US20090143759A1 - Methods, Devices, Kits and Systems for Defunctionalizing the Cystic Duct - Google Patents

Methods, Devices, Kits and Systems for Defunctionalizing the Cystic Duct Download PDF

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US20090143759A1
US20090143759A1 US12277338 US27733808A US2009143759A1 US 20090143759 A1 US20090143759 A1 US 20090143759A1 US 12277338 US12277338 US 12277338 US 27733808 A US27733808 A US 27733808A US 2009143759 A1 US2009143759 A1 US 2009143759A1
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canceled
device
method
cystic duct
further
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Jacques Van Dam
J. Craig Milroy
R. Matthew Ohline
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TREUS MEDICAL Inc
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    • AHUMAN NECESSITIES
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    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/1114Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
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    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • AHUMAN NECESSITIES
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2250/0014Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0039Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in diameter
    • AHUMAN NECESSITIES
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    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/02Holding devices, e.g. on the body
    • A61M2025/0213Holding devices, e.g. on the body where the catheter is attached by means specifically adapted to a part of the human body
    • A61M2025/0233Holding devices, e.g. on the body where the catheter is attached by means specifically adapted to a part of the human body specifically adapted for attaching to a body wall by means which are on both sides of the wall, e.g. for attaching to an abdominal wall
    • AHUMAN NECESSITIES
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    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • A61M2025/1043Balloon catheters with special features or adapted for special applications
    • A61M2025/1072Balloon catheters with special features or adapted for special applications having balloons with two or more compartments
    • AHUMAN NECESSITIES
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    • A61M25/1002Balloon catheters characterised by balloon shape
    • AHUMAN NECESSITIES
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    • A61M29/00Dilators with or without means for introducing media, e.g. remedies
    • A61M29/02Dilators made of swellable material

Abstract

The application discloses devices, systems, kits and methods for treating biliary disease. Devices comprise, for example, a component configurable for deployment between within a cystic duct of a patient which has a proximal end and a distal end. In some embodiments, a lumen may also extend therethrough.

Description

    CROSS-REFERENCE
  • This application claims the benefit of U.S. Provisional Application No. 60/991,682, filed Nov. 30, 2007, and Application No. 61/033,368 filed Mar. 3, 2008, which application is incorporated herein by reference.
  • This application has related subject matter to U.S. Utility patent application Ser. No. 12/______, filed Nov. ______, 2008, entitled “Methods, Devices, Kits and Systems for Defunctionalizing the Gallbladder” by Jacques Van Dam, J. Craig Milroy, and R. Matthew Ohline (identified as Attorney Docket No. 36233-701.202) and U.S. Utility patent application Ser. No. 12/______, filed Nov. ______, 2008, entitled, “Biliary Shunts, Delivery Systems, Methods of Using the Same, and Kits Therefor” by Jacques Van Dam, J. Craig Milroy, and R. Matthew Ohline (identified as Attorney Docket No. 36233-701.201), which applications are incorporated herein by reference.
  • FIELD OF THE INVENTION
  • The invention described in this patent application addresses challenges confronted in the treatment of biliary disease. Biliary disease includes conditions affecting the gallbladder, cystic duct, and common bile duct.
  • BACKGROUND OF THE INVENTION Biliary System Function and Anatomy
  • Bile is a greenish-brown digestive fluid produced by the liver 10 illustrated in FIG. 1, and is vital for the digestion of fatty foods. Bile is secreted by liver cells and collected by a network of ducts that converge at the common hepatic duct 12. While a small quantity of bile drains directly into the lumen of the duodenum 30 (the section of small intestine immediately downstream of the stomach), most travels through the common hepatic duct 12 and accumulates in the lumen of the gallbladder 14. Healthy gallbladders are pear-shaped sacs with a muscular wall that, on average, measure 10 cm in length and can store approximately 50 ml of fluid within its lumen. When fatty foods are ingested, the hormone cholecystokinin is released, which causes the gallbladder 14 to contract. Contraction of the gallbladder 14 forces bile to flow from the gallbladder 14, through the cystic duct 16, into the common bile duct 18, out the papilla 28, and finally into the duodenum 30 of the small intestine. Here, it mixes and reacts with the food that exits the stomach. The Sphincter of Oddi 26 controls secretions from the liver, pancreas 24, and gallbladder 14 into the duodenum 30 of the small intestine. The opening on the inside of the descending duodenum 30 after the Sphincter of Oddi 26 is called the major duodenal papilla 28 (of Vater). Together, the biliary ducts, the gallbladder 14, the cystic duct 16 and the common bile duct 18 comprise the biliary system (FIG. 1).
  • The pancreas 24 is a gland organ in the digestive and endocrine system of vertebrates. It is both an endocrine gland (producing several important hormones, including insulin, glucagon, and somatostatin), as well as an exocrine gland, secreting pancreatic juice containing digestive enzymes that pass to the small intestine. These enzymes help in the further breakdown of the carbohydrates, protein, and fat in the chyme. The pancreatic duct 22, or duct of Wirsung, is a duct joining the pancreas 24 to the common bile duct 18 to supply pancreatic juices which aid in digestion provided by the exocrine pancreas. The pancreatic duct 22 joins the common bile duct 18 just prior to the major duodenal papilla 28, after which both ducts perforate the medial side of the second portion of the duodenum 30 at the major duodenal papilla.
  • Biliary Disease:
  • The most common problem that arises in the biliary system is the formation of gallstones, a condition called cholelithiasis. Approximately 20 million Americans have gallstones, and about 1-3% will exhibit symptoms in any given year. In the U.S., gallstones are more common among women, with 25% of women having gallstones by the age of 60 and 50% by the age of 75, Pregnancy and hormone replacement therapy increase the risk of forming gallstones. Prevalence is lower for American men: approximately 25% will develop gallstones by the age of 75. In the U.S., gallstones are responsible for the highest number of hospital admissions due to severe abdominal pain.
  • Gallstones 20, 20′ are most often composed of cholesterol, but may also be formed from calcium bilirubinate, in which case they are called pigment stones. They range in size from a few millimeters to several centimeters, and are irregularly shaped solids resembling pebbles. They can form in the gallbladder 14, cystic duct 16, and/or the common bile duct 18 (FIG. 2). By themselves, gallstones 20 do not necessarily result in disease states. This is the case 90% of the time. However, stones can cause infection and inflammation, a condition known as cholecystitis, which is generally the result of restricting or blocking the flow of bile from the gallbladder 14 and common bile duct 18, or the fluids secreted by the pancreas 24.
  • Gallbladder disease may be chronic, and patients who suffer from this may periodically experience biliary colic. Symptoms include pain in the upper right abdomen near the ribcage, nausea, and/or vomiting. The pain may resolve within an hour of onset, may prove unresponsive to over-the-counter medicines, and may not decrease with changes of position or the passage of gas. Recurrence is common, with pain often recurring at the same time of day, but with frequency of less than once per week. Fatty or large meals may cause recurrence several hours after eating, often awakening the patient at night. Patients may elect to suffer from these symptoms for very long periods of time, such as years or even decades.
