CA2244080A1 - Methods and apparatus for blocking flow through blood vessels - Google Patents

Methods and apparatus for blocking flow through blood vessels Download PDF

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Publication number
CA2244080A1
CA2244080A1 CA002244080A CA2244080A CA2244080A1 CA 2244080 A1 CA2244080 A1 CA 2244080A1 CA 002244080 A CA002244080 A CA 002244080A CA 2244080 A CA2244080 A CA 2244080A CA 2244080 A1 CA2244080 A1 CA 2244080A1
Authority
CA
Canada
Prior art keywords
lumen
blood vessel
vessel
blood
catheter
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
CA002244080A
Other languages
French (fr)
Inventor
Philip C. Evard
J.C. Flaherty
John T. Garibotto
Patrick E. Macaulay
Timothy R. Machold
Joshua Makower
Jason B. Whitt
Marc Jensen
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Transvascular Inc
Original Assignee
Transvascular, Inc.
Philip C. Evard
J.C. Flaherty
John T. Garibotto
Patrick E. Macaulay
Timothy R. Machold
Joshua Makower
Jason B. Whitt
Marc Jensen
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from US08/730,327 external-priority patent/US6190353B1/en
Priority claimed from US08/730,496 external-priority patent/US5830222A/en
Application filed by Transvascular, Inc., Philip C. Evard, J.C. Flaherty, John T. Garibotto, Patrick E. Macaulay, Timothy R. Machold, Joshua Makower, Jason B. Whitt, Marc Jensen filed Critical Transvascular, Inc.
Publication of CA2244080A1 publication Critical patent/CA2244080A1/en
Abandoned legal-status Critical Current

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    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/848Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents having means for fixation to the vessel wall, e.g. barbs
    • A61F2002/8486Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents having means for fixation to the vessel wall, e.g. barbs provided on at least one of the ends
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2210/00Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/009Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof magnetic
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0004Rounded shapes, e.g. with rounded corners
    • A61F2230/001Figure-8-shaped, e.g. hourglass-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/0067Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0074Dynamic characteristics of the catheter tip, e.g. openable, closable, expandable or deformable
    • A61M25/0075Valve means
    • A61M2025/0076Unidirectional valves
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/0067Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0082Catheter tip comprising a tool
    • A61M2025/0096Catheter tip comprising a tool being laterally outward extensions or tools, e.g. hooks or fibres
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • A61M2025/1043Balloon catheters with special features or adapted for special applications
    • A61M2025/1052Balloon catheters with special features or adapted for special applications for temporarily occluding a vessel for isolating a sector

Abstract

This invention is methods and apparatus for occluding blood flow within a blood vessel (22). In a first series of embodiments, the present invention comprises a plurality of embolic devices (16) deployable through the lumen (12) of a conventional catheter (10) such that when deployed, said embolic devices (16) remain resident and occlude blood flow at a specific site within the lumen of the blood vessel (22). Such embolic devices (16) comprise either mechanical embolic devices that become embedded within or compress against the lumen of the vessel or chemical vaso-occlusive agents that seal off blood flow at a given site. A second embodiment of the present invention comprises utilization of a vacuum/cauterizing device capable of sucking in the lumen of the vessel about the device to maintain the vessel in a closed condition where there is then applied a sufficient amount of energy to cause the tissue collapsed about the device to denature into a closure. In a third series of embodiments, the present invention comprises the combination of an embolization facilitator coupled with the application of an energy force to form an intraluminal closure at a specified site within a vessel.

Description

WO 97/27893 PCTrUS97/01463 METHODS F~ND APPA ~ TUS FOR RTO~KTNG
F~QW ~K~U~ BLOOD VESSELS

Related Applications This patent application claims priority to United States Provisional Patent Application Serial No.
60/010,614, filed on February 2, 1996, and is a continuation-in-part of co-pending United States Patent Applications 08/730,327, filed on October 11, 1996 and 1008~730,496, filed on October 11, 1996, the entire disclosure of each such related application being expressly incorporated herein by reference.

Field of the Invention 15The present invention relates generally to medical devices, and more particularly to methods and apparatus for blocking or closing the lumens of blood vessels or other anatomical conduits.

20Background of the Invention In modern medical practice, it is often desirable to block or otherwise prevent flow through the lumen of a blood vessel or other anatomical conduit. Examples of medical procedures wherein it is desirable to block the lumens of blood vessels include: a) procedures intended to ~;m;n;sh or block the flow of blood into vascular aneurysms (e.g., cerebral aneurysms); b) procedures intended to occlude the side branches which emanate from a segment of a peripheral vein to prepare the vein se~ment for use as an in situ bypass conduit; c) procedures intended to treat varicose veins; d) transvascular, catheter-based procedures for bypassing obstructed, diseased or injured arteries as described in United States Patent Application Serial Nos. 08/730,327 and 08/730,496; e) procedures intended to block or ~i mi n;sh blood flow to a tumor; f) procedures intended to close congenital or acquired arterio-venous WO 97127893 PCTrUS97/01463 malformations; and g) procedures intended to temporarily or permanently block blood flow through a vessel as an adjuvant to placement of an endovascular graft for treatment of an aneurysm or other therapeutic intervention.
Examples of embolization devices useable to block the lumens of some blood vessels have been described in the following United States Patents: Nos. 5,382,260 to Dormandy, Jr. et al; 5,342,394 to Matsuno et al.;
5,108,407 to Geremia et al.; and 4,994,069 to Ritchart et al.; 5,382,261 to Palmaz; 5,486,193 to Bourne et al.;
5,49g,g95 to Teirstein; 5,578,074 to Mirigian; and also in Patent Cooperation Treaty International Publication No. W096/00034 to Palermo.
The new transvascular catheter-based bypass procedures described in co-pending Application Nos.
08f730,327 and Q8/730,496 include certain coronary artery bypass procedures wherein a tissue-penetrating catheter is advanced, transluminally, into the coronary vasculature and is utilized to form at least one blood flow passageway (e.g., a puncture tract or interstitial tunnel~ between an obstructed coronary artery and an adjacent coronary vein, at a site upstream of the arterial obstruction. Arterial blood will then flow from the obstructed coronary artery into the adjacent coronary vein. The lumen of the coronary vein is blocked or closed off immediately proximal to the first blood flow passageway such that arterial blood which enters the vein will be forced to flow through the vein in the retrograde direction. In this manner, the arterial blood from the obstructed artery may retroprofuse the myocardium through the coronary vein. Or, optionally, one or more secondary ~lood flow ~assageways ~e.g., puncture tracts or interstitial tunnels) may be formed between the coronary vein into which the arterial blood has been shunted, and the obstructed artery or another coronary artery, to allow the arterial blood to re-enter the coronary W O 97127893 PCT~US97/01463 arterial tree after having bypassed the arterial obstruction. In cases wherein such secondary blood flow passageways are formed between the coronary vein and one or more adjacent arteries, the lumen of the coronary vein may be blocked or closed off distal to such secondary passageways, to facilitate the re-entry of the shunted arterial blood into the coronary arterial circulation.
These transvascular, catheter-based coronary artery bypass procedures present unique and heretofore unaddressed problems relating to the type(s) of blocking apparatus which may be utilized to block the lumen of the coronary vein proximal and/or distal to the arterial-venous blood flow passageways (e.g., puncture tracts or interstitial tunnels) formed during the procedure. In particular, when arterial blood is bypassed through a proximal segment of the Great Cardiac Vein, it will typically be desirable to block the lumen of the Great Cardiac Vein at or near its confluence from the coronary venous sinus. This proximal segment of the Great Cardiac Vein is of tapered or angular configuration and, as a result, the deployment of typical embolization coils of the type traditionally utilized to embolize or block the lumens of blood vessels or the defined spaces of aneurysm may be inappropriate, due to the fact that such ~5 embolization coils may become dislodged or work loose due to the gradually tapered or widening anatomy of the proximal seg~ent of the Great Cardiac Vein.
Accordingly, there exists a need in the art for the development of new methods and apparatus for blocking or otherwise sealing the lumens of blood vessels or other anatomical conduits, and which are usable in tapered ~i.e., widening) segments of blood vessel (e.g., the prox;~l end of the great cardiac vein) and/or are capable of being removed following implantation and/or may be punctured or traversed following implantation.

-WOg7J27893 PCTrUS97/01463 Summary of the Invention The present invention provides methods and devices for blocking or closing the lumens o~ blood vessels to prevent blood flow therethrough. The devices of the present invention provide certain advantages over the prior art, such as i) possible removeability following implantation and/or ii) possible puncturability or retraverseability following implantation and/or iii) the ability to provide substantially immediate and permanent blockage of flow through a tapered or widening region of a b~ood vessel lumen (e.g., the proximal portion of the great cardiac vein).
The devices of the present invention generally fall into two main categories--i) implantable lumen-blocking ~5 devices, and ii) devices which are useable to weld or otherwise cause the lumenal walls o~ the blood vessel to constrict to a closed configuration or to constrict upon a member which has been placed within the blood vessel lumen.
Implantable Lumen Blocking Apparatus The implantable lumen blocking apparatus of the present invention generally comprise i) a blood vessel engaging portion which is operative to anchor the apparatus to the surrounding wall of the blood vessel and ii) a lumen blocking portion which is operative to prevent the flow of blood in at least one direction, through the lumen of the blood vessel.
In accordance with the invention, these implantable lumen blocking apparatus are initially deployable in a radially compact configuration to facilitate their ~ranslllmin~l delivery through the vasculature (e.g., within a delivery catheter or other delivery tool).
After reaching the desired implantation site, such lumen blocking apparatus are radially expandable to an~ 35 operative configuration wherein the blood vessel engaging portion of the apparatus will engage the blood vessel wall and the lumen blocking portion of the apparatus will W 097127893 PCTrUS97/01463 block the lumen of the blood vessel to prevent blood from flowing therethrough in at least one direction.
Further in accordance with the invention, the vessel-engaging portion of the apparatus may comprise a structural frame of wire or other suitable material. The lumen-blocking portion of the apparatus may comprise a membrane, sponge, fabric panel, plug, disc or other member sized to be traversely disposed within the vessel lumen to block the flow of blood.
Still further in accordance with the invention, the vessel engaging portion of the apparatus may comprise a plurality of members which emanate outwardly from a fulcrum point such that, when pressure is applied against the fulcrum point, such pressure will cause the plurality of members to become outwardly biased and thus radially expand, enlarge or exert outward pressure against the blood vessel wall, thereby deterring the apparatus from becoming dislodged or migrating from its seated position within the blood vessel.
Further in accordance with the invention, these implantable lumen-blocking apparatus may comprise radiographically visible material to permit the lumen blocking device to be visualized radiographically following implantation.
Still further in accordance with the invention, these implantable lumen-blocking apparatus may comprise resilient or shape memory material which will self-expand from its operative configuration by its own resilient force or by undergoing a phase transformation when exposed and warmed to body temperature. Alternatively, such implantable lumen blocking apparatus may comprise plastically deformable material which may be deformed ~rom its radially compact configuration to its operative con~iguration by application of pressure or force. Such plastically deformable embodiments, may be initially mounted upon a delivery catheter equipped with an outward pressure exerting tool (e.g., a balloon or other W 097127893 PCTrUS97101463 mechanical means) such that, after the device has been positioned at its desired location within a blood vessel, the pressure exerting tool may be used to plastically deform the device to its radially expanded configuration wherein the engaging portion of the device will engage the vessel wall. Alternatively, some of these apparatus may be inflatable from their radially compact configuration to their operative configuration.
Still further in accordance with the invention, at least some em~odiments of the implantable lumen blocking devices are removable following implantation within the lumen of a blood vessel. The means by which such removal may be ef~ected may include a connector or other attachment, member to facilitate linkage or connection to ~5 a wire, catheter or other retraction apparatus so as to pull, retract, rescue, draw, aspirate or otherwise move the previously implanted into the lumen of the catheter or other removal vehicle to remove the apparatus from the body. or, in embodiments wherein the vessel-engaging portion of the apparatus is formed of a shape memory alloy, the implanted apparatus may be subjectable to an in situ treatment to cause it to radially contract. Such in situ treatment may comprise the infusion of a cooled liquid (such as saline) to cause the shape memory material of the apparatus to transition ~rom one crystalline state to another with concurrent radial contraction of the apparatus from its operative con~iguration to a more radially compact configuration suitable for extraction and removal.
Still further in accordance with the invention, some embodiments of the implantable lumen-clocking apparatus may incorporate a lumen-blocking portion which is retranversible ~i.e., puncturable). In this manner, a needle or other puncturing element may be passed through the apparatus following its implantation to restore blood flow, or to gain access to portions of the blood vessel W 097127893 PCTrUS97101463 which are distal to the site at which the apparatus was implanted.
Still further in accordance with the invention, some embodiments of these implantable lumen-blocking apparatus may comprise a woven fabric or other tissue permeable material which will undergo cellular ingrowth or endothelialization. In these embodiments, the process of cellular ingrowth or endothelialization may be exploited to enhance the anchoring of the apparatus within the blood vessel lumen and/or to improve the long-term biocompatability of the apparatus following implantation thereof.
Lumen Welding Devices The invention also includes apparatus for welding 1~ the lumen of a blood vessel. In accordance with these embodiments of the invention, there are provided intraluminally insertable devices having at least one suction port and at least one energy-emitting region.
Suction is applied through the suction port to cause the lumen of the blood vessel to collapse in an area adjacent the energy-emitting region of the device. Thereafter, energy is delivered from the energy-emitting region to weld, cauterize or otherwise fuse the collapsed lumenal wall of the blood vessel, thereby closing the lumen of
2~ the blood vessel at that site. as an alternative to the use of emitted energy, these devices may deliver an adhesive or other chemical substance capable of adhering or chemically fusing the lumen of the blood vessel to form the desired closure of the lumen.
Further in accordance with this embodiment of the inventionr there is provided an intraluminally insertable device which has a balloon formed thereon, a fluid delivery port, and an energy emitting region. when the balloon is inflated, the balloon will temporarily block the vessel lumen. Thereafter, a flowable conductive medium ~e.g., saline solution) may be introduced through the fluid delivery port and into the vessel lumen adjacent the location of the energy emitting region.
Energ~ is then emitted such that the energy will be transmitted through the previously introduced conductive substance, to the wall of the blood vessel, thereby resulting in shrinkage or contraction of the vessel wall so as to result in closure of the blood vessel lumen at that site.
Still further in accordance with this aspect of the invention, there are provided intraluminal devices which deploy a core or embolic member which as a diameter smaller than the lumenal diameter of the blood vessel.
These devices subsequently emit radiofrequency energy or other energy to cause the wall of the blood vessel to shrink or constrict about the previously deployed core or lS embolic member. Thereafter, the device may be extracted, leaving the core or embolic member firmly implanted within the shrunken or constricted region of blood vessel, thereby closing the blood vessel at that site.
Further objects and advantages of the invention will become apparent to those skilled in the art upon reading and understanding of the following detailed description of the preferred embodiments, and upon consideration of the accompanying drawings wherein certain preferred embodi~ents and examples are shown.
Brief Description of the Drawings Figure 1 is a side view of a catheter utilized to deploy certain embolic devices within the vasculature according to the present invention;
Figure 2 is a partial cross-sectional view taken along lines 2-2 of Figure 1;
Figure 3 is a partial cross-sectional longitudinal view of the catheter of Figure 1 being utilized to deploy the second of two (2) embolic devices within a respective one of two adjacently positioned blood vessels having a blood ~low passageway formed therebetween via two (2) anastomotic connections;

W O 97n7893 PCTAUS97/01463 Figure 3a is a perspective view of a jellyfish-type embolic device according to a preferred embodiment of the present invention;
Figure 4 is a perspective view of the jellyfish-type embolic device of Figure 3a according to an alternative embodiment of the present invention;
Figure 5 is a perspective view of a sinusoidal wire-type embolic device according to the preferred embodiment of the present invention;
Figure 5a is a perspective view of the sinusoidal wire-type embolic device according to an alternative preferred embodiment of the present invention;
Figure 5b is a perspective view of the sinusoidal wire-type embolic device according to an alternative preferred embodiment of the present invention;
Figure 6 i6 a birdcage--type embolic device according to a preferred embodiment of the present invention;
Figure 6a is a perspective view of a preferred alternative embodiment of the birdcage-type embolic device;
Figure 6b is a perspective view of a preferred alternative embodiment of the birdcage-type embolic device;
Figure 7 is a perspective view of an umbrella-type embolic device according to a preferred embodiment of the present invention;
Figure 8 is a perspective view of a cup-type embolic device according to a preferred embodiment of the present 1nvention;
Figure 9a is a perspective view of a traversible-type embolization device according to a preferred embodiment of the present invention, said device assuming a first closed position;
~igure 9b is a perspective view of the traversible-- 35 type embolization device of Figure 9a assuming a second o~en position;

