Transluminal anastomosis method and apparatus

• US 6,328,727 B1
• Filed: 01/11/2000
• Issued: 12/11/2001
• Est. Priority Date: 09/20/1999
• Status: Expired due to Term

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Appriva Medical, Inc. (Medtronic Plc)
• Inventors: Lesh, Michael D., Frazier, Andrew G. C., Roue, Chad C., van der Burg, Erik J.
• Primary Examiner(s): MENDEZ, MANUEL A
• Application Number:
  US09/482,986
• Time in Patent Office: 700 Days
• Field of Search: 604/500, 604/115, 604/117, 604/507, 604/511, 606/139
• US Class Current: 604/500
• 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 17/0057 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 17/0401 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 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/12122 within the heart for closing a cardiac septal defect A61B17/0057
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00292 mounted on or guided by flexible, e.g. catheter-like, means
• CPC Class Codes: A61B 2017/00575 for closure at remote site, e.g. closing atrial septum defects
• CPC Class Codes: A61B 2017/00579 Barbed implements
• CPC Class Codes: A61B 2017/00632 Occluding a cavity, i.e. closing a blind opening
• CPC Class Codes: A61B 2017/00668 the implement being a tack or a staple
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0412 having anchoring barbs or pins extending outwardly from suture anchor body
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/042 plastically deformed during insertion
• CPC Class Codes: A61B 2017/0437 the barbs being resilient or spring-like
• CPC Class Codes: A61B 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• 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 2017/0472 : Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/0477 : with pre-tied sutures
• CPC Class Codes: A61B 2017/048 : for reducing heart wall tension, e.g. sutures with a pad on each extremity
• CPC Class Codes: A61B 2017/0488 : Instruments for applying suture clamps, clips or locks for applying suture anchors A61B2017/0409; for applying wound clamps A61B17/10; for applying ligaturing clamps or clips A61B17/128
• CPC Class Codes: A61B 2017/0645 : being elastically deformed for insertion
• CPC Class Codes: A61B 2017/0647 : having one single leg, e.g. tacks
• CPC Class Codes: A61F 2/24 : Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
• CPC Class Codes: A61F 2/2427 : Devices for manipulating or deploying heart valves during implantation
• CPC Class Codes: A61F 2/2487 : Devices within the heart chamber, e.g. splints
• CPC Class Codes: Y10S 606/907 : Composed of particular material or coated

Abstract

Disclosed is an anastomosis catheter, for achieving a tissue to tissue or synthetic graft to tissue attachment. The catheter includes a plurality of deployable tissue anchors, which may be laterally deployed into surrounding tissue. The anchors may be used to achieve end to end or end to side anastomoses. Methods are also disclosed.

Claims

1. A method of attaching a tubular graft to a vessel wall, comprising the steps of:

positioning a tubular graft within a vessel;

positioning a tissue anchor deployment catheter at a first position within the graft, the deployment catheter comprising a first plurality of tubular anchor supports, each carrying a tissue anchor; and

advancing the anchors out of the tubular supports and into the vessel wall to secure the graft to the vessel wall.

2. A method of attaching a tubular graft to a vessel wall as in claim 1, wherein the advancing the anchors step comprises advancing the anchors through the graft and into the vessel wall.

3. A method of attaching a tubular graft to a vessel wall as in claim 1, wherein the advancing the anchors step comprises advancing at least four anchors into the vessel wall.

4. A method of attaching a tubular graft to a vessel wall as in claim 1, wherein the advancing the anchors step comprises advancing from about four to about ten anchors simultaneously into the vessel wall.

5. A method of attaching a tubular graft to a vessel wall as in claim 1, wherein the advancing the anchors step comprises advancing the anchors through the vessel wall.

6. A method of attaching a tubular graft to a vessel wall as in claim 1, wherein the positioning a graft step comprises positioning a tubular PTFE graft.

7. A method of attaching a tubular graft to a vessel wall as in claim 1, wherein the catheter comprises a second plurality of anchors, and the method further comprises the step of advancing the catheter to a second position within the graft and advancing the second plurality of anchors into the vessel wall.

8. A method of attaching a first tubular structure to a second tubular structure in a patient, comprising the steps of:

identifying a first tubular structure in the patient;

positioning a second tubular structure in communication with the first tubular structure;

positioning an anchor deployment catheter within at least one of the first and second tubular structures; and

deploying a plurality of tissue anchors from the catheter and through at least one of the first and second tubular structures, to attach the first tubular structure to the second tubular structure;

wherein the deploying step comprises advancing an introducer along an anchor support to deploy an anchor from the anchor support.

9. A method as in claim 8, wherein the first tubular structure is a blood vessel.

10. A method as in claim 8, wherein the first tubular structure is a vein.

11. A method as in claim 8, wherein the first tubular structure is an artery.

12. A method as in claim 8, wherein the second tubular structure is a graft.

13. A method as in claim 12, wherein the graft is an autologous vessel.

14. A method as in claim 12, wherein the graft is a homograft.

15. A method as in claim 12, wherein the graft is a xenograft.

16. A method as in claim 12, wherein the graft is a prosthetic tubular graft.

17. A method as in claim 8, wherein the second tubular structure comprises a base on a prosthetic heart valve.