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WO2005079151A2 - Systeme endovasculaire et procede d'apport et de fixation de dispositifs intravasculaires - Google Patents

Systeme endovasculaire et procede d'apport et de fixation de dispositifs intravasculaires Download PDF

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Publication number
WO2005079151A2
WO2005079151A2 PCT/IL2005/000115 IL2005000115W WO2005079151A2 WO 2005079151 A2 WO2005079151 A2 WO 2005079151A2 IL 2005000115 W IL2005000115 W IL 2005000115W WO 2005079151 A2 WO2005079151 A2 WO 2005079151A2
Authority
WO
WIPO (PCT)
Prior art keywords
graft
stent
cartridge
detachable
endovascular
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.)
Ceased
Application number
PCT/IL2005/000115
Other languages
English (en)
Other versions
WO2005079151A3 (fr
Inventor
Edward G. Shifrin
Gennady S. Nickelshpur
Arkady 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.)
Individual
Original Assignee
Individual
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
Application filed by Individual filed Critical Individual
Publication of WO2005079151A2 publication Critical patent/WO2005079151A2/fr
Publication of WO2005079151A3 publication Critical patent/WO2005079151A3/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2/00—Filters 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
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
    • A61F2/966—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B17/0644—Surgical staples, i.e. penetrating the tissue penetrating the tissue, deformable to closed position
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2/00—Filters 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
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/9517—Instruments specially adapted for placement or removal of stents or stent-grafts handle assemblies therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A61B2017/00411—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like actuated by application of energy from an energy source outside the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/0046—Surgical instruments, devices or methods with a releasable handle; with handle and operating part separable
    • A61B2017/00473—Distal part, e.g. tip or head
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00831—Material properties
    • A61B2017/00867—Material properties shape memory effect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B2017/0645—Surgical staples, i.e. penetrating the tissue being elastically deformed for insertion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B2017/0688—Packages or dispensers for surgical staplers
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2/00—Filters 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
    • A61F2/0095—Packages or dispensers for prostheses or other implants
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2/07—Stent-grafts