W O 97/27893 PCT~US97/01463 Figure 10 is a perspective view of a diaphragm-type embolic device according to a preferred embodiment of the present invention;
Figure 11 is a perspective view of a capped coil-type embolic device according to a preferred embodimentof the present invention; Figure 12a is a cross-sectional view of a ring embolizer-type embolic device according to a preferred embodiment of the present invention, said ring embolizer device assuming a first uninflated state within the lumen of a blood vessel;
Figure 12b is a cross-sectional view of the ring embolizer-type embolic device of 12a assuming a second inflated state within the lumen of the blood vessel;
Figure 13a is a cross-sectional view of an expanding stent/sock-type em~olic device according to a preferred embodiment of the present invention, said expanding stent/sock assuming a first elongate position within the lumen of a blood vessel;
Figure 13b is a cross-sectional view of the expanding stent/sock o~ Figure 13a assuming a second inverted state causing said device to expand within said lumen;
Figure 14 is a cross-sectional view of a hook embolizer-type embolic device according to a preferred embodiment of the present invention seated within the lumen of a blood vessel;
Figure 15 is a cross-sectional view of a covered spherical coil-type em~olic device according to a preferred embodiment of the present invention seated within the lumen of a blood vessel;
Figure 16 is a cross-sectional view of an hourglass-type embolic device according to a preferred embodiment of the present invention seated within the lumen of a blood vessel;

W O97t27893 PCTrUS97/01463 Figure 17 is a cross-sectional view of a removable balloon-type embolic device according to a first preferred embodiment;
Figure 18 is a cross-sectional view of a removable balloon-type embolic device according to a second preferred embodiment;
Figure 19 is a cross-sectional view of a finder/spackler-type embolic device according to a preferred embodiment of the present invention disposed within the lumen of a blood vessel;
Figure 20 is a perspective view of a three-way valve stent embolic device according to a preferred embodiment of the present invention disposed within the lumen of a blood vessel;
Figure 21 is a cross-sectional view of an embolization agent being deployed within the lumen of a vessel according to a preferred embodiment of the present invention;
Figure 22 is a perspective view of a system for blocking blood flow within a vessel according to a preferred embodiment of the present invention;
Figure 23 is a perspective view of the distal end of a device for blocking blood flow within a vessel according to a preferred embodiment of the present invention;
Figure 24 is a cross-sectional view of the distal end of the device of Figure 23 disposed within a longitudinal section of a blood vessel;
Figure 25 is a cross-sectional view of the distal end of the device of Figure 23 being utilized to draw in the lumen of the vessel wall about the distal tip of the device;
Figure 26 is a cross-sectional view of the device of Figure 23 being utilized to form an intralll~i n~l closure within the blood vessel;
3 PCT~US97/01463 Figure 27 is a cross-sectional view of the distal end of a catheter being utilized to deposit a mass of autologous tissue within the lumen of the blood vessel;
Figure 28 is a cross-sectional view of a collection of conductive embolic strands deposited within the lumen of a blood vessel with an e~ternal electrical ground shown to be extending therefrom;
Figure 29a is a cross-sectional view of a textured electrode plug positioned within the lumen of a blood vessel with an insulated conductive guidewire extending therefrom;
Figure 29b is a cross-sectional view of the electrode plug of Figure 29a being fused to the lumen of the blood vessel, said electrode plug being coupled to an energy source via the conductive guidewire;
Figure 30 is a cross-sectional view of the distal end of a catheter being utilized to infuse a conductive substance within the lumen of a blood vessel, said distal end of the catheter having an insulated electrode protruding therefrom and a balloon assuming an inflated state positioned proximal said distal end; and Figure 30a is a cross-sectional view of a blood vessel having an intralllmi n~l closure formed therein.

25~etailed Description of the Preferred Embodiment Referring now to the drawings, and initially to Figures 1-21, there is shown methods and apparatus for occluding blood flow within a vessel at a desired location within the vasculature. The methods and 3~ apparatus disclosed herein are particularly well suited for promptly, if not immediately, occluding blood flow within a vessel having a tapered or widening lumen, such as the great cardiac vein, where vaso-occlusion is especially difficult. ~ikewise, the methods and apparatuses disclosed herein are ideally designed to be a~le to resist arterial-venous blood pressure differences and fluctuations such that blood flow may be occluded at CA 02244080 l998-07-24 W O 97/27893 PCTrUS97/01463 the desired location for prolonged, if not indefinite, lengths of time.
This need to achieve vaso-occlusion especially presents itself in certain in-situ bypass procedures wherein blood flow passageways are formed between two adjacently situated blood vessels ~e.g., between an obstructed coronary artery and adjacent coronary vein) to bypass a diseased, injured or obstructed segment of one blood vessel, as depicted in Figure 3, and has been previously described in United States Patent Application Serial Nos. 08/730,327 and 08/730,496, the teachings of which are expressly incorporated herein by reference. As shown, in order for the blood flow 18 to be rerouted around a diseased or obstructed segment 20 of vessel 22 requires that the blood flow 18 be redirected into the vessel 22 from which the flow of blood originated. To ensure that the blood flow 18 reenters the obstructed vessel 22, or to enter some other vessel after having bypassed the obstruction, it is essential that the adjacently situated blood vessel 24 through which the flow 18 is rerouted is sufficiently vaso-occluded at a site both upstream and downstream from the redirected blood flow 18.
While the prior art is replete with various embolization devices, such as helical coils, balloon catheters, and the like, such embolic devices lack features such as retrievability, retraversability and enhanced ability to remain seated within the vasculature and withstand arterial-venous blood pressure differences, particularly at points having a widening section of lumen, to thus avoid migration when deployed at the site to be embolized. In this regard, such prior art embolization devices, most notable of which being helical coils and chemical embolic agents, are typically poorly sized or adapted to maintain long term blocking at the desired widening section of lumen to be embolized as the widening lumen, coupled with the continuous non-uniform W 097~7893 PCT~US97/01463 arterial-venous blood pressure exerted against the device, causes the same to migrate away from the position at which such device is deployed.
Additionally, such prior art embolic devices suffer S from the drawback of being ill designed to be advanced through and deployed from the lumen of a delivery catheter. In this respect, such embolic devices must necessarily be compressed or otherwise reduced in size to be advanced through the lumen o~ the catheter and thereafter be capable of assuming an expanded position sufficient to occlude blood flow. Such devices, such as those described in U.S. Patent No. 5,499,995 to Teirstein, however, either fail to achieve a sufficiently compressed state to allow for easy deployment through the lumen of a catheter or, alternatively, once deployed through the catheter fail to assume a sufficiently expanded or vaso-occlusive configuration capable of not only occluding blood flow, but r~m~i n; ng firmly positioned within the lumen of the vessel at the site of desired deployment.
In a first series of embodiments illustrated in Figures 2-21 and discussed further herein, there is shown a multiplicity of embolic devices and embolic agents that are designed and configured to be deployed at the desired site to be occluded within the vasculature using a conventional catheter 10, as shown in Figure 1. As is well known in the art, such catheters 10 have a lumen 12 formed therein through which the embolic devices disclosed herein may be deployed at the desired site. In this regard, the embolic device 16, such as the one illustrated in Figure 2, is loaded within the lumen 12 of the catheter and advanced therethrough via a pusher 26, more clearly shown in Figure 3. Once the desired site to be embolized is accessed by the distal end 14 of the catheter 10, the embolic device 16 is advanced through the lumen 12 of the distal end 14 of the catheter 10 where the same r~i n~ resident.

W O 97/27893 PCT~US97/01463 Common to each of the embodiments disclosed herein is the advantage of each such device to either be more easily deployed, and more particularly, delivered through the lumen 12 of the catheter 10; resist dislodgment and remain more firmly positioned or seated at the desired site to be vaso-occluded; include means for retraversability to allow additional procedures to be performed therethrough at a later date; or include means to allow such devices to be retrieved, typically through a catheter, at a later date. It is further advantageous to provide such embolic devices that are radio opaque so that the position of such devices, and more particularly the placement thereof, can be determined with a high degree of accuracy. As will be recognized by those skilled in the art, such features provide the physician with enhanced capabilities to achieve greater vaso-occlusion within a patient at specific sites within the vasculature, as well as access or retrieve the same in the future, as may be necessary in later procedures.
With respect to the first of such embolic devices, there is shown in Figures 2, 3 and 3a a jellyfish-type embolic device 16 comprising a combination of a fabric, composite, braided, or polymer tip 16a placed over a cylindrical wire structure or frame 16b. The fabric or polymer tip 16a is preferably fabricated from a thin, stretchable material, such as either silicone, urethane, polyethylene, Teflon, nylon, Carbothane, Tecoflex, Tecothane, Tecoth, or other similar materials well-known to those skilled in the art. The fabric or polymer tip 16a may further be texturized or roughened to aid in endothelialization of the tip 16a and further, may preferably be reinforced with fabric comprised of polyester, nylon, Dacron, ePFTE, and the like, which may be molded into the cap 16a or exposed on the surface thereof. Alternatively, such reinforcement fabric may cover the entire polymer cap 16a or may be strategically located to prevent wear of such cap 16a. For example, CA 02244080 l998-07-24 W 097127893 PCT~US97/01463 such fabric may be utilized to stitch the cap onto the cylindrical wire structure 16b.
The cylindrical structure 16b is preferably fabricated from a malleable, radiopaque and biologically-compatible material, such as nickel titanium wire,tantalum, stainless steel, platinum, gold, tungsten, coated tungsten, titanium, MP35M Elgioy, platinum, as well as other alloys of these metals and the like, and is preferably formed to have a zig-zag configuration. The cylindrical structure 16b is further additionally formed such that the structure may exist in a first collapsed state, as depicted in Figures 2 and 3, for deployment through the lumen 12 of a catheter 10, and assume a second expanded position, as illustrated in Figures 3 and 3a, once ejected from the distal end 14 of catheter 10 at the desired point to be embolized. As will be recognized by those skilled in the art, by forming the cylindrical structure 16b from heat expansive or superelastic material, such as Nitinol, such embolic device 16 thus may assume a low profile for easier delivery through the lumen 12 of the deployment catheter 10. To further enhance the ability of the device 16 to assume such low profile, the wires comprising the cylindrical structure 16b may be formed to complimentary compress upon itself such that the diameter of the structure is greatly reduced. Likewise, such materials advantageously allow the device 16 to assume an expanded configuration which thus facilitates vaso-occlusion within the vessel 24. In this respect, the device 16 is preferably formed such that the elastic tip 16a is only formed around approximately one-half to one-third the distal end of the cylindrical portion 16b to thus allow the free end of the cylinder 16b to expand fully about the lumen of the vessel 24 once the same is deployed and allowed to assume the expanded configuration.
To further facilitate the ability of the cylindrical portion 16b to adhere to the lumen of the vessel 24 when W O 97/27893 PCTrUS97/01463 in the expanded configuration, the cylindrical structure 16b may have bends formed thereabout to thus enhance the frictional engagement between the structure 16b and the lumen of the vessel 24. As should be recognized, to achieve the optimal vaso-occlusive effect, the embolic device 16 should be deployed such that the membrane 16a faces the head-on flow of blood 18. By facing the flow of blood 18 head-on, such blood pressure actually facilitates the ability of the device 16 to remain seated within the desired site within the lumen of the vessel 24. In this regard, the free, uncovered portion of the cylindrical structure 16b is not constricted or otherwise restrained from assuming a fully expanded configuration.
In fact, as illustrated in Figure 3a, the free ends of the cylindrical structure 16b may be configured to bow outwardly to thus embed within the wall of the lumen at the site of vaso-occlusion.
As will be recognized, the embolization device 16, when lodged within the lumen 24 of a vessel in the expanded state, is oriented such that the elastomeric fabric or polymer tip 16a produces a vaso-occlusive surface that restricts blood flow through the vessel.
Advantageously, however, such fabric or polymer tip 16a further provides means for retraversibly accessing the vaso-occluded site, as may be necessary for certain procedures performed at a later time. In this respect, a catheter, for example, may be axially advanced through the drum-like occlusive barrier formed by the elastomeric tip 16a without otherwise altering the ability of the cylindrical structure 16b to remain seated axially about the lumen of the vessel. Likewise, such device 16, by virtue of the cylindrical structure 16b being fabricated from heat constrictive material, allows the device 16 to be easily retrieved through the lumen 12 of a catheter 10 by exposing the structure lOb to reduced temperatures, which thus causes the cylindrical structure 16b to assume W 097/27893 PCTrUS97/01463 a constricted configuration that enables the same to be axially withdrawn into the lumen 12 of a catheter 10.
Referring to Figures 4, 5 and 6, there are shown alternative embodiments of the jellyfish-type embolic device according to the present invention. With respect to Figure 4, there is shown an embolic device 28 comprised of a plurality of longitudinally extending wires 28b collectively connected at one end by a weld or an outer hypotube. The fabric or polymer tip 28a is placed about the distal one-third to one-half of the longitudinally egtending wires 28b such that when deployed, the elastomeric tip 28a radially expands to form a vaso-occlusive surface. As will be recognized, the longitudinally extending wires 28b, by virtue of their arrangement, are oriented to radially embed within the lumen of the vessel and actually enhance the ability of the device 28 to become more firmly seated at the site of vaso-occlusion as greater pressure is exerted by the occluded blood flow on the fabric of polymer tip 28a.
Additionally, it should be noted that such arrangement of longitudinally extending wires 28b may be easily collapsed to enable the device 28 to be retrieved through the lumen of a catheter, if necessary at a later time.
To enhance such retrievability, such device may further preferably include a ring member (not shown) formed upon the weld joining the elongate wires 28b to thus provide means to hook the device and retrieve the same through the lumen of a catheter should it be necessary to remove the device and restore blood flow through the vaso-occluded vessel.
Figure 5 depicts yet another embodiment 30 of thisfirst class of embolic devices wherein the cylindrical structure 30b comprises round wires assuming a sinusoidal configuration. The cylindrical structure 30b as shown is entirely covered with the elastomeric tip 30a such that when deployed, the cylindrical structure 30b e~pands, thus causing the elastomeric tip 30a to correspondingly W O 97/27893 PCT~US97/01463 expand radially about the lumen of the vessel, thus inhibiting blood flow therethrough. Advantageously, by fully covering the cylindrical structure 30b with the elastomeric covering 30a, there is thus achieved a 5 m~ l blocking effect with respect to vaso-occlusion through the vessel.
In a preferred embodiment, the configuration of the wound wire 30b depicted in Figure S may assume a zig-zag configuration 30c, as illustrated in Figure Sa. As illustrated, the wire structure is provided with a continuous series of straight sections 30d, rigidly connected at apices to form a zig-zag structure wherein, in a compressed state, the stress is stored in the straight sections 30d of the device thereby mi ni mi zing lS the stress on the joints/apices and allowing for low profile delivery.
In yet another preferred embodiment, the configuration of the wire structure 30b, 30c and pictures 5 and Sa, respectively, may be configured to form a frusto-conical structure 30d, such as that depicted in Figure 5b. Such embodiment is deployed such that the narrow end of the device is placed in the direction of blood flow with the widening end thus being allowed to more fully expand, and thus impart a greater axial compressive force about the lumen of the vessel.
Referring now to Figure 6, there is shown an alternative birdcage-type embolization device 32 according to a preferred embodiment of the present invention. In this embodiment, the embolic device 32, comprises a multiplicity of wires running longitudinally to form a cylindrical structure 32b, connected at both ends by a weld or an outer hypotube such that the central portion of the cylinder bows outwardly to form a bulbous shape. The elastomeric tip 32a is placed about a respective end of the device 32 to thus occlude blood flow once deployed within a lumen of a vessel. In variations of this embodiment, the cylindrical portion 32b may be formed such that the ends 32c', 32c'' of the structure are inverted at both ends axially within the structure, as depicted in Figure 6a. Such configuration min;m;zes trauma to the vessel upon deployment and thereafter. In an alternative embodiment, as shown in Figure 6b, the embolic device may be formed such that the center portion of the structure 32b is compressed to form a straight section 32d with bulbous structures 32e', 32e'' being formed on opposed ends of the structure 32b.
Advantageously, such configuration provides greater apposition to the vessel wall due to the two (2) bulbous structures 32e, 32e'' making contact axially about the lumen o~ the vessel.
With respect to Figure 7, there is shown an umbrella-type embolic 34 device according to a preferred embodiment of the present invention. The device, similar to the aforementioned jellyfish-type embolic embolizers, includes a network of longitudinally extending wires 34b surrounded by an elastic ~abric or polymer cap 34a. The wires 34b according to this embodiment, however, are outwardly hinged to force such wires 34b outward to a larger diameter. As such, the device 34 easily assumes a first collapsed position where it may be advanced through the catheter for deployment, and, thereafter may expand into a second state whereby the wires spring radially outward about the lumen of the vessel. By virtue of the orientation of the embolic device 34 within the vessel, it should be recognized that the flow of blood toward the device 34 actually facilitates the ability of the device 34 to remain seated within the vessel. As an option, the device 34 may further be provided with a grab ring to enable the device to be retrieved should it become necessary at a later time to remove the same.
Figure 8 depicts a cup-type emboLization device 36 according to a preferred embodiment of the present invention. Such device 36 comprises at least two (2) self-expanding wire structures 36a, 36b bent at substantially their respective mid-points and intersecting at said bends to preferably form approximately a 90~ angle, although other angles may be possible. The device 36 is covered with a graft or other microporous membrane 36c such that when deployed, the graft microporous membrane 36c facilitates and enhances the formation of a blood clot, thus occluding blood flow.
As will be recognized, the self-expanding wire structures 36a, 36b provide substantial radial force to seat the device within the vessel. Additionally, such device 36 offers the advantages of being able to be easily compressed, to thus enabling the device to be advanced and deployed through the lumen of a catheter. Such device 36 further provides the advantage of being able to be retrieved, much like the umbrella embolic device discussed above, insofar as the intersection of the wire structures 36a, 36b provides an ideal location to hook and retrieve such device 36 through the lumen of a catheter. A catch-ring (not shown) may further be formed at the intersection of the wire structures 36a to provide simpler means for retrieving such device 36.
Referring now to Figures 9a and 9b, there is shown a traversible embolization device 38 according to yet another preferred embodiment of the present invention.
The device 38 comprises a resilient spring disc 36a forming a conical blocker 38a. The pointed end of the blocker rests in the vessel in communication with the blood flow path depicted by the letter A. To ensure that such closure is maintained, there is provided a plurality of inwardly biased members 38c that force the device 38 to assume a first closed position as depicted in Figure 9a. Indeed, as should be recognized, the flow of blood in the direction A toward the conical shape 38a actually enhances and facilitates the ability of the device 38 to remain seated within the vessel.

