Devices for forming and/or maintaining connections between adjacent anatomical conduits

• US 6,432,127 B1
• Filed: 11/14/1997
• Issued: 08/13/2002
• Est. Priority Date: 10/11/1996
• Status: Expired due to Term

• Current Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Original Assignee: TransVascular, Inc. (Medtronic Plc)
• Inventors: Kim, Steven, Flaherty, J. Christopher, Makower, Joshua, Lamson, Theodore C., Whitt, Jason Brian
• Primary Examiner(s): Isabella, David J.
• Application Number:
  US08/970,694
• Time in Patent Office: 1,733 Days
• Field of Search: 606/191, 606/192, 606/193, 606/194, 606/195, 606/198, 606/200, 606/152, 606/153, 606/154, 606/155, 606/156, 623/1.11, 623/1.12, 623/1.13, 623/1.15, 623/1.16, 623/1.22, 623/1.23, 604/96, 604/104
• US Class Current: 623/1.11
• CPC Class Codes: A61B 17/00491 Surgical glue applicators surgical adhesives A61L24/00; two-component delivery syringes A61M5/19
• 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 17/12136 Balloons
• 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 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 18/1477 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 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 2017/00504 Tissue welding
• 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 2017/306 holding by means of suction
• CPC Class Codes: A61B 2017/347 Locking means, e.g. for locking instrument in cannula
• CPC Class Codes: A61B 2018/00392 : Transmyocardial revascularisation
• CPC Class Codes: A61B 2018/1425 : Needle
• CPC Class Codes: A61B 90/40 : Apparatus fixed or close to patients specially adapted for providing an aseptic surgical environment
• CPC Class Codes: A61F 2/064 : 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 2/2493 : Transmyocardial revascularisation [TMR] devices
• CPC Class Codes: A61F 2/90 : characterised by a net-like or mesh-like structure
• CPC Class Codes: A61F 2/91 : made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
• CPC Class Codes: A61F 2/915 : with bands having a meander structure, adjacent bands being connected to each other
• CPC Class Codes: A61F 2002/061 : provided with means for allowing access to secondary lumens
• CPC Class Codes: A61F 2002/30079 : magnetic
• CPC Class Codes: A61F 2002/825 : having longitudinal struts
• CPC Class Codes: A61F 2002/91525 : within the whole structure different bands showing different meander characteristics, e.g. frequency or amplitude
• CPC Class Codes: A61F 2002/91533 : characterised by the phase between adjacent bands
• CPC Class Codes: A61F 2002/91558 : connected peak to peak
• CPC Class Codes: A61F 2002/91575 : connected peak to trough
• CPC Class Codes: A61F 2002/91591 : Locking connectors, e.g. using male-female connections
• CPC Class Codes: A61F 2210/009 : magnetic
• CPC Class Codes: A61F 2230/0054 : V-shaped
• CPC Class Codes: A61F 2250/0048 : differing in mechanical expandability, e.g. in mechanical, self- or balloon expandability
• CPC Class Codes: A61M 2025/0076 : Unidirectional valves
• CPC Class Codes: A61M 2025/009 : the needle having a bent tip, i.e. the needle distal tip is angled in relation to the longitudinal axis of the catheter
• CPC Class Codes: A61M 2025/1052 : for temporarily occluding a vessel for isolating a sector

Abstract

Implantable connector devices which are useable to maintain fluidic connection between, or approximation of, openings formed in adjacent natural or prosthetic anatomical conduits (or adjacent openings formed in a single anatomical conduits). These connector devices generally comprise a plurality of radially expandable annular members having one or more elongate strut members extending therebetween. Initially, the device is mountable on or within a delivery catheter while in a radially compact configuration. After the delivery catheter has been inserted into the body, the device is caused to transition to a radially expanded configuration whereby it becomes implanted within the body so as to maintain the desired fluidic connection between, or the desired approximation of, the anatomical conduit(s).

