Target tissue localization assembly and method

• US 7,150,712 B2
• Filed: 08/05/2002
• Issued: 12/19/2006
• Est. Priority Date: 11/07/2000
• Status: Expired due to Fees

• Current Assignee: Artemis Medical, Inc. (Johnson & Johnson)
• Original Assignee: Artemis Medical, Inc. (Johnson & Johnson)
• Inventors: Laird, Robert J., Dubrul, William R., Buehlmann, Eric L.
• Primary Examiner(s): KASZTEJNA, MATTHEW JOHN
• Application Number:
  US10/212,467
• Publication Number:
  US 20040049224A1
• Time in Patent Office: 1,597 Days
• Field of Search: 600/114, 600/115, 600/567, 600/562, 600/564, 600/570
• US Class Current: 600/114
• CPC Class Codes: A61B 17/221 Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions surgical snare instruments A61B17/32056
• CPC Class Codes: A61B 18/148 having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
• 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 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/1205 Introduction devices
• CPC Class Codes: A61B 2017/22061 for spreading elements apart
• CPC Class Codes: A61B 2017/2212 having a closed distal end, e.g. a loop
• CPC Class Codes: A61B 2017/2215 having an open distal end
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/00601 Cutting
• CPC Class Codes: A61B 2018/1475 Electrodes retractable in or deployable from a housing
• CPC Class Codes: A61B 2090/3908 Soft tissue, e.g. breast tissue
• CPC Class Codes: A61B 90/02 Devices for expanding tissue, e.g. skin tissue implements for holding wounds open, surgical tractors A61B17/02; implantable mammary prosthesis A61F2/12; dilators A61M29/00
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers

Abstract

A target tissue localization assembly includes a radially expandable tissue anchor connected to the distal ends of an anchor assembly and an elongated anchor actuator element. A lock, engageable between the actuator element and the placement element, may be used to prevent collapse of the anchor from its radially expanded state. A sheath may be slidably mounted over the anchor assembly. The sheath and the anchor assembly may be configured to permit the sheath to move in a proximal direction, relative to the anchor assembly, past a chosen location while preventing the sheath from moving past the chosen location in a distal direction.

Claims

1. A target tissue localization assembly comprising:

an anchor assembly comprising;

an elongated placement element having a placement element distal end and a placement element proximal end;

an elongated anchor actuator element comprising a wire and having an actuator element distal end and an actuator element proximal end, extending along the placement element, the actuator element distal end movable relative to the placement element distal end;

and a radially expandable tissue anchor operably coupleable to the placement and anchor actuator elements, movable from a radially contracted condition to a radially expanded, deployed condition when the distal ends are moved relative to one another from a first state to a second state; and

a lock engageable between the actuator element and the placement element when the anchor is in the deployed condition to at least temporarily prevent collapse of the anchor by preventing movement of the distal ends back to the first state.

2. The assembly according to claim 1 wherein the anchor is connected to the distal ends of the placement and anchor actuator elements.

3. The assembly according to claim 1 further comprising a sheath slidably mounted over the anchor assembly.

4. The assembly according to claim 1 wherein the placement element comprises a hollow shaft.

5. The assembly according to claim 1 wherein the placement element is stiff.

6. The assembly according to claim 1 wherein the anchor comprises a tubular mesh tissue anchor.

7. The assembly according to claim 1 wherein the anchor is an axially collapsible, radially expandable anchor.

8. The assembly according to claim 7 wherein the anchor is movable from the radially contracted condition to the radially expanded, deployed condition when the distal ends are moved toward one another.

9. The assembly according to claim 1 further comprising the sheath assembly, said sheath assembly comprising:

a sheath, having proximal and distal ends, slidably mounted over the anchor assembly; and

a hub mounted to the proximal end of the sheath.

10. The assembly according to claim 1 further comprising:

a sheath slidably mounted over the anchor assembly;

a chosen one of the placement element and the sheath comprising a surface interruption at a first location along said chosen one;

the other of the placement element and the sheath comprising a surface interruption engagement element at a second position along said other; and

the surface interruption element and the surface interruption engagement element being configured to (a) permit the surface interruption engagement element to move past the surface interruption in a first direction but (b) not permit the surface interruption engagement element to move past the surface interruption in a second direction opposite the first direction.