W 097/27893 PCTrUS97/01463 Advantageously, however, the traversible embolization device 38 is capable of assuming a second open position whereby entry through the side of the device opposite the blood flow, depicted by the letter B, will cause an axial aperture to be formed within the device such that blood flow may be restored or the vessel accessed if necessary.
Referring now to Figure 10, there is depicted a diaphragm-type embolic device 42 according to a preferred embodiment of the present invention. Such device comprises a membrane 42b stretched over a resilient, annular outer spring 42a thus forming a disc with a flegible covering. The annular outer spring 42a may preferably be comprised of shape memory alloy, such as Nitinol, that expands when heated to certain temperatures, and more particularly, temperatures normally associated with the human body (i.e., approximately 98.6~ F). As will be recognized by those skilled in the art, the stretchable membrane 42b utilized to extend about the annular spring 42a can be penetrated and crossed, i.e., is retraversible, so that at a later time either side of the vaso-occluded site can be accessed, should it become necessary to access the same in the future.
2S Referring now to Figure 11, there is shown a cap-coil embolic device 40 according to another preferred embodiment of the present invention. Essentially, the device comprises a helical coil 40a contained within an elastomeric bag 40b. The device 40 is capable of being compressed, thus allowing the same advanced through the lumen of the deployment catheter where it is then pushed out, via the pusher, at the desired site to be occluded.
Once expelled, the coil 40a expands axially within the vessel in alignment with the direction of blood flow, thus causing the elastic material 40b covering the respective ends of the coil to occlude blood flow. Such device 40, in addition to achieving the desired vaso-W 097/27893 PCTrUS97/01463 occlusion, has the advantage of providing a retraversible axial pathway, formed by the elastomeric material stretched over the respective ends of the device 40, that may be accessed via a catheter through the occluded site should it be necessary at some later time to perform a procedure within the vessel on the site opposite the vaso-occlusion.
Figures 12a and 12b depict a ring embolizer device 44 comprised of the combination of a first hard cap of non-distensible material 44a coupled with a second inflatable occluder 44b that is fabricated from more distensible material. The device 44 is ejected through the distal end of the catheter with the occluder 44b r~mA; n; ng in an uninflated state. The device is expelled from the catheter such that the occluder 44b is axially positioned within the direction of blood flow, depicted by the letter C, and is then inflated with a biologically compatible material, such as saline. By virtue of the force of the blood flow compressing against the inflated occluder 44b, the distensible material of the occluder 44b is thus caused to radially expand and flare or bite into the lumen of the vessel 46 as shown in Figure 12b.
In this respect, the occluder 44b, by virtue of it having a fixed sur~ace area, provides radial compression about the lumen of the vessel 46 to thus cause the device 44 to remain in fixed position relative the lumen of the vessel.
Referring now to Figures 13a and 13b, there is shown an expanding stent/sock embolic device 48 according to a preferred embodiment of the present invention. The device 48 comprises a matrix 48a formed of a biologically compatible material, such as Nitinol, with a sock 48b formed at the respective end thereof. The matrix 48a is constructed such that it may assume a first collapsed position, thus enabling the device 48 to be advanced through a delivery catheter. In such collapsed state, as illustrated in Figure 13a, the device 48 is deployed at W 097/27893 PCTrUS97101463 the site to be occluded with the sock 48b formed at the end of the device being expelled in the direction of the blood flow, depicted by the letter D. Blood flows through the cylindrical structure 48a and thus tends to decrease its length thereby casing a corresponding increase in its diameter, thus locking the structure 48a in place. In this regard, the matrix comprising the cylindrical structure 48a radially compresses about the lumen of the vessel thus causing it to remain resident.
As should be recognized, the cap or sock ~8b is attached to the end of the cylinder to be oriented upstream the flow of blood, such that the cap or sock 48b is caused to axially invert within the cylindrical structure to thus block blood flow, as depicted by the letter F. Such design of the device 48 advantageously prevents migration from the desired site o~ vaso-occlusion as an increase in blood pressure pushing against such device 48 actually enhances the ability of the device 48 to become more securely seated within the vessel at the site of vaso-occlusion and further provides means for retraversing theembolic device through the sock 48b axially disposed within the matrix 48a.
Referring now to Figure 14, there is shown a hook-type embolic device 50 according to the preferred embodiment of the present invention. The device 50 comprises a sponge-like structure 50a comprised of tangled wire having hooks or protrusions 50b e~tending radially thereabout to embed the device 50 into the vessel wall in the downstream direction of blood flow.
By virtue of the frictional engagement between the hooks 50b with the lumen of the vessel 52, the device 50 is thus held in place indefinitely. The device may further preferably include radiological markers or may be radiopaque.
Figure 15 depicts yet another further preferred embodiment of a covered spherical coil embolizer device 54 according to the present invention. Such device .1.

W 097/27893 PCT~US97/01463 comprises a heat expandable coil (not shown) contained within an elastomeric covering S4a, such as silicone or polyurethane. The coil is preferably fabricated from shape memory alloy such as Nitinol, which becomes enlarged when warmed to body temperature. Essentially, the coil will expand radially at approximately 98.6~ F
and will compress radially about the lumen of the vessel 56 thus causing the device to remain resident at a specific site. As will be recognized, the coil will be deployed through the catheter in a contracted state so that the device may be easily delivered to a specific site.
To further enhance the ability of the device 54 to remain resident at a specific site within the lumen of a vessel, the coil may be designed such that when heat expanded, multiple ends of the coil 54b protrude from the elastomeric covering 54a which may serve to embed the device 54 within the lumen of the vessel 56, thus enhancing its ability to remain resident.
Referring now to Figure 16, there is shown an hourglass embolic device 58 according to a preferred embodiment of the present invention. The device 58 comprises a cylindrical tubular structure in which the diameter of the ends are greater than the diameter of the center of the device. Each respective end of the device is covered with a graft or other membrane 58c that, when positioned within the lumen of the vessel, occludes blood flow. The tubular structure is formed via a series of struts 58a held coupled at their mid-point 58b, thus 3~ allowing the respective ends of the struts to radially splay out which thus exerts radial pressure at both ends of the device, as depicted by the letter G. In an alternative embodiment, the struts, as opposed to being held coupled at their mid-point, are biased at their respective mid-points such that when collectively held together form the cylindrical tubular structure shown in Figure 16.

W O 97/27893 PCTrUS97101463 Advantageously, by exerting radial pressure at two points along the length of the vessel, such device 58 achieves a greater ability to remain seated, and thus will not migrate from its desired site of occlusion. In this regard, such device 58 actually becomes more firmly embedded within the lumen of the vessel as greater pressure is exerted against the ends of the device 58.
Furthermore, when the biased struts are utilized in the aforementioned alternative embodiment, there is additionally provided a retraversible axial pathway at the vaso-occluded site as the struts need not be coupled at their mid-point, which would otherwise obstruct such axial pathway.
Furthermore, such device 58 provides the advantage of being easily deployed, as well as retrieved, as the device 58 may easily assume a collapsed, linear configuration by lining the struts 58a in generally parallel relation to one another, thus reducing the size of the radially-extending ends of the struts of the device. Such reduction in the diameter of the ends of the device 58 allows it to be easily advanced through or withdrawn into the lumen of a catheter.
Referring now to Figure 17, there is shown a removable embolic device 60, according to a preferred embodiment, comprised of an inner core 60a and an outer coating 60b, wherein the inner core 60a consists of a material that expands and contracts via controllable means, such as a chemical reacting to either heat or cold, such as contacting the device 60 with heated or chilled saline solution. Such expansion and contraction of the inner core 60a may further be controlled by the use of thermal shape memory metal, such as Nitinol, or plastic having a requisite expandable force. Such inner core 60a may further be comprised of hydrogel contained within an elastomeric bag. As will be recognized, once the inner core 60a is deployed and is reacted to assume an expanded state, the outer coating 6Ob expands to . ~.

radially compress about the lumen of the vessel, thus occluding blood flow. As will be recognized, such device 60 advantageously allows for reversible vaso-occlusion insofar as the inner core 60a may be constricted, and thus the embolic device removed, as may be necessary at a later time to facilitate the removability of such device 60, outer coating 60b may preferably be fabricated from elastomeric materials having a smooth surface that is resistant to ingrowth and prevents blood from coagulating thereabout. As will be recognized, such features enable such device 60 to be more easily removed without the possibility of damaging or otherwise disrupting luminal tissue.
Similar to the embodiment depicted in Figure 17, Figure 18 depicts a removable balloon embolization device 62 which comprises a balloon filled with heat expandable material such that at temperatures above 90~ F, the expandable material expands outwardly to hold the balloon in fixed position relative the vessel wall. ~y virtue of the balloon-like nature of the outer periphery of the device, there is thus provided a less traumatic means of occluding blood flow. As with the device depicted in Figure 17, the removable balloon embolization device 62 may advantageously be retrieved by the application of a cooling source, such as cold saline. ~ikewise, to enhance such retrievability, the balloon embolization device 62 should be fabricated from stretchable material having a smooth outer surface that is resistant to ingrowth and prevents blood from clotting thereabout.
Referring now to Figures 19 and 20, and more particularly 19, there is shown two (2) embodiments of the present invention capable of restricting blood flow in more than one direction, and may further be utilized to reroute the flow of blood in a given direction. With ~ 35 respect to the embodiment shown in Figure 19, there is shown an embolizer finder/spackler 64 consisting of a double balloon catheter having a central lumen, having a W 097127893 PCTr~S97/01463 plurality of apertures 64d formed thereon, disposed therebetween and integrally formed therewith. When deployed as shown, each respective balloon 64a, 64b is inflated to expand about the lumen of the vessel and thus occlude blood flow therethrough. The lumen 64c disposed between the respective balloons 64a, 64b may be utilized to infuse contrast media via the apertures 64d formed thereon for defining offshoot vessels 68 extending from the portion of the occluded vessel 66. The lumen 64c disposed between the balloons may further be advantageously utilized to infuse embolization means to thus occlude any offshoot vessels 68 extending from the embolized section of vessel 66.
Such embodiment, in addition to providing the desired vaso-occlusion, further provides the advantage of defining offshoot vessels 68 that may otherwise go undetected (i.e., difficult to visualize) due to the high blood flow rate passing through the main vessel to be occluded. As will be appreciated by those skilled in the art, such high blood flow rate has a tendency to wash out or otherwise prevent sufficient contrast media from building up to detectable concentrations in such offshoot vessels. Additionally, such embodiment 64 further advantageously allows for the infusion of embolization means while such catheter re ~ln~ in place in the vessel, thus eliminating the need for additional devices and procedure in the event it is necessary to occlude such offshoot vessels.
Figure 20 depicts a three-valved stent 70 positionable within a vessel that, in addition to occluding blood flow, may be advantageously manipulated to redirect blood flow through a vessel as may be desired. In this respect, the stent 70, which may be deployed as all of the other aforementioned embodiments, namely, via expulsion through the lumen of a catheter of a desired location, is provided with three (3) valves 70a, 70b, 70c capable of occluding or facilitating blood W O 97/27893 PC~US97/01463 flow. The respective valves 70a, 70b, 70c may be manipulated such that blood flow paths can be controlled at particular pressure differentials. Advantageously, such embodiment 70 may be customized to create one flow channel under one set of pressure conditions and a different flow path under different conditions.
Referring now to Figure 21, there is shown yet a still further preferred way to achieve the desired site-specific vaso-occlusion via the deployment of a vaso-occlusive agent 72 through the distal end of thecatheter. As will be recognized, such embolic agent 72 may be an injectable fluid, such as a liquid polymer, that gels into a solid space-filling mass, at the site or sites to be occluded. Alternatively, such embolic agent 72 may comprise microspheres comprised of solid or woven material that adheres to and accumulates about the site to be occluded. Such accumulation thus causes the blood vessel to become occluded due to the generation of a blood clot about the embolic agent. To provide means for controllably releasing such embolic agent, there may be provided a vacuum source capable of applying controlled suction within the lumen 12 of the deployment catheter 10 to thus such back any excess embolic agent.
While it is understood that the aforementioned embolic devices disclosed herein are particularly well suited and adapted for vaso-occlusion within a vessel, it should further be recognized that such devices may have applicability to all cases where occlusion within a pathway is necessary.
Referring now to Figures 22-26, there is shown a further methods and apparatus for occluding blood flow at a specific site within the vasculature. As illustrated in Figure 22, the system 74 comprises the combination of a suction source 76 and an energy source 78 that are connected to and may be applied through a catheter or similar device via a hub attachment. The suction source 76 may be any of a number of devices capable of W 097/27893 PCT~US97/~1463 generating and sustaining a suction force. The energy source 78 may comprise either an RF or a microwave generator, laser or light source, or may just be a source of an electric current.
~eferring now to Figure 23, there is shown a preferred embodiment of the distal end 80 of a deployment catheter utilized to occlude blood flow at a desired site according to a preferred embodiment of the system 74. As illustrated, distal end 80 comprises a distal tip 82 having at least one electrode 84 formed at the distal-most end thereof designed to impart the energy received from the energy source 78. The distal tip 82 is further provided with at least one aperture 86 through which the suction force, provided via the suction source 76, may be applied. As will be recognized, the distal end 80 preferably includes two apertures 86a, 86b formed on opposed sides of the distal tip 82 to thus provide a uniform suction thereabout. Proximal end 80 is preferably provided a balloon 88 capable of inflating radially about the delivery catheter.
Referring now to Figures 24 through 26, there is schematically shown the steps illustrating intralllri n~ 1 closure of a vessel according to application of the system 74. As shown in Figure 24, the catheter, and more particularly distal end 80 thereof, is advanced through the vasculature to the desired site to be occluded. As discussed above, the desired site to be embolized may be accessed using conventional means known to those skilled in the art, such as by the use of a number of imaging modalities, such as by means of a specific image marker which may be disposed on distal end 80 of the catheter.
Once the desired site is accessed, the distal tip 82 of distal end 80 is positioned just proximal the site to be occluded. The balloon 88 formed proximal end 80 is then inflated to temporarily occlude blood flow, as well as to maintain the position of the distal tip 82 at the desired site where there is to be formed the intralllr;nAl W O 97/27893 PCT~US97/01463 closure. Thereafter, the suction source 76 is applied such that the lumen of the vessel 90 is drawn to and collapses about the distal tip 82 of the device, as illustrated in Figure 25. To facilitate the adherence of the lumen 90 of the vessel about the distal tip 82, such distal tip 82 may preferably be tapered. It should be recognized, however, that the lumen of the vessel may be collapsed about the distal tip of the device by mechanical means, such as by a hook extendable through the distal end of the catheter, that can embed within the lumen of the vessel and bring the same into contact with the distal end of the catheter.
While maintained in such collapsed state about the distal tip 82 of distal end 80, as illustrated in Figure 26, the energy source 78 connected to the device may be activated to transfer energy to the electrodes 84 disposed on the distal tip 82. As illustrated, the electrodes 84 deliver the energy to the junction between the apposed collapsed vessel walls 90, thus causing the walls of the lumen 90 to become fused or otherwise denatured to form a permanent closure within the lumen of the vessel. It should be noted that to enhance the ability of the device to more thoroughly fuse or otherwise close off the lumen of the vessel, there may further be provided an energy absorbing substance applied to the lumen of the vessel 90 that denatures or otherwise becomes fused to the lumen of the vessel. Such energy absorbing substances may comprise substances such as fibrin, polymers, or collagen. Alternatively, there may be provided a conducting substance applied to or about the lumen of the vessel 90, such as saline, to thus facilitate the transfer of energy from the electrodes 8 to the lumen of the vessel 90.
As will be recognized, the intraluminal closure formed via the aforementioned two (2) step process, namely, by collapsing the tissue within the lumen of the vessel and fusing the same to form an occlusive mass, W O 97/27893 PCT~US97/01463 forms a permanent closure within the lumen of the vessel, such closure may nonetheless be reopened at a later time by cutting or otherwise forming a bore through the denatured tissue mass. Indeed, it is contemplated that certain channel connectors, such as those described in Applicant's co-pending PCT International Patent Application No. , may be positioned within the fused tissue to thus provide means to restore blood flow through the vessel.
~eferring now to Figures 27 to 30a, there is shown yet another series of embodiments of methods and apparatus for occluding blood flow within a vessel. With respect to the ~ollowing class of embodiments, there is provided the combination of an embolic facilitator coupled with the application of an energy force to thus fuse the embolic facilitator to the lumen of a vessel at the specific site to be occluded. As with the first series of embolic device embodiments illustrated in Figures 2-21 above, the embolic ~acilitator is deposited within the vasculature, via a catheter, at the desired site to be embolized. Once positioned, there is applied a cauterizing or denaturing energy source which thus causes the lumen of the vessel to fuse about and fictionally adhere to the embolic device.
Referring now to Figure 27, there is shown the first of such embodiments. The particular embodiment 92 shown comprises the use of a mass of formed autologous tissue 94 harvested from the patient, which is deposited, via a catheter, at the site to be occluded. Thereafter, a denaturing or cauterizing energy can be applied, via an electrode disposed within the lumen of the deployment catheter, the tissue 94 to thus weld the same to the lumen of the vessel 96. It should be recognized, however, that such autologous tissue 94 may alternatively 3~ be wedged into place at the desired site to be embolized without being fused to the lumen of the vessel.
-Such embodiment 92 advantageously provides high biocompatability, coupled with the fact that an abundant source of such material may be readily derived from the host patient. Furthermore, the vaso-occlusion achieved by using autologous tissue has the advantage of being easily removed insofar as such tissue may be readily removed at a later time by degrading the tissue, such as by cauterizing or cutting the same, at a later date.
In an alternative embodiment, as depicted in Figure 28, the embolic facilitator device comprises a mass of intertwined wire mesh 100, referred to herein as embolization strands, that are connected at various random points within its structure and attached to an electrode or electrodes 102 whereby such strands 100 can be sufficiently energized to cause coagulation, and hence embolization, within the lumen of the vessel. At present, it is believed that the application from 2 to 50 watts to the strands 100 is sufficient to cause the necessary coagulation at the site to be embolized. As will be understood by those skilled in the art, the application of such power necessarily re~uires that an external ground plate 106 be applied to thus complete the circuit utilized to deliver such power.
Referring now to Figures 29a and 29b, there is shown yet another embodiment of the embolization system according to the present invention. Referring firstly to Figure 29a, there is provided a cylindrical, tubular electrode plug 110 having an insulated guidewire~conductor 112 extending from the proximal end ~0 thereof. The guidewire/conductor 112 preferably includes a breakpoint 112a formed at the distal end thereof, just proximal the electrode plug 110. As depicted in Figure 2gb, the guidewire/conductor 112 is connected, via a connector 118, to an energy source 116, which preferably comprises an RF generator.
~ nce the site to be occluded has been accessed, RF
energy is applied via the electrode plug 110 where such energy causes the vessel 114 to shrink about the plug 110 due to dehydration and denaturation of the lumen tissue 114, as illustrated in Figure 29b. The plug 110 thus becomes fused to the lumen 114 of the vessel and, as such, occludes blood flow. After the plug 110 has been sufficiently fused to the lumen tissue 114, the guidewire/conductor 112 is detached from the plug 110 by causing the guidewire 112 to sever at the breakpoint 112a formed on the distal end thereof. As will be recognized, the guidewire 112 may be configured to detach at the breakpoint 112a by forming the wire 112 such that the same breaks at the breakpoint 112a when sufficient tension is applied thereto. In this respect, it will be recognized that the tension necessary to brea~ the guidewire 112 at the breakpoint 112a will be less than the tension necessary to dislodge the plug 110 from the tissue from which it is fused within the lumen of the vessel. As an alternative, the breakpoint 112a may be formed to act as a fuse which could be broken by overloading the current of energy running therethrough.
Referring now to Figure 30, there is yet another preferred embodiment according to the embolization method of the present invention. In this embodiment 120, a deployment catheter 10 having an inflatable balloon 128 formed just proximal the distal end thereof is advanced to a site within the vasculature to be occluded. The ~alloon 128 is inflated to a point sufficient to occlude blood flow, as well as fix the distal end 14 of the catheter in position to form an intraluminal closure ~ithin the vessel at the desired site. In this regard, once maintained in the desired position, via the balloon 128, a conductive substance 122, such as saline, for example, is ejected from the distal end of the lumen of t~e catheter 14. A current is then passed through the conductive substance via an insulated electrode 126 extending through the distal end of the catheter 14. A
current is then passed through the conductive substance 122 and about the lumen of the vessel 130, thus causing the lumen 130 to denature such that a closure 130a, as depicted in 30a, is formed. As will be recognized, deployment of the balloon 128 prior to performing such procedure is necessary insofar as the application of an electric current in the presence of blood or other protein-containing fluid causes the latter to denature and congeal, thus possibly causing an undesirable thrombogenic event within the patient.
1~ There has thus been described in a plurality of methods and apparatus for selectively occluding blood flow at a specific site or sites within the vasculature.
While it is understood that the methods and apparatus disclosed herein are particularly well suited for intralllmin~l closure within a blood vessel, it should be understood by persons of ordinary skill in the art that the general method and devices as described herein are equally applicable to all cases where tissue needs to be brought into apposition for the purpose of creating a 2~ bond between the tissue surfaces. Such applications of the present invention may include, but are not limited to, closing wounds, bowel, lymphatics, ducts, gaps between tissues, or punctured access sites. It should be further understood that the methods and apparatus disclosed herein may be utilized to enhance drug delivery at specific sites within the body. It is therefore understood that modifications may be made without deviating from the scope of the present invention.

