Search Images Maps Play YouTube News Gmail Drive More »
Sign in
Screen reader users: click this link for accessible mode. Accessible mode has the same essential features but works better with your reader.

Patents

  1. Advanced Patent Search
Publication numberUS20040181245 A1
Publication typeApplication
Application numberUS 10/810,170
Publication date16 Sep 2004
Filing date26 Mar 2004
Priority date12 Oct 2000
Also published asUS6776785, US7303569, US20030212418
Publication number10810170, 810170, US 2004/0181245 A1, US 2004/181245 A1, US 20040181245 A1, US 20040181245A1, US 2004181245 A1, US 2004181245A1, US-A1-20040181245, US-A1-2004181245, US2004/0181245A1, US2004/181245A1, US20040181245 A1, US20040181245A1, US2004181245 A1, US2004181245A1
InventorsStephen Yencho, Jaime Vargas
Original AssigneeCardica, Inc.
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Superelastic anastomosis device
US 20040181245 A1
Abstract
An implantable superelastic anastomosis device may include a substantially continuous ring, the diameter of which may be substantially fixed. The anastomosis device may include first flange members and second flange members extending from an open central structure, where at least one second flange member has a free end oriented generally toward at least one first flange member after the anastomosis device has been deployed.
Images(11)
Previous page
Next page
Claims(23)
What is claimed is:
1. A one-piece anastomosis device for connecting a graft vessel to a target vessel, comprising:
a body formed from superelastic material, said body deformable from a constrained configuration to an unconstrained configuration; wherein in said unconstrained configuration said body includes at the distal end thereof a plurality of inner flange members forming an inner flange and includes at the proximal end thereof a plurality of outer flange members forming an outer flange; and wherein at least a portion of said body between said inner flange and said outer flange has substantially the same diameter in both said constrained configuration and said unconstrained configuration.
2. The anastomosis device of claim 1, wherein said portion of said body between said inner flange and said outer flange that maintains a substantially constant diameter in both said constrained configuration and said unconstrained configuration includes a substantially rigid ring.
3. The anastomosis device of claim 1, wherein at least one of said inner flange members is substantially blunt.
4. The anastomosis device of claim 1, wherein at least one of said outer flange members is substantially blunt.
5. The anastomosis device of claim 1, wherein at least one of said inner flange members substantially does not pierce the target vessel when said body is in the unconstrained configuration.
6. The anastomosis device of claim 1, wherein at least one of said outer flange members substantially does not pierce the target vessel when said body is in the unconstrained configuration.
7. The anastomosis device of claim 1, wherein said superelastic material is nickel-titanium alloy.
8. The anastomosis device of claim 1, wherein at least one said inner flange member is substantially radially offset from at least one said outer flange member.
9. The anastomosis device of claim 1, wherein the number of said inner flange members is equal to the number of said outer flange members.
10. An anastomosis device for connecting a graft vessel to a target vessel, comprising:
a substantially continuous ring, wherein the diameter of said ring is substantially fixed;
a plurality of inner flange members extending from said ring; and
a plurality of outer flange members extending from said ring.
11. The anastomosis device of claim 10, wherein said ring, said inner flange members and said outer flange members are composed of superelastic material.
12. The anastomosis device of claim 10, wherein at least one said inner flange member is substantially radially offset from at least one said outer flange member.
13. The anastomosis device of claim 10, wherein the number of said inner flange members is equal to the number of said outer flange members.
14. The anastomosis device of claim 10, wherein at least one of said inner flange members is substantially blunt.
15. The anastomosis device of claim 10, wherein at least one of said outer flange members is substantially blunt.
16. An anastomosis device for connecting a graft vessel to a target vessel, comprising:
a open central structure;
a plurality of first flange members extending from said central structure and movable from an insertion state to an expanded state; and
a plurality of second flange members extending from said central structure and movable from an insertion state to an expanded state, at least one said second flange member having a free end; wherein at least one said free end is oriented generally toward at least one said first flange member when said first flange members and said second flange members are in said expanded state.
17. The anastomosis device of claim 16, wherein at least one said free end is pointed, whereby said pointed free end penetrates the target vessel.
18. The anastomosis device of claim 16, wherein at least one said free end is pointed, whereby said pointed free end penetrates the graft vessel.
19. The anastomosis device of claim 16, wherein at least one said free end is angled relative to a remainder of the corresponding said second flange member.
20. The anastomosis device of claim 16, wherein said central structure has a substantially fixed perimeter.
21. The anastomosis device of claim 16, wherein said central structure is a substantially rigid ring.
22. The anastomosis device of claim 10, wherein at least one said first flange member is substantially radially offset from at least one said second flange member.
23. The anastomosis device of claim 10, wherein the number of said first flange members is equal to the number of said second flange members.
