Arteriovenous Shunt Having a Flow Control Mechanism

• US 20130261531A1
• Filed: 03/30/2012
• Published: 10/03/2013
• Est. Priority Date: 03/30/2012
• Status: Active Grant

• Current Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Original Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Inventors: Gallagher, John, McCaffrey, Gerry
• Granted Patent: US 9,067,050 B2
• Time in Patent Office: Days
• US Class Current: 604/9
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 2017/1107 for blood vessels
• CPC Class Codes: A61B 2017/1139 Side-to-side connections, e.g. shunt or X-connections
• CPC Class Codes: A61F 2/07 Stent-grafts
• CPC Class Codes: A61F 2002/072 Encapsulated stents, e.g. wire or whole stent embedded in lining
• CPC Class Codes: A61F 5/004 remotely adjustable
• CPC Class Codes: A61M 39/28 Clamping means for squeezing flexible tubes, e.g. roller clamps tube strippers A61M1/83
• CPC Class Codes: A61M 5/16813 by controlling the degree of opening of the flow line

Abstract

An arteriovenous shunt assembly including a shunt and a pull wire operated flow control mechanism. The shunt has a tubular body that defines a fluid passageway between a first end and a second end thereof The pull wire mechanism includes a portion disposed around the tubular shunt in at least one loop. The at least one loop may be selectively tightened or loosened remotely from the shunt to regulate the rate of blood flow through the tubular shunt.

Claims

1. An arteriovenous shunt assembly comprising:

a tubular shunt having a fluid passageway between open first end second ends thereof;

a flow control mechanism that includes a pull wire having a distal portion disposed around the tubular shunt in at least one loop; and

a subcutaneous control port containing ends of the pull wire, wherein pulling on at least one of the ends of the pull wire causes the pull wire to selectively tighten around the tubular shunt and radially constrict the tubular shunt, thereby reducing the rate of blood flow permitted through the fluid passageway of the tubular shunt.

2. The arteriovenous shunt assembly of claim 1, wherein the tubular shunt includes graft material having a plurality of self-expanding stents attached thereto.

3. The arteriovenous shunt assembly of claim 1, wherein the at least one loop of the distal portion of the flow control mechanism is disposed around an outer surface of the tubular shunt.

4. The arteriovenous shunt assembly of claim 1, wherein the at least one loop of the distal portion of the flow control mechanism is disposed within a track formed within an outer surface of the tubular shunt.

5. The arteriovenous shunt assembly of claim 1, wherein the at least one loop of the distal portion is a series of spaced apart loops disposed around the tubular shunt.

6. The arteriovenous shunt assembly of claim 1, wherein the tubular shunt has a first end segment for placement in a first vessel, a second end segment for placement in a second vessel, and an intermediate portion between the first and second end segments for extending through a tissue tract between the first and second vessel and the tubular shunt has an expanded diameter less than a luminal diameter of the first and second vessels.

7. The arteriovenous shunt assembly of claim 1, wherein the at least one loop of the distal portion of the flow control mechanism is positioned approximately at the longitudinal midpoint of the tubular shunt.

8. The arteriovenous shunt assembly of claim 1, wherein the flow control mechanism also includes an elongated shaft defining a first lumen for slidingly receiving a first elongated leg of the wire and a second lumen for slidingly receiving a second elongated leg of the wire, the elongated shaft having a distal end segment coupled to an inside surface of the tubular shunt and a proximal end coupled to the subcutaneous control port.

9. The arteriovenous shunt assembly of claim 1, wherein the first and second ends of the tubular shunt have a larger outer diameter than a middle portion of the tubular shunt.

10. A method for forming a connection between a first body vessel and a second body vessel for controlling blood flow through the connection, the method comprising the steps of:

intravascularly delivering a shunt assembly in its collapsed configuration to a tissue tract formed between the first vessel and the second vessel, the shunt assembly including a tubular shunt that defines a fluid passageway between a first end and a second end thereof and a flow control mechanism coupled to the shunt, wherein the flow control mechanism includes a continuous pull wire having a distal portion disposed around the tubular shunt in at least one loop;

positioning the tubular shunt through the tissue tract;

deploying the tubular shunt to an expanded configuration; and

pulling on an end of the pull wire to tighten the at least one loop of the distal portion to radially constrict the tubular shunt and thereby reduce the rate of blood flow permitted through the fluid passageway of the tubular shunt.

11. The method of claim 10, wherein first vessel is an artery and the second vessel is a vein adjacent to the artery.

12. The method of claim 11, wherein the artery is a femoral artery in a leg and the vein is a femoral vein in the leg, and the step of longitudinally shifting the flow control mechanism provides treatment for COPD.

13. The method of claim 10, wherein the step of deploying the tubular shunt includes retracting a sheath of a delivery system.

14. The method of claim 10, wherein the step of pulling on an end of the pull wire includes

forming a small incision through the patient'"'"'s skin in order to access ends of the wire;

and

pulling on at least one of the ends of the wire.

15. The method of claim 10, wherein the at least one loop of the distal portion is disposed around an outer surface of the tubular shunt.

16. The method of claim 10, wherein the at least one loop of the distal portion is disposed within a track formed within an outer surface of the tubular shunt.

17. The method of claim 10, wherein the at least one loop of the distal portion is a series of spaced apart loops disposed around the tubular shunt.

18. The method of claim 10, wherein the at least one loop of the distal portion is positioned approximately at the longitudinal midpoint of the tubular shunt.

19. The method of claim 10, wherein the flow control mechanism also includes an elongated shaft defining a first lumen for slidingly receiving a first elongated leg of the wire and a second lumen for slidingly receiving a second elongated leg of the wire, the elongated shaft having a distal end segment coupled to an inside surface of the tubular shunt.