Transluminal methods and devices for closing, forming attachments to, and/or forming anastomotic junctions in, luminal anatomical structures

• US 6,287,317 B1
• Filed: 04/05/2000
• Issued: 09/11/2001
• Est. Priority Date: 06/28/1997
• Status: Expired due to Term

• Current Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Original Assignee: TransVascular, Inc. (Medtronic Plc)
• Inventors: Machold, Timothy R., Flaherty, J. Christopher, Makower, Joshua, Whitt, Jason Brian, Garibotto, John Thomas
• Primary Examiner(s): Jackson, Gary
• Application Number:
  US09/543,251
• Time in Patent Office: 524 Days
• Field of Search: 606/139, 606/141, 606/144, 606/148, 606/153, 606/155, 606/213
• US Class Current: 606/153
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/06 Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials puncturing needles A61B17/34; hypodermic needles A61M5/32 ; sewing needles D05B85/00
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 17/12 for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord specially adapted for vas deferens or fallopian tubes A61F6/20; materials for ligaturing blood vessels A61L17/00
• CPC Class Codes: A61B 17/12013 for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 2017/00292 mounted on or guided by flexible, e.g. catheter-like, means
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/00946 malleable
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0419 H-fasteners
• CPC Class Codes: A61B 2017/0454 the anchor being crimped or clamped on the suture
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/06047 located at the middle of the needle
• CPC Class Codes: A61B 2017/1107 for blood vessels
• CPC Class Codes: A61B 2017/1135 End-to-side connections, e.g. T- or Y-connections
• CPC Class Codes: A61B 2017/1139 Side-to-side connections, e.g. shunt or X-connections

Abstract

Methods and apparatus for passing attachment apparatus (e.g., connector devices, staples, etc.) or connector material (e.g., suture thread, wire, cord, filament, monofilament, etc.) into or through the wall of a luminal anatomical structure (e.g., a blood vessel or other anatomical conduit) for the purpose of; i) closing the lumen of the anatomical structure, ii) forming an anastomotic junction between separate anatomical structures (or between approximated segments of the same anatomical structure), and/or iii) attaching an article (e.g., an endoluminal, extraluminal or transluminal graft) or other apparatus to the wall of the anatomical structure.

Claims

1. A method of passing a length of connector material through the wall of an anatomical structure which has a wall, and a lumen defined by said wall, said method comprising the steps of:

A. providing an intraluminal device which comprises;

i.) an elongate catheter which is advancable into the lumen of the anatomical structure;

ii.) a tissue penetrating member which is moveably disposed within said catheter, said tissue-penetrating member being advancable in at least one direction to create a puncture tract through a portion of the wall of the luminal anatomical structure into which the catheter has been inserted; and

,

iii.) a length of connector material attached to said tissue penetrating member so as to be drawn by the tissue-penetrating member through the puncture tract which it creates through a portion of the wall of the luminal anatomical structure;

B. positioning the catheter within the lumen of the anatomical structure;

C. passing the tissue penetrating member from the catheter, through the tissue which forms the wall of the anatomical structure, to create a puncture tract through the tissue at a first location and to draw the connector material through said puncture tract; and

, thereafter,

D. retracting the tissue penetrating member into the catheter.

2. The method of claim 1 wherein the method further comprises the steps of:

E. repositioning the catheter within the lumen of the anatomical structure;

F. again passing the tissue penetrating member from the catheter, and through the tissue which forms the wall of the anatomical structure so as to create a second puncture tract through the tissue at a second location and to draw the connector material through said second puncture tract; and

, thereafter,

G. again retracting the tissue penetrating member into the catheter.

3. The method of claim 2 wherein steps E-G are repeated at least one additional time to pass the connector material through at least a third puncture tract created at at least a third location on the wall of the anatomical structure.

4. The method of claim 1 wherein the method is performed to attach an article to the wall of the anatomical structure, and wherein the method further comprises the step of:

positioning the article at a desired location adjacent the wall of the anatomical structure, and wherein the catheter-positioning of step B is performed such that the tissue-penetrating member will pass through a portion of the article as well as through the tissue of the anatomical structure wall.

5. The method of claim 1 wherein said method is performed to at least partially close the lumen of the anatomical structure, and wherein said method further comprises the step of:

drawing the connector material taught to cause the wall of the anatomical structure to collapse and the thereby at least partially occlude the lumen of the anatomical structure.

6. The method of claim 1 wherein said method is performed for the purpose of forming an anastomotic junction between two segments of said anatomical structure, and wherein said method further comprises the step of:

approximating the two segments of said anatomical structure and causing the first and second locations to be positioned such that the connector material will form an anastomosis between the approximated segments of said anatomical structure.

7. The method of claim 5 wherein steps E-H are repeated at least one additional time to place at least a third engagement member at least a third location on the wall of the anatomical structure.