Definitions

  • the present invention relates to medical techniques, in particular,
  • present invention relates to methods and apparatus for securing
  • intravascular devices such as grafts or stent-grafts, to the wall of blood
  • organs such as the heart and liver, which leads to such dangerous
  • balloon is inflated by pressure of fluid, so that the corresponding portion
  • the lumen in the blood vessel remains narrow, there is inserted inside the
  • the stent deploys, separates
  • the stent on the walls of a blood vessel is performed via elastic forces of material the stent is made of, the stent is usually shajped as a spring or has
  • the aneurysm is a ballooning of the wall of an artery or aorta
  • 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 to the kidneys, the renal arteries.
  • the renal arteries Below the level of the renal arteries, the
  • abdominal aorta continues to about the level of the fourth lumbar
  • abdominal aorta is particularly susceptible to weakening, resulting in an
  • aortic aneurysm Such an aneurysm is often located near or including the
  • aneurysm may rupture, resulting in rapid, and usually fatal
  • aortic aneurysm is extremely high, there is also noticeable mortality and
  • a prosthetic device typically a synthetic tube
  • the graft serves to exclude the aneurysm
  • intravascular devices of ⁇ 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 a graft or a
  • This frame is covered by a sheath which can contract and expand together with the frame under the action of external
  • Aforesaid stent-grafts are provided with means for mechanical
  • fastener means made of a shape memory alloy are suggest fastener means made of a shape memory alloy. Among these are
  • This device for retaining a graft on an artery
  • the elongate members are elongated members extending therefrom.
  • the elongate members are
  • the device comprises at least two wires fabricated from a material which has
  • a spring or thermal shape memory alloy such as nickel/titanium shape
  • the wires can be constrained to be parallel, each wire
  • wires having two ends, the wires being joined together at or near to one end by
  • the device is
  • the lumen size in the aortic neck area is at
  • implanted device should be located.
  • the delivery system for this purpose the delivery system
  • balloon machanical deployable means are used resembling "Chinese
  • the catheter has a mechanically expanding mechanism on the distal end
  • mechanical dilating mechanism includes a pair of expanders which
  • a set of adjacent quadrates are preferably provided
  • the stent-graft complex includes a segment of prosthetic graft
  • each stent-graft complex is positioned relative to one other in a common
  • stents deployed.
  • the distal part of stents is deployed in the iliac arteries.
  • the delivered implanted devices are configured to be used inside operated blood vessels.
  • fixation means - stents which are not
  • aorta neck does not always allow to locate a stent at this place which
  • suturing tissues via fixing means such as clips, see, for example, suturing
  • a device for retaining a graft on an artery comprising a first part for
  • This first and second parts are connected by a resilient member, which
  • fixation is made of a shape memory alloy, and includes in transport
  • a delivery system including an expandable
  • Pat.AppI. 2003/0055441 disclose a system for making anastomoses
  • circumferentially provided means such as pin-shaped elements, for joining the abutting walls of the hollow stractures together.
  • Appl. 2003/0023248 discloses systems and methods for applying a suture
  • the systems and methods advance within a blood vessel lumen.
  • a catheter tube having a distal region that carries a suture
  • the systems and methods operate the suture applicator from a
  • tubular body and deployed to support a prosthetic in contact with an inner
  • a delivery tube may be included that is disposed for
  • the delivery tube may include an applicator head.
  • the applicator head may include an injection
  • fastener applier for fastening a vascular graft to a vessel with at least one
  • the applicator generally includes a tubular body configured for
  • a fastener applying head is movably mounted within the tubular body.
  • the applicator further includes a handle assembly
  • the handle assembly is mounted on a proximal end of the tubular body.
  • the applicator also includes a
  • stent-grafts have, as a rule, different functions, i.e. serve solely either
  • An object of the present invention is to develop a method
  • implanted endovascular prostheses particularly, grafts or stent-grafts, in
  • Another object of the present invention is to develop a system of
  • a third object of the present invention is to develop a new method
  • a subject-matter of the present invention Is an endovascular
  • This apparatus is assembled from a kit of elements and
  • one fastener means substantially U-shaped staple, and a control
  • This at least one detachable cartridge is secured on the
  • tubular body including a first, second and third connecting means.
  • the tubular body is configured for positioning within a blood
  • the apparatus includes at least one detachable cartridge adapted
  • This detachable cartridge is
  • At least one fastener means sabstantially a U-shaped staple, is
  • the U-shaped staple is disposed in the detachable cartridge to
  • control mechanism provided with a first, second and third
  • control means Is disposed on the tubular body end opposite to the at least
  • the control mechanism is associated with the
  • the first control means serves to control
  • second control means serves to control the detachment of the delivered
  • This holder is provided with
  • the holder for at least one detachable cartridge comprises a first and second supporting bushes and a
  • tubular body as well as an axial rod rigidly connecting the first and
  • the second axial bush is connected with the
  • the holder is provided with up to four detachable cartridges
  • the holder is provided with members
  • Each detachable cartridge comprises a means for retaining therein
  • At least one fastener means substantially a U-shaped staple.