11. The assembly according to claim 10 wherein said sheath comprises a hub, said surface interruption comprises a shoulder defined by a groove formed in the placement element, and said surface interruption engagement element comprises a clip carried by the hub, said clip comprising a spring finger which frictionally engages said placement element and permits the hub to move in a proximal direction past said shoulder while preventing the hub from moving past the shoulder in a distal direction.

12. The assembly according to claim 1 wherein the lock has a first surface and the placement element has a second surface, the first surface movable to a stable engagement position contacting the second surface when the anchor is in the deployed condition.

13. The assembly according to claim 12 wherein said placement element defines an axis and the first and second surfaces engage along a plane at an acute angle to said axis.

14. The assembly according to claim 1 further comprising a handle housing the lock.

15. The assembly according to claim 14 wherein said handle is removable;

thereby exposing the lock when the anchor is in the deployed condition and the first and second surfaces are engaged.

16. The assembly according to claim 1 wherein said anchor is effectively fully radially expanded when in the deployed condition.

17. The assembly according to claim 1 further comprising a protective cover, having a hollow cover interior, removably covering the placement element proximal end.

18. The assembly according to claim 17 wherein the placement element comprises a hollow tubular placement element and the protective cover has a fluid coupling so to permit fluid to be introduced through the fluid coupling, through the hollow cover interior and through the hollow tubular placement element.

19. A target tissue localization assembly comprising:

an elongated placement element having a placement element distal end and a placement element proximal end;

an elongated anchor actuator element having an actuator element distal end and an actuator element proximal end, extending along the placement element, the actuator element distal end movable relative to the placement element distal end;

a radially expandable tissue anchor having a distal anchor portion connected to the distal end of the anchor actuator element and a proximal anchor portion, at least a portion of the anchor positionable at an extended position relative to the distal end of the placement element;

a movement-limiting element engageable between the placement element and the proximal anchor portion when at said extended position so to at least hinder proximal movement of the proximal anchor portion when said actuator element is pulled proximally to permit radial expansion of the anchor to a deployed condition; and

locking means for at least temporarily preventing collapse of the anchor when the anchor is in the deployed condition.

20. The assembly according to claim 19 wherein the placement element comprises a stiff hollow shaft, said stiff hollow shaft constituting an introducer sheath.

21. The assembly according to claim 19 wherein the movement-limiting element is engageable between the distal end of the placement element and the proximal anchor portion.

22. The assembly according to claim 19 wherein the anchor actuator element comprises a flexible wire.

23. The assembly according to claim 19 wherein the anchor comprises an inner surface at said proximal anchor portion and the locking means comprises an element which frictionally engages the inner surface when the anchor is in the deployed condition.

24. The assembly according to claim 19 wherein said movement-limiting element extends radially outwardly and longitudinally proximally from the proximal anchor portion so to engage the placement element distal end.

25. The assembly according to claim 19 further comprising a protective cover, having a hollow cover interior, removably covering a proximal end of the placement element.

26. The assembly according to claim 25 wherein the placement element comprises a hollow tubular placement element and the protective cover has a fluid coupling so to permit fluid to be introduced through the fluid coupling, through the hollow cover interior and through the hollow tubular placement element.

27. The assembly according to claim 19 wherein the anchor actuator element comprises a wire.

28. The assembly according to claim 27 wherein the wire comprises a flexible twisted wire.

29. The assembly according to claim 19 wherein the anchor comprises a tubular mesh tissue anchor.

30. The assembly according to claim 19 wherein the anchor is an axially collapsible, radially expandable anchor.

31. The assembly according to claim 30 wherein the anchor is movable from a radially contracted condition to a radially expanded, deployed condition when the distal and proximal anchor portions are moved toward one another.

32. A method for localizing target tissue at a target site of a patient comprising:

percutaneously positioning a tip of an anchor assembly at or near a target site of a patient, the anchor assembly comprising;

an elongated placement element;

an elongated anchor actuator element comprising a wire and extending along the placement element; and

a radially expandable tissue anchor operably coupled to the placement and anchor actuator elements;

placing the anchor in a radially expanded condition by moving at least portions of the anchor actuator and placement elements relative to one another in a first direction; and

at least temporarily preventing movement of said portions of the anchor actuator and placement elements relative to one another in a second direction opposite said first direction thereby maintaining the anchor in the radially expanded condition.

33. The method according to claim 32 wherein the tip positioning step is carried out at a target site within a breast of a patient.

