Devices for connecting anatomical conduits such as vascular structures

• US 6,231,587 B1
• Filed: 03/11/1999
• Issued: 05/15/2001
• Est. Priority Date: 10/13/1995
• Status: Expired due to Term

• Current Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Original Assignee: TransVascular, Inc. (Medtronic Plc)
• Inventors: Makower, Joshua
• Primary Examiner(s): Buiz, Michael
• Assistant Examiner(s): LEWIS, WILLIAM W
• Application Number:
  US09/267,943
• Time in Patent Office: 796 Days
• Field of Search: 606/1, 606/108, 606/191, 606/194, 606/195, 606/198, 606/200, 606/152-156, 623/1, 623/12, 623/1.1, 623/1.11
• US Class Current: 606/198
• CPC Class Codes: A61B 1/3137 for examination of the interior of blood vessels
• 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 17/00491 Surgical glue applicators surgical adhesives A61L24/00; two-component delivery syringes A61M5/19
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 17/0643 with separate closing member, e.g. for interlocking with staple
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 17/12022 Occluding by internal devices, e.g. balloons or releasable wires plugging an opening in the wall of an organ A61B17/0057; occluders for the cervical canal A61F6/146; vas deferens occluders A61F6/20
• CPC Class Codes: A61B 17/12045 double occlusion, e.g. during anastomosis
• CPC Class Codes: A61B 17/12109 in a blood vessel
• CPC Class Codes: A61B 17/12131 characterised by the type of occluding device
• CPC Class Codes: A61B 17/12136 Balloons
• CPC Class Codes: A61B 17/12181 formed by fluidized, gelatinous or cellular remodelable materials, e.g. embolic liquids, foams or extracellular matrices
• CPC Class Codes: A61B 17/1219 expandable in contact with liquids
• CPC Class Codes: A61B 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 17/3496 Protecting sleeves or inner probes; Retractable tips for protecting body piercing guide needles A61M25/0612
• CPC Class Codes: A61B 18/00 Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body eye surgery A61F9/007; ear surgery A61F11/00
• CPC Class Codes: A61B 18/1445 at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
• CPC Class Codes: A61B 18/1477 Needle-like probes
• 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 18/24 : with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00243 : cardiac
• CPC Class Codes: A61B 2017/00247 : Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• 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 2017/003 : Steerable
• CPC Class Codes: A61B 2017/00504 : Tissue welding
• CPC Class Codes: A61B 2017/00641 : for closing fistulae, e.g. anorectal fistulae
• CPC Class Codes: A61B 2017/0641 : having at least three legs as part of one single body
• CPC Class Codes: A61B 2017/1107 : for blood vessels
• CPC Class Codes: A61B 2017/1139 : Side-to-side connections, e.g. shunt or X-connections
• CPC Class Codes: A61B 2017/12127 : Double occlusion, e.g. for creating blood-free anastomosis site
• CPC Class Codes: A61B 2017/22038 : with a guide wire
• CPC Class Codes: A61B 2017/22077 : with a part piercing the tissue A61B2017/22044 takes precedence
• CPC Class Codes: A61B 2017/306 : holding by means of suction
• CPC Class Codes: A61B 2017/347 : Locking means, e.g. for locking instrument in cannula
• CPC Class Codes: A61B 2017/3488 : Fixation to inner organ or inner body tissue
• CPC Class Codes: A61B 2018/00392 : Transmyocardial revascularisation
• CPC Class Codes: A61B 2018/00869 : Phase
• CPC Class Codes: A61B 2018/1425 : Needle
• CPC Class Codes: A61B 2090/378 : using ultrasound
• CPC Class Codes: A61B 2090/3925 : ultrasonic
• CPC Class Codes: A61B 2090/3929 : Active markers
• CPC Class Codes: A61B 2090/3958 : emitting a signal
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61B 90/40 : Apparatus fixed or close to patients specially adapted for providing an aseptic surgical environment
• CPC Class Codes: A61F 2/07 : Stent-grafts
• CPC Class Codes: A61F 2/2493 : Transmyocardial revascularisation [TMR] devices
• CPC Class Codes: A61F 2/90 : characterised by a net-like or mesh-like structure
• CPC Class Codes: A61F 2/95 : Instruments specially adapted for placement or removal of stents or stent-grafts
• CPC Class Codes: A61F 2002/30079 : magnetic
• CPC Class Codes: A61F 2002/8486 : provided on at least one of the ends
• CPC Class Codes: A61F 2210/009 : magnetic
• CPC Class Codes: A61M 2025/0076 : Unidirectional valves
• CPC Class Codes: A61M 2025/018 : Catheters having a lateral opening for guiding elongated means lateral to the catheter
• CPC Class Codes: A61M 2025/1052 : for temporarily occluding a vessel for isolating a sector

