APPARATUS AND METHOD FOR DELIVERY, SPREADING AND DOUBLE-ENDED FIXATION OF VASCULAR GRAFTS
First Claim
1. An apparatus for delivery and double-ended fixation of endovascular grafts or stent-grafts, comprising:
- a) a tubular body configured for positioning within a vessel, this tubular body being rigid in longitudinal direction and flexible in lateral direction, at one its end there are located two working heads, and at the other end—
a control mechanism;
b) a first working head with cartridges intended for location of fastener means, this working head is rigidly secured at the free end of tubular body and is made expandable to keep the first end of a delivered graft in contact with the inner surface of a blood vessel at the moment of their mutual fixation;
c) a second working head with cartridges intended for location of fastener means, this working head is secured near the free end of tubular body, some distance away from the first working head, aligned with the latter, this working head is also made expandable and serves to keep the second end of the delivered graft in contact with the inner surface of a blood vessel at the moment of their mutual fixation;
d) two cartridge groups, each including eight cartridges, which are incorporated in the construction of first and second working heads respectively, all cartridges are unified and interchangeable and each of the cartridges is intended for location at least of two fastener means, and all cartridges are provided with means for retaining therein fastener means, for imparting thereto progressive motion, for forming fastener means during their extension from these cartridges, as well as for storing and feeding standby fastener means;
e) a control mechanism, including a first control module for operation of the first working head, which is located at the free end of tubular body opposite to this head, as well as a second control module located on the tubular body between the first control module and second working head, rigidly connected with this second working head and serving for its operation, the first and second control modules being joined together via a connecting means,whereby a surgical operation may be performed for graft or stent-graft delivery and fixing both its ends to the walls of a blood vessel wall, substantially the aorta, from inside the aorta.
1 Assignment
0 Petitions
Accused Products
Abstract
The present invention relates to medical techniques, more particularly to methods and apparatus for delivery and double-ended fixation of vascular prosthesis—grafts or stent-grafts to blood vessel walls in direction from inside these vessels to their outer surface. The apparatus comprises a tubular body with two expandable working heads at the free end, means for securing thereon the prosthesis end. The heads have eight cartridges each, and each of these cartridges is provided with one basic and one standby fastener means, substantially U-shaped staples. A control mechanism is provided consisting of two control modules joined together. The apparatus is also provided with means for positioning inside a blood vessel. There is further proposed a method for delivery and double-ended fixation of an endovascular prosthesis to a blood vessel wall.
47 Citations
40 Claims
-
1. An apparatus for delivery and double-ended fixation of endovascular grafts or stent-grafts, comprising:
-
a) a tubular body configured for positioning within a vessel, this tubular body being rigid in longitudinal direction and flexible in lateral direction, at one its end there are located two working heads, and at the other end—
a control mechanism;b) a first working head with cartridges intended for location of fastener means, this working head is rigidly secured at the free end of tubular body and is made expandable to keep the first end of a delivered graft in contact with the inner surface of a blood vessel at the moment of their mutual fixation; c) a second working head with cartridges intended for location of fastener means, this working head is secured near the free end of tubular body, some distance away from the first working head, aligned with the latter, this working head is also made expandable and serves to keep the second end of the delivered graft in contact with the inner surface of a blood vessel at the moment of their mutual fixation; d) two cartridge groups, each including eight cartridges, which are incorporated in the construction of first and second working heads respectively, all cartridges are unified and interchangeable and each of the cartridges is intended for location at least of two fastener means, and all cartridges are provided with means for retaining therein fastener means, for imparting thereto progressive motion, for forming fastener means during their extension from these cartridges, as well as for storing and feeding standby fastener means; e) a control mechanism, including a first control module for operation of the first working head, which is located at the free end of tubular body opposite to this head, as well as a second control module located on the tubular body between the first control module and second working head, rigidly connected with this second working head and serving for its operation, the first and second control modules being joined together via a connecting means, whereby a surgical operation may be performed for graft or stent-graft delivery and fixing both its ends to the walls of a blood vessel wall, substantially the aorta, from inside the aorta. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39)
-
-
40. A method for delivery and double-ended fixation of a prosthesis, the graft or stent-graft, to the wall of a blood vessel from inside the latter, comprising the following successive steps:
-
i) preparing the prosthesis for delivery, mounting and securing its both ends on the apparatus working heads, as well as locating the prosthesis between working heads and its crimping to a given outer diameter; ii) setting the apparatus for delivery and fixation in operative position, inserting it in a corresponding blood vessel, bringing said first expandable working head to the securing area, precision axial and radial positioning in a given area of the blood vessel via a measuring scale on the surface of tubular body and via markers—
