Method of restoring reduced or absent blood flow capacity

• US 5,842,479 A
• Filed: 10/15/1996
• Issued: 12/01/1998
• Est. Priority Date: 06/07/1993
• Status: Expired due to Fees

• Current Assignee: Synectic Ventures III LLC (Synectic Asset Management, Inc.), Synectic Ventures II LLC (Synectic Asset Management, Inc.), Synectic Ventures I LLC (Synectic Asset Management, Inc.)
• Original Assignee: Endovascular Instruments, Inc.
• Inventors: Plaia, Mark, Nordgren, Gregory N., Reger, Vincent A.
• Primary Examiner(s): Clarke, Robert A.
• Application Number:
  US08/730,421
• Time in Patent Office: 777 Days
• Field of Search: 623/1, 606/194, 128/898
• US Class Current: 128/898
• CPC Class Codes: A61B 17/00008 Vein tendon strippers tube strippers A61M1/83
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 17/32075 Pullback cutting; combined forward and pullback cutting, e.g. with cutters at both sides of the plaque
• CPC Class Codes: A61B 17/320758 with a rotating cutting instrument, e.g. motor driven A61B17/320725, A61B17/32075 and A61B17/320783 take precedence; for removing intra-ocular material A61F9/00763; endoscopic rotatable cutting instruments A61B17/32002
• CPC Class Codes: A61B 2017/22051 with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation A61B2017/22048, A61B2017/3486 take precedence
• CPC Class Codes: A61B 2017/320741 for stripping the intima or the internal plaque from a blood vessel, e.g. for endarterectomy
• CPC Class Codes: A61B 2090/062 penetration depth
• CPC Class Codes: A61F 2/06 Blood vessels
• CPC Class Codes: A61F 2/07 Stent-grafts
• CPC Class Codes: A61F 2/848 having means for fixation to the vessel wall, e.g. barbs
• CPC Class Codes: A61F 2/86 Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
• CPC Class Codes: A61F 2/954 for placing stents or stent-grafts in a bifurcation
• CPC Class Codes: A61F 2/958 Inflatable balloons for placing stents or stent-grafts
• CPC Class Codes: A61F 2002/065 Y-shaped blood vessels
• CPC Class Codes: A61F 2002/075 the stent being loosely attached to the graft material, e.g. by stitching
• CPC Class Codes: Y10S 623/903 Blood vessel

Abstract

Methods of artificially lining a vessel, especially an artery, of a medical patient to address the existence of a flow-inhibiting atheroma and to significantly alleviate the probability of restenosis, and the resulting products.

Claims

1. A method of treating an artery, comprising the steps of:

accessing to the artery through a small man-made passageway;

initially loosening plaque from the artery at a segment remote from the man-made passageway using a loosening instrument introduced through the man-made passageway;

removing plaque from within the segment of an artery at which the loosening step took place and excising the removed plaque through the small man-made passageway using a removing instrument;

immediately thereafter, placing a substantial exposed collapsed vascular graft carried by an insertion instrument into the artery through the small man-made passageway and displacing the vascular graft to a location within the artery co-extensive at least in part with the segment, using the insertion instrument;

without substantial delay, causing the vascular graft to be disassociated from the insertion instrument and positioned in continuously contiguous adherence within said artery at said location.

2. A method of treating an artery, comprising the steps of:

treating plaque from within a segment of an artery through an arteriotomy at least in part by performing an atherectomy;

immediately after the treating step, placing a non-disintegrating vascular graft through the arteriotomy and at a location within and as an internal lining for the artery at least co-extensive with the treated segment;

adhering the vascular graft within said treated artery at said location.

3. A method according to claim 2 wherein the performing step comprises using an atherotome.

4. An integrated, continuous and substantially uninterrupted method of treating an artery, comprising the steps of:

performing a balloon angioplasty in an artery through an arteriotomy;

thereafter, without substantial interruption, parting plaque from within a segment of the artery and removing the plaque from the artery through the same arteriotomy;

immediately thereafter, without substantial interruption, placing a tubular vascular graft through the same arteriotomy at a location within and as an internal contiguous lining for the artery at least co-extensive with the segment;

immediately thereafter, without substantial interruption, adhering the tubular vascular graft within said artery at said location;

closing the arteriotomy only after the adhering step.