Claims

1. A device for facilitating fluid flow between a first opening formed in a first anatomical conduit and a second opening formed in a second anatomical conduit, said device comprising:

at least one proximal annular member and at least one distal annular member, each of said annular members having a radially compact configuration and a radially expanded configuration, the proximal annular member being sized to expand into contact with the first anatomical conduit, and the distal annular member being sized to expand into contact with the second anatomical conduit;

at least one curvilinear strut member connected to and extending between said proximal and distal annular members, said at least one strut member having a pre-expansion configuration and a post-expansion configuration, wherein outer ones of said strut members have a longer radius of curvature than inner ones of said strut members when the device is in its post-expansion configuration, and wherein said outer ones of said strut members are longer in length than said inner ones of said strut members, said outer ones of said strut members having at least one curvilinear wave formed therein while the device is in its pre-expansion configuration;

said device being initially transluminally deliverable with its annular members in their radially collapsed configurations and said at least one strut member is in its pre-expansion configuration, and wherein the at least one curvilinear post-expansion strut member is configured to maintain a patent curvilinear fluid flow path between the first and second conduits and through the device; and

,

said device being thereafter implantable with its annular members are in their radially expanded configurations and said at least one strut member is in its post-expansion configuration.

2. The device of claim 1 wherein said at least one strut member comprises a plurality of strut members.

3. The device of claim 1 having 4 to 8 strut members.

4. The device of claim 1 wherein said strut members are spaced apart from each other and disposed about a central axis when the device is in its implanted state, such that a hollow channel is defined within said strut members.

5. The device of claim 1 wherein said at least one strut member is formed of resilient material such that it remains in its pre-expansion configuration when radially constrained, but will assume its post-expansion configuration when radially unconstrained.

6. The device of claim 5 wherein said resilient material is selected from the group of resilient materials consisting of:

spring metal;

a resilient polymer; and

,

a shape memory alloy.

7. The device of claim 1 wherein said at least one strut member(s) is/are formed of malleable material.

8. The device of claim 7 wherein said malleable material is selected from the group of malleable materials consisting of:

plastically deformable metal; and

,

plastically deformable polymer.

11. The device of claim 1 wherein said annular members are self-expanding.

12. The device of claim 8 wherein said self-expanding annular members are formed of resilient material and are biased to their radially expanded configurations.

13. The device of claim 12 wherein said resilient material is selected from the group consisting of:

spring metal;

resilient polymer; and

,

shape memory alloy.

14. The device of claim 1 wherein said annular members are pressure-expandable.

15. The device of claim 14 wherein said pressure-expandable annular members are formed of malleable material capable of being plastically deformed from their radially compact configurations to their radially expanded configurations.

16. The device of claim 15 wherein said malleable material is selected from the group of malleable materials consisting of:

plastically deformable metal; and

plastically deformable polymer.

17. The device of claim 1 wherein said at least one strut member has first and second ends, said first and second ends being fused to said first and distal annular members.

18. The device of claim 13 wherein said at least one strut member has first and second ends which are connected to said first and distal annular members by flexible connections.

20. The device of claim 1 wherein the curvilinear post-expansion configuration of said at least one strut member is a serpentine configuration.

21. The device of claim 1 wherein the curvilinear post-expansion configuration of said at least one strut member is a generally U shaped configuration.

22. The device of claim 1 further comprising:

a plurality of transverse strut connector members formed between adjacent ones of said strut members.

23. The device of claim 1 further comprising a pliable covering formed on at least a portion of said device.

24. The device of claim 23 wherein said pliable covering is a generally cylindrical covering formed about said device, said cover defining a hollow lumen which extends longitudinally through the device.

25. The device of claim 23 wherein at least one flow-through opening is formed in said pliable covering.

27. The device of claim 1 wherein said at least one strut member has a post-expansion configuration which is multicurvate, such that said proximal and distal annular members may be positioned at spaced-apart locations in the same anatomical conduit and said at least one strut member may extend through said first and second openings and through a segment of an adjacent second anatomical conduit.

28. The device of claim 1 wherein at least some of the proximal and distal annular members are of differing size when in their radially expanded configurations.