Abstract

Method and apparatus for utilizing the vascular system as a conduit to reach other vascular and extravascular locations within the body. Included are methods for revascularization wherein the extravascular passageways are formed to permit blood flow between vascular locations. Also included are methods for performing transvascular interstitial surgery (TVIS) wherein extravascular passageways are formed from a blood vessel to another vascular or non-vascular intracorporeal location. Also disclosed are devices usable for forming extravascular passageways in accordance with the invention, or for modifying, valving, maintaining or closing such passageways.

Claims

1. A connector apparatus deliverable through a delivery catheter to a position between a first opening formed in a first vascular structure and second opening formed in a second vascular structure, said connector apparatus comprising:

a connector segment having first and second ends;

at least one projection on the first end of the connector segment;

at least one projection on the second end of the connector segment;

said connector apparatus being initially disposable in a compact configuration within said catheter and subsequently expellable from the catheter and deployable to an operative configuration wherein said at least one projection on the first end of the connector segment engages the first vascular structure adjacent the first opening therein and the at least one projection on the second end of the connector segment engages the second vascular structure adjacent the second opening therein.

2. The connector apparatus of claim 1 wherein said projections comprise wire loops each of which has at least one radius of curvature.

3. The connector apparatus of claim 1 wherein said projections and said connector segment are formed of a continuously wound wire.

4. The connector apparatus of claim 1 wherein said connector segment forms a substantially cylindrical structure that, when said connector apparatus is placed between said first and second openings, will facilitate a flow of blood therebetween.

5. The connector apparatus of claim 1 wherein said apparatus is configured so as to draw said first and second vascular structures toward one another.

6. The connector apparatus of claim 1 wherein the at least one projection on the first end of the connector segment comprises a first annular member and the at least one projection on the second end of the connector segment comprises a second annular member.

7. The connector apparatus of claim 6 wherein said connector segment comprises at least one tine.

8. The connector apparatus of claim 7 wherein said at least one tine extends from said first annular member and is connectable to said second annular member when the second annular member is brought into engagement therewith.

9. The connector apparatus of claim 1 wherein said connector segment is constructed such that when the connector apparatus is deployed in said operative configuration, said connector apparatus maintains said first and second openings in substantially fixed positions relative to each other.

10. A self-expanding connector apparatus according to claim 1 said apparatus being formed substantially of resilient material that compresses to said compact configuration when placed within the catheter and thereafter resiliently expands to said operative configuration when expelled from the catheter.

11. A connection apparatus for coupling an opening formed in a first blood vessel to an opening formed in a second blood vessel, each of said first and second blood vessels having a lumen and a wall wherein the opening is formed, said connection apparatus comprising:

a first vessel engaging portion configured to engage said first blood vessel adjacent the opening formed therein;

a second vessel engaging portion configured to engage said second blood vessel adjacent the opening formed therein;

the first and second vessel engaging portions each being selected from a group consisting of;

an annular flange, and

wire loops;

a connecting portion between the first and second vessel engaging portions,

wherein said first vessel engaging portion and said second vessel engaging portion are connected to one another by said connecting portion such that the openings formed in said first blood vessel and said second blood vessel are maintained in substantial alignment with each other.

12. The connection apparatus of claim 11 wherein the connecting portion is sized such that the wall of the first blood vessel is held in juxtaposition contact with the wall of the second blood vessel.

13. A connector apparatus for connecting a first anatomical structure having a wall and a lumen to a second anatomical structure having a wall and a lumen wherein a channel has been formed between the lumens of the first and second anatomical structure, through the walls of the first and second anatomical structures and through any tissue located between the first and second anatomical structures, said connector apparatus comprising:

at least one first vessel engaging member configured to engage the wall of the first anatomical structure;

at least one second vessel engaging member configured to engage the wall of the second anatomical structure; and

an intervening segment extending between and connecting said at least one first vessel engaging member to said at least one second vessel engaging member, said intervening segment extending through said channel and being operative to maintain patency of said channel such that body fluid may flow from the lumen of the first anatomical structure, through the channel and into the lumen of the second anatomical structure.

