Medical clip with tines, system and method of using same

• US 8,668,704 B2
• Filed: 04/24/2009
• Issued: 03/11/2014
• Est. Priority Date: 04/24/2009
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Rothstein, Paul
• Primary Examiner(s): MCEVOY, THOMAS M
• Application Number:
  US12/429,366
• Publication Number:
  US 20100274267A1
• Time in Patent Office: 1,782 Days
• Field of Search: 606/139, 606/142, 606/143, 606/144, 606/148, 606/151, 606/155, 606/157, 606/158, 606/215, 606/216, 606/219, 606/220, 606/221
• US Class Current: 606/151
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00579 Barbed implements
• CPC Class Codes: A61B 2017/00592 Elastic or resilient implements
• CPC Class Codes: A61B 2017/00623 Introducing or retrieving devices therefor
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014

Abstract

Device, system and method for drawing together patient tissue. A tether loop is coupled to a first end loop and a second end loop. The first end loop and the second end loop each have an end and are resiliently biased to coil when deployed from a delivery catheter. When positioned within the delivery catheter the first end loop and the second end loop become substantially linear. Upon deployment from the delivery catheter the end loops coil and the first end passes through a first piece of tissue while the second end passes through a second piece of tissue. Each piece of tissue is captured within the corresponding end loop, the coiling of each of which draws the two pieces of tissue together.

Claims

1. A medical clip adapted to be used with a delivery catheter having a longitudinal axis and a lumen, comprising;

a tether loop;

a first end loop having one end coupled to said tether loop and a first tip at an opposite end of said first end loop, said first end loop being resiliently biased to form a coil when said first end loop is free from being constrained by said lumen of said delivery catheter;

a second end loop having one end coupled to said tether loop and a second tip at an opposite end of said second end loop, said second end loop being resiliently biased to form a coil when said second end loop is free from being constrained by said lumen of said delivery catheter;

each of said first end loop and said second end loop being substantially linear when constrained in said lumen of said delivery catheter; and

wherein, upon initial deployment of said medical clip from said delivery catheter, said first tip extends from said first end loop and said second tip extends from said second loop in opposing directions approximately orthogonal to said longitudinal axis of said delivery catheter;

and further wherein said medical clip is a wire continuously extending from said first tip to said second tip and when free of said lumen, continuous extension of said wire in a direction from said first tip to said second tip defines a first wind direction for said first end loop, a second wind direction opposite said first wind direction for said tether loop, and said first wind direction for said second end loop;

whereby said first tip may pass through a first piece of said patient tissue and said second tip may pass through said second piece of said patient tissue capturing said first piece of patient tissue and said second piece of patient tissue and drawing said first piece of patient tissue and said second piece of patient tissue together.

2. The medical clip of claim 1 wherein said first end loop and said second end loop are resiliently biased to become co-planar with said tether loop when said first end loop and said second end loop are free from being constrained by said lumen of said delivery catheter.

3. The medical clip of claim 1 wherein said tether loop, said first end loop and said second end loop each comprise at least one full revolution.

4. The medical clip of claim 3 wherein said tether loop, said first end loop and said second end loop each comprise at least one-and-a-quarter revolutions.

5. A system for drawing together patient tissue, comprising:

a delivery catheter having a longitudinal axis and a lumen; and

a medical clip inserted in said lumen of said catheter, comprising;

a tether loop;

a first end loop having one end coupled to said tether loop and a first tip at an opposite end of said first end loop, said first end loop being resiliently biased to form a coil when said first end loop is free from being constrained by said lumen of said delivery catheter;

a second end loop having one end coupled to said tether loop and a second tip at an opposite end of said second end loop, said second end loop being resiliently biased to form a coil when said second end loop is free from being constrained by said lumen of said delivery catheter;

wherein relative to a continuous direction of extension of said medical clip from said first tip to said second tip, said coil of said first end loop has a counterclockwise winding, said tether loop has a clockwise winding, and said coil of said second end loop has a counterclockwise winding when said medical clip is free from being constrained by said lumen,

each of said first end loop and said second end loop being substantially linear when constrained in said lumen of said delivery catheter; and

wherein, upon initial deployment of said medical clip from said delivery catheter, said first tip extends from said first end loop and said second tip extends from said second loop in opposing directions approximately orthogonal to said longitudinal axis of said delivery catheter;

whereby said first tip may pass through a first piece of said patient tissue and said second tip may pass through said second piece of said patient tissue capturing said first piece of patient tissue and said second piece of patient tissue and drawing said first piece of patient tissue and said second piece of patient tissue together.

