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EP1860984A2 - Procede et appareil permettant une intervention ouverte de l'aorte au moyen de dispositifs intravasculaires - Google Patents

Procede et appareil permettant une intervention ouverte de l'aorte au moyen de dispositifs intravasculaires

Info

Publication number
EP1860984A2
EP1860984A2 EP03788710A EP03788710A EP1860984A2 EP 1860984 A2 EP1860984 A2 EP 1860984A2 EP 03788710 A EP03788710 A EP 03788710A EP 03788710 A EP03788710 A EP 03788710A EP 1860984 A2 EP1860984 A2 EP 1860984A2
Authority
EP
European Patent Office
Prior art keywords
stapler
substantiauy
die
blood vessel
intravascular device
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.)
Withdrawn
Application number
EP03788710A
Other languages
German (de)
English (en)
Inventor
Edward G. Shifrin
Mark A. Umansky
Mark D. Shvartsman
Gennady S. Nickelshpur
Wesley S. Moore
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.)
E S VASCULAR Ltd
Original Assignee
Ruby Hill Ltd
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 IL15228002A external-priority patent/IL152280A0/xx
Priority claimed from IL15481503A external-priority patent/IL154815A0/xx
Application filed by Ruby Hill Ltd filed Critical Ruby Hill Ltd
Publication of EP1860984A2 publication Critical patent/EP1860984A2/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
    • A61B17/115—Staplers for performing anastomosis, e.g. in a single operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
    • A61B17/115—Staplers for performing anastomosis, e.g. in a single operation
    • A61B17/1155—Circular staplers comprising a plurality of staples
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
    • A61B17/115—Staplers for performing anastomosis, e.g. in a single operation
    • A61B2017/1157—Staplers for performing anastomosis, e.g. in a single operation applying the staples radially