34. The method according to claim 32 wherein the placing step is carried out by:

positioning the tip at the target site;

moving the anchor assembly in a distal direction so to position the tip at a first distal position;

expanding the anchor to its radially expanded condition; and

said moving and expanding steps carried out so that the radially expanded anchor is at the target site when in its radially expanded condition.

35. The method according to claim 32 wherein the placing step comprises grasping a handle, the handle engaging a proximal portion of the actuator element, pushing the handle and the actuator element therewith in a distal direction to a distal position, and then pulling the handle and the actuator element therewith in a proximal direction from the distal position to a proximal position.

36. The method according to claim 35 further comprising separating the handle from the anchor assembly.

37. The method according to claim 32 wherein the tip positioning step takes place with the anchor assembly slidably housed within a sheath assembly.

38. The method according to claim 37 further comprising:

maintaining the sheath assembly at a fixed position relative to the patient following the positioning step; and

preventing proximal movement of the placement element relative to the sheath assembly.

39. The method according to claim 32 wherein said sheath is moved proximally when moved in said first direction and said sheath is move distally when moved in said second direction.

40. A target tissue localization assembly comprising:

an anchor assembly comprising;

an elongated placement element;

an elongated anchor actuator element extending along the placement element; and

a radially expandable tissue anchor operably coupleable to the placement and anchor actuator elements so to move from a radially contracted condition to a radially expanded condition when at least portions of the anchor actuator element and the placement element are moved relative to one another;

a sheath slidably mounted over the anchor assembly;

a chosen one of the placement element and the sheath comprising a surface interruption at a first location along said chosen one;

the other of the placement element and the sheath comprising a surface interruption engagement element at a second position along said other; and

the surface interruption element and the surface interruption engagement element being configured to (a) permit the surface interruption engagement element to move past the surface interruption in a first direction but (b) not permit the surface interruption engagement element to move past the surface interruption in a second direction opposite the first direction.

41. The assembly according to claim 40 wherein said sheath comprises a hub, said surface interruption comprises a shoulder defined by a groove formed in the placement element, and said proximal direction past said shoulder while preventing the hub from moving past the shoulder in a distal direction.

42. The assembly according to claim 40 wherein the placement and anchor actuation elements have distal ends, and the anchor is connected to the distal ends of the placement and anchor actuator elements.

43. The assembly according to claim 40 wherein the placement element comprises a hollow shaft.

44. The assembly according to claim 40 wherein the placement element is stiff.

45. The assembly according to claim 40 wherein the anchor actuator element comprises a wire.

46. The assembly according to claim 40 wherein the anchor comprises a tubular mesh tissue anchor.

47. The assembly according to claim 40 wherein the anchor is an axially collapsible, radially expandable anchor.

48. The assembly according to claim 47 wherein the placement and anchor actuator elements have distal ends, and the anchor is movable from the radially contracted condition to the radially expanded condition when the distal ends are moved toward one another.

49. The assembly according to claim 40 wherein said anchor is effectively fully radially expanded when in the deployed condition.

50. The assembly according to claim 40 further comprising a protective cover, having a hollow cover interior, removably covering a proximal end of the placement element.

51. The assembly according to claim 50 wherein the placement element comprises a hollow tubular placement element and the protective cover has a fluid coupling so to permit fluid to be introduced through the fluid coupling, through the hollow cover interior and through the hollow tubular placement element.

52. A method for localizing target tissue at a target site of a patient comprising:

percutaneously positioning a tip of an anchor assembly, slidably housed within a sheath assembly, at a target position relative to a target site of a patient, the anchor assembly comprising;

an elongated placement element;

an elongated anchor actuator element extending along the placement element said anchor actuator element comprising the tip; and

a radially expandable tissue anchor connected to the placement and anchor actuator elements;

maintaining the sheath assembly at a fixed position relative to the patent following the positioning step;

sliding the placement element distally within the sheath assembly from a first position to a second position;

preventing proximal movement of the placement element relative to the sheath assembly froze the second position to the first position; and

placing the anchor in a radially expanded condition by moving the anchor assembly relative to the placement element.

53. The method according to claim 52 wherein the tip positioning step is carried out at a target site within a breast of a patient.

54. The method according to claim 52 wherein the placing step is carried out by:

positioning the tip at the target site;

moving the anchor assembly in a distal direction so to position the tip at a first distal position;

expanding the anchor to its radially expanded condition; and

said moving and expanding steps carried out so that the radially expanded anchor is at the target site when in its radially expanded condition.