  • each detachable cartridge includes at least one means for
  • This means contains a flexible pusher, flexible in lateral
  • the tubular body of this endovascular apparatus includes a first
  • the third control means with means for imparting progressive movement
  • the control mechanism of this endovascular apparatus has at least
  • first control means at least one second control means and at least one
  • control mechanism may be provided with
  • the described endovacular apparatus has a first connecting means
  • stent-graft from the apparatus which may be mechanical or hydraulic.
  • the detachable cartridge of the endovascular apparatus has a
  • this recess is
  • Each detachable cartridge is provided with 'a means for fo ⁇ riing
  • curvilinear guiding surface has forming grooves which diverge at an
  • substantially a U-shaped staple has pointed free ends and is located in a
  • the detachable cartridge Is shaped substantially as a polyhedral
  • the detachable cartridge is provided with means for connection
  • the holder for at least one detachable cartridge may be additionally
  • These movable radial tongues may also serve as a means for
  • stent-graft for delivery and its securing on a cartridge or a holder of the
  • stent-graft adapted for anthropometric conditions of a specific patient
  • stent-graft and fix it to the walls of a blood vessel, substantially the aorta
  • each U-shaped staple enter the forming grooves on the curvilinear
  • graft wall gets sutured, via wire spirals formed from U-shaped staples, to
  • the endovascular apparatus for delivery
  • FIG. 1 shows general views of the suggested apparatus
  • FIG. 2 shows a general view of the kit of elements for assembling
  • FIG. 3 shows the general view of one of the apparatus of the
  • FIG. 4 shows the head of the first embodiment of the apparatus of
  • FIG. 5 shows a diagram of a graft or stent-graft fixation within the
  • FIG. 6 shows a general view of the suggested removable
  • FIG. 7 - 10 show successive stages of shaping a staple while it is
  • FIG. 11 shows a general view of the second embodiment of the
  • FIG. 12 shows a general view of the working part of the second
  • FIG. 13 shows the cartridge of the second embodiment of the
  • FIG. 14 show general views of the control mechanism according
  • FIG. 15 - 16 show two cartridge embodiments with movable
  • FIG. 17 - 18 show general views of the third embodiment of the
  • FIG. 19 - 20 show general views of the working part of the third
  • FIG. 21 - 22 show general views of the working part of the third
  • FIG. 23 shows the general view of a detachable cartridge
  • FIG. 24 shows the general view of a detachable cartridge
  • FIG. 25 shows the general view of a control mechanism of the
  • FIG. 26 shows the longitudinal section of a control mechanism of
  • FIG. 27 shows a diagram of performing the suggested method.
  • stent-grafts to the walls of blood vessels, substantially the aorta.
  • typical apparatus 1 of this system (FIG.l) comprises: a tubular body 3, at
  • the tubular body 3 includs a first,
  • the kit comprises: a set of removable cartridges 23,
  • the kit further comprises
  • Device 51 for delivery and fixation of grafts or stent-grafts shown in FIG. 3, 4.
  • Device 51 for delivery and fixation of grafts or stent-grafts 53 contains:
  • device 51 contains control mechanism 63, as well as a first
  • removable cartridge 55 (not shown in the drawings). Part of these
  • Removable cartridge 55 (FIG. 6) is intended to receive therein at
  • U-shaped staple 57 Is located in
  • the removable cartridge so as to progressively extend therefrom and be
  • cartridge 55 Is provided with
  • staple 57 has free pointed ends 71 facing the means 73 for shaping this
  • U-shaped staple 57 is located in removable cartridge 55 to
  • the means for retaining in removable cartridge 55 at least one
  • fastener means - U-shaped staple 57 is located lengthwise of removable
  • U-shaped staple 57 (FIG. 6) Is a flexible pusher 77 which Is flexible in
  • Each apparatus of the system further Includes control mechanism
  • FIG. 3 provided with at least one first control means 79, at least one
  • control mechanism 63 is associated with holder 59 for at least one
  • bearing member 85 which is flexible in lateral
  • First confrol means
  • 79 serves to control the deployment of delivered graft or stent-graft 53
  • second control means 81 serves to confrol aforesaid means 61
  • third control means 83 serves to control the
  • First connecting means 65 serves to operatively connect
  • first control means 79 with the means for controlling the deployment of a
  • graft or stent-graft such as a hydraulic balloon (not shown in
  • Second connecting means 67 (FIG. 3) is intended for
  • third connecting means 69 serves for
  • First connecting means 65 for operative connection of first
  • control means 79 with the means for controlling the deployment of a
  • delivered graft or stent-graft 53 may be hydraulic, such as a hydraulic
  • Second connecting means 67 for operative connection of second
  • control means 81 with means 61 for changing the spatial position of at
  • At least one cartridge 55 relative to holder 59 may be hydraulic, such as a
  • means - U-shaped staple 57 may be mechanical or electrical, such as a
  • Control mechanism 63 with at least one first control means 79, at
  • shaped staple 57 is located in its recess 91 in frictlona ⁇ contact with
  • Recess 91 In removable cartridge 55 is symmetrical about its
  • the cartridge is provided with a means for shaping U-shaped
  • This means is shaped as a curved guiding surface 73 which
  • Curved guiding surface 73 is provided with
  • U-shaped staple 57 has pointed free ends 71 (FIG. 6) and is
  • pointed ends 71 face the corresponding shaping grooves 97 on curved
  • Shaping grooves 97 diverge at an acute angle from
  • At least one removable cartridge 55 may serve as
  • FIG. 3, 4 a means for securing a delivered graft or stent-graft
  • Removable cartridge 55 may also be used as a means for deployment of a
  • FIGS. 11- 16 may be used for delivery and fixation of
  • apparatus 101 (FIG. 11) comprises: cartridge 103, wherein there are
  • first connecting means 111 second connecting means 113 and third
