Percutaneous bypass with branching vessel

• US 6,035,856 A
• Filed: 03/06/1997
• Issued: 03/14/2000
• Est. Priority Date: 03/06/1997
• Status: Expired due to Term

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Scimed Life Systems Incorporated (Boston Scientific Corporation)
• Inventors: LaFontaine, Daniel M., Wang, Lixiao, Hastings, Roger N., Euteneuer, Charles L.
• Primary Examiner(s): Yu, Mickey
• Assistant Examiner(s): CAMPEN, KELLY SCAGGS
• Application Number:
  US08/813,040
• Time in Patent Office: 1,104 Days
• Field of Search: 128/898, 623/1, 623/12, 623/66, 623/11, 623/3, 604/8, 604/9, 604/7
• US Class Current: 128/898
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00252 for by-pass connections, i.e. connections from heart chamber to blood vessel or from blood vessel to blood vessel
• CPC Class Codes: A61B 2017/1135 End-to-side connections, e.g. T- or Y-connections Y-shaped blood vessel prostheses A61F2002/065
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/00386 Coronary vessels
• CPC Class Codes: A61B 2090/3929 Active markers
• CPC Class Codes: A61B 2090/3958 emitting a signal
• CPC Class Codes: A61F 2/064 with special features to facilitate anastomotic coupling anastomosis of natural blood vessels A61B17/11
• CPC Class Codes: A61F 2/07 Stent-grafts
• CPC Class Codes: A61F 2/90 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 2002/828 Means for connecting a plurality of stents allowing flexibility of the whole structure
• CPC Class Codes: A61M 25/0082 Catheter tip comprising a tool
• CPC Class Codes: Y10S 623/901 Method of manufacturing prosthetic device

Abstract

In order to bypass a restriction in a parent vessel, a first site in a branch vessel branching from the aorta is accessed intraluminally. An occlusion is formed at the first site, and the aperture is formed in the branching vessel, intraluminally, proximal of the first site. An aperture is formed in the parent vessel distal of the restriction, and a lumen is formed which communicates between the branching vessel proximal of the occlusion, and the parent vessel distal of the restriction.

Claims

1. A method of percutaneously bypassing an incomplete occlusion in a restricted artery of a mammal having an aorta and a branching vessel branching from the aorta, the method comprising:

intraluminally accessing a first site in the branching vessel;

intraluminally forming an aperture in the branching vessel at the first site;

intraluminally forming a total occlusion in the restricted artery;

forming an aperture in the restricted artery distal of both the incomplete occlusion and the total occlusion; and

providing a conduit to form a lumen communicating through the aperture in the branching vessel with a lumen in the branching vessel proximal of the first site and through the aperture in the restricted artery with a lumen of the restricted artery distal of the incomplete occlusion and the total occlusion.

2. The method of claim 1 wherein intraluminally forming an aperture in the branching vessel comprises:

intraluminally severing the branching vessel at the first site to form a severed end.

3. The method of claim 2 wherein providing a conduit comprises:

attaching a region of the branching vessel proximate the severed end to a region of the restricted artery proximate the aperture such that a lumen in the branching vessel communicates with a lumen in the restricted artery.

4. The method of claim 3 wherein attaching a region of the branching vessel comprises:

inserting the severed end of the branching vessel through the aperture in the restricted artery into the lumen of the restricted artery; and

connecting the severed end to the restricted artery.

5. The method of claim 4 wherein connecting the severed end comprises:

deploying a stent in the restricted artery to attach the severed end to the restricted artery.

6. The method of claim 1 and further comprising:

prior to forming an aperture in the branching vessel, forming an occlusion in the branching vessel distal of the first site.

7. The method of claim 1 and further comprising:

prior to forming the aperture in the branching vessel, temporarily occluding the branching vessel proximal of a region in the branching vessel where the aperture is to be formed.

8. The method of claim 7 wherein temporarily occluding comprises:

advancing an expandable member through the branching vessel to the region proximal of the aperture in the branching vessel; and

expanding the expandable member to occlude the branching vessel.

9. The method of claim 1 wherein providing a conduit comprises:

placing a first emitter in the region of the restricted artery distal of both the incomplete occlusion and the total occlusion and a second emitter in an end of the conduit, the first and second emitters emitting location signals;

sensing the location signals and providing an operator perceptible output indicative of the location of the end of the conduit relative to the region of the restricted artery distal of the incomplete occlusion and the total occlusion; and

positioning the end of the conduit proximate a region of the restricted artery distal of the incomplete occlusion and the total occlusion based on the operator perceptible output.

10. A method of percutaneously bypassing a restriction in a restricted artery of a mammal having an aorta and a branching vessel branching from the aorta, the method comprising:

intraluminally accessing a first site in the branching vessel;

intraluminally severing the branching vessel at the first site to form a severed end;

forming an aperture in the restricted artery distal of the restriction; and

attaching a region of the branching vessel proximate the severed end to a region of the restricted artery proximate the aperture such that a lumen in the branching vessel communicates with a lumen in the restricted artery.

11. The method of claim 10 wherein attaching a region of the branching vessel comprises:

inserting the severed end of the branching vessel through the aperture in the restricted artery into the lumen of the restricted artery; and

connecting the severed end to the restricted artery.

12. The method of claim 11 wherein connecting the severed end comprises:

deploying a stent in the restricted artery to attach the severed end to the restricted artery.

13. The method of claim 10 wherein the restriction in the parent vessel is an incomplete occlusion, and further comprising:

prior to forming an aperture in the restricted artery, forming a total occlusion in the restricted artery proximal of a region where the aperture is to be formed.

14. The method of claim 10 wherein attaching a region of the branching vessel proximate the severed end comprises:

placing a first emitter in the region of the restricted artery distal of the restriction and a second emitter in the branching vessel proximate the severed end, the first and second emitters emitting location signals;

sensing the location signals and providing an operator perceptible output indicative of the location of the severed end relative to the region of the restricted artery distal of the restriction; and

positioning the severed end proximate a region of the restricted artery distal of the restriction based on the operator perceptible output.