  • Patients with chronic cholecystitis have gallstones and low-grade inflammation. Untreated, the gallbladder 14 may become scarred and stiff over time, leading to a condition called dysfunctional gallbladder. Patients who have chronic cholecystitis or dysfunctional gallbladder may experience gas, nausea, and abdominal discomfort after meals, and chronic diarrhea.
  • Acute cholecystitis (a surgical emergency) develops in 1-3% of those with symptomatic gallstone disease, and is due to obstruction of the common bile duct 18 or cystic duct 16 by stones or sludge. Symptoms are similar to biliary colic, though they are more severe and persistent. Pain in the upper right abdomen can be constant and severe, the intensity may increase when drawing breath, and it may last for days. Pain may radiate to the back, under the breastbone or the shoulder blades, and it may be perceived on the left side of the abdomen. In addition to nausea and vomiting, one third of patients experience fever and chills. Complications from acute cholecystitis can be serious and life threatening, and include gangrene, abscesses, perforation of the gallbladder 14 which can lead to bile peritonitis, pus in the gallbladder wall (empyema), fistulae, and gallstone ilius (when a gallstone creates a blockage in the small intestine).
  • When gallstones 20′ become lodged in the common bile duct 18 (FIG. 2), the condition is known as choledocholithiasis. Symptoms for this condition include pain, nausea and vomiting, and some patients develop jaundice, have dark urine and/or lighter stools, rapid heartbeat, and experience an abrupt drop in blood pressure. These symptoms can also be accompanied by fever, chills, and/or severe pain in the upper right abdomen. Complications from choledocholithiasis can also be very serious, and include infection of the common bile duct 18 (cholangitis) and inflammation of the pancreas 24 (pancreatitis).
  • A smaller patient population suffers from gallbladder disease that occurs in the absence of gallstones. This condition, called acalculous gallbladder disease, can also be chronic or acute. Chronic acalculous gallbladder disease, also called biliary dyskinesia, is thought to be caused by motility disorders that affect the gallbladder's ability to store and release bile. Acute acalculous gallbladder disease occurs in patients who suffer from other serious illnesses which can lead to inflammation of the gallbladder 14 because of a reduction in the supply of blood to the gallbladder 14 or a reduced ability to contract and empty bile into the duodenum 30.
  • Cancer can also develop in the gallbladder 14, though this condition is rare. Gallstones have been found in 80% of patients with gallbladder cancer. Gallbladder cancer typically develops from polyps, which are growths inside the gallbladder 14. When polyps 15 mm across or larger are observed, the gallbladder is removed as a preventive measure. Polyps smaller than 10 mm are widely accepted as posing low risk and are not generally removed. When detected early, before the cancer has spread beyond the mucosa (inner lining) of the gallbladder, the 5-year survival rate is approximately 68%. However, gallbladder cancer is not usually detected until patients are symptomatic, by which time the disease is more advanced.
  • Treatment of Biliary Disease:
  • The most effective treatment for biliary disease has been surgical removal of the gallbladder 14, a procedure called cholecystectomy. Surgical removal of the gallbladder 14 is indicated for patients who experience a number of less severe gallstone attacks, cholecystitis, choledocholithiasis, pancreatitis, acalculous biliary pain with evidence of impaired gallbladder 14 emptying, those at high risk for developing gallbladder cancer, and those who have previously undergone endoscopic sphincterotomy for common bile duct stones. Other treatment modalities exist and are frequently used, but gallbladder disease tends to recur in the majority of patients who forgo cholecystectomy and pursue alternatives. Removal of the gallbladder 14 is highly successful at permanently eliminating biliary disease. Cholecystectomy is one of the most commonly performed procedures on women. The gallbladder 14 is not an essential organ, and after a period of adjustment post surgery, patients tend to return to more or less normal digestive function.
  • Cholecystectomy can be performed either as open surgery, which requires a single larger incision in the upper right abdomen, or laparoscopic surgery, in which several small instruments are inserted through much smaller incisions in the abdomen. Approximately 80% of cholecystectomies are performed laparoscopically. The primary benefits of this minimally invasive approach are faster recovery for the patient, and a reduction in overall healthcare costs. Patients who receive laparoscopic cholecystectomy are usually released the same day. By contrast, patients receiving open cholecystectomies typically spend 5-7 days in a hospital before release. 5-10% of laparoscopic procedures convert to open procedures when difficulties arise, such as injury to major blood vessels, inadequate access, inadequate visualization, previous endoscopic sphincterotomy, and thickened gallbladder wall. Complications from cholecystectomy (open or laparoscopic) include bile duct injuries (0.1-0.5% for open, 0.3-2% with a declining trend for laparoscopic), pain, fatigue, nausea, vomiting, and infection. In up to 6% of cases, surgeons fail to identify and remove all gallstones present.
  • In some cases, the degree of infection and inflammation prevents patients from undergoing immediate cholecystectomy. In these cases, the gallbladder 14 must be treated with antibiotics and anti-inflammatory agents, and drained through a tube into a reservoir outside the abdomen. Placement of this tube occurs in a procedure called percutaneous cholecystostomy, in which a needle is introduced to the gallbladder 14 through the abdomen, fluid is withdrawn, and a drainage catheter is inserted. This catheter drains into an external bag which must be emptied several times a day until the tube is removed. The drainage catheter may be left in place for up to 8 weeks. In cases where no drainage catheter is inserted, the procedure is called gallbladder aspiration. Since no indwelling catheter is placed, the complication rate for gallbladder aspiration is lower than that of percutaneous cholecystostomy.
  • Treatment methodologies other than cholecystectomy include expectant management, dissolution therapy, endoscopic retrograde cholangiopanctreatograpy (ERCP) with endoscopic sphincterotomy, and extracorporeal shockwave lithotripsy (ESWL).
  • Expectant management is appropriate for patients who have gallstones but no symptoms, and for non-emergency cases with less severe symptoms. This approach is not recommended when patients are in high risk categories (e.g. high risk for gallbladder cancer) or have very large gallstones (e.g. greater than 3 cm).
  • Oral dissolution therapy involves the administration of pills containing bile acids that can dissolve gallstones. This approach is only moderately effective, and the rate of recurrence of gallstones after completion of treatment is high. It is not appropriate for patients with acute inflammation or stones in the common bile duct (more serious conditions). Dissolution therapy tends to be more effective for patients with cholesterol stones, and is sometimes used in conjunction with lithotripsy. Despite its relative ineffectiveness, it is costly: treatment can last up to 2 years and the drugs cost thousands of dollars per year.
  • Related to oral dissolution therapy is contact dissolution, a procedure that involves injection of a solvent such as methyl tert-butyl ether (MTBE) directly into the gallbladder 14. This approach is highly effective at dissolving gallstones, but patients may experience severe burning pain.