9. A system comprising:

a device for facilitating fluid flow between a first opening formed in a first anatomical conduit and a second opening formed in a second anatomical conduit, said device comprising;

at least one proximal annular member and at least one distal annular member, each of said annular members having a radially compact configuration and a radially expanded configuration, the proximal annular member being sized to expand into contact with the first anatomical conduit, and the distal annular member being sized to expand into contact with the second anatomical conduit;

at least one curvilinear strut member connected to and extending between said proximal and distal annular members, said at least one strut member having a pre-expansion configuration and a post-expansion configuration, wherein outer ones of said strut members have a longer radius of curvature than inner ones of said strut members when the device is in its post-expansion configuration, and wherein said outer ones of said strut members are longer in length than said inner ones of said strut members, said outer ones of said strut members having at least one curvilinear wave formed therein while the device is in its pre-expansion configuration;

said device being initially transluminally deliverable with its annular members in their radially collapsed configurations and said at least one strut member is in its pre-expansion configuration, and wherein the at least one curvilinear post-expansion strut member is configured to maintain a patent curvilinear fluid flow path between the first and second conduits and through the device; and

,

said device being thereafter implantable with its annular members are in their radially expanded configurations and said at least one strut member is in its post-expansion configuration; and

a pressure-exerting member positioned within said device and useable to cause the annular members to radially expand and the at least one strut member to deform from its pre-expansion configuration to its post-expansion configuration.

10. The system of claim 9 wherein said pressure-exerting device is a balloon which has a curved configuration when inflated to deform said strut members to a curvilinear post-expansion configurations.

19. The device of claim 10 wherein loops are formed on the first and second ends of said at least one strut member, and portions of said first and distal annular members are captured within said loops, to thereby form said flexible connections between the ends of said at least one strut member and first and distal annular members.

26. A device for facilitating fluid flow between a first opening formed in a first anatomical conduit and a second opening formed in a second anatomical conduit, said device comprising:

at least one proximal annular member and at least one distal annular member, each of said annular members having a radially compact configuration and a radially expanded configuration, the proximal annular member being sized to expand into contact with the first anatomical conduit, and the distal annular member being sized to expand into contact with the second anatomical conduit;

at least one strut member connected to and extending between said proximal and distal annular members, said at least one strut member having a pre-expansion configuration and a post-expansion configuration;

said device being initially transluminally deliverable with its annular members in their radially collapsed configurations and said at least one strut member is in its pre-expansion configuration, wherein the post-expansion configuration of said at least one strut member is curvilinear, and wherein the at least one curvilinear post-expansion strut member is configured to maintain a patent curvilinear fluid flow path between the first and second conduits and through the device;

said device being thereafter implantable with its annular members are in their radially expanded configurations and said at least one strut member is in its post-expansion configuration; and

further comprising a pliable covering formed transversely across the device to block flow of body fluid.

61. The device of claim 26 wherein said at least one strut member comprises a plurality of strut members.

62. The device of claim 26 having 4 to 8 strut members.

63. The device of claim 26 wherein said strut members are spaced apart from each other and disposed about a central axis when the device is in its implanted state, such that a hollow channel is defined within said strut members.

64. The device of claim 26 wherein said at least one strut member is formed of resilient material such that it remains in its pre-expansion configuration when radially constrained, but will assume its post-expansion configuration when radially unconstrained.

65. The device of claim 64 wherein said resilient material is selected from the group of resilient materials consisting of:

spring metal;

a resilient polymer; and

,

a shape memory alloy.

66. The device of claim 26 wherein said at least one strut member(s) is/are formed of malleable material.

67. The device of claim 66 wherein said malleable material is selected from the group of malleable materials consisting of:

plastically deformable metal; and

plastically deformable polymer.

68. The device of claim 26 wherein said annular members are self-expanding.

69. The device of claim 68 wherein said self-expanding annular members are formed of resilient material and are biased to their radially expanded configurations.

70. The device of claim 69 wherein said resilient material is selected from the group consisting of:

spring metal;

resilient polymer; and

shape memory alloy.