Description
  • [0001]
    This application is a continuation of U.S. patent application Ser. No. 09/687,216, filed on Oct. 12, 2000, which is incorporated by reference in its entirety.
  • BACKGROUND OF THE INVENTION
  • [0002]
    1. Field of the Invention
  • [0003]
    The invention relates to an implantable medical device such as an anastomosis device and a deployment system for implanting the device. In a preferred embodiment, the device can be used for forming a sutureless connection between a bypass graft and a graft vessel.
  • [0004]
    2. Brief Description of the Related Art
  • [0005]
    Vascular anastomosis is a procedure by which two blood vessels within a patient are surgically joined together. Vascular anastomosis is performed during treatment of a variety of conditions including coronary artery disease, diseases of the great and peripheral vessels, organ transplantation, and trauma. In coronary artery disease (CAD) an occlusion or stenosis in a coronary artery interferes with blood flow to the heart muscle. Treatment of CAD involves the grafting of a vessel in the form of a prosthesis or harvested artery or vein to reroute blood flow around the occlusion and restore adequate blood flow to the heart muscle. This treatment is known as coronary artery bypass grafting (CABG).
  • [0006]
    In the conventional CABG, a large incision is made in the chest and the sternum is sawed in half to allow access to the heart. In addition, a heart lung machine is used to circulate the blood so that the heart can be stopped and the anastomosis can be performed. During this procedure, the aorta is clamped, which can lead to trauma of the aortic tissue and/or dislodge plaque emboli, both of which increase the likelihood of neurological complications. In order to minimize the trauma to the patient induced by conventional CABG, less invasive techniques have been developed in which the surgery is performed through small incisions in the patients chest with the aid of visualizing scopes. Less invasive CABG can be performed on a beating or stopped heart and thus may avoid the need for cardiopulmonary bypass.
  • [0007]
    In both conventional and less invasive CABG procedures, the surgeon has to suture one end of the graft vessel to the coronary artery and the other end of the graft vessel to a blood supplying vein or artery. The suturing process is a time consuming and difficult procedure requiring a high level of surgical skill. In order to perform the suturing of the graft to the coronary artery and the blood supplying artery the surgeon must have relatively unobstructed access to the anastomosis site within the patient. In the less invasive surgical approaches, some of the major coronary arteries including the ascending aorta cannot be easily reached by the surgeon because of their location. This makes suturing either difficult or impossible for some coronary artery sites. In addition, some target vessels, such as heavily calcified coronary vessels, vessels having very small diameter, and previously bypassed vessels may make the suturing process difficult or impossible.
  • [0008]
    Accordingly, it would be desirable to provide a sutureless vascular anastomosis device which easily connects a graft to a target vessel. It would also be desirable to provide a sutureless anastomosis device which is formed of one piece and is secured to the target vessel in a single step.
  • SUMMARY OF THE INVENTION
  • [0009]
    A superelastic or pseudoelastic one piece anastomosis device according to the present invention connects a graft vessel to a target vessel. The anastomosis device deforms from an insertion configuration to a tissue holding configuration due to the superelastic or pseudoelastic properties of the material.
  • [0010]
    In accordance with one aspect of the present invention, a one piece anastomosis device for connecting a graft vessel to a target vessel includes a device body formed of a superelastic or pseudoelastic material. The device body has an insertion configuration and a tissue holding configuration in which the body has an inner flange and an outer flange. At least one of the inner and outer flanges is radially constrained in the insertion configuration for insertion into the target vessel. When the device body is released it self deforms to the tissue holding configuration.
  • [0011]
    In accordance with another aspect of the present invention, a tube deployed anastomosis system for connecting a graft vessel to a target vessel includes a deployment tube and an anastomosis device formed of a superelastic or pseudoelastic material. The device has an insertion configuration and a tissue holding configuration in which the device has an inner flange and an outer flange. The inner and outer flanges are radially constrained in the deployment tube in the insertion configuration for insertion into the target vessel and when released from the deployment tube, the device self deforms to the tissue holding configuration.