  • ERCP (endoscopic retrograde cholangiopancreatograpy) is a procedure in which an endoscope is introduced through the mouth of a patient, past the stomach to the papilla 28, where the common bile duct 18 empties into the duodenum 30. The overall goal of the procedure is to insert instruments and tools into the common bile duct 18 via the papilla 28 in order to treat biliary disease. Typically, endoscopic sphincterotomy is performed, which is a procedure that enlarges the opening of the papilla 28 in the small intestine. This can be accomplished surgically or via balloon dilation. Contrast agent is introduced into the common bile duct 18 to visualize the biliary tree fluoroscopically. Tools for clearing blockages, such as mechanical lithotripsy devices, can be deployed to crush gallstones and remove the resulting debris. Drainage catheters and stents may also be inserted to facilitate the drainage of bile past obstructions. Complications from this challenging procedure occur at a rate of 5-8%, and include recurrence of stone formation, pancreatitis, infection, bleeding, and perforation.
  • Extracorporeal shockwave lithotripsy (ESWL) is a technique in which focused, high-energy ultrasound is directed at the gallbladder 14. The ultrasound waves travel through the soft body tissue and break up the gallstones. The resulting stone fragments are then usually small enough to pass through the bile duct into the small intestine. Oral dissolution therapy is often used in conjunction with ESWL. This treatment is not in common use, as less than 15% of the patient population are good candidates. However, ESWL is used to treat patients who are not candidates for surgery. Complications from ESWL include pain in the gallbladder area, pancreatitis, and failure of the gallstone fragments to pass into the small intestine.
  • SUMMARY OF THE INVENTION
  • Devices for treating biliary disease are disclosed. Suitable devices comprise, for example, a component configurable for placement within a cystic duct of a biliary system of a patient which has a proximal end 102 and a distal end 104. In some aspects, a means adaptable for positioning within a lumen of a cystic duct of a biliary system of a patient is provided which has a proximal end and a distal end. Devices can further comprise a delivery mechanism for delivering a substance, such as bioresorbable materials or activatable materials. The means for positioning within a lumen can further provide, for example, a means for delivering a substance, such as bioresorbable materials or activatable materials. In some instances, the devices are adaptable and configurable to be removable. Additionally, or alternatively the device are adaptable and configurable to be expandable. Moreover, the devices can be configurable such that the device can achieve one or more configurations, such as a deployment configuration, a delivery configuration and a final configuration. In some embodiments, devices comprise a variable profile, for example, the device can be configurable to be variable along a cross-sectional area of the device. In some aspects, the devices are configurable for deployment by, for example, an endoscope, or by a guidance element such as a guidewire or guidance catheter. In other aspects a lumen can be provided that is configurable to provide restrictable fluid flow, for example by using one or more fluid control components. Devices can also be configured to comprise a valve. Suitable valves include, for example, a flow-restrictor valve or a one-way valve. Moreover, a means for controlling a material can be provided, such as a valve, including, for example, a flow-restrictor valve or a one-way valve. In some configurations of the device it may be desirable for the device to be flexible.
  • Still another aspect is directed to a biliary disease treatment device comprising: an implant adapted to be delivered by an endoscope, or guidance element such as a guidewire or guidance catheter to a gastrointestinal site in proximity to a gallbladder, and further adapted to form a conduit between the gastrointestinal site and the gallbladder. Devices can further comprise a delivery mechanism for delivering a substance, such as bioresorbable materials or activatable materials. In some instances, the devices are adaptable and configurable to be removable. Additionally, or alternatively the device are adaptable and configurable to be expandable. Moreover, the devices can be configurable such that the device can achieve one or more configurations, such as a deployment configuration, a delivery configuration and a final configuration. In some embodiments, devices comprise a variable profile, for example, the device can be configurable to be variable along a cross-sectional area of the device. In some aspects, the devices are configurable for deployment by, for example, an endoscope, or by a guidance element such as a guidewire or guidance catheter. In other aspects the lumen is configurable to provide restrictable fluid flow, for example by using one or more fluid control components. Devices can also be configured to comprise a valve. Suitable valves include, for example, a flow-restrictor valve or a one-way valve. In some configurations of the device it may be desirable for the device to be flexible.
  • Yet another aspect is directed to a biliary disease treatment device comprising: an implant adaptable to be delivered by percutaneous means, to a gastrointestinal site in proximity to a gallbladder, and further adapted to form a conduit means between the gastrointestinal site and the gallbladder. Percutaneous means includes, for example, guidewire, guiding catheter or endoscope.
  • Aspects of the invention also include methods of delivering a device to treat biliary disease. The methods of device delivery comprise, for example, using an endoscope to place guidance element, such as a guidewire or guidance catheter, between an access lumen and a gallbladder; inserting a delivery catheter over the guidance element and into the gallbladder; delivering a cystic duct defunctionalizing device on the guidance element; and positioning the cystic duct defunctionalizing device within a cystic duct. Additional method steps can include the step of passively retaining a distal end of the guidewire in the gallbladder while the guidewire is used to deliver additional elements. Moreover, the method can include the step of retaining a distal end of the guidewire within the gallbladder, retaining a distal end of the guidewire within the cystic duct, and/or retaining a distal end of the guidewire within the common bile duct. Additionally, gallstones can be removed through the created lumen, if desired. Additionally, in some instances, the method can include the step of localizing the gallbladder via endoscopic ultrasound and/or altering or altering and removing gallstones. It will be appreciated by those skilled in the art, that in some instances, it may be desirable to clear obstructions within the gallbladder. Moreover, it will be appreciated that the methods involved herein facilitated treatment of biliary disease without removal of the gallbladder. In still other methods, it may be desirable to also visualize a treatment area, before, during, or after any of the other method steps. In still other methods, a biological duct can be formed in situ from a patient's tissue. Moreover, the cystic duct defunctionalizing device can be changed, if desired, from a delivery configuration to a deployment configuration, from a delivery configuration to a final configuration, and/or from a deployment configuration to a final configuration. In still other aspects of the method, a cross-sectional profile of the cystic duct defunctionalizing device can be reduced. In other aspects, a valve can be operated to restrict fluid flow. In some instances it may be desirable to defunctionalize the cystic duct in situ. Such defunctionalizing can be achieved by, for example, delivering a substance into a space within the cystic duct. As will be appreciated by those skilled in the art, a wide range of substances can be delivered, including, for example, gels, foams, sclerosing agents, adhesives, bioadhesives, anti-inflammatory and inflammatory agents. Moreover, some substances can be selected that are capable of activation in situ. The amount of substance delivered can vary, as desired, and can include delivering an amount sufficient to fill, or substantially fill, the lumen of the cystic duct, or in the case of an activatable substance, an amount sufficient to result in an activated substance amount sufficient to fill, or substantially fill, the lumen of the cystic duct. In other aspects of the method, the step of defunctionalizing the cystic duct is achievable by delivering a plug or device into a space, or lumen, within the cystic duct. Suitable plugs may be configurable either internally or externally to seat within the lumen of the cystic duct. Moreover plugs or devices can further comprise one or more thread profiles, ridges or steps about its exterior surface adapted to aid in seating the device within the lumen of the duct. The plugs or devices can further comprise a valve.
  • Another aspect of the invention is directed to a kit for treating biliary disease. Kits include, for example, one or more devices configurable to be positioned within a cystic duct; and optionally a compound for delivery to a tissue. Other components of the kit include, one or more of, a catheter, a guidewire, an ablation device, a sclerosing agent, antibiotic agents, inflammatory agents, anti-inflammatory agents, biocompatible gels, biocompatible foams, activatable materials, scissors, scalpels, swabs, syringes, hemostats, lubricants, needles, snares, antiseptics, and anesthetics.