Claims (88)

WHAT IS CLAIMED IS:
1. A device which is implantable in a blood vessel to block the flow of blood in at least one direction through that blood vessel, said device comprising:
a) a blood vessel engaging portion which is initially disposable in a radially collapsed configuration such that said device may be passed into the lumen of the tapered segment of said blood vessel, and subsequently expandable to an operative configuration wherein it will frictionally engage the surrounding blood vessel wall to hold the device in fixed position within said blood vessel lumen;
and, b) a lumen blocking portion which is affixed to said engaging portion, said lumen blocking portion being configured such that, when said engaging portion is in its operative configuration and in contact with the blood vessel wall, said lumen blocking portion will block the flow of blood in at least one direction through said lumen.
2. The device of Claim 1 wherein said blood vessel engaging portion is a wire frame.
3. The device of Claim 1 wherein said blood vessel engaging portion is an inflatable member.
4. The device of Claim 1 wherein said blood vessel engaging portion has projections which embed in the wall of the blood vessel.
5. The device of Claim 1 wherein said blood vessel engaging portion has hooks which embed in the blood vessel.
6. The device of Claim 1 wherein the blood vessel engaging portion comprises an adhesive which adheres to the blood vessel wall.
7. The device of Claim 1 wherein the blood vessel engaging portion comprises a plurality of members which are connected at a central location, and which emanate outwardly from said central location such that, when said engaging portion is in its operative configuration, said elongate members will exert radial outward pressure against the blood vessel wall, said central location being further located and configured such that, when the device is implanted in a blood vessel, hemodynamic pressure against said central location will cause said elongate members to exert greater pressure against the blood vessel wall.
8. The device of Claim 1 wherein lumen blocking portion comprises a membrane.
9. The device of Claim 8 wherein said membrane is an elastomeric membrane.
10. The device of Claim 8 wherein one side of said membrane is formed of a first material which is resistant to cellular ingrowth, and the other side of said membrane is formed of a second material which is susceptible to cellular ingrowth.
11. The device of Claim 1 wherein said lumen blocking portion is a sponge.
12. The device of Claim 11 wherein said sponge is formed of a material selected from the group of materials consisting of:
gel foam;
collagen;
polymeric foam material;
textile material; and, woven fabric.
13. The device of Claim 1 wherein said lumen blocking portion is a disc.
14. The device of Claim 1 wherein said lumen blocking portion is a woven fabric member.
15. The device of Claim 1 wherein said lumen blocking portion is formed at least partially of a material which is capable of being penetrated by a transluminally advanceable penetrating member, after the device has been implanted in a blood vessel lumen.
16. The device of Claim 1 wherein the blood vessel engaging portion of the device is radially contractible following implantation so as to disengage from the blood vessel wall, thereby facilitating removal of the device.
17. The device of Claim 16 wherein said device further comprises a connector formed on the device to facilitate connection of the device to a transluminally inserted retrieval instrument which is operative to pull the device in to an adjacent catheter.
18. The device of Claim 17 wherein the blood vessel engaging portion of the device is constructed such that, when the retrieval instrument is attached to the connector and a pulling force is applied to the retrieval instrument, the blood vessel engaging portion of the device will be thereby caused to radially contract and disengage the blood vessel wall, thereby facilitating retraction of the device into the adjacent catheter.
19. The device of Claim 1 wherein said blood vessel engaging portion is formed of a shape memory material which transitions to said operative configuration when warmed to body temperature, but which may be radially contracted in situ by bathing the device in a cooled liquid so as to cool the device to a shape memory transition temperature which is lower than body temperature.
20. The device of Claim 1 wherein said blood vessel engaging portion is formed of resilient self-expanding material which is biased to said operative configuration such that, when unconstrained, said device will resiliently self-expand to said operative configuration.
21. The device of Claim 1 wherein said blood vessel engaging portion is formed of a plastically deformable material which is initially of said radially compact configuration, but which is subsequently deformable to said operative configuration by the application of pressure against said device.
22. The device of Claim 1 wherein:

a) said blood vessel engaging portion comprises a frame which is generally cylindrical when in its radially compact configuration, said frame having first and second opposed ends, said frame being capable of assuming a generally frustoconical shape which conforms to the shape of a tapered blood vessel wall, when the frame is expanded to its operative configuration and in engagement with said vessel wall; and, b) said lumen blocking portion comprises a pliable seal which is mounted on said frame, said seal being configured and positioned to form a transverse barrier within said blood vessel lumen when said frame is expanded to its operative configuration and in engagement with said vessel wall.
23. The device of Claim 22 wherein said cylindrical frame is fabricated from a shape memory material which has said collapsed configuration when at room temperature and which transitions to said operative configuration when warmed to body temperature.
24. The device of Claim 22 wherein said cylindrical frame has a plurality of projections formed thereon to embed within the blood vessel wall.
25. The device of Claim 24 wherein said frame is formed of wire members and wherein said projections comprise bends formed in said wire members.
26. The device of Claim 22 wherein said pliable seal is formed upon said first end of said cylindrical frame and is positioned relative to the direction of blood flow through the blood vessel lumen, such that the exertion of normal blood pressure against said seal will urge the second end of said cylindrical frame to further expand, thereby increasing the pressure exerted by the second end of said frame against the blood vessel wall.
27. The device of Claim 26 wherein the second end of said cylindrical frame flares outwardly such that, when in its operative configuration, said second end will conform to and engage the lumen of a tapered segment of blood vessel.
28. The device of Claim 22 wherein said seal is an elastomeric membrane having a porous fabric mounted thereon.
29. The device of Claim 22 wherein said cylindrical structure comprises a radiographically visible material.
30. The device of Claim 22 wherein:
a) said cylindrical frame comprises a plurality of longitudinally extending wires collectively connected at a respective end thereof;
and b) said seal is formed about said first end of said cylindrical structure such that said longitudinally extending wires extend from one side thereof.
31. The device of Claim 30 wherein said seal is oriented on said frame relative to the direction of blood flow such that the hemodynamic pressure on said seal will urge said longitudinally extending wires to embed within said lumen of said vessel.
32. The device of Claim 22 wherein:
a) said cylindrical frame comprises elongate members formed in a generally sinusoidal configuration; and b) said elastomeric seal entirely covers said frame.
33. The device of Claim 32 wherein said elongate members are formed in a zig-zag configuration with the apices of said zig-zag being located at the first and second ends of said cylindrical frame.
34. The device of Claim 21 wherein vessel engaging portion is a frame having a longitudinal axis, said frame being formed of a plurality of elongate wire members, each such wire member having first and second ends, said wire members being arranged about and parallel to said longitudinal axis, the first and second ends of said members being coterminous and collectively connected to form the ends of said frame, and said wire members being bowed radially outward from said longitudinal axis, such that said frame has a generally bulbous shape.
35. The device of Claim 34 wherein said ends of said frame are axially inverted within said frame.
36. The device of Claim 34 wherein the midsection of the frame is radially compressed to cause said frame to have a radially indented mid-portion between first and second bulbous portions.
37. The device of Claim 1 wherein:
a) said vessel engaging portion comprises a conical frame ; and, b) said lumen blocking portion comprises a pliable covering formed upon said frame.
38. The device of Claim 37 wherein said conical frame comprises a plurality of elongate wire members having first ends and second ends, the first ends of said wire members being convergent and collectively connected to form one end of the frame, the second ends of said wire members being unconnected and outwardly biased such that when said frame is expanded to its operative configuration, the second ends of said wire members will project radially outward and will engage the blood vessel wall.
39. The device of Claim 38 wherein said frame has a catch ring formed thereon to enable said device to be selectively removed from where such device is seated.
40. The device of Claim 1 wherein:
a) the blood vessel engaging portion comprises at least two self-expanding wire structures having bends formed at substantially the respective midpoints thereof, said at least two self-expanding wire structures being formed to intersect at said bends formed at the midpoints thereof, said wire structures being designed and configured to assume a first compressed configuration for deployment through a catheter, and a second expanded configuration for radially compressing against and adhering to said lumen of said blood vessel; and b) said lumen blocking portion comprises a microporous membrane formed about said intersecting wire structures, said membrane being formed about said intersecting wire such that when said intersecting wires assume said second expanded configuration, a cup-like structure is formed.
41. The device of Claim 40 wherein said microporous membrane is designed and configured to facilitate the formation of a blood clot when said device is deployed within said lumen of said blood vessel.
42. The device of Claim 40 wherein said device further includes a catch ring formed upon said intersection of said wire structures, said catch ring being designed and configured to allow said device to be removed from its seated position within said lumen of said blood vessel.
43. The device of Claim 1 wherein said device comprises an annular spring disk having a plurality of elongate, inwardly-biased members extending thereabout, said inwardly-biased elongate members having a pliable fabric formed thereover such that a conical-like structure is formed, said device being designed and configured to be oriented such that said conical structure is positioned in the direction of blood flow to be occluded.
44. The device of Claim 43 wherein said annular spring is designed to radially compress against and firmly seat said device within said lumen of said blood vessel.
45. The device of Claim 44 wherein said conical-like structure has an aperture formed at the distal-most tip thereof, said aperture being designed and configured to assume a first closed position and a second open position, said second open position being assumable when a force is axially exerted through said device through the side opposite the occluded blood flow.
46. The device of Claim 1 wherein said device comprises an annular spring having a pliable membrane formed thereabout, said annular spring being outwardly biased such that when said device is deployed within the lumen of a vessel, said annular spring imparts a radially compressive force about said lumen of said vessel.
47. The device of Claim 46 wherein said annular outer spring is comprised of heat expandable material that causes said spring to expand radially when heated to body temperature such that when said device is deployed within the lumen of a vessel, said annular spring expands radially to compress against said lumen of said vessel.
48. The device of Claim 46 wherein said membrane may be selectively penetrated.
49. The device of Claim 1 wherein said device comprises:
a) a helical coil being sized and adapted to be axially positioned within said lumen of said vessel, said helical coil being designed to assume a first compressed configuration for deployment through said lumen at said catheter, and a second expanded configuration for radially compressing against said lumen of said vessel when said device is selectively positioned therein; and b) an elastomeric bag covering said helical coil, said elastomeric bag being designed and configured to stretch about the opposed ends of said helical coil such that a vaso-occlusive barrier is formed.
50. The device of Claim 49 wherein said elastomeric bag may be selectively penetrated such that when said helical coil of said device is axially positioned within said lumen, there is defined a retransversible axial pathway at said specified site where said blood flow is occluded.
51. The device of Claim 1 wherein said device comprises a hard cap of non-distensible material coupled with an inflatable occluder, said hard cap and occluder being sized and adapted to be deployed through said lumen of said catheter when said occluder is maintained in an uninflated state, said occluder being so inflatable that when said device is deployed at said specified site, said occluder radially expands and compresses against said lumen of said vessel such that said device becomes firmly seated thereat.
52. The device of Claim 3 wherein aid occluder is formed to have a fixed surface area and is designed to be oriented in the direction of blood flow to be occluded such that when said occluder is deployed and contacted with a compressive force of blood flow, said occluder imparts a further radially-compressive force about said lumen at said specified site.
53. The device of Claim 1 wherein:
a) said blood vessel engaging portion comprises a cylindrical wire matrix designed to assume a first diametrically compressed configuration and a second diametrically expanded configuration, said matrix being deployable through said lumen of said catheter when maintained in said first compressed configuration, said matrix being rigidly positionable within said lumen of said vessel when maintained in said second expanded configuration; and b) said lumen blocking portion comprises a sock for occluding blood flow formed axially about a respective end of said matrix, said sock being so connected to said matrix such that when said device is deployed within the lumen of a vessel such that said sock is oriented in the direction of blood flow, said sock axially inverts within said matrix causing said matrix to assume said second expanded configuration.
54. The device of Claim 53 wherein said sock may be selectively penetrated such that said device forms a retransversible axial pathway at said specified site where said blood flow is occluded.
55. The device of Claim 1 wherein said device comprises a central mass of mesh wire having a plurality of projections radially-extending thereabout, said protrusions being designed and oriented to radially embed within said lumen of said vessel such that said device remains firmly seated at said specified site where said blood flow is occluded.
56. The device of Claim 55 wherein said wire mesh is designed and configured to promote the formation of a clot about said device such that a vaso-occlusive mass is formed about said device.
57. The device of Claim 55 wherein said protrusions comprise hooks oriented to embed within said lumen of said blood vessel.
58. The device of Claim 55 wherein said device is fabricated from shape memory material such that said device assumes a first compressed configuration for deployment through a catheter when subjected to a first reduced temperature, and assumes a second expanded configuration for radially compressing against and adhering to said lumen of said blood vessel when subjected to a second increased temperature.
59. The device of Claim 1 wherein said device comprises a spherical coil contained within an elastomeric covering, said spherical coil being designed to assume a first compressed configuration and a second expanded configuration such that when said device is maintained in said compressed condition, said device is deployable through said lumen of said catheter and when maintained in said expanded configuration, may radially expand and compress about said lumen of said catheter such that said device remains rigidly seated at said specified site where said blood flow is occluded.
60. The device of Claim 59 wherein said spherical coil is comprised of heat-expandable material such that when exposed to a first reduced temperature, said spherical coil assumes said first compressed configuration, and when exposed to a second increased temperature assumes said second expanded configuration.
61. The device of Claim 59 wherein said spherical coil has a plurality of elongate protrusions radially-extending through said elastomeric covering, said protrusions being designed and configured to embed within said lumen of said blood vessel to rigidly seat such device at said specified site where said blood flow is occluded.
62. The device of Claim 1 wherein said blood vessel engaging portion comprises a cylindrical tubular structure having a midsection and first and second opposed ends, said first and second opposed ends having a diameter greater than the diameter of said midsection, and said lumen blocking portion comprises first and second elastomeric seals formed on the first and second ends of said midsection, such that when said device is axially positioned within the lumen of said blood vessel said elastomeric seals produce vaso-occlusive barriers, said first and second opposed ends being designed and configured to radially compress against said lumen of said vessel such that said device remains rigidly seated at said specified site where said blood flow is occluded.
63. The device of Claim 61 wherein said cylindrical tubular structure is comprised of a plurality of struts held coupled at the respective midpoints thereof, said struts being so coupled at their midpoint such that the respective ends of said struts are biased to radially splay out to thus compress against said lumen of said vessel.
64. The device of Claim 63 wherein said struts are so coupled at their respective midpoints such that said cylindrical structure may assume a first collapsed configuration whereby the diameter of the first and second opposed ends may be decreased such that said device may be deployed and retrieved through a lumen of a catheter.
65. The device of Claim 64 wherein said cylindrical tubular structure assumes said first collapsed position by aligning said struts in generally parallel relation to one another.
66. The device of Claim 1 wherein said device comprises an inner core contained within an outer coating, said inner core being designed to selectively assume a first compressed configuration and a second expanded configuration wherein said device is maintained in said first compressed configuration said device may be deployed through a lumen of a catheter and when said device assumes said second expanded configuration, said device expands to radially compress and become rigidly seated at said specified site.
67. The device of Claim 66 wherein said outer coating is fabricated from a material having a smooth outer surface that is resistant to in-growth and prevents blood from clotting thereabout.
68. The device of Claim 1 wherein said device comprises a balloon filled with heat expandable material such that said balloon may selectively assume a first collapsed configuration and a second expanded configuration, said balloon being deployable through said lumen of said catheter when said heat expandable material assumes said first collapsed configuration, said balloon radially expanding within said lumen of said blood vessel to form a vaso-occlusive mass and remain rigidly seated at said specified site when maintained in said second expanded configuration.
69. The device as recited in Claim 68 wherein said device assumes said first collapsed position when subjected to a first reduced temperature, said balloon assuming said second expanded configuration when subjected to a second increased temperature.
70. The device as recited in Claim 69 wherein said device assumes said second expanded configuration when warmed to body temperature.
71. The device as recited in Claim 68 wherein said balloon is fabricated from a pliable material having a smooth outer surface that is resistant to ingrowth and prevents blood from clotting thereabout.
72. The device as recited in Claim 1 wherein said device comprises:
a) first and second balloon catheters selectively positionable along a segment of lumen of a blood vessel, said first and second balloons being inflatable such that blood flowing through said segment is occluded; and b) a central lumen disposed between said first and second balloon catheters, said central lumen having a plurality of apertures formed thereon for infusing embolization means therethrough, said embolization means forming a vaso-occlusive barrier about said lumen of said vessel.
73. The device of Claim 72 wherein said first and second balloons are positionable along a section of lumen having at least one side branch vessel extending therefrom, said lumen disposed between said first and second balloon catheters being designed and configured to infuse embolization means to occlude blood flow through said at least one offshoot vessel.
74. The device as recited in Claim 72 wherein said contrast media may be infused through said apertures of said lumen disposed intermediate said first and second catheter balloons prior to infusing said embolization means so that said offshoot vessels may be defined.
75. The device of Claim 1 wherein said device comprises a three-valved stent selectively positionable within a section of lumen of a vessel having at least one offshoot vessel extending therefrom, said stent being so positionable that blood flow through said vessel and said at least one offshoot vessel extending therefrom may be selectively controlled, said stent being designed and configured to assume a compressed configuration such that said stent may be deployed through the lumen of a catheter, said stent being designed to assume a second expanded configuration such that when positioned within said section of lumen, said stent imparts an axial force about said lumen such that said stent remains rigidly seated at said specified site.
76. The device of Claim 1 wherein said device comprises a chemical agent that, when deployed from said catheter, adheres to said lumen of said blood vessel and congeals to form a vaso-occlusive mass.
77. The device of Claim 76 wherein such device comprises an agent consisting of a clot inducing substance that adheres to said lumen and forms a blood clot thereabout, said blood clot becoming fused with said agent such that a vaso-occlusive mass is formed.
78. A device for closing the lumen of a blood vessel, said device comprising:
an elongate probe member having a distal end;
means for collapsing the blood vessel wall at a location adjacent the distal end of the probe;
a vessel wall fusing means for fusing the blood vessel wall;
said probe being insertable into a blood vessel at a location where it is desired to seal the lumen of the blood vessel, said means for collapsing the blood vessel wall being then useable to collapse a portion of the blood vessel adjacent the distal end of the probe, said vessel wall fusing means being then useable to fuse the blood vessel wall in the collapsed area, thereby closing the blood vessel lumen.
79. The device of Claim 78 wherein said means for collapsing the blood vessel wall is a suction lumen which extends longitudinally through the probe and which terminates in at least one suction port, such that suction may be applied to the blood vessel lumen adjacent the distal end of the probe to cause the blood vessel to collapse at that location.
80. The device of Claim 78 wherein said means for collapsing the blood vessel wall is a device which is connectible to the blood vessel wall and which is useable to force the blood vessel wall to a collapsed configuration.
81. The device of Claim 78 wherein said vessel wall fusing means is a lumen through which an adhesive may be passed, said lumen terminating in an adhesive outlet port, such that adhesive may be infused through the probe to seal the blood vessel lumen in the area wherein the blood vessel wall is collapsed.
82. The device of Claim 78 wherein said blood vessel wall fusing means is an energy emitting member formed on the probe and operable to emit energy to seal the blood vessel lumen in the area wherein the blood vessel wall is collapsed.
83. The device of Claim 82 wherein said energy emitting member is an electrode.
84. The device of Claim 83 wherein said electrode is monopolar electrode.
85. The device of Claim 83 wherein said electrode is bipolar electrode.
86. The device of Claim 79 wherein said device further comprises:

an inflatable balloon mounted on said probe at a location proximal to said least one suction port and said at least one energy emitting member, said balloon being configured such that when inflated said balloon will substantially occlude the lumen of the blood vessel and will prevent blood flow therethrough.
87. A device for closing the lumen of a blood vessel, said device comprising:
an elongate transluminally insertable probe having a detachable core member mounted on the distal end thereof and an energy-transmitting pathway extending longitudinally through the probe, said probe being insertable into the lumen of a blood vessel such that the core member is located at the site at which it is desired to close the blood vessel lumen, energy being subsequently passable through the probe member to cause the blood vessel wall to constrict about and engage the core member, thereby closing the lumen of the blood vessel, said core member being thereafter detachable from said probe member such that the probe member may be extracted and removed from the body leaving the core member implanted within the constricted region of the blood vessel.
88. A device for sealing the lumen of a blood vessel, said device comprising:
an elongate catheter having a hollow lumen extending longitudinally therethrough and terminating in a distal opening;
an energy-delivering member which is advanceable out of the distal opening of the catheter;
said catheter being advanceable through a blood vessel to a location at which the distal end of the catheter is adjacent the site at which the blood vessel is to be closed, a quantity of non-proteinaceous, energy-transmitting fluid being infusible through the lumen of the catheter so as to fill the lumen of the blood vessel adjacent the distal end of the catheter, said energy transmitting member being advanceable out of the opening of the catheter and into the energy-transmitting fluid such that energy delivered from the energy delivering member will be transmitted by the energy transmitting fluid to the surrounding wall of the blood vessel, thereby causing the blood vessel to constrict and close at that location.
CA002244080A 1996-02-02 1997-01-31 Methods and apparatus for blocking flow through blood vessels Abandoned CA2244080A1 (en)

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US1061496P 1996-02-02 1996-02-02
US60/010,614 1996-02-02
US08/730,327 1996-10-11
US08/730,327 US6190353B1 (en) 1995-10-13 1996-10-11 Methods and apparatus for bypassing arterial obstructions and/or performing other transvascular procedures
US08/730,496 US5830222A (en) 1995-10-13 1996-10-11 Device, system and method for intersititial transvascular intervention
US08/730,496 1996-10-11
PCT/US1997/001468 WO1997027898A1 (en) 1996-02-02 1997-01-31 Methods and apparatus for connecting openings formed in adjacent blood vessels or other anatomical structures