  • [0012]
    In accordance with another further aspect of the present invention, a method of deploying an anastomosis system for connecting a graft vessel to a target vessel includes the steps of: connecting a graft vessel to a one piece device formed of a superelastic or pseudoelastic material; poking a portion of the one piece device through the graft vessel; and deploying the one piece device by self deformation to a tissue holding configuration in which the device has an inner flange and an outer flange and traps the target vessel tissue between the inner flange and the outer flange.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • [0013]
    The invention will now be described in greater detail with reference to the preferred embodiments illustrated in the accompanying drawings, in which like elements bear like reference numerals, and wherein:
  • [0014]
    [0014]FIG. 1 is a perspective view of a first embodiment of an anastomosis device in a constrained configuration prior to use;
  • [0015]
    [0015]FIG. 2 is a perspective view of the anastomosis device of FIG. 1 in a deployed configuration;
  • [0016]
    [0016]FIG. 3 is a side cross sectional view of the anastomosis device of FIG. 1 with a graft vessel everted around the device and the device constrained by a tube prior to deployment;
  • [0017]
    [0017]FIG. 4 a side cross sectional view of the system of FIG. 3 being inserted into a target vessel:
  • [0018]
    [0018]FIG. 5 is a side cross sectional view of the system of FIG. 3 after release of an inner flange;
  • [0019]
    [0019]FIG. 6 is a side cross sectional view of the system of FIG. 3 with the inner flange imbedded in an inner wall of the target vessel wall;
  • [0020]
    [0020]FIG. 7 is a side cross sectional view of the system of FIG. 3 after release of the outer flange showing the deployment tube being removed;
  • [0021]
    [0021]FIG. 8 is a perspective view of an alternative embodiment of an anastomosis device in a constrained configuration prior to use;
  • [0022]
    [0022]FIG. 9 is a perspective view of the anastomosis device of FIG. 8 in a deployed configuration;
  • [0023]
    [0023]FIG. 10 is side cross sectional view of the anastomosis device of FIG. 8 after deployment shown connecting a graft and a target vessel;
  • [0024]
    [0024]FIG. 11 is a perspective view of an alternative embodiment of an anastomosis device in a constrained configuration prior to use;
  • [0025]
    [0025]FIG. 12 is a perspective view of the anastomosis device of FIG. 11 in a deployed configuration;
  • [0026]
    [0026]FIG. 13 is a side cross sectional view of the anastomosis device of FIG. 11 after deployment shown connecting a graft vessel to a target vessel;
  • [0027]
    [0027]FIG. 14 is a perspective view of an alternative embodiment of an anastomosis device in a constrained configuration prior to use;
  • [0028]
    [0028]FIG. 15 is a perspective view of the anastomosis device of FIG. 14 in a deployed configuration;
  • [0029]
    [0029]FIG. 16 is a perspective view of an alternative embodiment of an expandable body anastomosis device in a constrained configuration prior to use; and
  • [0030]
    [0030]FIG. 17 is a perspective view of the anastomosis device of FIG. 16 in a deployed configuration.
  • DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
  • [0031]
    The present invention relates to a superelastic or pseudoelastic anastomosis device and method for connecting a graft vessel to a target vessel without the use of conventional sutures. The quick and easy deployment of the anastomosis system according to the present invention greatly increases the speed with which anastomosis can be performed over the known sutured anastomosis methods. The anastomosis devices according to the present invention are particularly designed for use in connecting graft vessels to target vessel in a variety of anastomosis procedures, including coronary artery bypass grafting. In such procedures, a large vessel anastomotic device is used to connect a graft vessel to large diameter target vessels such as the aorta or it's major side branches and a small vessel anastomotic device is used for connecting a graft vessel to a target vessel having a small diameter such as a coronary artery.
  • [0032]
    Suturing a graft vessel to a target vessel with conventional procedures is difficult and time consuming, particularly in minimally invasive procedures where space may be limited and in procedures in which it may be desired to perform an anastomosis without stoppage of blood flow through the target vessel. The superelastic or pseudoelastic anastomosis device and method of the present invention allow anastomosis to be performed efficiently and effectively in tight spaces. The anastomosis may also be performed with or without stoppage of blood flow in a target vessel and with or without the use of cardiopulmonary bypass.
  • [0033]
    [0033]FIG. 1 illustrates an anastomosis device 10 according to a first embodiment of the present invention in a constrained insertion configuration in which the anastomosis device would be inserted into a target blood vessel. FIG. 2 illustrates the anastomosis device 10 of FIG. 1 in an expanded deployed configuration which holds a graft vessel to a target vessel. The superelastic or the pseudoelastic anastomosis device in FIG. 1 includes a substantially cylindrical body 14, a plurality of legs 16 extending from a first side of the body, and a plurality of hooks 18 extended from a second side of the body. In the insertion configuration illustrated in FIG. 1, the body 14, the legs 16, and the hooks 18, are substantially aligned in a constrained substantially cylindrical shape. The anastomosis device 10 may be held in the constrained substantially cylindrical shape by a deployment tool, such as a substantially cylindrical deployment tube. When the deployment tool is removed from the device 10, the device returns to a preset expanded shape illustrated in FIG. 2 due to the superelastic or pseudoelastic properties of the material.