71. The device of claim 26 wherein said annular members are pressure-expandable.

72. The device of claim 71 wherein said pressure-expandable annular members are formed of malleable material capable of being plastically deformed from their radially compact configurations to their radially expanded configurations.

73. The device of claim 72 wherein said malleable material is selected from the group of malleable materials consisting of:

plastically deformable metal; and

plastically deformable polymer.

74. The device of claim 26 wherein said at least one strut member has first and second ends, said first and second ends being fused to said first and distal annular members.

75. The device of claim 74 wherein said at least one strut member has first and second ends which are connected to said first and distal annular members by flexible connections.

76. The device of claim 74 wherein loops are formed on the first and second ends of said at least one strut member, and portions of said first and distal annular members are captured within said loops, to thereby form said flexible connections between the ends of said at least one strut member and first and distal annular members.

77. The device of claim 26 wherein the curvilinear post-expansion configuration of said at least one strut member is a serpentine configuration.

78. The device of claim 26 wherein the curvilinear post-expansion configuration of said at least one strut member is a generally U shaped configuration.

79. The device of claim 26 further comprising a plurality of transverse strut connector members formed between adjacent ones of said strut members.

80. The device of claim 26 wherein outer ones of said strut members have a longer radius of curvature than inner ones of said strut members when the device is in its second condition, and wherein said outer ones of said strut members are longer in length than said inner ones of said strut members, said outer ones of said strut members having at least one wave formed therein while the device is in its first condition.

81. The device of claim 26 wherein said pliable covering is a generally cylindrical covering formed about said device, said cover defining a hollow lumen which extends longitudinally through the device.

82. The device of claim 26 wherein at least one flow-through opening is formed in said pliable covering.

83. The device of claim 26 wherein said at least one strut member has a post-expansion configuration which is multicurvate, such that said proximal and distal annular members may be positioned at spaced-apart locations in the same anatomical conduit and said at least one strut member may extend through said first and second openings and through a segment of an adjacent second anatomical conduit.

29. A device for facilitating fluid flow between the lumen of a first anatomical conduit which has a first opening formed therein, and the lumen of a second anatomical conduit which has a second opening formed therein, said device comprising:

at least one proximal annular member, at least one distal annular member and at least one medial annular member, each of said annular members having a radially compact configuration and a radially expanded configuration;

at least first and second strut members each connected to and extending between said proximal and medial annular members, each said strut members having a pre-expansion configuration and a post-expansion configuration, wherein the post-expansion configuration of said at least one first strut member is curved in a first direction and the post-expansion configuration of said at least one second strut member is curved in a second direction, such that said first and second strut members combine to provide a serpentine configuration so as to maintain a patent serpentine fluid flow path between the first and second conduits and through the device;

said device being initially transluminally deliverable with its annular members in their radially collapsed configurations and said first and second strut members in their pre-expansion configurations; and

,

said device being thereafter implantable with its annular members in their radially expanded configurations and its first and second strut members in their post-expansion configurations.

30. The device of claim 29 wherein said at least one first and second strut members comprise a plurality of first and second strut members.

31. The device of claim 30 having 4 to 8 first strut members and 4-8 second strut members.

32. The device of claim 29 wherein adjacent ones of said first and second strut members are spaced apart from each other and disposed about a central axis when the device is implanted, such that a hollow channel is defined within said strut members.

33. The device of claim 29 wherein said first and second strut members are formed of resilient material such that they remain in their pre-expansion configurations when radially constrained, but will assume their post-expansion configurations when radially unconstrained.

34. The device of claim 33 wherein said resilient material is selected from the group of resilient materials consisting of:

spring metal;

a resilient polymer; and

,

a shape memory alloy.

35. The device of claim 29 wherein said first and second strut members are formed of malleable material.

36. The device of claim 35 wherein said malleable material is selected from the group of malleable materials consisting of:

plastically deformable metal; and

,

plastically deformable polymer.

37. The device of claim 29 wherein at least some of said proximal, distal and medial annular members are of different size when in their radially expanded configurations.

