Endoscopic device, prosthesis and method for use in endovascular repair

• US 5,330,490 A
• Filed: 04/10/1992
• Issued: 07/19/1994
• Est. Priority Date: 04/10/1992
• Status: Expired due to Fees

• Current Assignee: Jonathan Tiefenbrun, Peter J. Wilk
• Original Assignee: Jonathan Tiefenbrun, Peter J. Wilk
• Inventors: Wilk, Peter J., Tiefenbrun, Jonathan
• Primary Examiner(s): JAWORSKI, FRANCIS J
• Application Number:
  US07/866,758
• Time in Patent Office: 830 Days
• Field of Search: 623/1, 606/153, 606/191, 606/198, 604/96, 604/264
• US Class Current: 606/153
• CPC Class Codes: A61B 1/00082 Balloons
• CPC Class Codes: A61B 1/0051 with controlled bending of insertion part
• CPC Class Codes: A61B 1/05 characterised by the image sensor, e.g. camera, being in the distal end portion
• 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 17/064 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 17/10 for applying or removing wound clamps, e.g. containing only one clamp or staple A61B17/076 takes precedence; containing multiple wound clamps A61B17/068; Wound clamp magazines containers, packaging elements or packages specially adapted for particular articles or with special means for dispensing contents B65D83/00, B65D85/00
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/0034 adapted to be inserted through a working channel of an endoscope
• CPC Class Codes: A61B 2017/0647 having one single leg, e.g. tacks
• CPC Class Codes: A61B 2017/22059 transparent
• CPC Class Codes: A61B 2017/22064 transparent liquid
• CPC Class Codes: A61B 2017/22072 with an instrument channel, e.g. for replacing one instrument by the other in cannulas A61B17/3417
• CPC Class Codes: A61B 2017/2905 flexible
• CPC Class Codes: A61B 2090/373 using light, e.g. by using optical scanners
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61F 2/94 Stents retaining their form, i.e. not being deformable, after placement in the predetermined place
• CPC Class Codes: A61F 2220/0008 Fixation appliances for connecting prostheses to the body
• CPC Class Codes: A61F 2220/0016 with sharp anchoring protrusions, e.g. barbs, pins, spikes
• CPC Class Codes: A61F 2220/0058 soldered or brazed or welded
• CPC Class Codes: A61F 2220/0075 : sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable

Abstract

In a method for performing a vascular repair operation a tubular endovascular prosthesis member made of a nontoxic biocompatible material is inserted in a collapsed configuration into a blood vessel through an incision therein. Upon insertion, the tubular prosthesis member is expanded to a cylindrical configuration and attached along its upstream and downstream edges to the vessel wall. Where the attachment is implemented via a laser, an optical fiber is inserted into the blood vessel via an angioscopic instrument having a balloon with a mouth attached about a distal end of the angioscopic insertion member so that a distal tip of the insertion member is disposed inside the balloon. The balloon is made of a material transparent to optical radiation, as well as to the wavelength of the laser beam, whereby visualization of the arterial or venous wall and the bonding of the tubular prosthesis member thereto may be implemented through the balloon. The balloon is effective to displace blood from the distal end of the endoscopic insertion member to form a transparent pocket or space, thereby enabling visual inspection of a blood vessel into which the endoscopic instrument has been inserted. Endovascular inspection may alternatively be accomplished by a combined ultrasonic and optical angioscopic instrument.

Claims

1. A method for performing a vascular repair operation, comprising the steps of:

providing a tubular member made of a nontoxic biocompatible material;

making an incision in a blood vessel;

inserting said tubular member in a collapsed configuration through said incision into said blood vessel;

expanding said tubular member from said collapsed configuration into an opened configuration inside said blood vessel; and

bonding an upstream edge of said tubular member to said blood vessel by inserting an optical fiber through said incision into said blood vessel and directing a laser beam at said tubular member along said upstream edge, said optical fiber being disposed at least partially in an angioscopic instrument, further comprising the step of using said angioscopic instrument to locate said upstream edge inside said blood vessel.

