Method and devices for performing vascular anastomosis
First Claim
1. A catheter for performing an end-to-side anastomosis between a severed end of a first hollow organ and a side-wall of a second hollow organ of a patient, comprising:
- an elongated body having proximal and distal ends and adapted for introduction into and through the first hollow organ; and
a selectively operable cutter disposed within the body and having a cutting surface at the distal end which is configured to remove a portion of a side-wall of the second hollow organ.
4 Assignments
0 Petitions
Accused Products
Abstract
A method and devices are provided for performing end-to-side anastomoses between the severed end of a first hollow organ and the side-wall of a second hollow organ utilizing transluminal approach with endoscopic assistance. In particular, the method utilizes a catheter, having a selectively operable cutter, which is introduced into the first hollow organ until the distal end of the catheter is substantially adjacent to the severed end of the first hollow organ. The severed end of the first hollow organ is positioned in proximity to the site for anastomoses on the side wall of the second hollow organ and the severed end is secured in sealing engagement with the side-wall, thereby defining a region of securement on the side wall of the second hollow organ. The severed end of the first hollow organ is preferably secured to the side wall of the second hollow organ by activating a corkscrew element in the catheter to penetrate the side-wall of the second hollow organ and hold the severed end of the first hollow organ in mating engagement with the side-wall of the second hollow organ. A plurality of clips can be applied to the seam between the first hollow organ and the second hollow organ. Alternatively, the first and second hollow organs can be secured by suturing. The cutter is then activated to remove a portion of the side-wall of the second hollow organ, thereby creating an opening within the region of securement and establishing the anastomosis.
442 Citations
35 Claims
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1. A catheter for performing an end-to-side anastomosis between a severed end of a first hollow organ and a side-wall of a second hollow organ of a patient, comprising:
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an elongated body having proximal and distal ends and adapted for introduction into and through the first hollow organ; and a selectively operable cutter disposed within the body and having a cutting surface at the distal end which is configured to remove a portion of a side-wall of the second hollow organ. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. A method for establishing an end-to-side anastomosis between a severed end of a first hollow organ and a side-wall of a second hollow organ, the method comprising:
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(a) introducing a catheter, having proximal and distal ends, into the first hollow organ and passing the catheter through the first organ until the distal end of the catheter is substantially adjacent to the severed end of the first hollow organ, the catheter having a selectively operable cutter adapted to remove a portion of the side-wall of the second hollow organ; (b) positioning the severed end of the first hollow organ in proximity with the site for anastomosis of the second hollow organ; (c) securing the severed end of the first hollow organ in sealing engagement with the side-wall of the second hollow organ, thereby defining a region of securement on a side-wall of the second hollow organ; and (d) activating the cutter to remove a portion of a side-wall of the second hollow organ thereby creating an opening within the region of securement defined by the engagement of the severed end of the first hollow organ with the side-wall of the second hollow organ. - View Dependent Claims (10, 11, 12, 13, 14, 15, 16)
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17. A method for performing end-to-side anastomosis between a severed end of a first hollow organ and a side-wall of a second hollow organ, the method comprising:
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(a) introducing a catheter, having proximal and distal ends, into the first hollow organ and passing the catheter through the first organ until the distal end of the catheter is substantially adjacent to the severed end of the first hollow organ, the catheter having a corkscrew element and a selectively operable cutter adapted to remove a portion of the side-wall of the second hollow organ; (b) positioning the severed end of the first hollow organ in proximity with the site for anastomosis of the second hollow organ; (c) activating the corkscrew element whereby corkscrew element penetrates the side wall of the severed hollow organ and the severed end of the first hollow organ is held in mating relationship with the second hollow organ; (d) securing the severed end of the first hollow organ in sealing engagement with the side-wall of the second hollow organ, thereby defining a region of securement on a side-wall of the second hollow organ; and (e) activating the cutter to remove a portion of a side-wall of the second hollow organ thereby creating an opening within a region of securement defined by the engagement of the severed end of the first hollow organ with the side-wall of the second hollow organ. - View Dependent Claims (18, 19, 20, 21, 22, 23, 24)
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25. A method for performing a coronary bypass by establishing an end-to-side anastomosis between an arterial source of oxygenated blood and a coronary artery having a stenosis, the method comprising:
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(a) introducing a catheter, having proximal and distal ends, into the arterial source and passing the catheter through the arterial source until the distal end of the catheter is substantially adjacent to the severed end of the arterial source, the catheter having a selectively operable cutter adapted to remove a portion of the side-wall of the coronary artery; (b) severing the arterial source; (c) positioning the severed end of the arterial source in proximity with the site for anastomosis of the coronary artery; (d) securing the severed end of the first hollow organ in sealing engagement with the side-wall of the second hollow organ, thereby defining a region of securement on a side-wall of the second hollow organ; (e) activating the cutter to remove a portion of a side-wall of the coronary artery thereby creating an opening within the region of securement defined by the engagement of the severed end of the arterial source with the side-wall of the coronary artery. - View Dependent Claims (26, 27, 28, 29, 30, 31, 32)
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33. A method for performing coronary bypass by effecting an end-to-side anastomoses between a arterial source of oxygenated blood and a coronary artery, the method comprising:
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(a) introducing a plurality of trocar ports through the intercostal spaces of a patient; (b) performing gas dissection of the thoracic cavity; (c) isolating an arterial source of oxygenated blood; (d) severing the arterial source; (e) introducing a catheter, having proximal and distal ends, into the arterial source and passing the catheter through the arterial source until the distal end of the catheter is substantially adjacent to the severed end of the arterial source, the catheter having a corkscrew element adapted to penetrate and secure the side wall of the coronary artery, and a selectively operable cutter adapted to remove a portion of the side-wall of the coronary artery; (f) performing endoscopic dissection of the parietal pleura; (g) opening the pericardial sac; (h) isolating the coronary artery proximally and distally to the site for anastomosis; (i) placing the severed end of the arterial source in proximity to the site of anastomosis; (j) activating the corkscrew element whereby the severed end of the arterial source is held in mating relationship with the coronary artery; (k) securing the severed end of the arterial source in sealing engagement with the side wall of the coronary artery; (l) activating the cutter whereby a portion of the side wall of the coronary artery engaged by the corkscrew element is removed; (m) removing the cutter catheter and the portion of the side wall engaged by the corkscrew element; (n) closing the pericardial sac; (o) removing the trocar ports; and (p) evacuating the thoracic cavity. - View Dependent Claims (34, 35)
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Specification