40. The device of claim 29 wherein said annular members are self-expanding.

41. The device of claim 40 wherein said self-expanding annular members are formed of resilient material and are biased to their radially expanded configurations.

42. The device of claim 41 wherein said resilient material is selected from the group consisting of:

spring metal;

resilient polymer; and

,

shape memory alloy.

43. The device of claim 29 wherein said annular members are pressure-expandable.

44. The device of claim 43 wherein said pressure-expandable annular members are formed of malleable material capable of being plastically deformed from their radially compact configurations to their radially expanded configurations.

45. The device of claim 44 wherein said malleable material is selected from the group of malleable materials consisting of:

plastically deformable metal; and

plastically deformable polymer.

46. The device of claim 29 wherein said first and second strut members have first and second ends, the first and second ends of said first strut members being fused to said proximal and medial annular members and the first and second ends of said second strut members being fused to said medial and distal annular members.

47. The device of claim 46 wherein said first and second strut members have first and second ends, the first and second ends of said first strut members are connected to said proximal and medial annular members by flexible connections and the first and second ends of said second strut members are connected to said medial and distal annular members by flexible connections.

48. The device of claim 47 wherein loops are formed on the first and second ends of said first and second strut members, and portions of said annular members are captured within said loops, to thereby form said flexible connections between the ends of said strut members and said annular members.

49. The device of claim 29 further comprising:

a plurality of transverse strut connector members formed between adjacent ones of said strut members.

51. The device of claim 29 further comprising a pliable covering formed on at least a portion of said device.

52. The device of claim 51 wherein said pliable covering is a generally cylindrical covering formed about said device, said cover defining a hollow lumen which extends longitudinally through the device.

53. The device of claim 51 wherein at least one flow-through opening is formed in said pliable covering.

55. The device of claim 29 wherein said first and second strut members combine to have a post-expansion configuration which is multicurvate, such that said proximal and distal annular members may be positioned at spaced-apart locations in the same anatomical conduit and said strut member may extend through said first and second openings and into a segment of an adjacent second anatomical conduit with said medial annular member being located within said second anatomical conduit.

38. A system comprising:

a device for facilitating fluid flow between the lumen of a first anatomical conduit which has a first opening formed therein, and the lumen of a second anatomical conduit which has a second opening formed therein, said device comprising;

at least one proximal annular member, at least one distal annular member and at least one medial annular member, each of said annular members having a radially compact configuration and a radially expanded configuration;

at least one first strut member connected to and extending between said proximal and medial annular members, said at least one first strut member having a pre-expansion configuration and a post-expansion configuration, wherein the post-expansion configuration of said first strut member is curvilinear;

at least one second strut member connected to and extending between said medial and distal annular members, said at least one second strut member having a pre-expansion configuration and a post-expansion configuration, wherein the post-expansion configuration of said second strut member is curvilinear, and wherein the first and second curvilinear post-expansion strut members are configured to maintain a patent curvilinear fluid flow path between the first and second conduits and through the device;

said device being initially transluminally deliverable with its annular members in their radially collapsed configurations and said first and second strut members in their pre-expansion configurations; and

,

said device being thereafter implantable with its annular members in their radially expanded configurations and its first and second strut members in their post-expansion configurations; and

a pressure-exerting member positioned within said device and useable to cause the device to deform and become implanted such that its annular members are in their radially expanded configurations and its first and second strut members in their post-expansion configurations.

39. The system of claim 38 wherein said pressure-exerting device is a balloon which has a curved configuration when inflated to deform said first and second strut members to their curved post-expansion configurations.