  • Still another aspect of the invention is directed to a method of treating biliary disease comprising: accessing a lumen associated with a gallbladder; defunctionalizing a cystic duct. An aspect of the method enables the gallbladder to be left in situ. Additionally, the step of defunctionalizing the cystic duct can further comprise the step of delivering a substance to at least one of the cystic duct or the gallbladder. An amount of substance can be delivered such that it occupies, or substantially occupies the lumen, or is activated to occupy or substantially occupy the lumen of the cystic duct. One or more suitable substances can be delivered including, for example, antibiotics, inflammatory agents, and anti-inflammatory agents. In some instances, the method includes the step of preventing bile from entering the gallbladder lumen. Additionally, the method can include the step of localizing the gallbladder via endoscopic ultrasound. In other aspects of the method, the step of accessing the gallbladder is achieved via the gastrointestinal tract, such as by accessing the gastrointestinal tract at a duodenum. Additional aspects of the method include, for example, one or more of sclerosing, necrotizing or ablating tissue. Ablation techniques can, for example, be selected from the group comprising cryoablation, thermal ablation, chemical ablation, radio frequency ablation, ultrasound ablation, and microwave ablation. In some instances, a fluid can be delivered wherein the fluid is delivered, for example, with an angular orientation, moreover fluid can be delivered with at least one of a 360 degree radial pattern, a sharp stream, and a cone shape. Still further, the fluid can be delivered with a device comprising an articulating member or a means for articulating. In some aspects of the method it may be desirable to apply a vacuum to a lumen of the cystic duct or the gallbladder, and/or apply an adhesive to the lumen of the cystic duct. Additionally, in some instances the step of defunctionalizing the cystic duct may further comprise physically blocking a lumen of the cystic duct, such as with a plug, device, means for blocking or means for plugging.
  • Yet another aspect of the invention is directed to a device for treating biliary disease comprising a plug, device, means for blocking or means for plugging, adaptable and configurable to be positioned within a cystic duct of a patient having a proximal end and a distal end and is configurable either internally or externally to seat within a lumen of the cystic duct after deployment. The external configuration of the plug, device, or plugging means can be configurable to have one or more of threads, ridges, steps, or means for securing. Moreover, the ridges, steps or means for securing can be fixed or activatable. Additionally, the plug, device or plugging means can further comprise a valve, such as a one-way valve, or means for controlling or restricting a flow of fluid or flowable material. In some aspects the plug, device or plugging means can be positioned within or proximal to the cystic duct.
  • Another aspect of the invention is directed to the use of any of the devices disclosed herein for use in the treatment of biliary disease.
  • INCORPORATION BY REFERENCE
  • All publications, patents, and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication, patent, or patent application was specifically and individually indicated to be incorporated by reference.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • The novel features of the invention will be set forth with particularity in any claims presented based on this application. A better understanding of the features and advantages of the present invention will be obtained by reference to the following detailed description that sets forth illustrative embodiments, in which the principles of the invention are utilized, and the accompanying drawings of which:
  • FIG. 1 illustrates an overview of the biliary system;
  • FIG. 2 illustrates the biliary system with gallstones;
  • FIG. 3 illustrates an endoscope accessing the biliary system via the intestinal system;
  • FIGS. 4A-E illustrate cystic duct defunctionalization devices;
  • FIG. 5 illustrates a cystic duct defunctionalization device in combination with a guidewire; and
  • FIG. 6 illustrates a cystic duct plug with 1-way valve.
  • DETAILED DESCRIPTION OF THE INVENTION
  • Devices, systems, methods and kits provided herewith can obviate the need for a plurality of procedures, including, for example: 1) percutaneous cholecystostomy, 2) cholecystectomy, 3) percutaneous trans-hepatic cholangiography (PTHC), and 4) endoscopic retrograde cholangiopancreatography (ERCP). Additionally, disclosed treatment modalities enable treatment of a distal common bile duct 18 obstruction, e.g. secondary to pancreatic carcinoma, cholagiocarcinoma, and/or ampullary carcinoma. As will be appreciated by those skilled in the art, the conventional standard of care for treating biliary disease has been surgical removal of the gallbladder 14 and closure of the cystic duct 16. While this has proven to be an effective mechanism for permanently eliminating biliary disease and its recurrence, the present invention seeks to accomplish the same end in a less invasive and less costly way. This may be achieved by treating biliary disease without requiring the removal of the gallbladder 14. Methods and apparatus are described in this application that are intended to effectively treat biliary disease with the gallbladder 14 and cystic duct 16 left in situ by defunctionalizing the cystic duct.
  • Defunctionalization of the Cystic Duct:
  • In order to treat gallbladder 14 disease while leaving the gallbladder 14 in situ, it may be desirable to defunctionalize the cystic duct 16. The cystic duct 16 connects the gallbladder 14 and the common bile duct 18 (see FIG. 1), and is the flow path for bile into and out of the gallbladder 14. An objective of defunctionalizing the cystic duct 16 is to prevent bile from reaching the gallbladder 14. The gallbladder 14 may be otherwise unaltered, or it may be altered—e.g. a conduit or shunt may be placed for access and/or drainage, the gallbladder 14 may be defunctionalized, etc. When bile is unable to enter the cystic duct 16, and therefore the gallbladder 14, the gallbladder 14 will also be effectively defunctionalized, whether or not any other treatment is performed. Gallstones may form anywhere that bile is present in the biliary system, so preventing bile from flowing in the cystic duct 16 may prevent the formation of gallstones in the cystic duct 16 and gallbladder 14. Defunctionalization of the cystic duct 16 may be long- or short-term, temporary or permanent. The entire length of the cystic duct 16 may be defunctionalized, or it may be performed at one or more discrete locations. The treatment may be applied anywhere along the length of the cystic duct 16, from the point where it joins the common bile duct 18 to the point where it interfaces with the gallbladder 14. However, the preferred treatment location for defunctionalizing the cystic duct 16 is as close to the junction with the common bile duct 18 as possible without substantially affecting the function of the common bile duct 18.
  • In holding with the other methods and apparatus described in this application, it is most desirable to effect defunctionalization of the cystic duct 16 from within the gallbladder 14, inside the cystic duct 16, and/or inside the common bile duct 18. This eliminates the need for external, surgical access to these anatomical structures. Optionally, defunctionalization of the cystic duct 16 is achieved by the use of implements delivered endoscopically or means for accessing the cystic duct percutaneously. In some instances, directly visualizing the devices and navigational devices used may also be desirable, and may facilitate control and treatment. Visualization may be achieved by any suitable mechanism known in the art, including, for example, endoscopic ultrasound (EUS), or by using a small daughter endoscope (e.g. a cystoscope), or by using catheters incorporating small imaging sensors at the distal end (e.g. Avantis' Third Eye) and fiber optic imaging bundles (e.g. Boston Scientific's SpyGlass). Visualization and guidance may also be achieved via external imaging methods, such as fluoroscopy (with or without the use of contrast agent), ultrasound, X-ray, etc.