  • [0034]
    The anastomosis device 10 is made of a pseudoelastic or superelastic alloy, such as Nitenol or other pseudoelastic or superelastic material. The superelastic or pseudoelastic device 10 will self deform through superelastic or pseudoelastic behavior from the constrained insertion configuration illustrated in FIG. 1 to the expanded configuration illustrated in FIG. 2 when the constraining device or deployment tool is removed. The anastomosis device 10 formed of the superelastic or pseudoelastic material is formed in the final shape illustrated in FIG. 2 and is then isothermally deformed by constraining in a tube or other deployment tool in the substantially cylindrical shape illustrated in FIG. 1. The need for temperature control is avoided since the anastomosis device 10 reforms the deployed shape of FIG. 2 spontaneously when removed from the constraining tube. This allows the accurate placement of the anastomosis device 10 spontaneous and nearly instantaneously upon deployment of the device. The need for a mechanical deployment device to mechanically deform the anastomosis device from the insertion configuration to the deployed configuration is also avoided.
  • [0035]
    The anastomosis devices of the present invention may be made of any known superelastic or pseudoelastic material. U.S. Pat. No. 5,597,378 provides a discussion of superelastic and pseudoelastic materials and is incorporated herein by reference in its entirety.
  • [0036]
    The deployed anastomosis device 10 as shown in FIG. 2 includes an inner flange formed by outwardly extruding ends 22 of the J-shaped hooks 18. The deployed device 10 also includes an outer flange formed by the legs 16 extending outward from the body 14.
  • [0037]
    In use, a graft vessel 30, shown in FIG. 3, is threaded through a center of the anastomosis device 10. An end 34 of the graft vessel 30 is everted around the hooks 18 and the hook ends 22 penetrate into or through the everted end 34 of the graft vessel retaining the graft vessel in place on the anastomosis device 10.
  • [0038]
    As illustrated in FIG. 3, the anastomosis device 10 with the everted graft vessel 30 is positioned within a deployment tube 38 for delivery of the anastomosis device and graft vessel to an opening 40 in a target vessel 32. In the radially constrained insertion configuration, the leading edge or hook end of the anastomosis device may be substantially cylindrical or slightly conical for ease of insertion.
  • [0039]
    One embodiment of a method for deploying the anastomosis device 10 of the present invention will be described with reference to FIGS. 3-6. As shown in FIG. 3, the graft vessel 30 is prepared by everting an end 34 of the graft vessel around the hooks 18 of the anastomosis device 10. The hook ends 22 penetrate the graft vessel tissue to maintain the everted configuration of the graft vessel. The hooks 18 and the legs 16 of the anastomosis device 10 are radially constrained by inserting the anastomosis device 10 and everted end of the graft vessel 30 into a deployment tool 38 in the shape of a tube. When positioned inside the deployment tool 38, the anastomosis device 10 is in a generally cylindrical configuration for insertion into the target vessel 32.
  • [0040]
    As shown in FIG. 4, the deployment tool 38 is used to insert the anastomosis device 10 and the graft vessel 30 into the target vessel 32 until the hook ends 22 have passed through the opening 40 and are positioned within an interior of the blood vessel. As shown in FIGS. 3 and 4, a retainer tube 36 is positioned around the graft vessel 30 and inside the deployment tool 38 for holding and extruding the anastomosis device 10. A distal end 48 of the retainer tube 46 is positioned adjacent to a proximal end of the anastomosis device 10. The distal end 48 of the retainer tube 46 may be attached to or abut the anastomosis device 10 to hold the anastomosis device in place inside the deployment tube 38 during the insertion step of FIG. 4.
  • [0041]
    As shown in FIG. 5, the anastomosis device 10 is held in place by the retainer tube 46 while the deployment tube 38 is withdrawn or retracted to release the radial constraining force from the hooks 18. Upon removal of the deployment tube 38 from the hooks 18, the hook ends 22 and hook base portion 24 spontaneously spring outward due to the superelasticity or pseudoelasticity of the material.
  • [0042]
    As shown in FIG. 6, after the release of the hooks 18 the anastomosis device 10 is withdrawn by the deployment tool 38 against the interior wall of the target vessel 32 causing the hook ends 22 to be compressed against or penetrate into the tissue of the interior wall of the target vessel. The deployment tube 38 is then completely withdrawn as shown in FIG. 7 allowing the legs 16 to spontaneously spring outward to trap the wall of the target vessel 32 between the hooks 18 which form an inner flange and the legs 16 which form an outer flange for the deployed anastomosis device 10.
  • [0043]
    [0043]FIGS. 8-10 illustrate an alternative embodiment of an anastomosis device 50 having a central body portion 54. A first set of legs 56 extend from one end of the body 54 and a second set of pointed legs 58 extend from the second side of the body. In a constrained configuration illustrated in FIG. 8, the anastomosis device 50 is substantially tubular for insertion into a target vessel. In an expanded deployed configuration, illustrated in FIGS. 9 and 10, the anastomosis device 50 is substantially C-shaped in cross section with the legs 56 forming an outer flange and the pointed legs 58 forming an inner flange of the anastomosis device 50.
