Methods and devices for placing a conduit in fluid communication with a target vessel

• US 7,025,773 B2
• Filed: 05/07/2001
• Issued: 04/11/2006
• Est. Priority Date: 01/15/1999
• Status: Expired due to Fees

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Gittings, Darin C., Cole, David H., Sharkawy, Adam, Laroya, Gilbert S., Rapacki, Alan R., Buch, Wally S., Carson, Dean F., Lepulu, Keke
• Primary Examiner(s): Weiss, Howard
• Assistant Examiner(s): Trinh, Hoa (Vikki) B.
• Application Number:
  US09/850,883
• Publication Number:
  US 20020004663A1
• Time in Patent Office: 1,800 Days
• Field of Search: 606/153, 606/151, 606/152, 606/159, 606/108, 606/156, 623 115- 12
• US Class Current: 606/153
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 2017/00243 cardiac
• 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 2017/00867 shape memory effect for prostheses A61F2210/0014
• 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 Y-shaped blood vessel prostheses A61F2002/065
• CPC Class Codes: A61B 2017/2923 Toothed members, e.g. rack and pinion
• 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 2/86 Stents in a form characterised by the wire-like elements; Stents in the form 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 2/95 Instruments specially adapted for placement or removal of stents or stent-grafts
• CPC Class Codes: A61F 2/9517 handle assemblies therefor
• CPC Class Codes: A61F 2002/91508 the meander having a difference in amplitude along the band
• CPC Class Codes: A61F 2002/91516 the meander having a change in frequency along the band
• 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 2002/91541 Adjacent bands are arranged out of phase
• CPC Class Codes: A61F 2002/91558 connected peak to peak
• CPC Class Codes: A61F 2220/0008 Fixation appliances for connecting prostheses to the body
• CPC Class Codes: A61F 2220/005 : using adhesives
• CPC Class Codes: A61F 2220/0058 : soldered or brazed or welded
• CPC Class Codes: A61F 2220/0075 : sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2230/0054 : V-shaped
• CPC Class Codes: A61F 2230/0058 : X-shaped
• CPC Class Codes: A61F 2230/0067 : conical
• CPC Class Codes: A61F 2230/0076 : ellipsoidal or ovoid

Abstract

Methods and devices for placing a conduit in fluid communication with a target vessel and a source of blood, such as the aorta or a heart chamber. The device may be actuated using one hand to place the conduit. The invention allows air in the conduit to be removed prior to placement of the conduit. The invention deploys the conduit in the target vessel by moving a sheath in a distal direction and then in a proximal direction. A conduit is provided with a reinforcing member to prevent kinking of the conduit, and a structure for preventing blockage of the conduit by tissue. A vessel coupling may be used to secure a conduit to a target vessel so as to preserve native blood flow through the vessel, and the conduit may be placed in fluid communication with a target vessel via a laparoscopic or endoscopic procedure.

Claims

1. A method for deploying a conduit in a target vessel, the method comprising steps of:

(a) providing a conduit having a first end, a second end and a lumen, wherein the conduit is movable between deployed and non-deployed positions and at least a portion of the conduit is held in the non-deployed position by a retention member, the retention member comprises a sheath that overlies the non-deployed portion of the conduit, wherein the conduit comprises a stent and the deployed and non-deployed positions correspond, respectively, to expanded and collapsed orientations of the stent;

(b) positioning at least the non-deployed portion of the conduit in a lumen of a target vessel;

(c) moving the retention member in a first direction with respect to the conduit to move the non-deployed portion of the conduit to the deployed position, the retention member moving distally toward the target vessel; and

(d) moving the retention member in a second direction that is substantially opposite the first direction to remove the retention member from the target vessel, the retention member moving proximally away from the target vessel, wherein the sheath is removed through the lumen of the deployed portion of the conduit; and

coupling the sheath to a sheath removal mechanism and removing the sheath and the sheath removal mechanism from the target vessel.

2. The method of claim 1, wherein the sheath and the sheath removal mechanism are removed through the lumen of the conduit.

3. The method of claim 1, further comprising providing the sheath removal mechanism with a tapered portion that is coupled to the sheath and forms a smooth outer profile for removing the sheath.

4. The method of claim 1, wherein the portion of the conduit is secured to the target vessel without using suture to form a substantially suture-free anastomosis.

5. A method for placing a conduit in fluid communication with a target vessel so as to preserve native flow through the target vessel, the method comprising steps of:

(a) providing a vessel coupling and a conduit, wherein the vessel coupling has a first portion configured to secure the conduit to a target vessel so that the conduit is in fluid communication with the target vessel;

(b) moving the vessel coupling generally along a first direction to place the first portion of the vessel coupling at least partially within the lumen of the target vessel; and

(c) moving the first portion of the vessel coupling generally along a second direction within the lumen of the target vessel to deploy the vessel coupling and secure the conduit to the target vessel, wherein the second direction is transverse to the first direction.

6. The method of claim 5, wherein the first direction corresponds to the longitudinal axis of the conduit and the second direction corresponds to the longitudinal axis of the target vessel, and step (c) is performed by moving the first portion of the vessel coupling along a curved path between the two axes.