50. A device for facilitating fluid flow between the lumen of a first anatomical conduit which has a first opening formed therein, and the lumen of a second anatomical conduit which has a second opening formed therein, said device comprising:

at least one proximal annular member, at least one distal annular member and at least one medial annular member, each of said annular members having a radially compact configuration and a radially expanded configuration;

at least first and second strut members each connected to and extending between said proximal and medial annular members, each said strut members having a pre-expansion configuration and a post-expansion configuration, wherein outer ones of said strut members have a longer radius of curvature than inner ones of said strut members when the device is implanted, and wherein said outer ones of said strut members are longer in length than said inner ones of said strut members, said outer ones of said strut members having at least one curvilinear wave formed therein while in their pre-expansion configurations so as to maintain a patent curvilinear fluid flow path between the first and second conduits and through the device;

said device being initially transluminally deliverable with its annular members in their radially collapsed configurations and said first and second strut members in their pre-expansion configurations; and

,

said device being thereafter implantable with its annular members in their radially expanded configurations and its first and second strut members in their post-expansion configurations.

54. A device for facilitating fluid flow between the lumen of a first anatomical conduit which has a first opening formed therein, and the lumen of a second anatomical conduit which has a second opening formed therein, said device comprising:

at least one proximal annular member, at least one distal annular member and at least one medial annular member, each of said annular members having a radially compact configuration and a radially expanded configuration;

at least first and second strut members each connected to and extending between said proximal and medial annular members, each said strut members having a pre-expansion configuration and a post-expansion configuration, wherein the post-expansion configuration of each said strut members is curvilinear so as to maintain a patent curvilinear fluid flow path between the first and second conduits and through the device;

said device being initially transluminally deliverable with its annular members in their radially collapsed configurations and said first and second strut members in their pre-expansion configurations;

said device being thereafter implantable with its annular members in their radially expanded configurations and its first and second strut members in their post-expansion configurations; and

a pliable covering formed transversely across the device to block flow of body fluid.

56. A device for facilitating flow fluid between a first opening formed in an anatomical conduit and a second opening formed in an anatomical conduit, said device comprising:

at least one proximal annular member and at least one distal annular member, each of said annular members having a radially compact configuration and a radially expanded configuration;

at least one strut member connected to and extending between said proximal and distal annular members, said at least one strut member having a pre-expansion configuration and a post-expansion configuration, wherein outer ones of said strut members have a longer radius of curvature than inner ones of said strut members when the device is in its post-expansion configuration, and wherein said outer ones of said strut members are longer in length than said inner ones of said strut members, said outer ones of said strut members having at least one wave formed therein while the device is in its pre-expansion configuration;

said device being initially transluminally deliverable with its annular members in their radially collapsed configurations and said at least one strut member is in its pre-expansion configuration, wherein the proximal and distal annular members are coaxially positioned during transluminal delivery of the device; and

,

said device being thereafter implantable with its annular members are in their radially expanded configurations and said at least one strut member is in its post-expansion configuration.

57. A device for facilitating flow fluid between a first opening formed in an anatomical conduit and a second opening formed in an anatomical conduit, said device comprising:

at least one proximal annular member and at least one distal annular member, each of said annular members having a radially compact configuration and a radially expanded configuration;

at least one strut member connected to and extending between said proximal and distal annular members, said at least one strut member having a pre-expansion configuration and a post-expansion configuration;

said device being initially transluminally deliverable with its annular members in their radially collapsed configurations and said at least one strut member is in its pre-expansion configuration;

said device being thereafter implantable with its annular members are in their radially expanded configurations and said at least one strut member is in its post-expansion configuration; and

,

a pliable covering formed on at least a portion of said device, and formed transversely across the device to block flow of body fluid.

58. A device for facilitating fluid flow between the lumen of a first anatomical conduit which has a first opening formed therein, and the lumen of a second anatomical conduit which has a second opening formed therein, said device comprising:

at least one proximal annular member, at least one distal annular member and at least one medial annular member, each of said annular members having a radially compact configuration and a radially expanded configuration;

at least one first strut member connected to and extending between said proximal and medial annular members, said at least one first strut member having a pre-expansion configuration and a post-expansion configuration;

at least one second strut member connected to and extending between said medial and distal annular members, said at least one second strut member having a pre-expansion configuration and a post-expansion configuration, wherein the post-expansion configuration of said at least one first strut member is curved in a first direction and the post-expansion configuration of said at least one second strut member is curved in a second direction, such that said first and second strut members combine to provide a serpentine configuration;

said device being initially transluminally deliverable with its annular members in their radially collapsed configurations and said first and second strut members in their pre-expansion configurations; and

,

said device being thereafter implantable with its annular members in their radially expanded configurations and its first and second strut members in their post-expansion configurations.