  • [0044]
    The embodiment shown in FIGS. 8-10 may be deployed in a manner similar to that of the anastomosis device described above with respect to FIGS. 1-7. As shown in FIG. 10, the graft vessel 62 is everted around the anastomosis device 50. The anastomosis device 50 and graft vessel 62 are then inserted into an opening in the target vessel 64 in a constrained configuration. A constraining device such as the deployment tool 38 is then removed from the anastomosis device 50 and graft vessel 62 allowing the legs 56 and 58 to spontaneously spring outward by the superelastic or pseudoelastic properties of the material to form inner and outer flanges which trap the tissue of the target vessel 64 between the inner and outer flanges.
  • [0045]
    According to one preferred embodiment of the anastomosis device 50 the pointed legs 58 each include a pointed tissue penetrating end 66 and a rectangular stop member 68 for limiting the tissue penetration of the penetrating end. As shown in FIG. 10, the tissue penetrating end 66 of the pointed legs 58 penetrates into or through the graft vessel 62 to ensure the graft vessel is retained on the anastomosis device 50 during and after deployment.
  • [0046]
    In the deployed configuration illustrated in FIG. 10, the intima of the graft vessel 62 abuts an intima of the target vessel 64. Thus, the expansion of the inner flange of the anastomosis device 50 forms a vein gasket to seal the graft and target vessels together.
  • [0047]
    [0047]FIGS. 11-13 illustrate an alternative embodiment of the superelastic or pseudoelastic anastomosis device 80 in a radially constrained configuration illustrated in FIG. 11 and in an expanded tissue retaining configuration illustrated in FIGS. 12 and 13. The anastomosis device 80 includes a device body 84 formed of a plurality of substantially parallel spring elements 86 interconnecting to end members 88. Extending from the end members 88 are a plurality of prongs 90 which in the expanded tissue supporting configuration illustrated in FIG. 13, form inner and outer flanges to trap the tissue of the target vessel 96. As in the previous embodiments, a graft vessel 94 is inserted through a center of the anastomosis device body 84 and is everted around the prongs 90 of at least one end the device body. The prongs 90 penetrate into or through the graft vessel tissue to retain the graft vessel on the anastomosis device.
  • [0048]
    The anastomosis device 80 with the graft vessel 94 everted around the anastomosis device is inserted in a radially constrained configuration illustrated in FIG. 11 into an opening in the target vessel 96. When the radially constraining member such as a retainer tube is removed from the anastomosis device 80, the anastomosis device spontaneously self deforms and returns to the configuration of FIG. 12 due to the superelastic or pseudoelastic properties of the material.
  • [0049]
    As shown in FIG. 13, a first set of the prongs 90 forms a flange at the inner wall of the target vessel. The spring elements 86 allow the distance between the end members 88 to adjust somewhat to target vessels 96 having walls of different thicknesses. The spring elements 86 may also apply a compression force to the wall of the target vessel 96 once the anastomosis device 80 has been deployed to provide improved sealing.
  • [0050]
    In an alternate embodiment of the anastomosis device 80 of FIGS. 11-13, the graft vessel 94 may be attached to the anastomosis device without everting. This may be done by providing axial prongs, hooks, or barbs on the inner rail member 88 and hooking an end of the graft vessel on the hooks, prongs, or barbs without everting.
  • [0051]
    An alternative embodiment of an anastomosis device 100 includes an anastomosis device body 104, legs 106, and hooks 108, as in the embodiment of FIGS. 1 and 2. The embodiment of FIGS. 14 and 15 differs from the embodiment of FIGS. 1 and 2 in that the legs 106 are folded outward and downward adjacent the body 104 in the radially constrained insertion configuration illustrated in FIG. 14. The legs 106 will spontaneously spring out to the flange forming configuration of FIG. 15 when the radially constraining member such as a retainer tube is removed for deployment of the anastomosis device 100.
  • [0052]
    [0052]FIGS. 16 and 17 illustrate an alternative embodiment of an anastomosis device 200 including a device body 204, legs 206 and pointed legs 208. The body 204 is formed of axially extending members 210 interconnected by struts 212 which allow the body to expand radially. Positioned between the body 204 and the pointed legs 208 are hinges 214. FIG. 16 illustrates the anastomosis device 200 in a radially constrained insertion configuration with a graft vessel 220 extending through an interior of the device body 204 and everted over the pointed legs 208. The pointed legs 208 penetrate and hold the everted end of the graft vessel 220 on the device 200.
  • [0053]
    For insertion, the anastomosis device 200 of FIG. 16 is radially constrained in a deployment tube (not shown). As the deployment tube is withdrawn from the device 200, the pointed legs 208 fold outward to form an inner flange, the device body 204 expands radially, and the legs 206 fold outward to form an outer flange. The radially expanding body 204 helps to stretch and support an opening in the target vessel.
