until a plurality of tissue-piercing fasteners are placed, one-at-a-time, in the prosthesis.

Claims

1. A system comprising:

an intraluminal directing device sized and configured for introduction from a remote access site to a location within a blood vessel lumen, the intraluminal directing device including a deflectable distal region sized and configured for manipulation to orient the distal region with respect to a range of different desired fastening sites within the blood vessel lumen, and

an intraluminal fastener applier sized and configured to be introduced and withdrawn along the intraluminal directing device, the intraluminal fastener applier including a driven component sized and configured (i) to receive a single tissue-piercing fastener at the remote access site outside the intraluminal directing device, (ii) to be operated, after introduction of the intraluminal fastener applier along the intraluminal directing device to one of the desired fastening sites, to introduce the single tissue-piercing fastener into tissue at the desired one of the fastening sites, and (iii) to receive at the remote access site, after withdrawal of the intraluminal fastener applier along the intraluminal directing device, another single tissue piercing fastener, the intraluminal fastener applier accommodating (ii) and (iii) repeatedly, in concert with manipulation of the deflectable distal region of the intraluminal directing device with respect to a range of different desired fastening sites, until a desired plurality of tissue-piercing fasteners are introduced into tissue at different desired fastening sites within the blood vessel lumen.

2. A system according to claim 1

wherein at least one of the tissue-piercing fasteners comprises a helical tissue-piercing fastener.

3. A system according to claim 1

wherein at least one of the tissue-piercing fasteners comprises a fastener that pierces tissue in response to rotation;

and

wherein the driven component includes a rotary driver.

4. A system according to claim 1

wherein the desired plurality of tissue-piercing fasteners are introduced in a circumferentially spaced-apart pattern at the different desired fastening sites within the blood vessel lumen.

5. A system according to claim 1

wherein the intraluminal directing device is sized and configured for rotation in concert with deflecting the distal region.

6. A system according to claim 1

wherein the intraluminal directing device includes a passage accommodating the intraluminal fastener applier.

7. A method according to claim 6

wherein the passage comprises an interior lumen.

9. A system according to claim 7

wherein at least one of the tissue-piercing fasteners comprises a helical tissue-piercing fastener.

10. A system according to claim 7

wherein at least one of the tissue-piercing fasteners comprises a fastener that pierces tissue in response to rotation;

and

wherein the driven component includes a rotary driver.

11. A system according to claim 7

wherein the desired plurality of tissue-piercing fasteners are introduced in a circumferentially spaced-apart pattern at the different desired fastening sites to secure the prosthesis to the blood vessel lumen.

12. A system according to claim 7

wherein the intraluminal directing device is sized and configured for rotation in concert with deflecting the distal region.

13. A system according to claim 7

wherein the intraluminal directing device includes a passage accommodating the intraluminal fastener applier.

14. A system according to claim 13

wherein the passage comprises an interior lumen.

8. A system comprising:

a prosthesis sized and configured for deployment within a blood vessel lumen,

an intraluminal directing device sized and configured for introduction from a remote access site to a location within the prosthesis, the intraluminal directing device including a deflectable distal region sized and configured for manipulation to orient the distal region with respect to a range of different desired fastening sites to secure the prosthesis to the blood vessel lumen, and

an intraluminal fastener applier sized and configured to be introduced and withdrawn along the intraluminal directing device, the intraluminal fastener applier including a driven component sized and configured (i) to receive a single tissue-piercing fastener at the remote access site outside the intraluminal directing device, (ii) to be operated, after introduction of the intraluminal fastener applier along the intraluminal directing device to one of the desired fastening sites, to introduce the single tissue-piercing fastener at a desired one of the fastening sites, and (iii) to receive at the remote access site, after withdrawal of the intraluminal fastener applier along the intraluminal directing device, another single tissue piercing fastener, the intraluminal fastener applier accommodating (ii) and (iii) repeatedly, in concert with manipulation of the deflectable distal region of the intraluminal directing device with respect to a range of different desired fastening sites, until a desired plurality of tissue-piercing fasteners are introduced at different desired fastening sites to secure the prosthesis to the blood vessel lumen.

15. A method comprising

providing a plurality of tissue-piercing fasteners,

providing a tissue fastener applier,

providing a directing device, and

introducing the tissue fastener applier into a blood vessel lumen to apply single tissue-piercing fasteners to a prosthesis within the blood vessel lumen sequentially along a path established by the directing device that, between fastener applications, is manipulated into orientation with different desired fastening sites, until a plurality of tissue-piercing fasteners are placed, one-at-a-time, in the prosthesis.

16. A method according to claim 15

wherein at least one of the tissue-piercing fasteners comprises a helical tissue-piercing fastener.

17. A method according to claim 15

wherein at least one of the tissue-piercing fasteners comprises a fastener that pierces tissue in response to rotation, and

wherein the tissue fastener applier includes a rotary driver.

18. A method according to claim 15

wherein the plurality of tissue-piercing fasteners are introduced in a circumferentially spaced-apart pattern at the different desired fastening sites in the prosthesis.

19. A method according to claim 15

wherein the directing device includes a deflectable distal region.

20. A method according to claim 15

wherein the directing device includes a passage accommodating the fastener applier.

21. A method according to claim 20

wherein the passage comprises an interior lumen.

22. A method according to claim 15

further including, between fastener applications, reloading a single tissue-piercing fastener in the tissue fastener applier.

23. A method according to claim 15

further including, between fastener applications, reloading a single tissue-piercing fastener in the tissue fastener applier at a remote access location.