59. A device for facilitating fluid flow between the lumen of a first anatomical conduit which has a first opening formed therein, and the lumen of a second anatomical conduit which has a second opening formed therein, said device comprising:

at least one proximal annular member, at least one distal annular member and at least one medial annular member, each of said annular members having a radially compact configuration and a radially expanded configuration;

at least one first strut member connected to and extending between said proximal and medial annular members, said at least one first strut member having a pre-expansion configuration and a post-expansion configuration;

at least one second strut member connected to and extending between said medial and distal annular members, said at least one second strut member having a pre-expansion configuration and a post-expansion configuration, wherein outer ones of said strut members have a longer radius of curvature than inner ones of said strut members when the device is implanted, and wherein said outer ones of said strut members are longer in length than said inner ones of said strut members, said outer ones of said strut members having at least one wave formed therein while in their pre-expansion configurations;

said device being initially transluminally deliverable with its annular members in their radially collapsed configurations and said first and second strut members in their pre-expansion configurations; and

,

said device being thereafter implantable with its annular members in their radially expanded configurations and its first and second strut members in their post-expansion configurations.

84. The device of claim 59 wherein the proximal, distal and medial annular members are coaxially positioned during transluminal delivery of the device.

85. The device of claim 84 wherein the proximal and distal annular members have different longitudinal axes after the device has been implanted.

86. The device of claim 59 wherein said at least one first and second strut members comprise a plurality of first and second strut members.

87. The device of claim 86 having 4 to 8 first strut members and 4-8 second strut members.

88. The device of claim 86 wherein adjacent ones of said first and second strut members are spaced apart from each other and disposed about a central axis when the device is implanted, such that a hollow channel is defined within said strut members.

89. The device of claim 59 wherein said first and second strut members are formed of resilient material such that they remain in their pre-expansion configurations when radially constrained, but will assume their post-expansion configurations when radially unconstrained.

90. The device of claim 89 wherein said resilient material is selected from the group of resilient materials consisting of:

spring metal;

a resilient polymer; and

a shape memory alloy.

91. The device of claim 59 wherein said first and second strut members are formed of malleable material.

92. The device of claim 91 wherein said malleable material is selected from the group of malleable materials consisting of:

plastically deformable metal; and

plastically deformable polymer.

93. The device of claim 59 wherein at least some of said proximal, distal and medial annular members are of different size when in their radially expanded configurations.

94. The device of claim 59 wherein said annular members are self-expanding.

95. The device of claim 59 wherein said self-expanding annular members are formed of resilient material and are biased to their radially expanded configurations.

96. The device of claim 95 wherein said resilient material is selected from the group consisting of:

spring metal;

resilient polymer; and

shape memory alloy.

97. The device of claim 59 wherein said annular members are pressure-expandable.

98. The device of claim 97 wherein said pressure-expandable annular members are formed of malleable material capable of being plastically deformed from their radially compact configurations to their radially expanded configurations.

99. The device of claim 98 wherein said malleable material is selected from the group of malleable materials consisting of:

plastically deformable metal; and

plastically deformable polymer.

100. The device of claim 59 wherein said first and second strut members have first and second ends, the first and second ends of said first strut members being fused to said proximal and medial annular members and the first and second ends of said second strut members being fused to said medial and distal annular members.

101. The device of claim 59 wherein said first and second strut members have first and second ends, the first and second ends of said first strut members are connected to said proximal and medial annular members by flexible connections and the first and second ends of said second strut members are connected to said medial and distal annular members by flexible connections.

102. The device of claim 101 wherein loops are formed on the first and second ends of said first and second strut members, and portions of said annular members are captured within said loops, to thereby form said flexible connections between the ends of said strut members and said annular members.