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Families Citing this family (366)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5976159A (en) * 1995-02-24 1999-11-02 Heartport, Inc. Surgical clips and methods for tissue approximation
US5904697A (en) 1995-02-24 1999-05-18 Heartport, Inc. Devices and methods for performing a vascular anastomosis
US6283951B1 (en) 1996-10-11 2001-09-04 Transvascular, Inc. Systems and methods for delivering drugs to selected locations within the body
US6283983B1 (en) 1995-10-13 2001-09-04 Transvascular, Inc. Percutaneous in-situ coronary bypass method and apparatus
US6007544A (en) * 1996-06-14 1999-12-28 Beth Israel Deaconess Medical Center Catheter apparatus having an improved shape-memory alloy cuff and inflatable on-demand balloon for creating a bypass graft in-vivo
US5662124A (en) 1996-06-19 1997-09-02 Wilk Patent Development Corp. Coronary artery by-pass method
US5755682A (en) * 1996-08-13 1998-05-26 Heartstent Corporation Method and apparatus for performing coronary artery bypass surgery
US5989276A (en) * 1996-11-08 1999-11-23 Advanced Bypass Technologies, Inc. Percutaneous bypass graft and securing system
US6293955B1 (en) 1996-09-20 2001-09-25 Converge Medical, Inc. Percutaneous bypass graft and securing system
US6432127B1 (en) * 1996-10-11 2002-08-13 Transvascular, Inc. Devices for forming and/or maintaining connections between adjacent anatomical conduits
US6120432A (en) 1997-04-23 2000-09-19 Vascular Science Inc. Medical grafting methods and apparatus
IL119911A (en) 1996-12-25 2001-03-19 Niti Alloys Tech Ltd Surgical clip
US5944750A (en) * 1997-06-30 1999-08-31 Eva Corporation Method and apparatus for the surgical repair of aneurysms
US5855599A (en) * 1997-09-02 1999-01-05 Sitek, Inc. Silicon micro machined occlusion implant
US6102941A (en) * 1997-10-06 2000-08-15 Heartstent Corporation Transmyocardial implant with coronary ingrowth
US5984956A (en) * 1997-10-06 1999-11-16 Heartstent Corporation Transmyocardial implant
US6074416A (en) * 1997-10-09 2000-06-13 St. Jude Medical Cardiovascular Group, Inc. Wire connector structures for tubular grafts
NL1007349C2 (en) * 1997-10-24 1999-04-27 Suyker Wilhelmus Joseph Leonardus System for the mechanical production of anastomoses between hollow structures; as well as device and applicator for use therewith.
US6217527B1 (en) 1998-09-30 2001-04-17 Lumend, Inc. Methods and apparatus for crossing vascular occlusions
US6231546B1 (en) 1998-01-13 2001-05-15 Lumend, Inc. Methods and apparatus for crossing total occlusions in blood vessels
US6081738A (en) 1998-01-15 2000-06-27 Lumend, Inc. Method and apparatus for the guided bypass of coronary occlusions
US6193734B1 (en) * 1998-01-23 2001-02-27 Heartport, Inc. System for performing vascular anastomoses
US6994713B2 (en) 1998-01-30 2006-02-07 St. Jude Medical Atg, Inc. Medical graft connector or plug structures, and methods of making and installing same
JP4187411B2 (en) 1998-01-30 2008-11-26 セント ジュード メディカル エーティージー, インコーポレイテッド Device for use in closing a septal defect
US6651670B2 (en) 1998-02-13 2003-11-25 Ventrica, Inc. Delivering a conduit into a heart wall to place a coronary vessel in communication with a heart chamber and removing tissue from the vessel or heart wall to facilitate such communication
US6808498B2 (en) 1998-02-13 2004-10-26 Ventrica, Inc. Placing a guide member into a heart chamber through a coronary vessel and delivering devices for placing the coronary vessel in communication with the heart chamber
EP1054641A1 (en) 1998-02-13 2000-11-29 Ventrica Inc. Methods and devices providing transmyocardial blood flow to the arterial vascular system of the heart
US6176864B1 (en) * 1998-03-09 2001-01-23 Corvascular, Inc. Anastomosis device and method
NO981277D0 (en) * 1998-03-20 1998-03-20 Erik Fosse Method and apparatus for suture-free anastomosis
EP1083835A4 (en) 1998-05-29 2004-06-02 By Pass Inc Methods and devices for vascular surgery
US20050283188A1 (en) * 1998-05-29 2005-12-22 By-Pass, Inc. Vascular closure device
US6361559B1 (en) * 1998-06-10 2002-03-26 Converge Medical, Inc. Thermal securing anastomosis systems
US6406488B1 (en) 1998-08-27 2002-06-18 Heartstent Corporation Healing transmyocardial implant
ATE322230T1 (en) * 1998-09-10 2006-04-15 Percardia Inc TMR DEVICE
US6261304B1 (en) 1998-09-10 2001-07-17 Percardia, Inc. Delivery methods for left ventricular conduit
US6196230B1 (en) 1998-09-10 2001-03-06 Percardia, Inc. Stent delivery system and method of use
US6254564B1 (en) 1998-09-10 2001-07-03 Percardia, Inc. Left ventricular conduit with blood vessel graft
US6290728B1 (en) * 1998-09-10 2001-09-18 Percardia, Inc. Designs for left ventricular conduit
US8034100B2 (en) 1999-03-11 2011-10-11 Endologix, Inc. Graft deployment system
US6261316B1 (en) 1999-03-11 2001-07-17 Endologix, Inc. Single puncture bifurcation graft deployment system
KR20020067616A (en) 1999-03-19 2002-08-23 바이-패스, 인크. Vascular surgery
US6695859B1 (en) 1999-04-05 2004-02-24 Coalescent Surgical, Inc. Apparatus and methods for anastomosis
US6712836B1 (en) 1999-05-13 2004-03-30 St. Jude Medical Atg, Inc. Apparatus and methods for closing septal defects and occluding blood flow
US6428550B1 (en) * 1999-05-18 2002-08-06 Cardica, Inc. Sutureless closure and deployment system for connecting blood vessels
US7892246B2 (en) * 1999-07-28 2011-02-22 Bioconnect Systems, Inc. Devices and methods for interconnecting conduits and closing openings in tissue
US6165185A (en) * 1999-07-28 2000-12-26 Vasconnect, Inc. Method for interconnecting vessels in a patient
US6253768B1 (en) 1999-08-04 2001-07-03 Percardia, Inc. Vascular graft bypass
US6302892B1 (en) 1999-08-04 2001-10-16 Percardia, Inc. Blood flow conduit delivery system and method of use
US6458153B1 (en) * 1999-12-31 2002-10-01 Abps Venture One, Ltd. Endoluminal cardiac and venous valve prostheses and methods of manufacture and delivery thereof
US20030130671A1 (en) * 1999-11-23 2003-07-10 Duhaylongsod Francis G. Anastomosis device and method
US6602263B1 (en) 1999-11-30 2003-08-05 St. Jude Medical Atg, Inc. Medical grafting methods and apparatus
IL153753A0 (en) * 2002-12-30 2003-07-06 Neovasc Medical Ltd Varying-diameter vascular implant and balloon
US7232449B2 (en) * 2000-04-29 2007-06-19 Medtronic, Inc. Components, systems and methods for forming anastomoses using magnetism or other coupling means
US7241300B2 (en) * 2000-04-29 2007-07-10 Medtronic, Inc, Components, systems and methods for forming anastomoses using magnetism or other coupling means
US8518062B2 (en) 2000-04-29 2013-08-27 Medtronic, Inc. Devices and methods for forming magnetic anastomoses between vessels
WO2001097695A1 (en) * 2000-06-20 2001-12-27 Chf Solutions, Inc. Anastomosis device and method
US20060135947A1 (en) * 2000-10-27 2006-06-22 Pulmonx Occlusal stent and methods for its use
US6966917B1 (en) 2000-11-09 2005-11-22 Innovation Interventional Technologies B.V. Deformable connector for mechanically connecting hollow structures
US6554764B1 (en) 2000-11-13 2003-04-29 Cardica, Inc. Graft vessel preparation device and methods for using the same
US6974476B2 (en) * 2003-05-05 2005-12-13 Rex Medical, L.P. Percutaneous aortic valve
US7909837B2 (en) 2000-12-13 2011-03-22 Medtronic, Inc. Methods, devices and systems for forming magnetic anastomoses
US20020183769A1 (en) * 2001-05-30 2002-12-05 St. Jude Medical Atg, Inc. Medical grafting methods and apparatus
US7338514B2 (en) 2001-06-01 2008-03-04 St. Jude Medical, Cardiology Division, Inc. Closure devices, related delivery methods and tools, and related methods of use
MXPA03012055A (en) * 2001-06-20 2005-07-01 Park Medical Llc Anastomotic device.
US7115136B2 (en) * 2001-06-20 2006-10-03 Park Medical Llc Anastomotic device
US7708712B2 (en) * 2001-09-04 2010-05-04 Broncus Technologies, Inc. Methods and devices for maintaining patency of surgically created channels in a body organ
US6605098B2 (en) 2001-09-28 2003-08-12 Ethicon, Inc. Surgical device for creating an anastomosis between first and second hollow organs
US7892247B2 (en) * 2001-10-03 2011-02-22 Bioconnect Systems, Inc. Devices and methods for interconnecting vessels
DE60236755D1 (en) 2001-10-04 2010-07-29 Neovasc Medical Ltd RIVER REDUCING IMPLANT
AU2002347900B8 (en) * 2001-10-11 2006-01-12 Emphasys Medical, Inc. Bronchial flow control devices and methods of use
US7318833B2 (en) 2001-12-19 2008-01-15 Nmt Medical, Inc. PFO closure device with flexible thrombogenic joint and improved dislodgement resistance
US7029482B1 (en) * 2002-01-22 2006-04-18 Cardica, Inc. Integrated anastomosis system
NL1020288C1 (en) * 2002-04-02 2003-05-07 Eric Berreklouw An assembly comprising a stabilizer and an instrument to be positioned in or around a passage surrounded by body tissue.
US7648515B2 (en) * 2002-04-16 2010-01-19 Tyco Healthcare Group Lp Method and apparatus for anastomosis including an expandable anchor
AU2003221744A1 (en) * 2002-04-19 2003-11-03 Broncus Technologies, Inc. Devices for maintaining surgically created openings
WO2003092469A2 (en) * 2002-04-29 2003-11-13 Eva Corporation Method and apparatus for supporting a surgical component
US7976564B2 (en) 2002-05-06 2011-07-12 St. Jude Medical, Cardiology Division, Inc. PFO closure devices and related methods of use
AU2003231312B2 (en) * 2002-05-06 2008-10-23 Drexel University Tissue joining devices capable of delivery of bioactive agents and methods for use thereof
US7101395B2 (en) 2002-06-12 2006-09-05 Mitral Interventions, Inc. Method and apparatus for tissue connection
WO2004000134A2 (en) 2002-06-19 2003-12-31 Tyco Healthcare Group, Lp Method and apparatus for anastomosis including annular joining member
US7998155B2 (en) * 2002-06-20 2011-08-16 Tyco Healthcare Group Lp Method and apparatus for anastomosis including annular joining member
NO20023605D0 (en) 2002-07-29 2002-07-29 Sumit Roy Method and apparatus for interconnecting two tubular members
CA2503258C (en) 2002-08-28 2011-08-16 Heart Leaflet Technologies, Inc. Method and device for treating diseased valve
US7351247B2 (en) 2002-09-04 2008-04-01 Bioconnect Systems, Inc. Devices and methods for interconnecting body conduits
FR2846520B1 (en) * 2002-11-06 2006-09-29 Roquette Freres USE OF MALTODEXTRINS BRANCHED AS BLEACHES OF GRANULATION
US7077801B2 (en) 2003-02-19 2006-07-18 Corlife Gbr Methods and devices for improving cardiac output
WO2004087236A2 (en) * 2003-03-28 2004-10-14 Board Of Regents, The University Of Texas System Stents and methods for creating an anastomosis
US8372112B2 (en) 2003-04-11 2013-02-12 St. Jude Medical, Cardiology Division, Inc. Closure devices, related delivery methods, and related methods of use
US20040267306A1 (en) 2003-04-11 2004-12-30 Velocimed, L.L.C. Closure devices, related delivery methods, and related methods of use
US20040215323A1 (en) * 2003-04-24 2004-10-28 Medtronic Ave, Inc. Membrane eyelet
CA2525094C (en) * 2003-05-07 2013-04-09 Advanced Bio Prosthetic Surfaces, Ltd. Metallic implantable grafts and method of making same
CA2526347C (en) * 2003-05-20 2010-07-06 The Cleveland Clinic Foundation Apparatus and methods for repair of a cardiac valve
US8308682B2 (en) 2003-07-18 2012-11-13 Broncus Medical Inc. Devices for maintaining patency of surgically created channels in tissue
US20050070939A1 (en) * 2003-09-30 2005-03-31 Jean Beaupre Unfolding anastomosis ring device
EP1673039B1 (en) * 2003-10-10 2008-12-03 William A. Cook Australia Pty. Ltd. Stent graft fenestration
US7413573B2 (en) * 2003-10-10 2008-08-19 William A. Cook Australia Pty. Ltd. Fenestrated stent grafts
US8043357B2 (en) 2003-10-10 2011-10-25 Cook Medical Technologies Llc Ring stent
US9078780B2 (en) * 2003-11-08 2015-07-14 Cook Medical Technologies Llc Balloon flareable branch vessel prosthesis and method
EP1547526A1 (en) * 2003-12-23 2005-06-29 UMC Utrecht Holding B.V. Operation element, operation set and method for use thereof
US7618427B2 (en) * 2003-12-29 2009-11-17 Ethicon Endo-Surgery, Inc. Device and method for intralumenal anastomosis
ES2725721T3 (en) 2004-02-03 2019-09-26 V Wave Ltd Device and method to control pressure in vivo
DE102004009892A1 (en) * 2004-02-26 2005-09-15 Gfe Medizintechnik Gmbh Implantable prosthesis for the repair of hernia defects
US8048140B2 (en) * 2004-03-31 2011-11-01 Cook Medical Technologies Llc Fenestrated intraluminal stent system
US9358141B2 (en) 2004-03-31 2016-06-07 Cook Medical Technologies Llc Stent deployment device
US8425539B2 (en) 2004-04-12 2013-04-23 Xlumena, Inc. Luminal structure anchoring devices and methods
US20050228413A1 (en) * 2004-04-12 2005-10-13 Binmoeller Kenneth F Automated transluminal tissue targeting and anchoring devices and methods
US20050243343A1 (en) * 2004-04-30 2005-11-03 Nexpress Solutions Llc PMS color expansion with fifth color
US8308760B2 (en) * 2004-05-06 2012-11-13 W.L. Gore & Associates, Inc. Delivery systems and methods for PFO closure device with two anchors
US20050278013A1 (en) * 2004-05-26 2005-12-15 Matthew Rust Method for endovascular bypass stent graft delivery
JP5178194B2 (en) * 2004-06-14 2013-04-10 ロックス メディカル, インコーポレイテッド Devices, systems, and methods for arterio-venous fistula generation
US8162963B2 (en) 2004-06-17 2012-04-24 Maquet Cardiovascular Llc Angled anastomosis device, tools and method of using
US8409167B2 (en) 2004-07-19 2013-04-02 Broncus Medical Inc Devices for delivering substances through an extra-anatomic opening created in an airway
WO2006017714A2 (en) * 2004-08-04 2006-02-16 Rebecca Delegge Thermal transition methods and devices
US7515970B2 (en) 2004-08-18 2009-04-07 Cardiac Pacemakers, Inc. Transeptal lead
US7828814B2 (en) 2004-08-27 2010-11-09 Rox Medical, Inc. Device and method for establishing an artificial arterio-venous fistula
US11207457B2 (en) * 2004-08-27 2021-12-28 Edwards Lifesciences Corporation Device and method for establishing an artificial arterio-venous fistula
US20060047337A1 (en) 2004-08-27 2006-03-02 Brenneman Rodney A Device and method for establishing an artificial arterio-venous fistula
US9706997B2 (en) * 2004-08-27 2017-07-18 Rox Medical, Inc. Device and method for establishing an artificial arterio-venous fistula
GB0419954D0 (en) 2004-09-08 2004-10-13 Advotek Medical Devices Ltd System for directing therapy
US9486216B2 (en) * 2004-09-27 2016-11-08 David W. Wright Fastener apparatus for tissue and methods of deployment and manufacture
IL164563A0 (en) * 2004-10-13 2005-12-18 Protech Medical Technologies L Prostate treatment stent
US20060111704A1 (en) * 2004-11-22 2006-05-25 Rox Medical, Inc. Devices, systems, and methods for energy assisted arterio-venous fistula creation
WO2006062996A2 (en) 2004-12-08 2006-06-15 Kenneth Binmoeller Method and apparatus for performing needle guided interventions
US8226592B2 (en) * 2004-12-15 2012-07-24 Rox Medical, Inc. Method of treating COPD with artificial arterio-venous fistula and flow mediating systems
DE102005003632A1 (en) 2005-01-20 2006-08-17 Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. Catheter for the transvascular implantation of heart valve prostheses
US20060212049A1 (en) * 2005-03-16 2006-09-21 Mohiuddin Mohammed M Pyeloplasty clip
US7763037B2 (en) * 2005-03-18 2010-07-27 Castlewood Surgical, Inc. System and method for attaching a vein, an artery, or a tube in a vascular environment
US8777967B2 (en) 2005-06-09 2014-07-15 Xlumena, Inc. Methods and devices for anchoring to tissue
US8784437B2 (en) 2005-06-09 2014-07-22 Xlumena, Inc. Methods and devices for endosonography-guided fundoplexy
EP1898811B1 (en) 2005-06-30 2019-03-06 Rox Medical, Inc. Devices and systems for creation of a peripherally located fistula
EP1912592A4 (en) * 2005-07-26 2016-01-06 Rox Medical Inc Devices, systems, and methods for peripheral arteriovenous fistula creation
US8790396B2 (en) * 2005-07-27 2014-07-29 Medtronic 3F Therapeutics, Inc. Methods and systems for cardiac valve delivery
US8083727B2 (en) 2005-09-12 2011-12-27 Bridgepoint Medical, Inc. Endovascular devices and methods for exploiting intramural space
JP5586147B2 (en) 2005-09-12 2014-09-10 ブリッジポイント、メディカル、インコーポレイテッド Intravascular device for utilizing the space in the wall
US11020141B2 (en) 2005-09-12 2021-06-01 Bridgepoint Medical, Inc. Endovascular devices and methods
US8025655B2 (en) 2005-09-12 2011-09-27 Bridgepoint Medical, Inc. Endovascular devices and methods
US7918870B2 (en) 2005-09-12 2011-04-05 Bridgepoint Medical, Inc. Endovascular devices and methods
WO2007083288A2 (en) 2006-01-23 2007-07-26 Atria Medical Inc. Heart anchor device
US20070179507A1 (en) * 2006-01-31 2007-08-02 Bhavin Shah Fistula graft deployment systems and methods
US20110071455A1 (en) * 2006-04-06 2011-03-24 Beane Richard M Method and apparatus for suturelessly connecting a conduit to a hollow organ
US7678141B2 (en) 2006-04-18 2010-03-16 Medtronic Vascular, Inc. Stent graft having a flexible, articulable, and axially compressible branch graft
BRPI0602382A (en) * 2006-06-06 2008-01-22 Luiz Gonzaga Granja Jr anastomosis prosthesis
BRPI0602379A (en) * 2006-06-06 2008-01-22 Luiz Gonzaga Granja Jr anastomosis prosthesis
US10888354B2 (en) 2006-11-21 2021-01-12 Bridgepoint Medical, Inc. Endovascular devices and methods for exploiting intramural space
US11298511B2 (en) 2006-11-21 2022-04-12 Bridgepoint Medical, Inc. Endovascular devices and methods for exploiting intramural space
US9060802B2 (en) 2006-11-21 2015-06-23 Bridgepoint Medical, Inc. Endovascular devices and methods for exploiting intramural space
US8523931B2 (en) 2007-01-12 2013-09-03 Endologix, Inc. Dual concentric guidewire and methods of bifurcated graft deployment
JP5284282B2 (en) * 2007-01-30 2013-09-11 ボストン サイエンティフィック リミテッド A medical device that delivers therapeutic agents to the heart valve
JP2010517641A (en) * 2007-02-05 2010-05-27 ボストン サイエンティフィック サイムド,インコーポレイテッド Device and method for closing a vascular opening using a permanent implant
EP1955664A1 (en) * 2007-02-06 2008-08-13 Universiteit Utrecht Holding B.V. Device for bypass surgery
US20080208214A1 (en) * 2007-02-26 2008-08-28 Olympus Medical Systems Corp. Applicator and tissue fastening method through natural orifice
US8257383B2 (en) * 2007-03-29 2012-09-04 Boston Scientific Limited Lumen reentry devices and methods
US7896915B2 (en) 2007-04-13 2011-03-01 Jenavalve Technology, Inc. Medical device for treating a heart valve insufficiency
EP1982658A1 (en) * 2007-04-16 2008-10-22 Corlife GbR Vessel connector and kit with applicator for surgery
US9282967B2 (en) 2007-08-02 2016-03-15 Bioconnect Systems, Inc. Implantable flow connector
US8690816B2 (en) 2007-08-02 2014-04-08 Bioconnect Systems, Inc. Implantable flow connector
US20090093825A1 (en) * 2007-08-21 2009-04-09 Castlewood Surgical, Inc. System and Method for Providing a Coil Element in a Vascular Environment
US20090093837A1 (en) * 2007-10-09 2009-04-09 Wilson-Cook Medical Inc. Anastomosis plug for bariatric surgery
EP2211968B1 (en) 2007-10-22 2020-02-26 Bridgepoint Medical, Inc. Devices for crossing chronic total occlusions
US9301761B2 (en) * 2007-10-22 2016-04-05 James E. Coleman Anastomosis devices and methods
US20090143713A1 (en) * 2007-11-30 2009-06-04 Jacques Van Dam Biliary Shunts, Delivery Systems, Methods of Using the Same and Kits Therefor
CA2707043A1 (en) 2007-12-11 2009-06-18 Cornell University Method and apparatus for sealing an opening in the side wall of a body lumen
US8337425B2 (en) 2008-02-05 2012-12-25 Bridgepoint Medical, Inc. Endovascular device with a tissue piercing distal probe and associated methods
EP2259830B1 (en) 2008-02-05 2017-08-16 Bridgepoint Medical, Inc. Crossing occlusions in blood vessels
WO2009105699A1 (en) 2008-02-22 2009-08-27 Endologix, Inc. Design and method of placement of a graft or graft system
BR112012021347A2 (en) 2008-02-26 2019-09-24 Jenavalve Tecnology Inc stent for positioning and anchoring a valve prosthesis at an implantation site in a patient's heart
US9044318B2 (en) 2008-02-26 2015-06-02 Jenavalve Technology Gmbh Stent for the positioning and anchoring of a valvular prosthesis
US20090254105A1 (en) * 2008-04-04 2009-10-08 Medtronic Vascular, Inc. Anastomotic connectors
US8236040B2 (en) 2008-04-11 2012-08-07 Endologix, Inc. Bifurcated graft deployment systems and methods
EP2291128B1 (en) 2008-04-28 2016-08-31 Bridgepoint Medical, Inc. Apparatus for crossing occlusions in blood vessels
US20090281379A1 (en) 2008-05-12 2009-11-12 Xlumena, Inc. System and method for transluminal access
US8454632B2 (en) 2008-05-12 2013-06-04 Xlumena, Inc. Tissue anchor for securing tissue layers
WO2010002931A1 (en) 2008-07-01 2010-01-07 Endologix, Inc. Catheter system
US8828026B2 (en) 2008-07-11 2014-09-09 Olympus Medical Systems Corp. Tissue fastening apparatus
US20100010520A1 (en) * 2008-07-11 2010-01-14 Olympus Medical Systems Corp. Tissue fastener
US8162958B2 (en) 2008-07-11 2012-04-24 Olympus Medical Systems Corp. Tissue fastening tool and applicator for indwelling the same within body, and tissue fastening method through natural orifice
US9820746B2 (en) * 2008-07-28 2017-11-21 Incube Laboratories LLC System and method for scaffolding anastomoses
WO2010024867A1 (en) * 2008-08-27 2010-03-04 Cleveland Clinic Foundation Stent graft fixation coupling
JP5750051B2 (en) 2009-01-22 2015-07-15 コーネル ユニヴァーシティー Method and apparatus for restricting flow through a lumen wall
US20100191168A1 (en) 2009-01-29 2010-07-29 Trustees Of Tufts College Endovascular cerebrospinal fluid shunt
KR101781653B1 (en) 2009-02-20 2017-09-25 코비디엔 엘피 Methods and devices for venous occlusion for the treatment of venous insufficiency
US10143455B2 (en) 2011-07-20 2018-12-04 Covidien LLP Enhanced ultrasound visualization of intravascular devices