Definitions

  • the present invention relates to medical techniques, in particular,
  • the present invention relates to
  • An aortic aneurysm (or its rupture) is a . most common form of
  • the aortic aneurysm is a ballooning of the wall of an artery
  • the aorta is the main artery, which supplies blood to the
  • the aorta arises from the left ventricle of the heart
  • the abdominal aorta supplies two side vessels
  • the renal arteries To the kidneys, the renal arteries. Below the level of the renal arteries, the renal arteries, the renal arteries.
  • abdominal aorta continues to about the level of the fourth lumbar
  • portion of the abdominal aorta is particularly susceptible to weakening
  • an aneurysm is often located near
  • aneurysm may rupture, resulting in rapid, and usually fatal
  • Aneurysrns in the abdominal aorta are associated with a
  • a prosthetic device typically a synthetic tube
  • the graft serves to exclude the aneurysm
  • intravascular devices of the "stent-graft" type. They are inserted and
  • the stent-graft are insufficient for its fixation in a blood vessel, the stent-graft
  • the common repair means is to deploy of a stent-
  • Parodi discloses a stent-graft device for locating inside an aorta
  • the graft has
  • the limbs having respective distal end portion having
  • This frame is covered by a sheath which can
  • Aforesaid stent-grafts are provided with means for mechanical
  • Fixation Means [0013] The problem of fixation of stents and stent-grafts inside the aorta
  • the stent can be expanded from a
  • Samuels in U.S. 5423851 discloses a method and apparatus for
  • This stent-graft can bend to
  • components for treating aortic aneurysrns includes a reinforcing graft and
  • branch vessels for example the iliac, and renal arteries.
  • tubular graft member tubular graft member.
  • the structural support forms a spiral about the
  • tubular graft tubular graft
  • hooks and anchor members integral or not integral with the stent-graft
  • EP 657147 A2 EP 466518A2, U.S. 5669936, U.S. 6004347, U.S.
  • Taheri, Syde in U.S. 5843169 discloses an apparatus for stapling
  • graft material to a blood vessel wall comprising a stapling device, a
  • Tanner, Howard in U.S. 5944750 discloses an attachment
  • the attachment assembly comprises an attachment cuff
  • the apparatus also comprises a visualization apparatus for real
  • a penetration apparatus is
  • the fastener assemblies are shaped as a
  • fasteners including a plurality of rings.
  • Tanner can be used only inside the aorta and not inside iliac arteries.
  • the stent-graft may be displaced from its
  • the staple inserter ejects staples in a radial direction
  • it includes a staple
  • the staple inserter also includes an anvil outside the organic duct, and a
  • Pat. FR 2746292 describes the surgical staple, which has a circular
  • the staple can have a barbed end.
  • a device for this staples inserting comprises a guide tube, extending
  • the device has several drawbacks. It is rather difficult to set the
  • An object of the present invention is to provide reliable and
  • intravascular devices to the wall of the aorta, iliac arteries or other
  • Another object of the present invention is to provide suturing of a
  • the present invention includes a method for mttaluminal fixation
  • intravascular devices such as grafts, stent-grafts.
  • the method includes several successive steps. At the first step a
  • substantially graft or stent-graft is fitted over the body of this stapler
  • the fitted intravascular device is secured on the stapler body via
  • corresponding intravascular device substantially a graft or stent-graft
  • this intravascular device is set in a desired
  • a graft on the wall of a blood vessel, substantially the aorta. Then there is
  • intravascular device the place of its supposed attachment to to the blood
  • the stapler is brought into inoperative position necessary for its free removal and is removed from the intravascular
  • This stapler is brought into operative position, whereupon its
  • intravascular device such as a graft or stent graft to a blood vesel wall via
  • an intravascular device such as a stent graft having a broad
  • proximal part and bifurcated distal part is secured to the wall of a blood
  • the set contains at least one
  • first stapler for securing the broad proximal part of the stent-graft to the
  • aorta wall and at least one second stapler for securing to the bifurdates
  • proximal end of the stent-graft having a broad proximal part is secured to
  • staplers comprised in the set of staplers, and using simultaneously at least
  • the stent-graft may be
  • both branches of the bifurcated distal part of a stent-graft are both branches of the bifurcated distal part of a stent-graft.
  • the claimed invention also includes a stapler for mfraluminal
  • This stapler contains a substantially cylindrical hollow body
  • the die of the claimed stapler is intended for locating fastener
  • proximal end proximal end, distal end, a substantially cylindrical generatrix and an
  • This bottom has a through axial
  • these recesses with grooves have different depth relative to
  • the recesses with grooves may have at
  • the fastener means substantially U-shaped staples, are arranged
  • the die lid has a through axial hole, substantially cylindical
  • All these means are disposed in the lid body near the points of
  • the means for holding the free ends of U-shaped staples are
  • torsion spring members located near the points of intersection of radial slots with the distal end face and and cylindrical generatrix of the die lid.
  • the die lid may be
  • the stapler further contains a pressure rod located inside the stapler
  • hollow body having a longitudinal axis, a proximal end and a distal
  • the pressure rod is operatively connected via its distal end with the
  • control lever spring-loaded, has a thrust collar near jits distal end and is
  • this pressure rod is shaped substantially as a cone and is disposed in the
  • This pressure rod has an
  • angle at cone vertex from about 3 degrees to approximately 35 degrees
  • the stapler further contains means for thransmitting axial force
  • the curved L-shaped levers are pivotally mounted by the end of
  • shaped levers are configured to periodically engage via the inner surface
  • the flange has evenly arranged radial slots, and in each
  • the curved L-shaped levers are pivotally
  • the body and the inner ribs of this die extending from the wall of its inner axial cavity in direction to the longitudinal axis of the die.
  • ribs have evenly disposed radial slots, and in each of the latter there is
  • intravascular devices substantially grafts or stent-grafts. This means
  • the claimed stapler is provided with an
  • This additional device contains a stepped rod, thin-wall bush and
  • the stepped rod has a first end and a second end, and
  • the stepped rod is twice that of inclination angles of outer surfaces of the
  • the additional device further contains a thin-wall bush the inner
  • the thin-wall bush has a thrust collar at one its end.
  • the additional device contains a pressure bush with a
  • FIG. 1 is a perspective view of a stapler apparatus according the
  • FIG. 2 is the longitudinal section of the stapler, according to the
  • FIG. 3 is the front view of the claimed stapler according to the
  • FIG. 4 is the longitudinal section of the stapler according to the
  • FIG. 5 - 7 is the first embodiment of the stapler die - its
  • FIG. 8 - 11 is the second embodiment of the stapler die - its
  • FIG. 12 - 14 is the Ud of the stapler die - its longitudinal section
  • FIG. 15 is the pressure rod, side view
  • FIG. 16 is a U-shaped staple
  • FIG. 17 is an L-shaped lever and diagram of its engagement with
  • FIG. 18 is a diagram of securing L-shaped levers on a ring
  • FIG. 19 - 20 are the longitudinal and cross sections of an aditional bush
  • FIG. 21 - 23 are elements of the additional device for the claimed
  • stapler stepped rod, thin-waU rod and pressure bush
  • FIG. 24 is a diagram of the additional device operation.
  • FIG. 25 - 26 are diagrams of setting a graft and stent-graft using a
  • the present invention (FIG. 1) comprises a stapler 1 for
  • intraluminal fixation of intravascular devices substantially grafts or stent ⁇
  • Stapler 1 comprises a substantially cylindrical hollow body 10
  • FIG. 1 having an inner axial cavity, a proximal end 12 and distal end
  • FIG. 2, 3 show the longitudinal section of stapler 1, according to
  • Lock 26 (FIG. 2) of stapler 1 is pivotaUy mounted on pin 28 and
  • Control lever 18 is pivotaUy mounted on pin 32.
  • pressure rod 34 is a means for transmitting the axial force from control
  • Pressure rod 34 (FIG. 2, 3) is operatively connected via its distal end 40
  • control lever 18 loaded by spring 44, has a thrust coUar 46 near its
  • Pressure rod 34 (FIG. 2) is reciprocable inside die 20 and die Ud 22.
  • the stapler is provided
  • Die 20 is secured on body 10 via screws 54.
  • Die 20 may be made of
  • FIG.4 shows the longitudinal section of stapler 1 according to the
  • Stapler 1 according to this embodiment differs only
  • Control lever 18 is pivotaUy mounted on pin 32. Inside hollow body
  • This pressure rod 34 is a means for
  • Pressure rod 34 (FIG. 2, 4) is operatively
  • control lever 18 connected via its distal end 40 with control lever 18, loaded with spring
  • the stapler is also provided with curved L-shaped levers
  • Levers 48 are movably disposed in slots
  • Die 20 is mounted on body 10 via
  • Die 20 of the claimed stapler serves for locating fastener means
  • barrel 60 having a proximal end 62, distal end 64, cylindrical generatrix
  • bottom 70 has through evenly arranged radial slots 72 (FIG. 6, 7), and on
  • proximal end 62 is also shaped as a barrel 60 having a proximal end 62, distal end 64,
  • This bottom 70 has through evenly arranged radial
  • levers 48 (FIG. 8 - 9).
  • grooves 78 have substantiaUy the same depth relative to the end face
  • grooves 78 have substantially different depths relative o end face 74
  • Recesses 76 with grooves 78 may have at least
  • U-shaped staples 42 are disposed radially in grooves 78 of die 20
  • SubstantiaUy V-shaped guiding surfaces 80 have guiding sides
  • Die Ud 22 (FIG. 12 - 14) has a through axial hole 82, substantiaUy
  • FIG. 15 shows in more detaU the pressure rod 34 operatively
  • control lever 18 connected via its distal end 40 with control lever 18, loaded by spring 44,
  • Proximal end 38 of pressure rod 34 is substantiaUy
  • pressure rod 34 has an angle A at the cone vertex ranging from about
  • FIG. 16 shows in more detaU a U-shaped staple 42.
  • staple 42 has sUghtly bent and pointed ends 96 and is substantially
  • Stapler 1 comprises curved L-shaped levers 48 (FIG. 17) serving
  • Levers 48 are movably disposed in slots 58
  • Curved L-shaped levers 48 are pivotally
  • L-shaped levers 48 are adapted to periodicaUy engage via inner sides 106
  • stapler 1 may comprise a die 20, die Ud 22 and
  • fastener means substantiaUy U-shaped staples 42 located in grooves 78
  • control lever 18 disposed on the other side of the working end of control lever 18, as weU
  • fastener means U- shaped staples 42, with which lock screw 110 is
  • control lever 18 operatively connected via the working end of control lever 18 and
  • This additional device contains a stepped
  • FIG. 21 has a first end 122 and second end 124 contains on its outer
  • step of this rod by a value exceeding four depths of waUs of said
  • the additional device further contains a thin-waU bush 130 (FIG.
  • bush 130 is smaUer than the outer diameter of the last step of rod 120 at
  • Thin-waU bush 130 is provied with a coUar 132 at
  • the ad nonal device contains a pressure bush 140 (FIG. 22).
  • the claimed invention includes a method
  • an intravascular device such as graft or stent-graft 3
  • the method comprises several successive steps (FIG. 25). At the
  • U-shaped staples 42 (if it is loaded or not), and if necessary, it is loaded.
  • intravascular device substantially graft or stent-graft, with partial
  • graft 3 may be more securely fixed on body 10 of
  • lock screw 110 By screwing in this lock screw 110 until stop
  • This stapler 1 is brought into operative position, whereupon its actuator with U-shaped staples 42 located in die
  • shaped staples 42 partly project outside aorta 200 and bend on its outer
  • the set contains at least one first stapler for securing
  • bifurcated istal part 224 and 226 of stent-graft 220 Securing the end of
  • stent-graft having a broad proximal part 222 to the wall of aorta 200 in
  • the neck area 228 of aorta 200 is performed by the first of staplers 1

