Device for creating openings in pressurized vessels with deformable walls

• US 20080249516A1
• Filed: 03/05/2008
• Published: 10/09/2008
• Est. Priority Date: 03/05/2007
• Status: Active Grant

• Current Assignee: Amt Medical B.V.
• Original Assignee: AMJ, BV
• Inventors: Muenker, Frank Michael
• Granted Patent: US 8,273,078 B2
• Time in Patent Office: Days
• US Class Current: 606/10
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/062 Needle manipulators
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/1107 for blood vessels
• CPC Class Codes: A61B 2017/1121 adapted for performing tissue or graft eversion
• 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 2017/306 holding by means of suction
• CPC Class Codes: A61B 2018/00291 using suction
• CPC Class Codes: A61B 2018/00386 Coronary vessels

Abstract

The catheter (1) has a fastener (10) for firmly holding the wall (19) of vessel (18) when it is cut by optical fibers (3). The fastener (10) has an engaging element which can be a pin (20), roughened surface (23), spiral grooves (27), dendritic grooves (31), adhesive surface (34) or pointed pins (38).

Claims

1. A catheter for performing arteriotomies on intracorporal vessels comprising:

(a) a tubular body having a proximal end and a distal end;

(b) a ring shaped cutting device positioned at the distal end of the tubular body for cutting a hole in a wall of a vessel to be treated;

(c) a bore inside the tubular body and the cutting device; and

(d) a fastener positioned in the bore at the distal end of the bore, the fastener adapted to firmly hold a portion of the wall of the vessel that forms the hole when a vacuum suction is applied through the bore and the hole is cut in the wall of the vessel by the cutting device.

2. The catheter of claim 1 wherein

the cutting device is a laser device.

3. The catheter of claim 2 wherein

the laser device is optical fibers which form a ring that extends outward from the distal end of the tubular body.

4. The catheter of claim 1 wherein

the tubular body has a stopper on an outside wall of the tubular body at the distal end of the tubular body.

5. The catheter of claim 1 wherein

the tubular body has an inner sleeve, an outer sleeve and an annulus between the inner sleeve and the outer sleeve;

and

the cutting device is optical fibers which are positioned in the annulus and form a ring that extends outward at the distal end of the tubular body.

6. The catheter of claim 1 wherein

the fastener is a porous member mounted in the bore and a protrusion extending outward from the member towards the distal end of the bore.

7. The catheter of claim 6 wherein

the protrusion is a plurality of protrusions.

8. The catheter of claim 1 wherein

the fastener is a porous member having grooved surface facing the distal end of the bore.

9. The catheter of claim 1 wherein

the fastener is a porous member having an adhesive surface facing the distal end of the bore.

10. The catheter of claim 1 wherein

the fastener is a porous member having a roughened surface facing the distal end of the bore.

11. The catheter of claim 1 wherein

the fastener is a plurality of protrusions fixed to an inner wall of the tubular body and extending towards the distal end of the bore.

12. The catheter of claim 1 wherein

the fastener is a porous member having a plurality of protrusions extending outward from the member towards the distal end of the bore and the distal end of the protrusions are pointed.

13. The catheter of claim 6

wherein

the porous member is a perforated plate coaxially positioned in the bore and the protrusion is a single pin fixed centrally to the plate and extends towards the distal end of the bore but not beyond a planar area defined by the distal end of the cutting device.

14. The catheter of claim 6

wherein the protrusion is at least one pin and extends from the plate a distance of about 0.1 to 5 times of a wall thickness of the intracorporal vessel and the distal end of the pin is about 0% to 120% of the inner diameter of the bore from the planar area defined by the distal end of the cutting device.

15. The catheter of claim 14, wherein the pin extends from the plate a distance of about 0.5 to 2 times of the wall thickness of the intracorporal vessel.

16. The catheter of claim 14, wherein the distal end of the pin is about 0% to 40%, preferably about 5% to 30% or about 10% to 25% of the inner diameter of the bore from the planar area defined by the distal end of the cutting device.

17. The catheter of claim 13 wherein the pin extends from the plate a distance of about 0.05 to about 0.5 mm and the distal end of the pin is about 0.05 to 0.6 mm from the planar area defined by the distal end of the cutting device.

18. The catheter of claim 1, wherein the fastener comprises a porous member having a porous central portion and a non-porous rim surrounding the porous central portion, and wherein, viewed in radial direction of the bore, the rim extends over at least 10% of the radius of the bore.

19. The catheter of claim 6, wherein the protrusion is a pin and wherein the fastener comprises a porous member having a porous central portion and a non-porous rim surrounding the porous central portion, and wherein a width of the rim is about 70% or more of the length of the pin.

20. The catheter of claim 18, wherein the rim has a surface that is grooved and/or roughened and/or adhesive.

21. The catheter of claim 19, wherein the rim has a surface that is grooved and/or roughened and/or adhesive.

25. The catheter according to claim 1, wherein the fastener comprises a plate positioned in the bore and a protrusion fixed to the plate and extending towards the distal end of the bore, wherein the protrusion is provided with a channel extending from the proximal side of the plate to the distal end of the protrusion and wherein the distal end of the protrusion is optionally provided with cuts extending from the channel in a radial direction of the bore.

22. A method for performing bypass surgery on intracorporal vessels comprising:

providing a catheter having a tubular body having a proximal end, and a distal end, a ring shaped cutting device positioned at the distal end of tubular body, a bore inside the tubular body and the cutting device and a fastener positioned with the bore at the distal end of the bore;

attaching a rigid spacer to an end of a bypass vessel;

attaching the end of the bypass vessel to an outer surface of a wall of a vessel which is to be treated;

inserting the catheter into the bypass vessel until the cutting device abuts the wall;

applying a vacuum suction through the bore to firmly hold a portion of the outer surface of the wall of the vessel against the fastener;

cutting a hole in the held portion of the wall;

and removing the catheter with the cut portion of the wall held by the fastener.

23. Method according to claim 22 wherein a spacer is on the outside wall of the tubular body at the distal end and the catheter is inserted into the bypass vessel until the stopper abuts the spacer.

24. Method according to claim 23 wherein the spacer is a ring and the attaching step comprises:

placing the ring over the bypass vessel;

folding an end portion of the bypass vessel back on itself over the ring; and

attaching the end portion of retain the ring, forming a rigid end of the bypass vessel.