US8518060B2 (en) 2009-04-09 2013-08-27 Medtronic, Inc. Medical clip with radial tines, system and method of using same
US8506622B2 (en) * 2009-04-17 2013-08-13 Medtronic Vascular, Inc. Mobile external coupling for branch vessel connection
US8540764B2 (en) * 2009-04-17 2013-09-24 Medtronic Vascular, Inc. Mobile external coupling for branch vessel connection
WO2010123668A1 (en) * 2009-04-20 2010-10-28 Rox Medical, Inc. Device and method for establishing an artificial arterio-venous fistula
US9364259B2 (en) 2009-04-21 2016-06-14 Xlumena, Inc. System and method for delivering expanding trocar through a sheath
US9381041B2 (en) 2009-04-21 2016-07-05 Xlumena, Inc. Methods and devices for access across adjacent tissue layers
US8668704B2 (en) 2009-04-24 2014-03-11 Medtronic, Inc. Medical clip with tines, system and method of using same
US20110054586A1 (en) 2009-04-28 2011-03-03 Endologix, Inc. Apparatus and method of placement of a graft or graft system
EP2424447A2 (en) 2009-05-01 2012-03-07 Endologix, Inc. Percutaneous method and device to treat dissections
US10772717B2 (en) 2009-05-01 2020-09-15 Endologix, Inc. Percutaneous method and device to treat dissections
US20210161637A1 (en) 2009-05-04 2021-06-03 V-Wave Ltd. Shunt for redistributing atrial blood volume
US9801617B2 (en) 2009-05-06 2017-10-31 Hansa Medical Products, Inc. Self-adjusting medical device
EP2434961B1 (en) 2009-05-29 2015-01-14 Xlumena, Inc. Apparatus and method for deploying stent across adjacent tissue layers
US9901347B2 (en) 2009-05-29 2018-02-27 Terus Medical, Inc. Biliary shunts, delivery systems, and methods of using the same
EP2445418B1 (en) * 2009-06-26 2015-03-18 Cook Medical Technologies LLC Linear clamps for anastomosis
WO2011008989A2 (en) 2009-07-15 2011-01-20 Endologix, Inc. Stent graft
JP5588511B2 (en) 2009-07-27 2014-09-10 エンドロジックス、インク Stent graft
WO2011025855A2 (en) 2009-08-28 2011-03-03 Si Therapies Ltd. Inverted balloon neck on catheter
US20110118765A1 (en) * 2009-11-18 2011-05-19 Aguirre Andres F Anastomosis stent
US8740970B2 (en) * 2009-12-02 2014-06-03 Castlewood Surgical, Inc. System and method for attaching a vessel in a vascular environment
US8870950B2 (en) 2009-12-08 2014-10-28 Mitral Tech Ltd. Rotation-based anchoring of an implant
WO2011082227A1 (en) 2009-12-29 2011-07-07 Boston Scientific Scimed, Inc. High strength low opening pressure stent design
US20110184504A1 (en) * 2010-01-22 2011-07-28 Medtronic Vascular, Inc. Methods and Apparatus for Providing an Arteriovenous Fistula
US20110224785A1 (en) 2010-03-10 2011-09-15 Hacohen Gil Prosthetic mitral valve with tissue anchors
US8449512B2 (en) * 2010-04-09 2013-05-28 Davinci Biomedical Research Products Inc. Stoma stabilitating device and method
CN103002833B (en) 2010-05-25 2016-05-11 耶拿阀门科技公司 Artificial heart valve and comprise artificial heart valve and support through conduit carry interior prosthese
US9452015B2 (en) 2010-06-15 2016-09-27 Avenu Medical, Inc. Intravascular arterial to venous anastomosis and tissue welding catheter
CA2804524C (en) 2010-06-15 2018-04-10 Caymus Medical, Inc. Systems and methods for creating arteriovenous (av) fistulas
US9017351B2 (en) 2010-06-29 2015-04-28 Artventive Medical Group, Inc. Reducing flow through a tubular structure
US9247942B2 (en) 2010-06-29 2016-02-02 Artventive Medical Group, Inc. Reversible tubal contraceptive device
US9763657B2 (en) 2010-07-21 2017-09-19 Mitraltech Ltd. Techniques for percutaneous mitral valve replacement and sealing
US8992604B2 (en) 2010-07-21 2015-03-31 Mitraltech Ltd. Techniques for percutaneous mitral valve replacement and sealing
US9132009B2 (en) 2010-07-21 2015-09-15 Mitraltech Ltd. Guide wires with commissural anchors to advance a prosthetic valve
US11653910B2 (en) 2010-07-21 2023-05-23 Cardiovalve Ltd. Helical anchor implantation
US9149277B2 (en) 2010-10-18 2015-10-06 Artventive Medical Group, Inc. Expandable device delivery
EP2635241B1 (en) 2010-11-02 2019-02-20 Endologix, Inc. Apparatus for placement of a graft or graft system
US9271733B2 (en) 2010-11-11 2016-03-01 Willson T. Asfora Sutureless vascular anastomosis connection
US9345484B2 (en) 2010-11-11 2016-05-24 Asfora Ip, Llc Deployment tool for sutureless vascular anastomosis connection
WO2012068298A1 (en) 2010-11-17 2012-05-24 Endologix, Inc. Devices and methods to treat vascular dissections
WO2012071031A1 (en) * 2010-11-23 2012-05-31 Treus Medical, Inc Biliary shunts, delivery systems, and methods of using the same
CN102068293A (en) * 2011-01-28 2011-05-25 西安交通大学 Magnetic device applied to anastomosis of large and medium blood vessels
WO2012111137A1 (en) * 2011-02-18 2012-08-23 株式会社パイオラックスメディカルデバイス Stent for abdominal cavity-vein shunt
US8808350B2 (en) 2011-03-01 2014-08-19 Endologix, Inc. Catheter system and methods of using same
CN102133120A (en) * 2011-03-08 2011-07-27 西安交通大学 Magnetic device applicable to anastomosis of large vessels
KR20140015413A (en) 2011-03-08 2014-02-06 더블유.엘. 고어 앤드 어소시에이트스, 인코포레이티드 Medical device for use with a stoma
EP2688516B1 (en) 2011-03-21 2022-08-17 Cephea Valve Technologies, Inc. Disk-based valve apparatus
EP2693981A4 (en) 2011-04-01 2015-07-01 Univ Cornell Method and apparatus for restricting flow through an opening in the side wall of a body lumen, and/or for reinforcing a weakness in the side wall of a body lumen, while still maintaining substantially normal flow through the body lumen
US9138230B1 (en) 2011-04-29 2015-09-22 Avenu Medical, Inc. Systems and methods for creating arteriovenous (AV) fistulas
US8709034B2 (en) 2011-05-13 2014-04-29 Broncus Medical Inc. Methods and devices for diagnosing, monitoring, or treating medical conditions through an opening through an airway wall
US9345532B2 (en) 2011-05-13 2016-05-24 Broncus Medical Inc. Methods and devices for ablation of tissue
US11135054B2 (en) 2011-07-28 2021-10-05 V-Wave Ltd. Interatrial shunts having biodegradable material, and methods of making and using same
WO2013021374A2 (en) 2011-08-05 2013-02-14 Mitraltech Ltd. Techniques for percutaneous mitral valve replacement and sealing
EP3417813B1 (en) 2011-08-05 2020-05-13 Cardiovalve Ltd Percutaneous mitral valve replacement
US8852272B2 (en) 2011-08-05 2014-10-07 Mitraltech Ltd. Techniques for percutaneous mitral valve replacement and sealing
WO2013055703A1 (en) 2011-10-07 2013-04-18 Cornell University Method and apparatus for restricting flow through an opening in a body lumen while maintaining normal flow
EP2768432A1 (en) 2011-10-21 2014-08-27 JenaValve Technology Inc. Catheter system for introducing an expandable heart valve stent into the body of a patient, insertion system with a catheter system and medical device for treatment of a heart valve defect
KR101330397B1 (en) * 2011-11-01 2013-11-15 재단법인 아산사회복지재단 A device for blood vessel anastomosis using the self-expandable material or structure and a method for blood vessel anastomosis using the same
WO2013067446A1 (en) 2011-11-04 2013-05-10 Caymus Medical, Inc. Systems and methods for percutaneous intravascular access and guidewire placement
WO2013078235A1 (en) 2011-11-23 2013-05-30 Broncus Medical Inc Methods and devices for diagnosing, monitoring, or treating medical conditions through an opening through an airway wall
US8968233B2 (en) 2012-02-03 2015-03-03 Medtronic Vascular, Inc. Arteriovenous shunt having a moveable valve
JP6182545B2 (en) 2012-02-08 2017-08-16 アベヌ メディカル インコーポレイテッドAvenu Medical,Inc. Intravascular arteriovenous anastomosis and tissue junction catheter
US8808620B1 (en) 2012-02-22 2014-08-19 Sapheon, Inc. Sterilization process design for a medical adhesive
US9056191B2 (en) * 2012-04-11 2015-06-16 Covidien Lp Apparatus and method for removing occlusive tissue
US9314600B2 (en) 2012-04-15 2016-04-19 Bioconnect Systems, Inc. Delivery system for implantable flow connector
US10434293B2 (en) 2012-04-15 2019-10-08 Tva Medical, Inc. Implantable flow connector
US9811613B2 (en) 2012-05-01 2017-11-07 University Of Washington Through Its Center For Commercialization Fenestration template for endovascular repair of aortic aneurysms
CN104470471B (en) 2012-05-16 2017-05-31 耶拿阀门科技有限责任公司 Catheter delivery system and Medical Devices for treating cardiac valves defect for introducing distensible heart valve prosthesis
EP2900175A4 (en) 2012-09-28 2015-08-19 Rox Medical Inc Methods, systems and devices for treating hypertension
US20140114266A1 (en) * 2012-10-22 2014-04-24 Ams Research Corporation Ostomy Implant System and Method
JP6175511B2 (en) 2012-11-14 2017-08-02 アベヌ メディカル インコーポレイテッドAvenu Medical,Inc. A device to create an arteriovenous fistula
WO2014113773A1 (en) 2013-01-18 2014-07-24 The Johns Hopkins University Ultrasound-detectable markers, ultrasound system, and methods for monitoring vascular flow and patency
WO2014115149A2 (en) 2013-01-24 2014-07-31 Mitraltech Ltd. Ventricularly-anchored prosthetic valves
US10076331B2 (en) 2013-02-01 2018-09-18 Nanyang Technological University Device and method for forming an anastomotic joint between two parts of a body
US9095344B2 (en) 2013-02-05 2015-08-04 Artventive Medical Group, Inc. Methods and apparatuses for blood vessel occlusion
US8984733B2 (en) 2013-02-05 2015-03-24 Artventive Medical Group, Inc. Bodily lumen occlusion
EP2958527B1 (en) 2013-02-21 2020-07-22 Boston Scientific Scimed, Inc. Devices for forming an anastomosis
ES2800029T3 (en) 2013-05-21 2020-12-23 V Wave Ltd Apparatus for applying devices to reduce left atrial pressure
US9737306B2 (en) 2013-06-14 2017-08-22 Artventive Medical Group, Inc. Implantable luminal devices
US9737308B2 (en) 2013-06-14 2017-08-22 Artventive Medical Group, Inc. Catheter-assisted tumor treatment
US10149968B2 (en) 2013-06-14 2018-12-11 Artventive Medical Group, Inc. Catheter-assisted tumor treatment
US9636116B2 (en) 2013-06-14 2017-05-02 Artventive Medical Group, Inc. Implantable luminal devices
US8870948B1 (en) 2013-07-17 2014-10-28 Cephea Valve Technologies, Inc. System and method for cardiac valve repair and replacement
US10070866B1 (en) 2013-08-01 2018-09-11 Avenu Medical, Inc. Percutaneous arterial to venous anastomosis clip application catheter system and methods
CN105491978A (en) 2013-08-30 2016-04-13 耶拿阀门科技股份有限公司 Radially collapsible frame for a prosthetic valve and method for manufacturing such a frame
US20150112383A1 (en) * 2013-10-21 2015-04-23 Cook Medical Technologies Llc Closure device
EP3998100A1 (en) 2014-01-15 2022-05-18 Tufts Medical Center, Inc. Endovascular cerebrospinal fluid shunt system
US9737696B2 (en) 2014-01-15 2017-08-22 Tufts Medical Center, Inc. Endovascular cerebrospinal fluid shunt
US10772672B2 (en) 2014-03-06 2020-09-15 Avenu Medical, Inc. Systems and methods for percutaneous access and formation of arteriovenous fistulas
CN106413632A (en) * 2014-03-10 2017-02-15 巴拉技术有限公司 Surgical procedure and devices for use therein
US9687240B2 (en) * 2014-03-14 2017-06-27 Cook Medical Technologies Llc Implant for facilitating sutureless side-to-side arteriovenous fistula creation and maintaining patency
US9554801B2 (en) 2014-03-14 2017-01-31 Cook Medical Technologies Llc Extravascular implant for facilitating sutured side-to-side arteriovenous fistula creation and maintaining patency
GB2527075A (en) 2014-03-17 2015-12-16 Daassist As Percutaneous system, devices and methods
US10363043B2 (en) 2014-05-01 2019-07-30 Artventive Medical Group, Inc. Treatment of incompetent vessels
US11712230B2 (en) 2014-05-02 2023-08-01 W. L. Gore & Associates, Inc. Occluder and anastomosis devices
US10363040B2 (en) * 2014-05-02 2019-07-30 W. L. Gore & Associates, Inc. Anastomosis devices
US11439396B2 (en) 2014-05-02 2022-09-13 W. L. Gore & Associates, Inc. Occluder and anastomosis devices
US9561320B2 (en) 2014-06-05 2017-02-07 Cook Medical Technologies Llc Device for promoting fistula patency and method
EP2952142B1 (en) 2014-06-06 2017-09-06 Cook Medical Technologies LLC Device for forming fistula between blood vessels
US9545263B2 (en) 2014-06-19 2017-01-17 Limflow Gmbh Devices and methods for treating lower extremity vasculature
US10524910B2 (en) 2014-07-30 2020-01-07 Mitraltech Ltd. 3 Ariel Sharon Avenue Articulatable prosthetic valve
US10194914B2 (en) * 2014-08-14 2019-02-05 W. L. Gore & Associates, Inc. Anastomosis devices
CN107148293B (en) 2014-10-31 2020-08-11 西瑞维斯克有限责任公司 Methods and systems for treating hydrocephalus
WO2016093877A1 (en) 2014-12-09 2016-06-16 Cephea Valve Technologies, Inc. Replacement cardiac valves and methods of use and manufacture
US9974651B2 (en) 2015-02-05 2018-05-22 Mitral Tech Ltd. Prosthetic valve with axially-sliding frames
CA3162308A1 (en) 2015-02-05 2016-08-11 Cardiovalve Ltd. Prosthetic valve with axially-sliding frames
CA2977681A1 (en) 2015-03-05 2016-09-09 Merit Medical Systems, Inc. Vascular prosthesis deployment device and method of use
JP6525668B2 (en) * 2015-03-27 2019-06-05 テルモ株式会社 Medical device
EP3632378A1 (en) 2015-05-01 2020-04-08 JenaValve Technology, Inc. Device and method with reduced pacemaker rate in heart valve replacement
EP3291773A4 (en) 2015-05-07 2019-05-01 The Medical Research, Infrastructure, And Health Services Fund Of The Tel Aviv Medical Center Temporary interatrial shunts
EP3294221B1 (en) 2015-05-14 2024-03-06 Cephea Valve Technologies, Inc. Replacement mitral valves
US10849746B2 (en) 2015-05-14 2020-12-01 Cephea Valve Technologies, Inc. Cardiac valve delivery devices and systems
US10022252B2 (en) 2015-06-10 2018-07-17 Cook Medical Technologies Llc Spiral blood flow device with diameter independent helix angle
US11129737B2 (en) 2015-06-30 2021-09-28 Endologix Llc Locking assembly for coupling guidewire to delivery system
US10499919B2 (en) 2015-08-21 2019-12-10 Avenu Medical, Inc. Systems and methods for percutaneous access and formation of arteriovenous fistulas
US10470906B2 (en) 2015-09-15 2019-11-12 Merit Medical Systems, Inc. Implantable device delivery system
US9789294B2 (en) 2015-10-07 2017-10-17 Edwards Lifesciences Corporation Expandable cardiac shunt
CN108136164B (en) 2015-10-30 2020-12-08 西瑞维斯克公司 Systems and methods for treating hydrocephalus
US10893847B2 (en) 2015-12-30 2021-01-19 Nuheart As Transcatheter insertion system
CA3010542A1 (en) * 2016-01-08 2017-07-13 Nuheart As Connector for coupling anatomical walls
US10531866B2 (en) 2016-02-16 2020-01-14 Cardiovalve Ltd. Techniques for providing a replacement valve and transseptal communication
US10813644B2 (en) 2016-04-01 2020-10-27 Artventive Medical Group, Inc. Occlusive implant and delivery system
US11065138B2 (en) 2016-05-13 2021-07-20 Jenavalve Technology, Inc. Heart valve prosthesis delivery system and method for delivery of heart valve prosthesis with introducer sheath and loading system
US10835394B2 (en) 2016-05-31 2020-11-17 V-Wave, Ltd. Systems and methods for making encapsulated hourglass shaped stents
US20170340460A1 (en) 2016-05-31 2017-11-30 V-Wave Ltd. Systems and methods for making encapsulated hourglass shaped stents
CN109803607B (en) * 2016-06-13 2021-07-20 主动脉公司 Systems, devices, and methods for marking and/or enhancing fenestrations in prosthetic implants
US11331187B2 (en) 2016-06-17 2022-05-17 Cephea Valve Technologies, Inc. Cardiac valve delivery devices and systems
CN109789009B (en) 2016-08-02 2021-04-16 主动脉公司 Systems, devices, and methods for coupling a prosthetic implant to an fenestration
USD800908S1 (en) 2016-08-10 2017-10-24 Mitraltech Ltd. Prosthetic valve element
US10856975B2 (en) 2016-08-10 2020-12-08 Cardiovalve Ltd. Prosthetic valve with concentric frames
WO2018064325A1 (en) 2016-09-29 2018-04-05 Merit Medical Systems, Inc. Pliant members for receiving and aiding in the deployment of vascular prostheses
USD810941S1 (en) 2016-10-06 2018-02-20 Edwards Lifesciences Corporation Cardiac shunt
US10335528B2 (en) 2016-10-07 2019-07-02 Nuheart As Transcatheter method and system for the delivery of intracorporeal devices
US10537672B2 (en) 2016-10-07 2020-01-21 Nuheart As Transcatheter device and system for the delivery of intracorporeal devices
EP3538192A4 (en) 2016-11-11 2020-09-30 Avenu Medical, Inc. Systems and methods for percutaneous intravascular access and guidewire placement
EP4209196A1 (en) 2017-01-23 2023-07-12 Cephea Valve Technologies, Inc. Replacement mitral valves
CA3051272C (en) 2017-01-23 2023-08-22 Cephea Valve Technologies, Inc. Replacement mitral valves
CN110392557A (en) 2017-01-27 2019-10-29 耶拿阀门科技股份有限公司 Heart valve simulation
US10624643B2 (en) * 2017-01-30 2020-04-21 Ethicon Llc Elongated tissue compression device system with smooth outer contour and orthogonal curved aligning surfaces
US11291807B2 (en) 2017-03-03 2022-04-05 V-Wave Ltd. Asymmetric shunt for redistributing atrial blood volume
WO2018158747A1 (en) 2017-03-03 2018-09-07 V-Wave Ltd. Shunt for redistributing atrial blood volume
WO2018170064A1 (en) 2017-03-15 2018-09-20 Merit Medical Systems, Inc. Transluminal stents and related methods
EP3595596B1 (en) 2017-03-15 2023-09-06 Merit Medical Systems, Inc. Transluminal delivery devices and related kits
USD836194S1 (en) 2017-03-21 2018-12-18 Merit Medical Systems, Inc. Stent deployment device
CN110730634A (en) 2017-04-10 2020-01-24 林弗洛公司 Apparatus and method for treating the vasculature of a lower limb
US11724075B2 (en) 2017-04-18 2023-08-15 W. L. Gore & Associates, Inc. Deployment constraining sheath that enables staged deployment by device section
US10537670B2 (en) 2017-04-28 2020-01-21 Nuheart As Ventricular assist device and method
US10888646B2 (en) 2017-04-28 2021-01-12 Nuheart As Ventricular assist device and method
KR20230062885A (en) 2017-06-20 2023-05-09 보스톤 싸이엔티픽 싸이메드 인코포레이티드 Systems for creating permanent drainage fistula
KR101976743B1 (en) * 2017-07-14 2019-05-09 주식회사 비씨엠 Stent insertion device for human digestive organ connection
US10575948B2 (en) 2017-08-03 2020-03-03 Cardiovalve Ltd. Prosthetic heart valve
US10888421B2 (en) 2017-09-19 2021-01-12 Cardiovalve Ltd. Prosthetic heart valve with pouch
US10537426B2 (en) 2017-08-03 2020-01-21 Cardiovalve Ltd. Prosthetic heart valve
US11793633B2 (en) 2017-08-03 2023-10-24 Cardiovalve Ltd. Prosthetic heart valve
US11246704B2 (en) 2017-08-03 2022-02-15 Cardiovalve Ltd. Prosthetic heart valve
EP3691568A4 (en) * 2017-09-01 2021-08-25 Transmural Systems LLC Percutaneous shunt devices and related methods
WO2019060816A2 (en) 2017-09-25 2019-03-28 Aortica Corporation Systems, devices, and methods for coupling a prosthetic implant to a fenestrated body
US10610235B2 (en) * 2017-09-27 2020-04-07 Spiration, Inc. Tissue fastening tool
GB201720803D0 (en) 2017-12-13 2018-01-24 Mitraltech Ltd Prosthetic Valve and delivery tool therefor
GB201800399D0 (en) 2018-01-10 2018-02-21 Mitraltech Ltd Temperature-control during crimping of an implant
US11744589B2 (en) * 2018-01-20 2023-09-05 V-Wave Ltd. Devices and methods for providing passage between heart chambers
US11458287B2 (en) 2018-01-20 2022-10-04 V-Wave Ltd. Devices with dimensions that can be reduced and increased in vivo, and methods of making and using the same
US10898698B1 (en) 2020-05-04 2021-01-26 V-Wave Ltd. Devices with dimensions that can be reduced and increased in vivo, and methods of making and using the same
US11013900B2 (en) 2018-03-08 2021-05-25 CereVasc, Inc. Systems and methods for minimally invasive drug delivery to a subarachnoid space
JP2020011058A (en) * 2018-07-06 2020-01-23 川澄化学工業株式会社 Communication member
US10470797B1 (en) 2018-07-17 2019-11-12 SlipStream, LLC Systems and methods for vascular access
CA3105543C (en) * 2018-07-18 2023-08-22 W. L. Gore & Associates, Inc. Medical devices for shunts, occluders, fenestrations and related systems and methods
CN116636953A (en) * 2018-09-19 2023-08-25 Nxt生物医疗有限责任公司 Method for establishing connection and shunt between vessel and chamber of biological structure
AU2019359268A1 (en) 2018-10-09 2021-04-08 Limflow Gmbh Devices and methods for catheter alignment
US11678970B2 (en) 2018-12-04 2023-06-20 Boston Scientific Scimed, Inc. Device for anastomotic bypass
CA3127324A1 (en) 2019-01-23 2020-07-30 Neovasc Medical Ltd. Covered flow modifying apparatus
JP2022519869A (en) * 2019-02-07 2022-03-25 エヌエックスティー バイオメディカル,エルエルシー Rivet shunt and placement method
US11612385B2 (en) 2019-04-03 2023-03-28 V-Wave Ltd. Systems and methods for delivering implantable devices across an atrial septum
EP3972499A1 (en) 2019-05-20 2022-03-30 V-Wave Ltd. Systems and methods for creating an interatrial shunt
KR20220020912A (en) 2019-06-17 2022-02-21 보스톤 싸이엔티픽 싸이메드 인코포레이티드 Covered Endoprosthesis with Improved Bifurcation Access
CN110522485B (en) * 2019-08-27 2020-12-11 浙江大学 Degradable intestinal tract complete diversion bracket
US20210121180A1 (en) * 2019-10-24 2021-04-29 Atrium Medical Corporation Endovascular fixation device
WO2021087294A1 (en) 2019-11-01 2021-05-06 Limflow Gmbh Devices and methods for increasing blood perfusion to a distal extremity
EP4061291A1 (en) 2019-11-18 2022-09-28 Boston Scientific Scimed Inc. Stent with improved anti-migration properties
JP2023539519A (en) 2020-09-01 2023-09-14 ボストン サイエンティフィック サイムド,インコーポレイテッド Clamping system and method for luminal attachment crimp or wound defect
JP2023548982A (en) 2020-11-09 2023-11-21 ヴェノヴァ メディカル、インコーポレイテッド Endovascular implants, devices, and accurate placement methods
US11234702B1 (en) 2020-11-13 2022-02-01 V-Wave Ltd. Interatrial shunt having physiologic sensor
US20230099881A1 (en) * 2021-09-27 2023-03-30 Medtronic, Inc. Interatrial shunting devices, systems and methods
WO2023199267A1 (en) 2022-04-14 2023-10-19 V-Wave Ltd. Interatrial shunt with expanded neck region
CN116236236B (en) * 2022-12-21 2023-11-24 南京思脉德医疗科技有限公司 Oval hole blood sealing plug and plugging device