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne des techniques médicales, notamment des procédés et un appareil permettant de supprimer l'occlusion des vaisseaux sanguins au moyen de greffes et d'empêcher la rupture abdominale de l'aorte au moyen de greffes et de greffes d'endoprothèse. Plus précisément, l'invention concerne des procédés et un appareil permettant de placer et de fixer des dispositifs intravasculaires, notamment des greffes et des greffes d'endoprothèse, au moyen d'un conduit spécialement créé par des moyens chirurgicaux afin d'accéder à la lumière d'un vaisseau sanguin. L'invention porte sur un procédé nouveau et amélioré permettant de fixer un dispositif intravasculaire à la paroi d'un vaisseau sanguin en combinaison avec une agrafeuse nouvelle et améliorée qui fonctionne d'après ce procédé. Cette agrafeuse comprend un corps creux, un poinçon et un couvercle de poinçon étant disposés au niveau de l'extrémité proximale du corps creux et, au niveau de l'extrémité distale, à un certain angle par rapport à l'autre extrémité, sont disposés un manche et un levier de contrôle qui sont connectés pivotant au moyen de ce manche et sont connectés de manière opérationnelle au moyen d'un élément de pression mobile, une pointe étant située à l'intérieur du corps et du poinçon. Des moyens de fixation sont disposés dans le poinçon. Le mouvement du levier de contrôle est converti en forces radiales nécessaires pour poinçonner la paroi du dispositif intravasculaire, pour entourer le vaisseau sanguin et pour fixer les moyens d'attache lors de l'inclinaison simultanée de leurs extrémités. La fixation d'un dispositif intravasculaire, notamment une greffe ou une greffe d'endoprothèse, sur la paroi d'un vaisseau sanguin, à savoir l'aorte, est effectuée au moyen d'un ensemble d'au moins deux agrafeuses dans lesquelles sont simultanément placés plusieurs moyens de fixation.
EP03788710A 2002-10-14 2003-09-25 Procede et appareil permettant une intervention ouverte de l'aorte au moyen de dispositifs intravasculaires Withdrawn EP1860984A2 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
IL15228002A IL152280A0 (en) 2002-10-14 2002-10-14 Method and apparatus for open aortic repair by intravascular devices
IL15481503A IL154815A0 (en) 2003-03-09 2003-03-09 Method and apparatus for open aortic repair by intravascular devices
PCT/IL2003/000766 WO2004034868A2 (fr) 2002-10-14 2003-09-25 Procede et appareil permettant une intervention ouverte de l'aorte au moyen de dispositifs intravasculaires