  • [0054]
    Each of the anastomosis devices according to the present invention are preferably single piece devices which are formed in a substantially tubular shape. The anastomosis devices may be formed by laser cutting or punching from a tube or sheet of superelastic or pseudoelastic material. Alternatively, the devices may be formed from superelastic or pseudoelastic wire. The devices may be provided in varying sizes to join vessels of different sizes. The legs, hooks, prongs, and other device elements which have been discussed above with regard to the various embodiments may be used in varying numbers and arrangements depending on the particular application.
  • [0055]
    The invention has been described as an anastomosis device which is constrained for insertion in a radially constrained configuration with a deployment tool such as tube. However, the deployment tube may take other non-tubular shapes.
  • [0056]
    Although the invention has been primarily discussed with respect to coronary artery bypass surgery, the anastomosis devices of the present invention may by used in other types of anastomosis procedures. For example, the anastomosis device may be used in femoral-femoral bypass, vascular shunts, subclavian-carotid bypass, organ transplants, and the like. The devices according to the present invention may be used with venous grafts such as a harvested saphenous vein graft, arterial graft, such as a dissected mammal artery, or a synthetic prosthesis, as required.
  • [0057]
    Finally, the anastomosis devices according to the present invention have been illustrated as substantially cylindrical members. However, the devices can also be shaped into ovals, football shapes, or other shapes. Oval shapes can be particularly useful for accommodating small target vessels.
  • [0058]
    While the invention has been described in detail with reference to the preferred embodiments thereof, it will be apparent to one skilled in the art that various changes and modifications can be made and equivalents employed, without departing from the present invention.
Patent Citations
Cited PatentFiling datePublication dateApplicantTitle
US3254650 *19 Mar 19627 Jun 1966Michael B CollitoSurgical anastomosis methods and devices
US4366819 *17 Nov 19804 Jan 1983Kaster Robert LAnastomotic fitting
US4368436 *28 May 198011 Jan 1983Sgs-Ates Componenti Elettronici S.P.A.Overload protection device for power output circuits
US4503568 *25 Nov 198112 Mar 1985New England Deaconess HospitalSmall diameter vascular bypass and method
US4523592 *25 Apr 198318 Jun 1985Rollin K. Daniel P.S.C.Anastomotic coupling means capable of end-to-end and end-to-side anastomosis
US4589416 *11 Apr 198520 May 1986United States Surgical CorporationSurgical fastener retainer member assembly
US4593693 *26 Apr 198510 Jun 1986Schenck Robert RMethods and apparatus for anastomosing living vessels
US4657019 *10 Apr 198414 Apr 1987Idea Research Investment Fund, Inc.Anastomosis devices and kits
US4665906 *21 May 198619 May 1987Raychem CorporationMedical devices incorporating sim alloy elements
US4747407 *2 Jun 198631 May 1988The Field Surgery Research Department of the Third Military Medical UniversityBlood vessel anastomat
US4752024 *17 Oct 198621 Jun 1988Green David TSurgical fastener and surgical stapling apparatus
US4892098 *25 Feb 19889 Jan 1990Sauer Jude STubular tissue welding device without moving parts
US4907591 *29 Mar 198813 Mar 1990Pfizer Hospital Products Group, Inc.Surgical instrument for establishing compression anastomosis
US4917087 *30 Aug 198817 Apr 1990Walsh Manufacturing (Mississuaga) LimitedAnastomosis devices, kits and method
US4917090 *19 Jan 198817 Apr 1990Unilink, Inc.Method for performing an anastomosis
US4917091 *24 May 198917 Apr 1990Unilink AbAnnular fastening means
US4930674 *24 Feb 19895 Jun 1990Abiomed, Inc.Surgical stapler
US5005749 *1 Jul 19889 Apr 1991United States Surgical Corp.Anastomosis surgical stapling instrument
US5104025 *28 Sep 199014 Apr 1992Ethicon, Inc.Intraluminal anastomotic surgical stapler with detached anvil
US5119983 *26 May 19879 Jun 1992United States Surgical CorporationSurgical stapler apparatus
US5178796 *2 Apr 199212 Jan 1993Pfizer Inc.Method for oxygen removal with keto-gluconates