  • Defunctionalization of the cystic duct 16 may be accomplished by a variety of mechanisms, including, but not limited to, ablation methods (e.g. cryo-, thermal-, RF, microwave, ultrasound, etc.) and mechanical methods (e.g. plugs, stoppers, sutures, staples, clamps, clips, adhesives, bioadhesives, vacuum with adhesives/bioadhesives, vacuum without adhesives/bioadhesives, etc.). Regardless of the method used, it may be helpful to begin the process by inserting a guidance element 530, such as a guidewire, guidance catheter or any suitable means for accessing the cystic duct 16 from within the gallbladder 14, though a conduit that connects the gallbladder 14 lumen to the access lumen, e.g. at or near the duodenum 30, or from within the common bile duct 18, as may be done during ERCP. A guidance element 530 (FIG. 5) (e.g. a guidewire, guidance catheter, etc.) may be useful for inserting and navigating items into the cystic duct 16, such as ablation catheters, visualization catheters, mechanisms of treating gallstones within the cystic duct 16, devices 520 for defunctionalizing the cystic duct 16, and other mechanisms of defunctionalizing the cystic duct 16. Since the cystic duct 16 is funnel-shaped (with a larger diameter at the opening into the gallbladder 14 than at the junction with the common bile duct 18), and spirals as it progresses (an anatomical feature called the valves of Heister), it may be easily traversed with a guidance element 530, such as a guidewire or guidance catheter, from within the gallbladder 14 simply by pushing. However, the guidance element 530 may be configured or configurable to facilitate advancement. Moreover, alternate shapes of the guidance element 530 may facilitate advancement, such as a cork-screw shape, spiral shape, or a tip that is preferentially bent to one side. In these cases, successfully advancing the guidance element 530 into the cystic duct 16 may be achieved by pushing, torquing (rotating), or a combination of pushing and torquing.
  • If defunctionalization is achieved by physically blocking the cystic duct 16, a cystic duct defunctionalization device 420 serving a similar function as, for example, a bottle stopper may be used (FIG. 4A). The defunctionalization device 420 has a proximal end and a distal end. Such a device 420 may be inserted into the cystic duct 16 from the gallbladder 14, through a conduit that connects the gallbladder 14 to an access lumen such as the duodenum 30. The plug 420 may be inserted before, during, or after other treatments for inflammation, infection, gallstones, etc. have been administered or completed. The plug 420 may be left in place for a limited period of time, or permanently. The plug 420 or means for plugging the cystic duct may be comprised of any suitable biocompatible material, such as silicone, polytetrafluroethylene (PTFE), stainless steel, titanium, shape memory materials (e.g. Nitinol), etc. The device 420 may be configured or configurable to provide a means for blocking the cystic duct.
  • Devices 420 may optionally incorporate features that aid in retaining and securing the device in place. Such features may be inactive (that is, fixed and integral to or incorporated into the devices), e.g. a spiral thread pattern 422 (in which case, the devices should be rotated into position in the cystic duct 16 at installation, FIG. 4B), one or more ridges 423 (FIG. 4 c), and/or one or more backward-facing steps 424 resembling a hose barb (FIG. 4D). Each of these one or more threads 422, ridges 423, and steps 424 features enable the device 420 to be secured within the cystic duct 14. Alternately, the retaining features may be active 425 so that they may be activated once the device is in the desired position, e.g. with shape memory alloys (e.g. Nitinol) or with mechanically triggered movable elements (FIG. 4E).
  • Additionally, a plug or stopper device 620 may have one or more flow control elements, such as 1-way valves 640 which allow flow out of the gallbladder 14 and cystic duct 16, but does not allow flow into the cystic duct 16 or gallbladder 14 (FIG. 6). This may be useful in cases where drainage of the gallbladder 14 and/or cystic duct 16 is desired, and provides either a primary or secondary flow path for fluids. Additionally, activatable materials can be delivered to the cystic duct. Suitable activatable materials include, for example, sclerosing substances, gels, foams, adhesives, bioadhesives. Any of such activatable materials may be selected so that they are absorbed or break down within the body over a desired period of time. Additionally, a vacuum may be applied to the cystic duct in order to close or substantially close it. This may be done in combination with the use of any of the other techniques described herein.
  • Since stones 20 may be present in the cystic duct 16 at the time of treatment, it may be necessary to eliminate them before, during, or after defunctionalization. This may be achieved using mechanical lithotripsy, snares, chemical/contact dissolution with substances such as methyl tertiary-butyl ether (MTBE), ultrasound energy, or any other useful or effective mechanism of breaking up and/or removing gallstones. Removal of gallstones through a conduit placed in the gallbladder 14 allows clinicians to access the cystic duct 16 from the reverse direction, which is not possible with conventional techniques. This may dramatically facilitate the process of treating gallstones 20 in the cystic duct 16 and common bile duct 18, which can be difficult using conventional techniques.
  • A method of treating biliary disease involves using an endoscope 310 to access a region in the gastrointestinal (GI) tract to which the cystic duct 16 is in close proximity, locating the cystic duct 16, accessing the cystic duct 16, and then treating the underlying condition that led to the need for intervention (FIG. 3). Treatments may also include, but are not limited to: providing for drainage of the gallbladder 14 and/or the biliary tree, delivering antibiotics, inflammatory, anti-inflammatory agents (any of which may be short-term acting, fast acting, or time release), and/or other substances (e.g. adhesives, bioadhesives, etc.) and/or activatable materials to the gallbladder 14 and/or biliary tree, removing gallstones 20, facilitating the destruction and subsequent removal of gallstones, clearing obstructions, delivering catheters, delivering stents (drug coated or not drug coated), temporarily or permanently defunctionalizing the cystic duct 16, temporarily or permanently defunctionalizing the gallbladder 14. Devices and therapies can be delivered in a single treatment, with minimal likelihood of or necessity for follow-up or repeat procedures.
  • Localization of the gallbladder 14 can be performed via endoscopic ultrasound (EUS) by accessing the wall of the GI tract with an endoscope 310 as shown in FIG. 3. Localization may also be achieved by any other method that visualizes anatomical features, such as fluoroscopy, x-rays, magnetic resonance imaging (MRI), computed axial tomography (CT) scans, ultrasound imaging from outside the body, or any method of anatomical imaging and visualization.
  • Once the gallbladder 14 has been located, it may be accessed and/or treated through the wall of the GI tract 350 (or any lumen in proximity to the gallbladder 14) with tools and devices (e.g. needles, guidewires, guidance catheters, shunts, dilators, etc.) delivered through, for example, an endoscope 310. Such tools and devices may be inserted down the length of the endoscope's working channel 312, or loaded onto or near the distal end of the endoscope 310. Alternately, tools and other devices may be used that do not require the aid of the endoscope for navigation or delivery. Direct visualization may be provided by the endoscope 310 during the procedure, as well as irrigation, suction, and insufflation.
  • Though the preferred location for accessing the gallbladder lumen is the duodenum 30, it may also be readily achieved through the wall of other regions of the GI tract, such as the stomach or the jejunum, for example. Thus, any lumen in close proximity to the gallbladder 14 is a candidate for access to and treatment of the gallbladder 14 and other members of the biliary system.