Publications (1)

Publication Number Publication Date
EP1860984A2 true EP1860984A2 (fr) 2007-12-05

Family

ID=32109298

Family Applications (1)

Application Number Title Priority Date Filing Date
EP03788710A Withdrawn EP1860984A2 (fr) 2002-10-14 2003-09-25 Procede et appareil permettant une intervention ouverte de l'aorte au moyen de dispositifs intravasculaires

Country Status (3)

Country Link
EP (1) EP1860984A2 (fr)
AU (1) AU2003264848A1 (fr)
WO (1) WO2004034868A2 (fr)

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
IL161067A0 (en) * 2004-03-24 2004-08-31 Edward G Shifrin Method and apparatus for laparoscopic aortic repair by intravascular devices
CN103142270B (zh) * 2012-12-26 2015-08-19 苏州天臣国际医疗科技有限公司 圆管型吻合器及其钉筒组件

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4872874A (en) * 1987-05-29 1989-10-10 Taheri Syde A Method and apparatus for transarterial aortic graft insertion and implantation
US5720755A (en) * 1995-01-18 1998-02-24 Dakov; Pepi Tubular suturing device and methods of use
DE19731834A1 (de) * 1997-07-24 1999-06-17 Ernst Peter Prof Dr M Strecker Implantationsvorrichtung

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See references of WO2004034868A3 *

Also Published As

Publication number Publication date
WO2004034868A3 (fr) 2004-08-12
WO2004034868A2 (fr) 2004-04-29
AU2003264848A8 (en) 2004-05-04
AU2003264848A1 (en) 2004-05-04

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