Endovascular aneurysm repair method

• US 7,959,663 B2
• Filed: 09/29/2006
• Issued: 06/14/2011
• Est. Priority Date: 11/28/2001
• Status: Expired due to Fees

• Current Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Original Assignee: Aptus Endosystems Inc. (Medtronic Plc)
• Inventors: Bolduc, Lee
• Primary Examiner(s): Nguyen; Anhtuan T
• Assistant Examiner(s): SZPIRA, JULIE ANN
• Application Number:
  US11/540,427
• Publication Number:
  US 20070021829A1
• Time in Patent Office: 1,719 Days
• Field of Search: 623/1.13, 623/1.15, 623/1.38, 623/23.75, 606/108, 606/151, 606/153, 606/215, 606/216, 128/898
• US Class Current: 623/1.13
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• 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 17/072 for applying a row of staples in a single action , e.g. the staples being applied simultaneously
• CPC Class Codes: A61B 17/10 for applying or removing wound clamps, e.g. containing only one clamp or staple A61B17/076 takes precedence; containing multiple wound clamps A61B17/068; Wound clamp magazines containers, packaging elements or packages specially adapted for particular articles or with special means for dispensing contents B65D83/00, B65D85/00
• CPC Class Codes: A61B 2017/00292 mounted on or guided by flexible, e.g. catheter-like, means
• CPC Class Codes: A61B 2017/00778 Operations on blood vessels A61B2017/22097, A61B2017/320741 take precedence
• CPC Class Codes: A61B 2017/0646 for insertion into cartillege, e.g. meniscus
• CPC Class Codes: A61B 2017/0649 Coils or spirals
• CPC Class Codes: A61F 2/06 Blood vessels
• 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 2/848 having means for fixation to the vessel wall, e.g. barbs
• CPC Class Codes: A61F 2/90 characterised by a net-like or mesh-like structure
• CPC Class Codes: A61F 2002/061 provided with means for allowing access to secondary lumens
• CPC Class Codes: A61F 2002/065 Y-shaped blood vessels
• CPC Class Codes: A61F 2002/067 modular
• CPC Class Codes: A61F 2002/075 the stent being loosely attached to the graft material, e.g. by stitching
• CPC Class Codes: Y10S 623/903 Blood vessel

Abstract

A method for repairing a diseased or damaged section of an aorta (i) introduces an intraluminal directing device from a remote access site to a location within a prosthesis at a target site in an aorta where the diseased or damaged section exists, the intraluminal directing device including a deflectable distal region; (ii) establishes a path to a desired fastening site on the prosthesis by manipulating the intraluminal directing device within the prosthesis to orient the distal region with respect to the desired fastening site; (iii) introduces from an intraluminal fastener applier, that is introduced along the path established in (ii), at least one tissue-piercing fastener into tissue at the desired fastening site to anchor the prosthesis; (iv) establishes a path to a different desired fastening site on the prosthesis by manipulating the intraluminal directing device within the prosthesis to orient the distal region with respect to the different desired fastening site; (v) introduces from an intraluminal fastener applier, that is introduced through the path established in (iv), at least one tissue-piercing fastener into tissue at the different desired fastening site to further anchor the prosthesis; and (vi) repeats (iv) and (v) until a desired plurality of tissue-piercing fasteners are introduced into tissue to anchor the prosthesis.

Claims

1. A method for repairing a diseased or damaged section of an aorta comprising:

(i) introducing an intraluminal directing device from a remote access site to a location within a prosthesis at a target site in an aorta where the diseased or damaged section exists, the intraluminal directing device including a deflectable distal region;

(ii) establishing a path to a desired fastening site on the prosthesis by manipulating the intraluminal directing device within the prosthesis to orient the distal region with respect to the desired fastening site;

(iii) advancing an intraluminal fastener applier through the path established in (ii) and rotating at least one tissue-piercing fastener into tissue at the desired fastening site to anchor the prosthesis, the at least one tissue-piercing fastener configured to pierce tissue in response to rotation;

(iv) establishing a path to a different desired fastening site on the prosthesis by manipulating the intraluminal directing device within the prosthesis to orient the distal region with respect to the different desired fastening site;

(v) advancing an intraluminal fastener applier through the path established in (iv) and rotating an additional at least one tissue-piercing fastener into tissue at the different desired fastening site to further anchor the prosthesis, the additional tissue-piercing fastener configured to pierce tissue in response to rotation;

wherein (iii) and/or (v) includes rotating the fastener with a rotary driver; and

(vi) repeating (iv) and (v) until a desired plurality of tissue-piercing fasteners are introduced into tissue to anchor the prosthesis.

2. A method according to claim 1

wherein the prosthesis includes at least one self-expanding scaffold, and

wherein (i) comprises releasing the prosthesis from constraint to permit the at least one scaffold of the prosthesis to self-expand at the target site.

3. A method according to claim 1

wherein the prosthesis includes at least one malleable scaffold, and

wherein (i) comprises applying a radially expansive force within the prosthesis to cause expansion of the at least one scaffold.

4. A method according to claim 1

wherein at least one of the tissue-piercing fasteners comprises a helical tissue-piercing fastener.

5. A method according to claim 1

wherein the desired plurality of tissue-piercing fasteners are introduced in a circumferentially spaced-apart pattern to anchor the prosthesis.

6. A method according to claim 1

wherein (ii) includes rotating the intraluminal directing device and/or deflecting the distal region.

7. A method according to claim 1

wherein the intraluminal directing device includes a passage, and

wherein (iii) and (v) includes introducing an intraluminal fastener applier to the desired fastening site through the passage.

8. A method according to claim 7

wherein the passage comprises an interior lumen.