Devices, systems, and methods for prosthesis delivery and implantation

• US 20100094400A1
• Filed: 12/10/2009
• Published: 04/15/2010
• Est. Priority Date: 11/28/2001
• Status: Abandoned Application

• Current Assignee: Aptus Endosystems Inc. (Medtronic Plc)
• Original Assignee: Aptus Endosystems Inc. (Medtronic Plc)
• Inventors: Stafford, Joshua, Laroya, Gilbert, Bolduc, Lee
• Application Number:
  US12/653,219
• Publication Number:
  US 20100094400A1
• Time in Patent Office: Days
• US Class Current: 623/1.11
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• 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 17/3415 for introducing tubes or catheters, e.g. gastrostomy tubes, drain catheters A61B17/3417 takes precedence; body piercing catheter guide needles A61M25/06
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00327 with actuating members moving in opposite directions
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0441 the shaft being a rigid coil or spiral
• CPC Class Codes: A61B 2017/0649 Coils or spirals
• CPC Class Codes: A61B 2090/3966 Radiopaque markers visible in an X-ray image
• CPC Class Codes: A61M 2025/015 Details of the distal fixation of the movable mechanical means
• CPC Class Codes: A61M 25/0136 Handles therefor
• CPC Class Codes: A61M 25/0147 with movable mechanical means, e.g. pull wires

Abstract

Devices, systems, and methods use a catheter device sized and configured for introduction to a targeted site in a hollow body organ or blood vessel. The catheter device includes a first release mechanisms coupled to the prosthesis to secure at least one region of the prosthesis to the catheter shaft, and a second release mechanism coupled to the prosthesis in cooperation with the first release mechanism to prevent full release of the at least one region of the at least one region of the prosthesis from the catheter shaft after actuation of the first release mechanism. A fastening device sized and configured for introduction to the targeted site in the hollow body organ or blood vessel occupied by the catheter device, includes an actuator to deploy a fastener in the at least one region of the prosthesis after actuation of the first release mechanism and before actuation of the second release mechanism.

Claims

1. A method comprising

providing a prosthesis including a proximal region and a distal region, each of the proximal and distal regions being sized and configured for self-expansion between a radially compressed condition and a radially expanded condition,

providing a deployment catheter including a shaft sized and configured to carry the prosthesis, a first proximal release mechanism coupling the proximal region of the prosthesis to the shaft to retain the proximal region in the radially compressed condition, a second proximal release mechanism coupling the proximal region of the prosthesis to the shaft, independent of the first proximal release mechanism, to retain the proximal region coupled to the shaft while the proximal region is in the radially expanded condition, and a distal release mechanism, independent of the first and second proximal release mechanisms, coupling the distal region of the prosthesis to the shaft to retain the distal region the radially compressed condition,

providing a guide device separate from the deployment catheter, the guide device defining a guide passage,

providing a fastener device separate from the guide device and the deployment catheter and being sized and configured to pass through the guide passage, the fastener device carrying at least one fastener,

positioning the deployment catheter at a targeted site in a hollow body organ or blood vessel, the first proximal release mechanism and the distal release mechanisms of the deployment catheter retaining the proximal and distal regions of the prosthesis, respectively, in the radially compressed condition,

actuating the first proximal release mechanism and not the second proximal release mechanism and not the distal release mechanism to release the proximal region of the prosthesis for self-expansion from the radially compressed condition to the radially expanded condition, thereby allowing adjustment of a position of the prosthesis, while the proximal region is in the radially expanded condition, relative to the targeted site by manipulation of the deployment catheter,

deploying the guide device into the proximal region while the proximal region is in the radially expanded condition,

deploying the fastener device through the guide passage of the guide device into the proximal region while the proximal region is in the radially expanded condition,

operating the fastener device to apply the fastener to fasten the proximal region of the prosthesis to the targeted site while the proximal region is in the radially expanded condition,

after applying the fastener, actuating the second proximal release mechanism to release the proximal region of the prosthesis from the deployment catheter, and

actuating the distal release mechanism to allow the distal region of the prosthesis to self expand from the radially compressed condition to the radially expanded condition.

2. A method according to claim 1

further comprising, after actuating the first proximal release mechanism and before applying the fastener, manipulating the deployment catheter to adjust a position of the prosthesis either longitudinally and/or rotationally relative to the targeted site.

3. A method according to claim 1

wherein the deployment catheter includes an interlock mechanism to prevent actuation of the second proximal release mechanism before actuation of the first proximal release mechanism.

4. A method according to claim 1

wherein the prosthesis is longitudinally compliant.