Endovascular aneurysm repair system

• US 9,320,589 B2
• Filed: 06/16/2011
• Issued: 04/26/2016
• Est. Priority Date: 11/28/2001
• Status: Expired due to Term

• Current Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Original Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Inventors: Bolduc, Lee
• Primary Examiner(s): Eastwood, David C
• Assistant Examiner(s): TON, MARTIN TRUYEN
• Application Number:
  US13/162,384
• Publication Number:
  US 20120065661A1
• Time in Patent Office: 1,776 Days
• Field of Search: 606/108, 606/155, 606/157, 623/1.11
• US Class Current: 1/1
• 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

Method and apparatus for implanting radially expandable prostheses in the body lumens rely on tacking or anchoring of the prostheses with separately introduced fasteners. The prostheses may be self-expanding or balloon expandable. After initial placement, a fastener applier system is introduced within the expanded prostheses to deploy a plurality of fasteners at least one prosthesis end, usually as each end of the prosthesis. The fasteners are usually helical fasteners which are delivered from a helical track in the fastener applier by rotation with a rotator wire. The fasteners will be applied singly, typically in circumferentially spaced-apart patterns about the interior of each end of the prosthesis.

Claims

1. A system comprising:

an intraluminal directing device sized and configured for introduction from a remote access site to a location within a blood vessel lumen, the intraluminal directing device including a deflectable distal region sized and configured for manipulation to orient the distal region with respect to different desired fastening sites within the blood vessel lumen;

a single helical tissue-piercing fastener having a proximal diagonal component extending across the diameter of the helical tissue-piercing fastener; and

an intraluminal fastener applier including a driven component, a distal end of the intraluminal fastener applier comprising a lumen configured to receive the helical tissue-piercing fastener, the intraluminal fastener applier having internal helical grooves positioned along the entire length of the helical tissue-piercing fastener, the distal end of the driven component comprising a fastener driver, a first portion of which is positioned proximal to and immediately adjacent the helical grooves and the helical tissue-piercing fastener and is sized such that the helical tissue-piercing fastener cannot move proximally past the fastener driver within the lumen of the intraluminal fastener applier and a second portion of which is configured to engage the proximal diagonal component of the tissue-piercing fastener, the driven component being rotatable within the lumen to cause the helical tissue-piercing fastener to rotate along the internal helical grooves of the lumen and out of the distal end of the intraluminal fastener applier, and the intraluminal fastener applier being sized and configured to be introduced along the intraluminal directing device.

2. A system according to claim 1 wherein a desired plurality of tissue-piercing fasteners are introduced one fastener at a time in a circumferentially spaced-apart pattern at the different desired fastening sites within the blood vessel lumen.

3. A system according to claim 1 wherein the intraluminal directing device is sized and configured for rotation in concert with deflecting the distal region.

4. A system according to claim 1 wherein the intraluminal directing device includes a passage accommodating the intraluminal fastener applier.

9. The system according to claim 1, wherein the fastener driver comprises:

the second portion extending distally from the first portion, wherein the second portion is configured to be received within at least a portion of the helical tissue-piercing fastener.

10. The system according to claim 9,

wherein a proximal end of the helical tissue-piercing fastener comprises the proximal diagonal component, and

wherein the second portion of the fastener driver is configured to engage the proximal diagonal component to drive the helical tissue-piercing fastener out of the distal end of the intraluminal fastener applier.

5. A system comprising:

a prosthesis sized and configured for deployment within a blood vessel lumen,

an intraluminal directing device sized and configured for introduction from a remote access site to a location within the prosthesis, the intraluminal directing device including a deflectable distal region sized and configured for manipulation to orient the distal region with respect to different desired fastening sites to secure the prosthesis within the blood vessel lumen;

a single helical tissue-piercing fastener having a proximal diagonal component extending across the diameter of the helical tissue-piercing fastener; and

an intraluminal fastener applier including a driven component, a distal end of the intraluminal fastener applier comprising a lumen configured to receive the helical tissue-piercing fastener, the intraluminal fastener applier having internal helical grooves positioned along the entire length of the helical tissue-piercing fastener, the distal end of the driven component comprising a fastener driver, a first portion of which is positioned proximal to and immediately adjacent the helical grooves and the helical tissue-piercing fastener and is sized such that the helical tissue-piercing fastener cannot move proximally past the fastener driver within the lumen of the intraluminal fastener applier and a second portion of which is configured to engage the proximal diagonal component of the tissue-piercing fastener, the driven component being rotatable within the lumen to cause the helical tissue-piercing fastener to rotate along the internal helical grooves of the lumen and out of the distal end of the intraluminal fastener applier, and the intraluminal fastener applier being sized and configured to be introduced along the intraluminal directing device.

6. A system according to claim 5 wherein a desired plurality of tissue-piercing fasteners are introduced one fastener at a time in a circumferentially spaced-apart pattern at the different desired fastening sites to secure the prosthesis to the blood vessel lumen.

7. A system according to claim 5 wherein the intraluminal directing device is sized and configured for rotation in concert with deflecting the distal region.

8. A system according to claim 5 wherein the intraluminal directing device includes a passage accommodating the intraluminal fastener applier.

11. The system according to claim 5, wherein the fastener driver comprises:

the second portion extending distally from the first portion, wherein the second portion is configured to be received within at least a portion of the helical tissue-piercing fastener.

12. The system according to claim 5,

wherein a proximal end of the helical tissue-piercing fastener comprises the proximal diagonal component, and

wherein the second portion of the fastener driver is configured to engage the proximal diagonal component to cause the helical tissue-piercing fastener to rotate along the internal helical grooves of the lumen and out of the distal end of the intraluminal fastener applier.