6. The system of claim 5 wherein said first end loop and said second end loop are resiliently biased to become co-planar with said tether loop when said first end loop and said second end loop are free from being constrained by said lumen of said delivery catheter.

7. The system of claim 5 wherein said tether loop, said first end loop and said second end loop each comprise at least one full revolution.

8. The system of claim 7 wherein said tether loop, said first end loop and said second end loop each comprise at least one-and-a-quarter revolutions.

9. A medical clip adapted to be used with a delivery catheter having a longitudinal axis and a lumen, said delivery catheter forming an opening having a first side and a second side opposite said first side and defining a major plane of said delivery catheter, comprising;

a tether loop resiliently biased to form a coil having a spring force;

a first end loop having one end coupled to said tether loop and a first tip at an opposite end of said first end loop, said first end loop being resiliently biased to form a coil when said first end loop is free from being constrained by said lumen of said delivery catheter;

a second end loop having one end coupled to said tether loop and a second tip at an opposite end of said second end loop, said second end loop being resiliently biased to form a coil when said second end loop is free from being constrained by said lumen of said delivery catheter;

each of said first end loop and said second end loop being substantially linear when constrained in said lumen of said delivery catheter; and

wherein said medical clip is configured such that;

during an initial stage of deployment of said medical clip from said delivery catheter, said first tip exits said delivery catheter proximate said first side of said opening and curls in a first orthogonal direction relative to said major plane and said second tip exits said delivery catheter proximate said second side of said opening and curls in a second orthogonal direction relative to said major plane; and

during an intermediate stage of deployment of said medical clip from said delivery catheter, at least a portion of said first end loop exits said delivery catheter proximate said second side of said opening and at least a portion of said second end loop exits said delivery catheter proximate said first side of said opening;

wherein said first tip may pass through a first piece of patient tissue in said first orthogonal direction relative to said deployment catheter and said second tip may pass through a second piece of patient tissue in said second orthogonal direction relative to said deployment catheter, capturing said first piece of patient tissue and said second piece of patient tissue; and

wherein said spring force of said tether coil draws said first piece of patient tissue and said second piece of patient tissue toward each other by exerting a force in said second orthogonal direction on said first end loop and a force in said first orthogonal direction on said second end loop.

10. The medical clip of claim 9 wherein, upon deployment of said medical clip from said delivery catheter, said first tip extends from said first end loop and said second tip extends from said second loop in opposing directions approximately orthogonal to said longitudinal axis of said delivery catheter.

11. A medical clip adapted to be used with a delivery catheter having a lumen and a lumen wall, said delivery catheter forming an opening having a first side and a second side opposite said first side, said first side and said second side defining a major plane of said catheter, comprising:

a central spring resiliently biased to form a loop in a compressed state;

a first separator segment extending from a first end of said central spring;

a first tissue capture spring having a first tip and being coupled to said first separator segment;

a second separator segment extending from a second end of said central spring;

a second tissue capture spring having a second tip and being coupled to said second separator segment;

wherein relative to a line passing through said first and second separator segments, said first and second tissue capturing springs project away from said line in a first direction and said central spring projects away from said line in a second direction opposite said first direction;

wherein when said medical clip is positioned in said lumen of said delivery catheter said central spring is maintained in an uncompressed state by said lumen wall and said first tip and said second tip are proximate said opening;

wherein said first tissue capture spring is resiliently biased such that said first tip exits said opening proximate said first side and wherein said second tissue capture spring is resiliently biased such that said second tip exits said opening proximate said second side; and

wherein said central spring is resiliently biased such that at least a portion of said first tissue capture spring between said first tip and said first separator segment exits said opening proximate said second side and at least a portion of said second tissue capture spring between said second tip and said second separator segment exits said opening proximate said first side, and wherein when said central spring transitions from said uncompressed state to said compressed state said first tissue capture spring moves, at least in part, toward said first side and said second tissue capture spring moves, at least in part, toward said second side.

