PERCUTANEOUS TETHER LOCKING

• US 20150119936A1
• Filed: 10/28/2014
• Published: 04/30/2015
• Est. Priority Date: 10/30/2013
• Status: Active Grant

• Current Assignee: 4Tech Inc.
• Original Assignee: 4Tech Inc.
• Inventors: GILMORE, Michael, TOBIS, Idan, MAISANO, Francesco, MURPHY, Charlotte, CLARKE, Gareth, LYNN, Kevin
• Granted Patent: US 10,022,114 B2
• Time in Patent Office: Days
• US Class Current: 606/232
• 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 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00783 Valvuloplasty
• 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 2017/0462 One way system, i.e. also tensioning the suture
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/0488 Instruments for applying suture clamps, clips or locks for applying suture anchors A61B2017/0409; for applying wound clamps A61B17/10; for applying ligaturing clamps or clips A61B17/128
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61F 2/82 Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents stent-grafts for tubular structures of the body other than blood vessels A61F2/04; stent-grafts for blood vessels A61F2/07; instruments specially adapted for placement or removal of stents or stent-grafts A61F2/95; for closing wounds, or holding wounds closed A61B17/04 - A61B17/115; dilators A61M29/00

Abstract

A tether-securing device is provided that includes a tubular element, which is shaped so as define a lateral wall that surrounds a lumen. The lateral wall is shaped so as to define a one-way locking opening. The tether-securing device further includes at least one tether, which (a) has at least a first tether end portion, and (b) passes through the lumen and the one-way locking opening. The tether-securing device additionally includes first and second tissue anchors. The first tissue anchor is connected to the first tether end portion. The one-way locking opening is configured to (a) allow sliding of the at least one tether in a first direction through the one-way locking opening, and (b) inhibit sliding of the at least one tether in a second direction opposite the first direction. Other embodiments are also described.

Claims

1. Apparatus comprising:

a tether-securing device, which comprises a tubular element, which is shaped so as define a lateral wall that surrounds a lumen, wherein the lateral wall is shaped so as to define a one-way locking opening;

at least one tether, which (a) has at least a first tether end portion, and (b) passes through the lumen and the one-way locking opening; and

first and second tissue anchors, wherein the first tissue anchor is connected to the first tether end portion,

wherein the one-way locking opening is configured to (a) allow sliding of the at least one tether in a first direction through the one-way locking opening, and (b) inhibit sliding of the at least one tether in a second direction opposite the first direction.

2. The apparatus according to claim 1, wherein the one-way locking opening is shaped as a slit.

3. The apparatus according to claim 1, wherein the first direction is from inside the tubular element to outside the tubular element.

6. The apparatus according to claim 1, wherein the one-way locking opening has uneven edges.

7. The apparatus according to claim 6, wherein the uneven edges are jagged or serrated.

8. The apparatus according to claim 1, wherein the at least one tether defines a plurality of securement protrusions spaced at intervals along the at least one tether.

12. The apparatus according to claim 1,

wherein a single tether of the at least one tether has the first tether end portion and a second tether end portion, which second tether end portion is connected to the second tissue anchor, and

wherein the single tether comprises at least the following non-overlapping longitudinal portions disposed in sequence along the single tether:

the first tether end portion,

a first portion that passes through the securing-device lumen and the one-way locking opening,

a looped middle portion that extends out of and away from the one-way locking opening, and then loops back to the one-way locking opening,

a second portion that passes through the securing-device lumen and the one-way locking opening, and

the second tether end portion.

13. The apparatus according to claim 12, wherein the lateral wall is shaped so as to define first and second non-constraining openings, which are sized and shaped to allow free sliding therethrough of two longitudinal portions, respectively, of the single tether.

15. The apparatus according to claim 12, further comprising a fixation tether, which is connected to the looped middle portion of the single tether.

18. The apparatus according to claim 1, wherein the second tissue anchor comprises a head and a tissue-coupling element, and wherein the tether-securing device is fixed to the head, such that the tether-securing device surrounds at least a portion of the head.

19. The apparatus according to claim 18, wherein the tether-securing device is configured to rotate with respect to the head.

20. The apparatus according to claim 18, wherein the lateral wall is shaped so as to define a non-constraining opening, which is sized and shaped to allow free sliding therethrough of the at least one tether.

22. The apparatus according to claim 1,

wherein the at least one tether comprises first and second tethers, which (a) have the first tether end portion and a second tether end portion, respectively, and (b) pass through (i) the lumen and (ii) the one-way locking opening,

wherein the second tissue anchor is connected to the second tether end portion, and

wherein the one-way locking opening is configured to (a) allow the sliding of the first and the second tethers in the first direction through the one-way locking opening, and (b) inhibit the sliding of the first and the second tethers in the second direction.

25. The apparatus according to claim 1, further comprising:

a venous tissue anchor, which is configured to be implanted in a vein selected from the group of veins consisting oft an inferior vena cava, a superior vena cava, and a coronary sinus; and

a fixation tether, which is connected to the venous tissue anchor and the at least one tether.