2. The method defined in claim 1 wherein said angioscopic instrument includes a balloon having a mouth attached about a distal end of said angioscopic instrument so that a distal tip of said angioscopic instrument is disposed inside said balloon, said balloon being made of a material transparent to both optical radiation and the wavelength of said laser beam, further comprising the steps of inflating said balloon at least partially inside said tubular member in a region about said upstream edge and directing said laser beam at said upstream edge through said balloon.

3. The method defined in claim 1, further comprising the step of attaching a downstream edge of said tubular member to said blood vessel.

4. The method defined in claim 1 wherein said tubular member has an upstream portion formed of graft tissue which defines said upstream edge.

5. A method for performing a vascular repair operation, comprising the steps of:

providing a tubular member made of a nontoxic biocompatible material;

making an incision in a blood vessel;

inserting said tubular member in a collapsed configuration through said incision into said blood vessel;

expanding said tubular member from said collapsed configuration into an opened configuration inside said blood vessel; and

attaching an upstream edge of said tubular member to said blood vessel, said step of attaching including the steps of (a) providing an annular reinforcement ring inside said tubular member at said upstream edge and (b) applying an annular clamping element about said blood vessel at said upstream edge to fix said blood vessel and said tubular member between said ring and said clamping element.

6. The method defined in claim 5 wherein said reinforcement ring is separate from said tubular member and is inserted separately into said blood vessel.

7. The method defined in claim 5 wherein said annular clamping element takes the form of an elongate flexible element, said step of applying including the step of tying said flexible element about said blood vessel at said upstream edge of said tubular member.

8. A method for performing a vascular repair operation, comprising the steps of:

providing a tubular member made of a nontoxic biocompatible material;

making an incision in a blood vessel;

inserting said tubular member in a collapsed configuration through said incision into said blood vessel;

expanding said tubular member from said collapsed configuration into an opened configuration inside said blood vessel;

inserting an angioscopic instrument through said incision into said blood vessel;

using said angioscopic instrument to locate an upstream edge of said tubular member inside said blood vessel; and

upon locating said upstream edge by using said angioscopic instrument, inserting attaching an upstream edge of said tubular member to said blood vessel.

9. The method defined in claim 8 wherein said step of attaching includes the steps of stapling said upstream edge to said blood vessel.

10. The method defined in claim 9 wherein said step of attaching includes the step of inserting a stapling device into said blood vessel through said incision and operating said stapling device to eject staples through said tubular member and said blood vessel.

11. The method defined in claim 8 wherein said step of attaching includes the step of bonding said tubular member along said upstream edge to said blood vessel.

12. The method defined in claim 11 wherein said step of bonding includes the steps of inserting an optical fiber through said incision into said blood vessel and directing a laser beam at said tubular member along said upstream edge.

13. The method defined in claim 8 wherein said angioscopic instrument includes a balloon having a mouth attached about a distal end of said angioscopic instrument so that a distal tip of said angioscopic instrument is disposed inside said balloon, said balloon being made of a material transparent to both optical radiation and the wavelength of said laser beam, further comprising the steps of inflating said balloon at least partially inside said tubular member in a region about said upstream edge and directing said laser beam at said upstream edge through said balloon.

14. The method defined in claim 8 wherein said step of attaching includes the steps of (a) providing an annular reinforcement ring inside said tubular member at said upstream edge and (b) applying an annular clamping element about said blood vessel at said upstream edge to fix said blood vessel and said tubular member between said ring and said clamping element.

15. The method defined in claim 14 wherein said reinforcement ring is separate from said tubular member and is inserted separately into said blood vessel.

16. The method defined in claim 14 wherein said annular clamping element takes the form of an elongate flexible element, said step of applying including the step of tying said flexible element about said blood vessel at said upstream edge of said tubular member.

17. The method defined in claim 8 wherein said step of attaching includes the step of stapling said upstream edge to said blood vessel.

18. The method defined in claim 17 wherein said step of attaching includes the step of inserting a stapling device into said blood vessel through said incision and operating said stapling device to eject staples through said tubular member and said blood vessel.

19. The method defined in claim 8, further comprising the step of attaching a downstream edge of said tubular member to said blood vessel.