12. The clip of claim 11 wherein said first tissue capture spring and said second tissue capture spring are maintained in an approximately linear state by said lumen wall.

13. The clip of claim 11:

wherein said first tissue capture spring moves, at least in part, in a first direction perpendicular to said major plane of said delivery catheter;

wherein said second tissue capture spring moves, at least in part, in a second direction perpendicular to said major plane of said delivery catheter opposite said first direction; and

wherein when said central spring transitions from said uncompressed state to said compressed state said first tissue capture spring moves, at least in part, toward said first side and said second tissue capture spring moves, at least in part, toward said second side.

14. The clip of claim 11 wherein said first tissue capture spring and said second tissue capture spring are resiliently biased to become co-planar with said central spring when said first tissue capture spring and said second tissue capture spring are free from being constrained by said lumen of said delivery catheter.

15. The clip of claim 11 wherein said central spring, said first tissue capture spring and said second tissue capture spring each comprise at least one full revolution.

16. The clip of claim 15 wherein said central spring, said first tissue capture spring and said second tissue capture spring each comprise at least one-and-a-quarter revolutions.

17. A medical clip system, comprising:

a delivery catheter having a lumen and a lumen wall, said delivery catheter forming an opening having a first side and a second side opposite said first side, said first side and said second side defining a major plane of said catheter;

a medical clip, comprising;

a central spring resiliently biased to form a loop in a compressed state;

a first tissue capture spring having a first tip and being coupled to a first end of said central spring;

a second tissue capture spring having a second tip and being coupled to a second end of said central spring;

wherein said system is configured such that;

in a pre-deployment stage when said medical clip is positioned in said lumen of said delivery catheter, said central spring is maintained in an uncompressed state by said lumen wall and said first tip and said second tip are proximate said opening;

in an initial stage of deployment said first tissue capture spring is resiliently biased such that said first tip exits said opening proximate said first side and wherein said second tissue capture spring is resiliently biased such that said second tip exits said opening proximate said second side;

in an intermediate stage of deployment said central spring is resiliently biased such that at least a portion of said first tissue capture spring exits said opening proximate said second side and at least a portion of said second tissue capture spring exits said opening proximate said first side; and

in a final stage of deployment when said central spring transitions from said uncompressed state to said compressed state said first tissue capture spring moves more proximate said second side and said second tissue capture spring moves more proximate said first side.

18. The system of claim 17 wherein said first tissue capture spring and said second tissue capture spring are maintained in an approximately linear state by said lumen wall.

19. The system of claim 17:

wherein said first tissue capture spring moves, at least in part, in a first direction perpendicular to said major plane of said delivery catheter;

wherein said second tissue capture spring moves, at least in part, in a second direction perpendicular to said major plane of said delivery catheter opposite said first direction; and

wherein when said central spring transitions from said uncompressed state to said compressed state said first tissue capture spring moves, at least in part, toward said first side and said second tissue capture spring moves, at least in part, toward said second side.

20. The system of claim 17 wherein said first tissue capture spring and said second tissue capture spring are resiliently biased to become co-planar with said central spring when said first tissue capture spring and said second tissue capture spring are free from being constrained by said lumen of said delivery catheter.

21. The system of claim 17 wherein said central spring, said first tissue capture spring and said second tissue capture spring each comprise at least one full revolution.

22. The system of claim 21 wherein said central spring, said first tissue capture spring and said second tissue capture spring each comprise at least one-and-a-quarter revolutions.