X-ray contrast marks, as well as deploying the first expandable working head in such a way, that the first end of a delivered prosthesis is in contact with the inner surface of the blood vessel at the moment of their mutual fixation, and the cartridges of this expandable working head are located near corresponding suturing points;iii) setting in motion said U-shaped staples of the cartridge group of first expandable working head accomplished by action of said flexible pushers activated, in their turn, via first pressure bush, second connecting means and second control means of first module of the control mechanism, which are associated with these pushers, whereby pointed ends of each of the U-shaped staples enter forming grooves of curvilinear guiding surface of a corresponding removable cartridge, are curled therein, diverging in opposite directions from one another, pierce the prosthesis wall and surrounding blood vessel wall and return again over a spiral to said curvilinear guiding surface, repeating this rotation if permitted by the given staple length, whereby the wall of the prosthesis first end gets sutured by wire spirals formed from U-shaped staples, to a corresponding wall area of the blood vessel, and said U-shaped staples entirely emerge from recesses of corresponding cartridges and are released from these cartridges, forming an oversew suture at the first end of the prosthesis; iv) reloading the cartridge group of first expandable working head with standby U-shaped staples accomplished by partial removal of said flexible pushers activated, in their turn, via first pressure bush, second connecting means and second control means of first module of the control mechanism, which are associated with these pushers, whereby each of the spring-loaded standby U-shaped staples emerges from the through slot of a corresponding cartridge, and then, at reverse motion of a corresponding flexible pusher, moves by its action into said recess, where the basic U-shaped staple was located before, whereby first working head of the apparatus is made ready for another suturing; v) if another suturing is necessary, setting in motion said standby U-shaped staples of first expandable working head accomplished by action of said flexible pushers activated, in their turn, via first pressure bush, second connecting means and second control means of first module of the control mechanism, which are associated with these pushers, whereby pointed ends of each of the standby U-shaped staples enter the forming grooves of curvilinear guiding surface of a corresponding removable cartridge, are curled therein, pierce the wall of the prosthesis first end and surrounding blood vessel wall and return again over a spiral to said curvilinear guiding surface, repeating this rotation if permitted by the given staple length, whereby the wall of the prosthesis first end gets sutured again by wire spirals formed from standby U-shaped staples, to a corresponding area of the blood vessel wall, and said standby U-shaped staples entirely emerge from recesses of corresponding cartridges and are released from these cartridges, forming a second oversew suture at the first end of this prosthesis; vi) spreading, if it is necessary, the prosthesis sutured at one end accomplished by turning the gear of said connecting means, which enables the second control module and second working head rigidly connected therewith to move along the apparatus tubular body some predesigned distance towards the first control module; vii) setting in motion said U-shaped staples of the cartridge group of second working head accomplished by action of said flexible pushers activated, in their turn, via second pressure bush, fourth connecting means and second control means of second module of the control mechanism, which are associated with these pushers, whereby pointed ends of each of the U-shaped staples enter the forming grooves of curvilinear guiding surface of a corresponding removable cartridge, are curled therein, diverging in opposite directions from one another, pierce the prosthesis wall and surrounding blood vessel wall and return again over a spiral to said curvilinear guiding surface, repeating this rotation if permitted by the given staple length, whereby the wall of the prosthesis second end gets sutured by wire spirals formed from U-shaped staples, to a corresponding area of the blood vessel wall, and said U-shaped staples entirely emerge from recesses of corresponding cartridges and are released from these cartridges, forming an oversew suture at the second end of this prosthesis; viii) reloading the cartridge group of second working head with standby U-shaped staples accomplished by partial removal of said flexible pushers activated, in their turn, via second pressure bush, fourth connecting means and second control means of second module of the control mechanism, which are associated with these pushers, whereby each of the spring-loaded standby U-shaped staples emerges from the through slot of a corresponding cartridge, and then, at reverse motion of a corresponding flexible pusher, moves by its action into said recess, where the basic U-shaped staple was located before, whereby the second working head of said apparatus for delivery and fixation is made ready for another suturing; ix) if another suturing is necessary, setting in motion said standby U-shaped staples in cartridges of second working head accomplished by action of said flexible pushers activated, in their turn, via second pressure bush, fourth connecting means and second control means of second module of the control mechanism, which are associated with these pushers, whereby pointed ends of each of the standby U-shaped staples enter the forming grooves of curvilinear guiding surface of a corresponding removable cartridge, are curled therein, diverging in opposite directions from one another, pierce the wall of said prosthesis second end and surrounding blood vessel wall and return again over a spiral to said curvilinear guiding surface, repeating this rotation if permitted by the given staple length, whereby the wall of this prosthesis second end gets sutured again by wire spirals formed from standby U-shaped staples, to a corresponding area of this blood vessel wall, and said standby U-shaped staples entirely emerge from recesses of corresponding cartridges and are released from these cartridges, forming a second oversew suture at the second end of a corresponding prosthesis; x) separating both ends of a delivered and sutured prosthesis from the apparatus for delivery and fixation, returning both its expandable heads to original position; xi) setting the apparatus for delivery and fixation in inoperative position and its removal from the prosthesis and from the blood vessel.
-
Specification