  • FIG. 12 shows a general view of the apparatus working part
  • Cartridge 103 Is intended for receiving U-shaped
  • the cartridge 3 and holder 7 may be
  • [ ⁇ l ⁇ l] Cartridge 103 (FIG. 12, 13) comprises a means for retaining
  • Cartridge 103 further includes at least one means
  • cartridge 103 is
  • this means comprising a curvilinear
  • U-shaped staple 105 is located in carfridge 103 in recess 125 and
  • U-shaped staple I05 has free
  • U-shaped staple I05 Is located in recess 125 of carfridge
  • the cartridge body further contains slots 131 for mounting sliding
  • lid 117 as well as longitudinal duct 133 to locate flexible pusher
  • U- shaped staple 105 is disposed in Its recess 125 in
  • Curvilinear guiding surface 123 has forming grooves 135, 137
  • U-shaped staple 105 having pointed free ends 129 is disposed in
  • Cartridge 103 is further provided with a means for securing the
  • This means contains substantially movable
  • delivered graft or stent-graft is performed by sinking movable radial
  • the apparatus has a control mechanism 109 with body 141 and
  • handle 1 3 provided at least with one first control means 145, at least one
  • Control mechanim 109 is associated with tubular holder 107 for •
  • tubular bearing member 151 which is flexible in lateral
  • mechanism 109 first
  • control means 145 serves to control the securing of a delivered graft or
  • Second control means 147 serves to control the
  • third control means 149 serves to control the extension of fastener
  • control means 153 may be also provided with an additional control means 153 to control, if
  • suggested apparatus 101 includes a first, second and
  • connecting means 111 serves for operative connection of first confrol
  • Second connecting means 113 is intended for operative
  • third connecting means 115 serves for operative connection of third
  • control means 149 with the means for imparting progressive motion to
  • the fastener means - U- shaped staple 105.
  • First connecting means 111 may be mechanical or hydraulic. This
  • first and second control means 145 and 147 control the extension and sinking of movable radial tongues 139 (FIG. 11,
  • means contain a mechanical member, such as a tube having longtudinal
  • rigidity and lateral flexibility In the other embodiment it may be a
  • hydraulic line 161 for delivering fluid to balloon 159 and for removing
  • the connecting means 115 serves to control, via third control
  • connecting means 115 Is electrical, such as a metal member with shape
  • Control mechanism 109 may be supplied with detachable
  • This apparatus 201 comprises (FIG. 17 - 18) : at least one
  • detachable carfridge 203 with at least one fastener means, substantially
  • control mechanism 209 as well as a tubular body including a first, second
  • Endovascular apparatus 201 has a control mechanism 209 with at
  • control means 217 at least one second control means 219 and at
  • control means 221 (FIG. 17, 18). If necessary, control
  • mechanism 209 may be provided with detachable additional sections for
  • FIG. 19 - 22 show two embodiments of the working part of the
  • FIG. 19 - 20 show an embodiment of
  • FIG. 21 - 22 show an
  • Each detachable cartridge 203 is provided at
  • sliding lid 223 serves as with a sliding lid 223 and flexible pusher 225.
  • Sliding lids 223 serve as
  • Flexible pushers 225 flexible in lateral direction and rigid in longitudinal
  • FIG. 23, 24 has a body 227 provided with a recess 229 for receiving at
  • At least one fastener means substantially U-shaped staple 2 ⁇ 5, slots 231 for
  • U-shaped staple 205 is located
  • recess 229 is symmetric about the longitudinal axis of cartridge 203 and parallel with its outer
  • Each detachable cartridge 203 is provided with a means for
  • This means contains a curvilinear guiding surface 237 connecting
  • the curvilinear guiding surface 237 has
  • shape staple 205 has pointed free ends 243 and is located in recess 229 of
  • Detachable cartridge 203 is shaped substantially as a polyhedral,
  • a tetrahedral prism 245 (FIG. 12), with two skewed lateral
  • this acute angle is located on the longitudinal axis of holder 207 for
  • detachable cartridges 203 To provide tighter arrangement of detachable
  • Detachable cartridge 203 Is provided with means for connection
  • tetrahedral prism 245 and are integral therewith.
  • Holder 207 in both embodiments contains a first
  • First supporting bush 259 is rigidly mounted at
  • this link is flexible In lateral direction and rigid in longitudinal direction
  • FIG. 21 - 22 show an embodiment of endovascular apparatus 201
  • Movable radial tongues 269 may also serve as a means
  • control mechanism 209 (FIG. 21 - 22).
  • Control mechanism 209 is shown in more detail in FIG. 25, 26. It
  • first control means 217 is provided with first control means 217, second control means 219, and
  • First control means - arm 217 serves to actuate
  • means - handle 219 serves to actuate the suction of working fluid from
  • slider 279 (FIG. 26) serves to control the extension of U-
  • second confrol means 217 and 219 may be located in detachable
  • control sections connected with control mechanism 209 or disposed
  • the suggested endovascular apparatus 201 has a first connecting
  • This means 211 may be mechanical, such as
  • a wire link may also contain a hydraulic line (not shown in the
  • control means 219 with means for securing a delivered graft or stent-graft
  • connecting means 213 may be also mechanical, such as a wire link. It
  • fluid receptacle (not shown in the drawings) may be the same, whereas
  • first and second confrol means 217 and 219 - separate, independant
  • Endovascular apparatus 201 has also a third connecting means
  • Third connecting means 215 may be mechanical,
  • Third connecting means 215 may be also electrical, such as a rod or tube made from a material with memory effect
  • FIG.27 present invention
  • stent-graft for delivery and its securmg on a cartridge or a holder of the
  • kit 21 of standardized elements is assembled from kit 21 of standardized elements.
  • each U-shaped staple 205 205 enter the forming grooves 239, 241 on the curvilinear guiding surface