26. The apparatus according to claim 25, wherein the venous tissue anchor comprises a stent.

4-5. -5. (canceled)

9-11. -11. (canceled)

14. (canceled)

16-17. -17. (canceled)

21. (canceled)

23-24. -24. (canceled)

27-63. -63. (canceled)

64. A method comprising:

delivering, to a vicinity of an anatomical site of a subject;

(a) a tether-securing device, which includes a tubular element, which is shaped so as define a lateral wall that surrounds a lumen, wherein the lateral wall is shaped so as to define a one-way locking opening,

(b) at least one tether, which (i) has at least a first tether end portion, and (ii) passes through the lumen and the one-way locking opening, wherein the one-way locking opening is configured to (i) allow sliding of the at least one tether in a first direction through the one-way locking opening, and (ii) inhibit sliding of the at least one tether in a second direction opposite the first direction, and

(c) first and second tissue anchors, wherein the first tissue anchor is connected to the first tether end portion;

implanting the first and the second tissue anchors in tissue of the subject; and

tensioning the at least one tether by sliding the at least one tether in the first direction through the one-way locking opening.

65. The method according to claim 64,

wherein a single tether of the at least one tether has the first tether end portion and a second tether end portion, which second tether end portion is connected to the second tissue anchor,

wherein the single tether includes at least the following non-overlapping longitudinal portions disposed in sequence along the single tether:

the first tether end portion,

a first portion that passes through the securing-device lumen and the one-way locking opening,

a looped middle portion that extends out of and away from the one-way locking opening, and then loops back to the one-way locking opening,

a second portion that passes through the securing-device lumen and the one-way locking opening, and

the second tether end portion, and

wherein tensioning the tether comprises proximally sliding the first and the second portions of the tether through the one-way locking opening in the first direction by pulling, in the first direction, on the looped middle portion.

66. The method according to claim 65,

wherein the lateral wall is shaped so as to define first and second non-constraining openings, which are sized and shaped to allow free sliding therethrough of two longitudinal portions, respectively, of the single tether, and

wherein sliding the tether through the one-way locking opening further comprises sliding the two non-overlapping longitudinal portions of the tether through the first and the second non-constraining openings, respectively.

68. The method according to claim 65, further comprising connecting a fixation tether to the looped middle portion of the single tether.

69. The method according to claim 68, further comprising implanting a venous tissue anchor, which is connected to the fixation tether, in a vein selected from the group of veins consisting of:

an inferior vena cava, a superior vena cava, and a coronary sinus.

71. The method according to claim 64, wherein the second tissue anchor includes a head and a tissue-coupling element, and wherein the tether-securing device is fixed to the head, such that the tether-securing device surrounds at least a portion of the head.

72. The method according to claim 71, wherein the tether-securing device is configured to rotate with respect to the head.

73. The method according to claim 71,

wherein the lateral wall is shaped so as to define a non-constraining opening, which is sized and shaped to allow free sliding therethrough of the tether, and

wherein sliding the tether through the one-way locking opening further comprises sliding the tether through the non-constraining opening.

75. The method according to claim 64,

wherein the at least one tether includes first and second tethers, which (a) have the first tether end portion and a second tether end portion, respectively, and (b) pass through (i) the lumen and (ii) the one-way locking opening,

wherein the second tissue anchor is connected to the second tether end portion,

wherein the one-way locking opening is configured to (a) allow the sliding of the first and the second tethers in the first direction through the one-way locking opening, and (b) inhibit the sliding of the first and the second tethers in the second direction, and

wherein tensioning the at least one tether comprises tensioning the first and the second tethers by sliding the first and the second tethers in the first direction through the one-way locking opening.

76. The method according to claim 75,

wherein the lateral wall is shaped so as to define first and second non-constraining openings, which are sized and shaped to allow free sliding therethrough of the first and the second tethers, respectively,

wherein the first and the second tethers slidably pass through the first and the second non-constraining openings, respectively, and

wherein sliding the first and the second tethers through the one-way locking opening further comprises sliding the first and the second tethers through the first and the second non-constraining openings, respectively.

78. The method according to claim 64, wherein the one-way locking opening is shaped as a slit.

79. The method according to claim 64, wherein the first direction is from inside the tubular element to outside the tubular element.

80. The method according to claim 64, wherein the one-way locking opening has uneven edges.

81. The method according to claim 80, wherein the uneven edges are jagged or serrated.

88. The method according to claim 64, further comprising:

implanting a venous tissue anchor in a vein selected from the group of veins consisting of;

an inferior vena cava, a superior vena cava, and a coronary sinus; and

connecting, to the at least one tether, a fixation tether which is connected to the venous tissue anchor.

67. (canceled)

70. (canceled)

74. (canceled)

77. (canceled)

82-87. -87. (canceled)

89-127. -127. (canceled)