  • The devices and methods disclosed herein facilitate defunctionalizing the cystic duct without the need for surgery.
  • Kits:
  • All of the devices required to deliver and install a conduit, treat and/or defunctionalize the cystic duct 16, may be packaged in a kit. Bundling all devices, tools, components, materials, and accessories needed to perform these procedures into a kit may enhance the usability and convenience of the devices, and also improve the safety of the procedure by encouraging clinicians to use the items believed to result in the best outcomes. The kit may be single-use or reusable, or it may incorporate some disposable single-use elements and some reusable elements. The kit may contain, but is not limited to, the following: implantable and/or non-implantable devices; delivery devices (e.g., needles, guidewires, guidance catheters, dilators, etc.); balloon inflation/deflation accessories; syringes; fluid flow, temperature, and pressure measurement instruments; scissors; scalpels; clips; ablation catheters; endoscopic tools (e.g. lithotripsy devices, snares, graspers, clamps, forceps, etc.). The kit may be supplied in a tray, which organizes and retains all items so that they can be quickly identified and used.
  • DESCRIPTION OF OTHER USES
  • The techniques and devices described in this application may prove beneficial in applications beyond their initial use in the treatment of biliary disease.
  • For example, they may prove to be an effective mechanism of treating cholangitis (infection of the common bile duct 18). This condition is usually bacterial, and occurs when the bile duct is blocked by gallstones 20′ or a tumor. Traditional treatment involves the insertion of a stent or drainage catheter into the common bile duct 18 to allow bile to drain into the duodenum 30 from locations above the obstruction. Placement of a conduit into the gallbladder 14 may allow for an alternate method of draining bile and/or other fluids into the duodenum 30. Any blockage in the common bile duct 18 between the entrance of the cystic duct 16 and the duodenum 30 may be treated in this way. See FIG. 2.
  • Another use of the devices and techniques described elsewhere in this application may be to create anastomoses between any body lumens in proximity to one another. This may include, but is not limited to: small bowel to small bowel anastomoses, small bowel to large bowel anastomoses, large bowel to large bowel anastomoses, and stomach to small bowel anastomoses. Additionally, creating a conduit between the stomach and other body lumens may be useful and effective for treating and/or managing obesity.
  • Another use of the devices and techniques described herein is for drainage of any body lumen into another body lumen in proximity, for example, the drainage of pancreatic pseudocysts.
  • While preferred embodiments of the present invention have been shown and described herein, it will be obvious to those skilled in the art that such embodiments are provided by way of example only. Numerous variations, changes, and substitutions will now occur to those skilled in the art without departing from the invention. It should be understood that various alternatives to the embodiments of the invention described herein may be employed in practicing the invention. It is intended that the following claims define the scope of the invention and that methods and structures within the scope of these claims and their equivalents be covered thereby.

Claims (87)

  1. 1. A device for treating biliary disease comprising: a component configurable for placement within a cystic duct of a biliary system of a patient which has a proximal end and a distal end.
  2. 2. The device of claim 1 further comprising a delivery mechanism for delivering a substance.
  3. 3. The device of claim 1 wherein the device is formed from at least one of a bioresorbable material or an activatable material.
  4. 4. The device of claim 1 wherein the device is removable.
  5. 5. The device of claim 1 wherein the device is expandable.
  6. 6. The device of claim 1 further comprising one or more configurations selected from a deployment configuration, a delivery configuration and a final configuration.
  7. 7. The device of claim 6 further comprising a variable profile.
  8. 8. The device of claim 1 wherein a cross-sectional area of the device is variable along a length.
  9. 9. The device of claim 1 wherein the device is configurable for deployment by an endoscope.
  10. 10. The device of claim 1 wherein the device is configurable for deployment by a guidance element.
  11. 11. The device of claim 1 wherein a lumen is provided that is configurable to provide restrictable fluid flow.
  12. 12. The device of claim 10 further comprising one or more fluid control components.
  13. 13. (canceled)
  14. 14. (canceled)
  15. 15. The device of claim 1 wherein the device is flexible.
  16. 16. A biliary disease treatment device comprising:
    an implant adapted to be delivered by an endoscope, guidance element to a gastrointestinal site in proximity to a gallbladder, and further adapted to form a conduit between the gastrointestinal site and the gallbladder.
  17. 17. (canceled)
  18. 18. (canceled)
  19. 19. (canceled)
  20. 20. (canceled)
  21. 21. (canceled)
  22. 22. (canceled)
  23. 23. (canceled)
  24. 24. (canceled)
  25. 25. (canceled)
  26. 26. (canceled)
  27. 27. (canceled)
  28. 28. A method of delivering a device to treat biliary disease comprising:
    a. using an endoscope to place a guidance element between an access lumen and a gallbladder;
    b. inserting a delivery catheter over the guidance element and into the gallbladder;
    c. delivering a cystic duct defunctionalizing device on the guidance element; and
    d. positioning the cystic duct defunctionalizing device within a cystic duct.
  29. 29. (canceled)
  30. 30. (canceled)
  31. 31. (canceled)
  32. 32. (canceled)
  33. 33. (canceled)
  34. 34. The method of claim 28 further comprising the step of localizing the gallbladder via endoscopic ultrasound.
  35. 35. The method of claim 28 further comprising the step of removing gallstones.
  36. 36. The method of claim 28 further comprising the step of altering gallstones.
  37. 37. The method of claim 36 further comprising the step of removing the altered gallstones.
  38. 38. (canceled)
  39. 39. The method of claim 28 wherein the biliary disease is treated without removal of the gallbladder.
  40. 40. The method of claim 28 wherein the biliary disease is treated without removal of the cystic duct.
  41. 41. (canceled)
  42. 42. The method of claim 28 further comprising the step of forming a biological duct in situ from a patient's tissue.
  43. 43. The method of claim 28 further comprising the step of changing the cystic duct defunctionalizing device from a delivery configuration to a deployment configuration.
  44. 44. The method of claim 28 further comprising the step of changing the cystic duct defunctionalizing device from a delivery configuration to a final configuration.
  45. 45. The method of claim 28 further comprising the step of changing the cystic duct defunctionalizing device from a deployment configuration to a final configuration.
  46. 46. The method of claim 28 further comprising the step of reducing a cross-sectional profile of the cystic duct defunctionalizing device.
  47. 47. (canceled)
  48. 48. The method of claim 28 further comprising the step of defunctionalizing the cystic duct in situ.
  49. 49. The method of claim 48 wherein the step of defunctionalizing is achieved by delivering a substance into a space within the cystic duct.
  50. 50. The method of claim 49 wherein the delivered substance is selected from the group consisting of gel and foam.
  51. 51. The method of claim 49 further comprising the step of activating the delivered substance in situ.
  52. 52. The method of claim 49 further comprising delivering an amount of substance sufficient to fill, or substantially fill, the cystic duct lumen.
  53. 53. The method of claim 48 wherein the step of defunctionalizing is achieved by delivering a plug into a space within the cystic duct.
  54. 54. The method of claim 53 wherein the plug is configurable either internally or externally to seat within the lumen.