Family Cites Families (60)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3042021A (en) 1958-11-25 1962-07-03 Read Thane Bypass type insert plug for body passageway
CA1245931A (en) * 1984-09-21 1988-12-06 Sophia Pesotchinsky Positionable tissue interfacing device for the management of percutaneous conduits
US4580568A (en) 1984-10-01 1986-04-08 Cook, Incorporated Percutaneous endovascular stent and method for insertion thereof
US4665918A (en) 1986-01-06 1987-05-19 Garza Gilbert A Prosthesis system and method
SU1635966A1 (en) * 1988-03-17 1991-03-23 Свердловский государственный медицинский институт Method for anastomosis of hollow organs
US4994066A (en) * 1988-10-07 1991-02-19 Voss Gene A Prostatic stent
US5609626A (en) 1989-05-31 1997-03-11 Baxter International Inc. Stent devices and support/restrictor assemblies for use in conjunction with prosthetic vascular grafts
US5035706A (en) 1989-10-17 1991-07-30 Cook Incorporated Percutaneous stent and method for retrieval thereof
US5053040A (en) * 1989-11-09 1991-10-01 Goldsmith Iii Manning M Method of performing a myringotomy
US5059166A (en) * 1989-12-11 1991-10-22 Medical Innovative Technologies R & D Limited Partnership Intra-arterial stent with the capability to inhibit intimal hyperplasia
IL94138A (en) * 1990-04-19 1997-03-18 Instent Inc Device for the treatment of constricted fluid conducting ducts
US5035702A (en) 1990-06-18 1991-07-30 Taheri Syde A Method and apparatus for providing an anastomosis
US5234447A (en) * 1990-08-28 1993-08-10 Robert L. Kaster Side-to-end vascular anastomotic staple apparatus
US5108420A (en) * 1991-02-01 1992-04-28 Temple University Aperture occlusion device
US5304220A (en) 1991-07-03 1994-04-19 Maginot Thomas J Method and apparatus for implanting a graft prosthesis in the body of a patient
DE69228184T2 (en) 1991-07-04 1999-09-16 Earl Owen TUBULAR, SURGICAL IMPLANT
US5269802A (en) * 1991-09-10 1993-12-14 Garber Bruce B Prostatic stent
CA2079417C (en) 1991-10-28 2003-01-07 Lilip Lau Expandable stents and method of making same
FR2683449A1 (en) * 1991-11-08 1993-05-14 Cardon Alain ENDOPROTHESIS FOR TRANSLUMINAL IMPLANTATION.
FR2688401B1 (en) 1992-03-12 1998-02-27 Thierry Richard EXPANDABLE STENT FOR HUMAN OR ANIMAL TUBULAR MEMBER, AND IMPLEMENTATION TOOL.
US5282810A (en) 1992-04-08 1994-02-01 American Cyanamid Company Surgical anastomosis device
GR930100244A (en) * 1992-06-30 1994-02-28 Ethicon Inc Flexible endoscopic surgical port
US5735892A (en) 1993-08-18 1998-04-07 W. L. Gore & Associates, Inc. Intraluminal stent graft
DE4334140C2 (en) 1993-10-07 1996-04-18 Angiomed Ag Stent and device with stent
US5443497A (en) * 1993-11-22 1995-08-22 The Johns Hopkins University Percutaneous prosthetic by-pass graft and method of use
US5486191A (en) 1994-02-02 1996-01-23 John Hopkins University Winged biliary stent
US5466242A (en) * 1994-02-02 1995-11-14 Mori; Katsushi Stent for biliary, urinary or vascular system
US5476506A (en) * 1994-02-08 1995-12-19 Ethicon, Inc. Bi-directional crimped graft
EP0793457B2 (en) 1994-04-06 2006-04-12 WILLIAM COOK EUROPE ApS A medical article for implantation into the vascular system of a patient
DE4418336A1 (en) 1994-05-26 1995-11-30 Angiomed Ag Stent for widening and holding open receptacles
RU2071732C1 (en) 1994-07-04 1997-01-20 Новокузнецкий государственный институт усовершенствования врачей Device for carrying out compression anastomosis of hollow organs
US5702419A (en) 1994-09-21 1997-12-30 Wake Forest University Expandable, intraluminal stents
US5554162A (en) 1994-12-02 1996-09-10 Delange; Gregory S. Method and device for surgically joining luminal structures
US5514176A (en) * 1995-01-20 1996-05-07 Vance Products Inc. Pull apart coil stent
US5591226A (en) 1995-01-23 1997-01-07 Schneider (Usa) Inc. Percutaneous stent-graft and method for delivery thereof
US5976159A (en) 1995-02-24 1999-11-02 Heartport, Inc. Surgical clips and methods for tissue approximation
US5695504A (en) 1995-02-24 1997-12-09 Heartport, Inc. Devices and methods for performing a vascular anastomosis
BE1009278A3 (en) 1995-04-12 1997-01-07 Corvita Europ Guardian self-expandable medical device introduced in cavite body, and medical device with a stake as.
US5746766A (en) 1995-05-09 1998-05-05 Edoga; John K. Surgical stent
GR1002392B (en) 1995-07-14 1996-07-05 Stapler for trapping the free end of a vessel with staples of the male-female type and joining thereof to the vessel implant
AU729466B2 (en) 1995-10-13 2001-02-01 Transvascular, Inc. A device, system and method for interstitial transvascular intervention
US5782844A (en) 1996-03-05 1998-07-21 Inbae Yoon Suture spring device applicator
US5713949A (en) 1996-08-06 1998-02-03 Jayaraman; Swaminathan Microporous covered stents and method of coating
US5755773A (en) 1996-06-04 1998-05-26 Medtronic, Inc. Endoluminal prosthetic bifurcation shunt
US5697971A (en) 1996-06-11 1997-12-16 Fischell; Robert E. Multi-cell stent with cells having differing characteristics
US5676670A (en) 1996-06-14 1997-10-14 Beth Israel Deaconess Medical Center Catheter apparatus and method for creating a vascular bypass in-vivo
US5797920A (en) 1996-06-14 1998-08-25 Beth Israel Deaconess Medical Center Catheter apparatus and method using a shape-memory alloy cuff for creating a bypass graft in-vivo
US6007544A (en) * 1996-06-14 1999-12-28 Beth Israel Deaconess Medical Center Catheter apparatus having an improved shape-memory alloy cuff and inflatable on-demand balloon for creating a bypass graft in-vivo
ATE309762T1 (en) 1996-09-26 2005-12-15 Scimed Life Systems Inc COMBINED MEDICAL DEVICE CONSISTING OF A SUPPORT STRUCTURE AND A MEMBRANE
US5824046A (en) 1996-09-27 1998-10-20 Scimed Life Systems, Inc. Covered stent
US5868781A (en) 1996-10-22 1999-02-09 Scimed Life Systems, Inc. Locking stent
AU5197098A (en) 1996-11-07 1998-05-29 Vascular Science Inc. Artificial tubular body organ grafts
AU5162598A (en) 1996-11-07 1998-05-29 Vascular Science Inc. Tubular medical graft connectors
US5976178A (en) 1996-11-07 1999-11-02 Vascular Science Inc. Medical grafting methods
JP2001502588A (en) 1996-11-07 2001-02-27 セント ジュード メディカル カルディオバスキュラー グループ,インコーポレイテッド Medical implantation methods and devices
DE69732791T2 (en) 1996-11-07 2005-09-15 St. Jude Medical ATG, Inc., Maple Grove Medical graft connector
US6019788A (en) 1996-11-08 2000-02-01 Gore Enterprise Holdings, Inc. Vascular shunt graft and junction for same
US5827321A (en) 1997-02-07 1998-10-27 Cornerstone Devices, Inc. Non-Foreshortening intraluminal prosthesis
US5817126A (en) 1997-03-17 1998-10-06 Surface Genesis, Inc. Compound stent
US5957949A (en) * 1997-05-01 1999-09-28 World Medical Manufacturing Corp. Percutaneous placement valve stent

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US6616675B1 (en) 2003-09-09
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WO1997027898A1 (en) 1997-08-07
CA2244079A1 (en) 1997-08-07

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