103. The device of claim 59 further comprising a plurality of transverse strut connector members formed between adjacent ones of said strut members.

60. A device for facilitating fluid flow between the lumen of a first anatomical conduit which has a first opening formed therein, and the lumen of a second anatomical conduit which has a second opening formed therein, said device comprising:

at least one proximal annular member, at least one distal annular member and at least one medial annular member, each of said annular members having a radially compact configuration and a radially expanded configuration;

at least one first strut member connected to and extending between said proximal and medial annular members, said at least one first strut member having a pre-expansion configuration and a post-expansion configuration;

at least one second strut member connected to and extending between said medial and distal annular members, said at least one second strut member having a pre-expansion configuration and a post-expansion configuration;

said device being initially transluminally deliverable with its annular members in their radially collapsed configurations and said first and second strut members in their pre-expansion configurations;

said device being thereafter implantable with its annular members in their radially expanded configurations and its first and second strut members in their post-expansion configurations; and

,

a pliable covering formed on at least a portion of said device, and formed transversely across the device to block flow of body fluid.

104. The device of claim 60 wherein the proximal, distal and medial annular members are coaxially positioned during transluminal delivery of the device.

105. The device of claim 104 wherein the proximal and distal annular members have different longitudinal axes after the device has been implanted.

106. The device of claim 60 wherein said at least one first and second strut members comprise a plurality of first and second strut members.

107. The device of claim 106 having 4 to 8 first strut members and 4-8 second strut members.

108. The device of claim 106 wherein adjacent ones of said first and second strut members are spaced apart from each other and disposed about a central axis when the device is implanted, such that a hollow channel is defined within said strut members.

109. The device of claim 60 wherein said first and second strut members are formed of resilient material such that they remain in their pre-expansion configurations when radially constrained, but will assume their post-expansion configurations when radially unconstrained.

110. The device of claim 109 wherein said resilient material is selected from the group of resilient materials consisting of:

spring metal;

a resilient polymer; and

a shape memory alloy.

111. The device of claim 60 wherein said first and second strut members are formed of malleable material.

112. The device of claim 111 wherein said malleable material is selected from the group of malleable materials consisting of:

plastically deformable metal; and

plastically deformable polymer.

113. The device of claim 60 wherein at least some of said proximal, distal and medial annular members are of different size when in their radially expanded configurations.

114. The device of claim 60 wherein said annular members are self-expanding.

115. The device of claim 60 wherein said self-expanding annular members are formed of resilient material and are biased to their radially expanded configurations.

116. The device of claim 115 wherein said resilient material is selected from the group consisting of:

spring metal;

resilient polymer; and

shape memory alloy.

117. The device of claim 60 wherein said annular members are pressure-expandable.

118. The device of claim 117 wherein said pressure-expandable annular members are formed of malleable material capable of being plastically deformed from their radially compact configurations to their radially expanded configurations.

119. The device of claim 118 wherein said malleable material is selected from the group of malleable materials consisting of:

plastically deformable metal; and

plastically deformable polymer.

120. The device of claim 60 wherein said first and second strut members have first and second ends, the first and second ends of said first strut members being fused to said proximal and medial annular members and the first and second ends of said second strut members being fused to said medial and distal annular members.

121. The device of claim 60 wherein said first and second strut members have first and second ends, the first and second ends of said first strut members are connected to said proximal and medial annular members by flexible connections and the first and second ends of said second strut members are connected to said medial and distal annular members by flexible connections.

122. The device of claim 121 wherein loops are formed on the first and second ends of said first and second strut members, and portions of said annular members are captured within said loops, to thereby form said flexible connections between the ends of said strut members and said annular members.

123. The device of claim 60 further comprising a plurality of transverse strut connector members formed between adjacent ones of said strut members.

124. The device of claim 60 wherein said pliable covering is a generally cylindrical covering formed about said device, said cover defining a hollow lumen which extends longitudinally through the device.

125. The device of claim 60 wherein at least one flow-through opening is formed in said pliable covering.