5. A substantially uninterrupted method of treating an artery, comprising the steps of:

creating an access passageway into the artery;

without substantial interruption, removing plaque from within a segment of an artery using an instrument introduced through the same access passageway;

immediately thereafter, without substantial interruption, placing a vascular graft coupled to an insertion and placement instrument through the same access passageway and at a location within and as an internal lining for the artery co-extensive at least in part with the segment;

without substantial interruption, securing the vascular graft within said artery at said location;

closing the access passageway.

6. An integrated method performed as an on-going uninterrupted procedure for treating an artery, comprising the steps of:

creating an arteriotomy;

treating plaque from within a segment of an artery remote from the arteriotomy with an instrument passed into the artery through the arteriotomy;

thereafter, without appreciable delay, placing an externally exposed vascular tubular graft clamped to a second instrument through the arteriotomy to the treated location within the artery segment remote from the arteriotomy and immediately adhering the tubular graft as an internal tubular lining for the artery co-extensive at least in part with the treated segment at least in part by radially expanding at least one non-penetrating compression only entirely internal stent against the interior of the tubular graft after jointly advancing the vascular graft, the entirely internal stent and the second instrument to the treated segment of the artery.

7. An integrated method of treating an artery, comprising the following continuous and substantially uninterrupted steps of:

treating plaque from within a segment of an artery to increase the diametral size of a flow path therein;

immediately thereafter and without material interruption, placing a vascular tubular graft at a location within and as an internal lining for the artery co-extensive at least in part with the treated segment at least in part by collectively advancing the graft and a non-penetrating compression only stent located entirely within the graft into the artery;

without significant delay, securing the vascular graft within said artery at said location.

8. An uninterrupted method of treating an artery, comprising the steps of:

performing an arteriotomy and retaining the arteriotomy in an open condition throughout the method;

without material delay, dislodging plaque from within a segment of an artery using an instrument introduced through the open arteriotomy;

without material delay, removing dislodged plaque and the instrument through the open arteriotomy;

immediately thereafter and without material delay placing a vascular graft and a second instrument carrying the graft through the open arteriotomy to a location within and as an internal contiguous lining for the artery co-extensive at least in part with the segment at least in part by radially expanding the vascular graft at least in part by expanding a balloon inside the graft one or more times while so located in the artery;

securing the vascular graft within said artery at said location;

closing the arteriotomy.

9. An integrated on-going method of treating an artery, comprising the steps of:

removing plaque from within a segment of an artery;

thereafter without material delay, placing a tubular vascular graft at a location within and as an internal lining for the artery co-extensive at least in part with the segment;

thereafter without material delay, securing the tubular vascular graft within said artery at said location at least in part by holding the vascular graft in the arterial segment by expanding at least one compression only non-penetrating stent disposed entirely inside the tubular vascular graft.

10. A procedure of treating an artery, comprising the steps of:

removing plaque from within a segment of an artery;

thereafter without substantial interruption, placing a vascular graft at a location within and as an internal lining for the artery co-extensive at least in part with the segment;

thereafter without substantial interruption securing the vascular graft within said artery at said location at least in part by holding the vascular graft in the arterial segment by expanding at least one compression only non-penetrating stent disposed within a proximal portion of the vascular graft only.

11. A method of treating an artery, comprising practicing the following steps successively without substantial interruption:

vacating plaque from within a segment of an artery;

immediately thereafter and without material interruption, placing a tubular vascular graft at a location within and as an internal lining for the artery co-extensive at least in part with the segment;

immediately thereafter and without material interruption, securing the tubular vascular graft within said artery at said location at least in part by independently placing the tubular vascular graft and at least one compression only non-penetrating stent disposed entirely within the tubular vascular graft within the arterial segment followed by expanding the stent solely inside the vascular graft.

12. A method of continuous uninterrupted steps for treating an artery, the steps comprising:

eliminating at least some plaque from within a segment of an artery;

without interruption, securing a tubular vascular graft within said artery at said segment at least in part after placing and securing at least one unexpanded non-penetrating stent entirely within the tubular vascular graft and jointly inserting the entirely internal non-penetrating stent entirely internal and the tubular vascular graft together into the artery followed by expanding the non-penetrating entirely internal stent in respect to the tubular vascular graft.