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Animal Behavior & Ethology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Vascular Medicine (AREA)
  • Cardiology (AREA)
  • Transplantation (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Prostheses (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

L'invention a trait aux techniques médicales. Elle concerne plus particulièrement des procédés et des systèmes permettant de fixer des dispositifs endovasculaires tels que des greffes ou des endoprothèses-greffes, aux parois de vaisseaux sanguins, depuis l'intérieur des vaisseaux vers leur surface extérieure. Un système endovasculaire assure l'apport et la fixation de greffes ou d'endoprothèses-greffes aux parois de vaisseaux sanguins, notamment l'aorte. Ce système comprend un corps tubulaire, au moins une cartouche détachable pourvue d'au moins un moyen de fixation, un élément de retenue destiné à au moins une cartouche détachable, un mécanisme de commande ainsi qu'un premier, un deuxième et un troisième moyen connecteur. L'invention concerne aussi un procédé d'apport et de fixation d'une greffe ou d'une endoprothèse-greffe à la paroi d'un vaisseau sanguin, depuis l'intérieur de celui-ci.
PCT/IL2005/000115 2004-02-19 2005-02-01 Systeme endovasculaire et procede d'apport et de fixation de dispositifs intravasculaires Ceased WO2005079151A2 (fr)

Applications Claiming Priority (6)

Application Number Priority Date Filing Date Title
IL160458 2004-02-19
IL160457 2004-02-19
IL16045704 2004-02-19
IL16045904 2004-02-19
IL16045804 2004-02-19
IL160459 2004-02-19

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Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2009094189A1 (fr) * 2008-01-24 2009-07-30 Medtronic, Inc. Systèmes de mise en place et procédés d'implantation de valvules cardiaques prothétiques
US20100019016A1 (en) * 2006-03-23 2010-01-28 Edoga John K Vascular Anastomotic Staplers
EP3888601A1 (fr) * 2020-01-31 2021-10-06 DePuy Synthes Products, Inc. Système pour faciliter l'administration d'un dispositif de traitement intravasculaire mécanique
US11259919B2 (en) 2008-01-24 2022-03-01 Medtronic, Inc. Stents for prosthetic heart valves
US11951007B2 (en) 2008-01-24 2024-04-09 Medtronic, Inc. Delivery systems and methods of implantation for prosthetic heart valves

Family Cites Families (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5749918A (en) * 1995-07-20 1998-05-12 Endotex Interventional Systems, Inc. Intraluminal graft and method for inserting the same
US5968053A (en) * 1997-01-31 1999-10-19 Cardiac Assist Technologies, Inc. Method and apparatus for implanting a graft in a vessel of a patient
DE19731834A1 (de) * 1997-07-24 1999-06-17 Ernst Peter Prof Dr M Strecker Implantationsvorrichtung
CA2344252A1 (fr) * 1998-09-18 2000-03-30 United States Surgical Corporation Applicateur de fixation endovasculaire
US7351258B2 (en) * 2001-04-20 2008-04-01 The Research Foundation Of State University Of New York At Stony Brook Apparatus and method for fixation of vascular grafts

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20100019016A1 (en) * 2006-03-23 2010-01-28 Edoga John K Vascular Anastomotic Staplers
WO2009094189A1 (fr) * 2008-01-24 2009-07-30 Medtronic, Inc. Systèmes de mise en place et procédés d'implantation de valvules cardiaques prothétiques
US11083573B2 (en) 2008-01-24 2021-08-10 Medtronic, Inc. Delivery systems and methods of implantation for prosthetic heart valves
US11259919B2 (en) 2008-01-24 2022-03-01 Medtronic, Inc. Stents for prosthetic heart valves
US11607311B2 (en) 2008-01-24 2023-03-21 Medtronic, Inc. Stents for prosthetic heart valves
US11951007B2 (en) 2008-01-24 2024-04-09 Medtronic, Inc. Delivery systems and methods of implantation for prosthetic heart valves
EP3888601A1 (fr) * 2020-01-31 2021-10-06 DePuy Synthes Products, Inc. Système pour faciliter l'administration d'un dispositif de traitement intravasculaire mécanique
US11992241B2 (en) 2020-01-31 2024-05-28 DePuy Synthes Products, Inc. System to assist delivery of a mechanical intravascular treatment device

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