  55. 55. The method of claim 53 wherein the plug further comprises one or more thread profiles, ridges or steps about its exterior surface.
  56. 56. (canceled)
  57. 57. A kit for treating biliary disease comprising:
    a. a device configurable to be positioned within a cystic duct; and optionally
    b. a compound for delivery to a tissue.
  58. 58. (canceled)
  59. 59. (canceled)
  60. 60. (canceled)
  61. 61. (canceled)
  62. 62. (canceled)
  63. 63. (canceled)
  64. 64. (canceled)
  65. 65. (canceled)
  66. 66. A method of treating biliary disease comprising:
    a. accessing a lumen associated with a gallbladder;
    b. defunctionalizing a cystic duct.
  67. 67. (canceled)
  68. 68. (canceled)
  69. 69. (canceled)
  70. 70. The method of claim 69 wherein the substance is one or more of antibiotics, inflammatory agents, and anti-inflammatory agents.
  71. 71. The method of claim 66 further comprising the step of preventing bile from entering the gallbladder lumen.
  72. 72. (canceled)
  73. 73. The method of claim 66 further comprising the step of accessing the gallbladder via the gastrointestinal tract.
  74. 74. The method of claim 73 wherein the step of accessing is performed in the gastrointestinal tract at a duodenum.
  75. 75. The method of claim 73 wherein the step of defunctionalizing the cystic duct further comprises one or more of sclerosing, necrotizing or ablating tissue.
  76. 76. The method of claim 75 wherein an ablation technique is selected from the group comprising cryoablation, thermal ablation, chemical ablation, radio frequency ablation, ultrasound ablation, and microwave ablation.
  77. 77. The method of claim 73 further comprising the step of delivering a fluid with an angular orientation.
  78. 78. The method of claim 73 further comprising the step of delivering a fluid with at least one of a 360 degree radial pattern, a sharp stream, and a cone shape.
  79. 79. The method of claim 73 further comprising the step of delivering a fluid with a device comprising an articulating member.
  80. 80. The method of claim 73 wherein the step of defunctionalizing the cystic duct further comprises applying a vacuum to a lumen of the cystic duct or the gallbladder.
  81. 81. The method of claim 80 further comprising the step of applying all adhesive to the lumen of the cystic duct.
  82. 82. (canceled)
  83. 83. A device for treating biliary disease comprising a plug adapted and configurable to be positioned within a lumen of a cystic duct of a patient having a proximal end and a distal end and is configurable either internally or externally to seat within the lumen after deployment.
  84. 84. The device of claim 83 wherein the external configuration is one or more of threads, ridges and steps.
  85. 85. (canceled)
  86. 86. (canceled)
  87. 87. The device of claim 83 wherein the plug is positioned within or proximal to a cystic duct.
US12277338 2007-11-30 2008-11-25 Methods, Devices, Kits and Systems for Defunctionalizing the Cystic Duct Abandoned US20090143759A1 (en)

Priority Applications (3)

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US99168207 true 2007-11-30 2007-11-30
US3336808 true 2008-03-03 2008-03-03
US12277338 US20090143759A1 (en) 2007-11-30 2008-11-25 Methods, Devices, Kits and Systems for Defunctionalizing the Cystic Duct

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US12277338 US20090143759A1 (en) 2007-11-30 2008-11-25 Methods, Devices, Kits and Systems for Defunctionalizing the Cystic Duct
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US12951803 US9282968B2 (en) 2007-11-30 2010-11-22 Applicator for endoscopic treatment of biliary disease
US12959264 US20110071566A1 (en) 2007-11-30 2010-12-02 Methods, devices, kits and systems for defunctionalizing the cystic duct
US13410281 US20120289880A1 (en) 2007-11-30 2012-03-01 Methods, Devices, Kits and Systems for Defunctionalizing the Cystic Duct
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Cited By (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050228413A1 (en) * 2004-04-12 2005-10-13 Binmoeller Kenneth F Automated transluminal tissue targeting and anchoring devices and methods
US20090143713A1 (en) * 2007-11-30 2009-06-04 Jacques Van Dam Biliary Shunts, Delivery Systems, Methods of Using the Same and Kits Therefor
US20100222750A1 (en) * 2009-02-27 2010-09-02 Vanderbilt University Replenishable drug delivery implant for bone and cartilage
US20110054381A1 (en) * 2009-05-29 2011-03-03 Jacques Van Dam Biliary shunts, delivery systems, and methods of using the same
US20110106225A1 (en) * 2009-10-29 2011-05-05 Elmer Lucas B Method For Surgically Treating A Patient By Deactivating A Portion Of The Digestive Enzymes
US20110137394A1 (en) * 2009-05-29 2011-06-09 Xlumena, Inc. Methods and systems for penetrating adjacent tissue layers
WO2011143137A3 (en) * 2010-05-08 2012-03-15 The Board Of Trustees Of The Leland Stanford Junior University Devices and methods to treat gallstone disease
US8357193B2 (en) 2009-05-29 2013-01-22 Xlumena, Inc. Apparatus and method for deploying stent across adjacent tissue layers
US8425539B2 (en) 2004-04-12 2013-04-23 Xlumena, Inc. Luminal structure anchoring devices and methods
US8454632B2 (en) 2008-05-12 2013-06-04 Xlumena, Inc. Tissue anchor for securing tissue layers
US9364259B2 (en) 2009-04-21 2016-06-14 Xlumena, Inc. System and method for delivering expanding trocar through a sheath
US9381041B2 (en) 2009-04-21 2016-07-05 Xlumena, Inc. Methods and devices for access across adjacent tissue layers

Families Citing this family (47)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2009117435A3 (en) 2008-03-17 2009-11-26 Northwestern University Devices and methods for percutaneous access, hemostasis, and closure
US8968210B2 (en) 2008-10-01 2015-03-03 Covidien LLP Device for needle biopsy with integrated needle protection
US9332973B2 (en) 2008-10-01 2016-05-10 Covidien Lp Needle biopsy device with exchangeable needle and integrated needle protection
US9782565B2 (en) 2008-10-01 2017-10-10 Covidien Lp Endoscopic ultrasound-guided biliary access system
US8721580B2 (en) * 2009-09-21 2014-05-13 Alcon Research, Ltd. Power saving glaucoma drainage device
US8545431B2 (en) * 2009-09-21 2013-10-01 Alcon Research, Ltd. Lumen clearing valve for glaucoma drainage device
US8419673B2 (en) 2009-09-21 2013-04-16 Alcon Research, Ltd. Glaucoma drainage device with pump