US5193731 *18 Sep 199016 Mar 1993United States Surgical CorporationAnastomosis surgical stapling instrument
US5205459 *1 Sep 199227 Apr 1993Ethicon, Inc.Surgical anastomosis stapling instrument
US5217474 *15 Jul 19918 Jun 1993Zacca Nadim MExpandable tip atherectomy method and apparatus
US5221281 *30 Jun 199222 Jun 1993Valleylab Inc.Electrosurgical tubular trocar
US5222963 *17 Jan 199129 Jun 1993Ethicon, Inc.Pull-through circular anastomosic intraluminal stapler with absorbable fastener means
US5275322 *28 Jan 19934 Jan 1994Ethicon, Inc.Surgical anastomosis stapling instrument
US5285945 *30 Dec 199215 Feb 1994Ethicon, Inc.Surgical anastomosis stapling instrument
US5290298 *2 May 19911 Mar 1994United States Surgical CorporationFragmentable anastomotic device
US5292053 *10 Mar 19938 Mar 1994Ethicon, Inc.Surgical anastomosis stapling instrument
US5304220 *3 May 199319 Apr 1994Maginot Thomas JMethod and apparatus for implanting a graft prosthesis in the body of a patient
US5314435 *19 May 199224 May 1994United States Surgical CorporationAnvil delivery system
US5314468 *14 Dec 199224 May 1994Wilson Ramos MartinezAortic valved tubes for human implants
US5392979 *12 Nov 199328 Feb 1995United States Surgical CorporationSurgical stapler apparatus
US5395030 *2 Jun 19937 Mar 1995Olympus Optical Co., Ltd.Surgical device for stapling and fastening body tissues
US5395311 *17 Aug 19927 Mar 1995Andrews; Winston A.Atherectomy catheter
US5503635 *12 Nov 19932 Apr 1996United States Surgical CorporationApparatus and method for performing compressional anastomoses
US5515478 *13 Sep 19947 May 1996Computer Motion, Inc.Automated endoscope system for optimal positioning
US5522834 *14 Nov 19944 Jun 1996Applied Medical Resources CorporationInternal mammary artery catheter and method
US5524180 *3 Jun 19934 Jun 1996Computer Motion, Inc.Automated endoscope system for optimal positioning
US5707362 *3 Apr 199513 Jan 1998Yoon; InbaePenetrating instrument having an expandable anchoring portion for triggering protrusion of a safety member and/or retraction of a penetrating member
US5707380 *23 Jul 199613 Jan 1998United States Surgical CorporationAnastomosis instrument and method
US5709335 *31 Oct 199520 Jan 1998Heartport, Inc.Surgical stapling instrument and method thereof
US5709693 *20 Feb 199620 Jan 1998Cardiothoracic System, Inc.Stitcher
US5725544 *12 Apr 199410 Mar 1998Oticon A/SMethod and instrument for establishing the receiving site of a coronary artery bypass graft
US5725553 *30 May 199610 Mar 1998Moenning; Stephen P.Apparatus and method for protecting a port site opening in the wall of a body cavity
US5732872 *6 Feb 199631 Mar 1998Heartport, Inc.Surgical stapling instrument
US5754741 *16 Dec 199619 May 1998Computer Motion, Inc.Automated endoscope for optimal positioning
US5855583 *22 Nov 19965 Jan 1999Computer Motion, Inc.Method and apparatus for performing minimally invasive cardiac procedures
US5868763 *16 Sep 19969 Feb 1999Guidant CorporationMeans and methods for performing an anastomosis
US5875782 *14 Nov 19962 Mar 1999Cardiothoracic Systems, Inc.Methods and devices for minimally invasive coronary artery revascularization on a beating heart without cardiopulmonary bypass
US5878193 *16 Oct 19962 Mar 1999Computer Motion, Inc.Automated endoscope system for optimal positioning
US5879371 *9 Jan 19979 Mar 1999Elective Vascular Interventions, Inc.Ferruled loop surgical fasteners, instruments, and methods for minimally invasive vascular and endoscopic surgery
US5881943 *20 Nov 199716 Mar 1999Heartport, Inc.Surgical anastomosis apparatus and method thereof
US5893369 *24 Feb 199713 Apr 1999Lemole; Gerald M.Procedure for bypassing an occlusion in a blood vessel
US5904697 *5 Oct 199818 May 1999Heartport, Inc.Devices and methods for performing a vascular anastomosis
US5907664 *11 Mar 199625 May 1999Computer Motion, Inc.Automated endoscope system for optimal positioning
US6013190 *21 Jan 199811 Jan 2000Vascular Science Inc.Catheters with integrated lumen and methods of their manufacture and use
US6015416 *26 Feb 199818 Jan 2000Ethicon Endo-Surgery, Inc.Surgical anastomosis instrument
US6022367 *18 Jun 19978 Feb 2000United States SurgicalSurgical apparatus for forming a hole in a blood vessel
US6024748 *17 Jun 199715 Feb 2000United States Surgical CorporationSingleshot anastomosis instrument with detachable loading unit and method