14. A connector apparatus of claim 13 wherein said at least one first vessel engaging member is an annular flange.

15. The connector apparatus of claim 13 wherein said vessel engaging member comprises wire loops which have at least one radius of curvature.

16. The connector apparatus of claim 13 wherein said vessel engaging members and said intervening segment are formed of a continuously wound wire.

17. The connector apparatus of claim 13 wherein said intervening segment forms a substantially cylindrical structure between said at least one first vessel engaging member and said at least one second engaging member such that when said connector apparatus is placed between said first and second vascular structures, said intervening segment will facilitate a flow of blood therebetween.

18. The connector apparatus of claim 13 wherein said apparatus is configured so as to draw said first and second vascular structures toward one another.

19. A method for connecting a first vascular structure to a second vascular structure, said method comprising the steps of:

a. providing a tissue pentrating member having a lumen extending therethrough;

b. advancing said tissue penetrating member from said first vascular structure into said second vascular structure;

c. inserting a guidewire through the lumen of the tissue penetrating member and into said second vascular structure;

d. removing said tissue penetrating member and leaving the guidewire in pace;

e. inserting over said guidewire a connector deployment device having a connector apparatus deployable therefrom; and

f. deploying said connector apparatus such that said connector apparatus becomes positioned between said first and second vascular structures.

20. The method of claim 19 wherein said first vascularstructure is a vein and said second structure lumen is an artery.

21. The method of claim 19 wherein said first vascular structure is an artery and said second vascular structure is a vein.

22. A connector apparatus for connecting two anatomical vessels, said connector apparatus comprising:

at least one first vessel engaging member comprising wire loops which have at least one radius of curvature, the first vessel engaging member disposed in a first plane;

at least one second vessel engaging member disposed in a second plane; and

an intervening segment disposed in a plane substantially perpendicular to said first and second planes and connecting said at least one first vessel engaging member to said at least one second vessel engaging member.

23. The connector apparatus of claim 22 wherein said vessel engaging members and said intervening segment are formed of a continuously wound wire.

24. The connector apparatus of claim 22 wherein said intervening segment forms a substantially cylindrical structure between said at least one first vessel engaging member and said at least one second engaging member such that when said connector apparatus is placed between said first and second vascular structures, said intervening segment will facilitate a flow of blood therebetween.

25. The connector apparatus of claim 22 wherein said apparatus is configured so as to draw said first and second vascular structures toward one another.

26. A connector apparatus for connecting two anatomical vessels, said connector apparatus comprising:

at least one first vessel engaging member disposed in a first plane;

at least one second vessel engaging member disposed in a second plane; and

an intervening segment disposed in a plane substantially perpendicular to said first and second planes and connecting said at least one first vessel engaging member to said at least one second vessel engaging member, wherein said vessel engaging members and said intervening segment are formed of a continuously wound wire.

27. The connector apparatus of claim 26 wherein said intervening segment forms a substantially cylindrical structure between said at least one first vessel engaging member and said at least one second engaging member such that when said connector apparatus is placed between said first and second vascular structures, said intervening segment will facilitate a flow of blood therebetween.

28. The connector apparatus of claim 26 wherein said apparatus is configured so as to draw said first and second vascular structures toward one another.

29. A connector apparatus for connecting two anatomical vessels, said connector apparatus comprising:

at least one first vessel engaging member disposed in a first plane;

at least one second vessel engaging member disposed in a second plane; and

an intervening segment disposed in a plane substantially perpendicular to said first and second planes and connecting said at least one first vessel engaging member to said at least one second vessel engaging member, wherein said intervening segment forms a substantially cylindrical structure between said at least one first vessel engaging member and said at least one second engaging member such that when said connector apparatus is placed between said first and second vascular structures, said intervening segment will facilitate a flow of blood therebetween.

30. The connector apparatus of claim 29 wherein said apparatus is configured so as to draw said first and second vascular structures toward one another.

31. A connector apparatus for connecting two anatomical vessels, said connector apparatus comprising:

at least one first vessel engaging member disposed in a first plane;

at least one second vessel engaging member disposed in a second plane;

an intervening segment disposed in a plane substantially perpendicular to said first and second planes and connecting said at least one first vessel engaging member to said at least one second vessel engaging member, wherein said apparatus is configured so as to draw said first and second vascular structures toward one another.