Method and apparatus for attaching or locking an implant to an anatomic vessel or hollow organ wall

• US 6,669,707 B1
• Filed: 01/24/2000
• Issued: 12/30/2003
• Est. Priority Date: 07/21/1998
• Status: Expired due to Term

• Current Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Original Assignee: Lee L. Swanstrom
• Inventors: Morales, Pedro, Swanstrom, Lee L.
• Primary Examiner(s): Woo, Julian W.
• Application Number:
  US09/489,820
• Time in Patent Office: 1,436 Days
• Field of Search: 606/151, 606/153, 606/213, 606/216, 606/217, 606/72, 606/74, 606/103, 606/219, 606/220, 606/75, 606/232, 411/340, 411/483, 411/485, 411/501, 411/502, 411/513, 411/515, 24/727, 246/73, 247/061.1, 24/679, 24/67.P, 623/1.11, 623/1.23, 623/1.36, 16/93.D, 132/57.1, 132/284
• US Class Current: 606/153
• CPC Class Codes: A61B 17/0643 with separate closing member, e.g. for interlocking with staple
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0419 H-fasteners
• CPC Class Codes: A61F 2/07 Stent-grafts
• CPC Class Codes: A61F 2002/072 Encapsulated stents, e.g. wire or whole stent embedded in lining
• CPC Class Codes: A61F 2002/075 the stent being loosely attached to the graft material, e.g. by stitching

Abstract

An attachment or locking apparatus which can effectively secure an implant, such as a stent or stent graft, to a vessel or hollow organ wall and which allows minimally-invasive techniques, such as laparoscopy, to be used to attach the implant. The locking element is inserted through an anatomic vessel or hollow organ wall and the implant from outside of the vessel or hollow organ. The locking element preferably is composed of a thin retaining element and a clamping element at one end of the retaining element. A positioning device with an attached locking element may be inserted into the patient'"'"'s body, such that the positioning device penetrates both the vascular or hollow organ wall and the implant deployed within the vascular or hollow organ wall. The clamping element, held within the positioning device, is then ejected into the vessel or hollow organ. The locking element is pulled tight, and then the locking element is secured into place. The locking element made be secured in place by physically deforming a portion of the retaining element outside of the vascular or hollow organ wall, by either winding or bending the retaining element.

Claims

1. A method for securing an implant at a site in an anatomic wall comprising:

guiding the implant to the site;

making a percutaneous incision near the site;

providing a tool holding at least one locking element including a clamping element and a retaining element;

inserting the tool through the percutaneous incision;

puncturing the exterior of the anatomic wall and the implant with a cannula;

ejecting the clamping element into an interior of the anatomic wall so that a portion of the retaining element is located outside of the anatomic wall; and

physically deforming the portion of the retaining element to thereby clamp the implant to the anatomic wall.

2. The method of claim 1 further comprising:

making a second percutaneous incision in the proximity of the anatomic wall; and

wherein the act of guiding includes guiding through the second percutaneous incision and to the site.

3. The method of claim 2, wherein:

the act of making a second percutaneous incision includes making an incision near a femoral artery.

5. The method of claim 2, wherein:

the act of making a second percutaneous incision includes making an incision near a distal end of an abdominal aorta.

6. The method of claim 1 wherein

the act of guiding include guiding the implant using interventional techniques.

7. The method of claim 1, further comprising:

pulling the locking element taut after the act of ejecting the clamping element into the interior of the anatomic wall.

8. The method of claim 1 wherein:

the act of guiding the implant to the site includes guiding the implant to an anatomic vessel.

9. The method of claim 1 wherein:

the act of guiding the implant to the site includes guiding the implant to a hollow organ.

10. The method of claim 1 further comprising:

making an additional percutaneous incision; and

inserting an endoscope through the additional percutaneous incision.

11. The method of claim 1 further comprising:

making an additional percutaneous incision; and

inserting at least one tool through the additional percutaneous incision.

12. The method of claim 1 wherein:

the portion of the retaining element is deformed by bending.

13. The method of claim 1 wherein:

the portion of the retaining element is deformed by wrapping the portion of the retaining element into a coil shape.

14. The method of claim 13 wherein:

the portion of the retaining element is wrapped around a cylindrical tip of a tool.

15. The method of claim 1 further comprising:

Placing a reinforcement ring around an exterior of the anatomic wall, and

wherein the portion of the retaining element is deformed against the reinforcement ring.

4. The method of claimed 2, wherein:

the act of making a second percutaneous incision includes making an incision near an iliac artery.

16. Apparatus for attaching an implant to an anatomic wall, the apparatus comprising:

an implant locking device having a clamping element for disposition against said implant and having a retaining element configured to extend through said anatomic wall and said implant to said clamping element, said retaining element being flexibly joined to said clamping element at a location which a is intermediate between opposite ends of said clamping element, said flexible joining enabling said clamping element to be turned into a substantially parallel relationship with said retaining element during penetration of said locking device into said anatomic wall and said implant and enabling turning of said clamping element into a substantially transverse relationship to said retaining element following said penetration, said clamping element and said retaining element are made of metallic wire, the metallic wire which forms said retaining element is bent 360°

to form an end of the retaining element that is remote from said clamping element and wherein parallel portions of said metallic wire extend from said end of said retaining element to said clamping element, and a weld joining said parallel portions of said metallic wire at least at one location thereon.

17. In an implant and implant locking device for disposition at an anatomic wall, the combination comprising:

a stent configured for emplacement at a first side of the anatomic wall, a body of cushioning material configured for emplacement at an opposite side of the anatomic wall, a clamping element extending within said stent, and a retaining element extending from said clamping element and which penetrates said stent and said body of cushioning material, said retaining element being connected to said clamping element at a location thereon which is intermediate between ends of the clamping element, said clamping element being turnable relative to said retaining element between a first orientation at which the clamping element extends in substantially parallel relationship with the retaining element and a second orientation at which the clamping element extends in a substantially transverse relationship with the retaining element and abuts an inner surface of said stent.

18. The apparatus of claim 17 wherein said clamping element and said retaining element are formed by an integral body of wire having arms which extend in part al relationship to from said retaining element and which are bent outward at said location to form said clamping element.

19. The apparatus of claim 17 wherein said clamping element is connected to said retaining element by a pivot connection at said location.

20. The apparatus of claim 17 wherein said stent has a curved inner surface and wherein said clamping element has a curvature substantially conforming with the curvature of said inner surface of said stent.

21. The apparatus of claim 17 wherein said retaining element is formed of bendable material and wherein a portion of the retaining element is bent to lay against said body of cushioning material to secure said retaining element and clamping element and said stent in place.