US6030370 *27 Jan 199829 Feb 2000Aesculap Ag And Co. KgSurgical instrument
US6030395 *28 May 199929 Feb 2000Kensey Nash CorporationAnastomosis connection system
US6036699 *26 Mar 199714 Mar 2000Perclose, Inc.Device and method for suturing tissue
US6036700 *14 Jul 199814 Mar 2000Ethicon Endo-Surgery, Inc.Surgical anastomosis instrument
US6036702 *23 Apr 199714 Mar 2000Vascular Science Inc.Medical grafting connectors and fasteners
US6036703 *5 Feb 199914 Mar 2000Ethicon Endo-Surgery Inc.Method and apparatus for establishing anastomotic passageways
US6036704 *13 May 199914 Mar 2000Yoon; InbaeAnastomosis apparatus and method for anastomosing an anatomical tubular structure
US6036705 *1 Jun 199914 Mar 2000Kensey Nash CorporationAnastomosis connection system and method of use
US6050472 *11 Apr 199718 Apr 2000Olympus Optical Co., Ltd.Surgical anastomosis stapler
US6053390 *10 May 199925 Apr 2000United States SurgicalAnvil for surgical stapler
US6056762 *22 May 19972 May 2000Kensey Nash CorporationAnastomosis system and method of use
US6066144 *15 Jul 199823 May 2000Ethicon Endo-Surgery, Inc.Surgical anastomosis method
US6066148 *30 Apr 199623 May 2000Oticon A/SMethod and anastomotic instrument for use when performing an end-to-side anastomosis
US6068637 *29 Aug 199630 May 2000Cedar Sinai Medical CenterMethod and devices for performing vascular anastomosis
US6167889 *28 Jun 19992 Jan 2001Cardiothoracic Systems, Inc.Method for coronary artery bypass
US6171319 *27 Apr 19999 Jan 2001Cardio Medical Solutions, Inc.Anastomosis device with hole punch
US6171321 *18 May 19999 Jan 2001Heartport, Inc.Devices and methods for performing a vascular anastomosis
US6176413 *20 Jan 200023 Jan 2001Heartport, Inc.Surgical anastomosis apparatus and method thereof
US6176864 *9 Mar 199823 Jan 2001Corvascular, Inc.Anastomosis device and method
US6186942 *7 Apr 199913 Feb 2001St. Jude Medical Cardiovascular Group, Inc.Medical grafting methods and apparatus
US6187019 *5 Oct 199913 Feb 2001Ethicon Endo-Surgery, Inc.Surgical anastomosis instrument
US6187020 *6 Jul 199913 Feb 2001Laboratoire Perouse ImplantConnecting device for anastomosis, device for fitting fasteners and implant including them
US6190396 *14 Sep 199920 Feb 2001Perclose, Inc.Device and method for deploying and organizing sutures for anastomotic and other attachments
US6190397 *3 Jun 199920 Feb 2001Origin Medsystems, Inc.Means and method for performing an anastomosis
US6190590 *28 Feb 199620 Feb 2001Impra, Inc.Apparatus and method for making flanged graft for end-to-side anastomosis
US6193129 *24 Jan 200027 Feb 2001Ethicon Endo-Surgery, Inc.Cutting blade for a surgical anastomosis stapling instrument
US6193734 *5 Jan 199927 Feb 2001Heartport, Inc.System for performing vascular anastomoses
US6206912 *4 Aug 199927 Mar 2001St. Jude Medical Anastomotic Technology Group Inc.Medical grafting methods and apparatus
US6206913 *12 Aug 199827 Mar 2001Vascular Innovations, Inc.Method and system for attaching a graft to a blood vessel
US6235054 *27 Feb 199822 May 2001St. Jude Medical Cardiovascular Group, Inc.Grafts with suture connectors
US6371964 *15 Nov 199916 Apr 2002Vascular Innovations, Inc.Trocar for use in deploying an anastomosis device and method of performing anastomosis
US6391036 *31 Mar 200021 May 2002St. Jude Medical Atg Inc.Medical graft connector or plug structures, and methods of making and installing same
US6508822 *14 Apr 200021 Jan 2003St. Jude Medical Atg, Inc.Medical graft assembly
US6511491 *1 Aug 200128 Jan 2003St. Jude Medical Atg, Inc.Medical grafting methods and apparatus
US6537288 *6 Dec 200125 Mar 2003Cardica, Inc.Implantable medical device such as an anastomosis device
US6695859 *31 Mar 200024 Feb 2004Coalescent Surgical, Inc.Apparatus and methods for anastomosis
US6699256 *2 Jun 20002 Mar 2004St. Jude Medical Atg, Inc.Medical grafting apparatus and methods
US6736825 *27 Dec 200118 May 2004Integrated Vascular Interventional Technologies, L C (Ivit Lc)Paired expandable anastomosis devices and related methods
Classifications
U.S. Classification606/153
International ClassificationA61B17/11, A61B17/064
Cooperative ClassificationA61B2017/1135, A61B2017/0641, A61B2017/1107, A61B17/11, A61B17/064, A61B17/0644
European ClassificationA61B17/11, A61B17/064D