US8257295B2 (en) 2009-09-21 2012-09-04 Alcon Research, Ltd. Intraocular pressure sensor with external pressure compensation
US8277417B2 (en) * 2009-09-23 2012-10-02 James J. Fedinec Central venous catheter kit with line gripping and needle localizing devices
US20110184504A1 (en) * 2010-01-22 2011-07-28 Medtronic Vascular, Inc. Methods and Apparatus for Providing an Arteriovenous Fistula
US9179968B2 (en) * 2010-05-10 2015-11-10 St. Jude Medical Luxembourg Holding S.À.R.L. Irrigated finned ablation head
CN103118607B (en) * 2010-07-16 2015-09-23 伊西康内外科公司 Bile from the gallbladder into the guide means intestine
WO2012007044A1 (en) * 2010-07-16 2012-01-19 Ethicon Endo-Surgery, Inc. A device for translumenal diversion of bile
US9198791B2 (en) 2010-07-22 2015-12-01 Endobetix Ltd. Pancreaticobiliary diversion device
ES2566498T3 (en) * 2010-10-18 2016-04-13 Apollo Endosurgery, Inc. intragastric implants with duodenal anchors
WO2012071031A1 (en) * 2010-11-23 2012-05-31 Treus Medical, Inc Biliary shunts, delivery systems, and methods of using the same
US8535259B2 (en) * 2010-12-29 2013-09-17 Ethicon Endo-Surgery, Inc. Methods for biliary diversion
US8298168B2 (en) * 2011-01-27 2012-10-30 Medtronic Xomed, Inc. Adjustment for hydrocephalus shunt valve
WO2013004264A1 (en) * 2011-07-01 2013-01-10 Ethicon Endo-Surgery, Inc. A method and device for creating an alternative bile flow path
US8585631B2 (en) 2011-10-18 2013-11-19 Alcon Research, Ltd. Active bimodal valve system for real-time IOP control
US8840578B2 (en) 2011-12-09 2014-09-23 Alcon Research, Ltd. Multilayer membrane actuators
US8579848B2 (en) 2011-12-09 2013-11-12 Alcon Research, Ltd. Active drainage systems with pressure-driven valves and electronically-driven pump
US8603024B2 (en) 2011-12-12 2013-12-10 Alcon Research, Ltd. Glaucoma drainage devices including vario-stable valves and associated systems and methods
US9622910B2 (en) 2011-12-12 2017-04-18 Alcon Research, Ltd. Active drainage systems with dual-input pressure-driven values
US9339187B2 (en) 2011-12-15 2016-05-17 Alcon Research, Ltd. External pressure measurement system and method for an intraocular implant
US8986240B2 (en) 2012-02-14 2015-03-24 Alcon Research, Ltd. Corrugated membrane actuators
US9155653B2 (en) 2012-02-14 2015-10-13 Alcon Research, Ltd. Pressure-driven membrane valve for pressure control system
US8998838B2 (en) 2012-03-29 2015-04-07 Alcon Research, Ltd. Adjustable valve for IOP control with reed valve
US8652085B2 (en) 2012-07-02 2014-02-18 Alcon Research, Ltd. Reduction of gas escape in membrane actuators
US9572712B2 (en) 2012-12-17 2017-02-21 Novartis Ag Osmotically actuated fluidic valve
US9528633B2 (en) 2012-12-17 2016-12-27 Novartis Ag MEMS check valve
US9295389B2 (en) 2012-12-17 2016-03-29 Novartis Ag Systems and methods for priming an intraocular pressure sensor in an intraocular implant
JP6159829B2 (en) 2013-02-28 2017-07-05 ボストン サイエンティフィック サイムド,インコーポレイテッドBoston Scientific Scimed,Inc. Medical instruments used through at least one of the biliary tract and pancreatic duct
US9226851B2 (en) 2013-08-24 2016-01-05 Novartis Ag MEMS check valve chip and methods
US9283115B2 (en) 2013-08-26 2016-03-15 Novartis Ag Passive to active staged drainage device
US9289324B2 (en) 2013-08-26 2016-03-22 Novartis Ag Externally adjustable passive drainage device
JP6167811B2 (en) * 2013-09-30 2017-07-26 日本ゼオン株式会社 Tubular organ between bypass stent
DE102013112437A1 (en) * 2013-11-13 2015-05-13 Universität Rostock Biliäre- and pancreatic duct drainage
US9044301B1 (en) * 2013-11-25 2015-06-02 Innfocus, Inc. Methods, systems and devices for treating glaucoma
US9681983B2 (en) 2014-03-13 2017-06-20 Novartis Ag Debris clearance system for an ocular implant
US9603742B2 (en) 2014-03-13 2017-03-28 Novartis Ag Remote magnetic driven flow system
US20150313597A1 (en) * 2014-05-02 2015-11-05 W. L. Gore & Associates, Inc. Anastomosis Devices
KR20170002644A (en) * 2014-06-18 2017-01-06 엑스루메나 인크 Biliary Stent
CN104586472B (en) * 2015-02-13 2016-08-31 中南大学湘雅医院 One kind of bile duct stones placed Cholangioscopic occluder
US9655777B2 (en) 2015-04-07 2017-05-23 Novartis Ag System and method for diagphragm pumping using heating element
US20170007276A1 (en) * 2015-07-07 2017-01-12 Empire Technology Development Llc Gallstone removal through cholecystoduodenal fistula by anastomosis device
US20170119365A1 (en) * 2015-11-03 2017-05-04 W. L. Gore & Associates, Inc. Endoscopic organ manipulation devices and methods

Citations (86)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2127903A (en) * 1936-05-05 1938-08-23 Davis & Geck Inc Tube for surgical purposes and method of preparing and using the same
US3818511A (en) * 1972-11-17 1974-06-25 Medical Prod Corp Medical prosthesis for ducts or conduits
US3834394A (en) * 1969-11-21 1974-09-10 R Sessions Occlusion device and method and apparatus for inserting the same
US3933040A (en) * 1973-11-07 1976-01-20 Metco, Inc. Flowmeter
US4085757A (en) * 1976-04-29 1978-04-25 P Pevsner Miniature balloon catheter method and apparatus
US4263917A (en) * 1979-04-06 1981-04-28 Moss James P Method of sealing bile duct during cholangiography
US4781677A (en) * 1985-07-17 1988-11-01 Wilcox Gilbert M Method of treatment utilizing a double balloon nasobiliary occlusion catheter
US4900303A (en) * 1978-03-10 1990-02-13 Lemelson Jerome H Dispensing catheter and method
US4968294A (en) * 1989-02-09 1990-11-06 Salama Fouad A Urinary control valve and method of using same
US4994066A (en) * 1988-10-07 1991-02-19 Voss Gene A Prostatic stent
US5159925A (en) * 1988-09-09 1992-11-03 Gynelab, Inc. Cauterizing apparatus and method for laparoscopic cholecystostomy, gallbladder ablation and treatment of benign prostate hypertrophy
US5197948A (en) * 1991-01-03 1993-03-30 Kamran Ghodsian Intra-abdominal organ manipulator, irrigator and aspirator
US5201746A (en) * 1991-10-16 1993-04-13 United States Surgical Corporation Surgical hemostatic clip
US5334210A (en) * 1993-04-09 1994-08-02 Cook Incorporated Vascular occlusion assembly
US5443449A (en) * 1991-03-01 1995-08-22 Applied Medical Resources Corporation Cholangiography catheter
US5454788A (en) * 1991-04-24 1995-10-03 Baxter International Inc. Exchangeable integrated-wire balloon catheter
US5466242A (en) * 1994-02-02 1995-11-14 Mori; Katsushi Stent for biliary, urinary or vascular system
US5514088A (en) * 1986-06-09 1996-05-07 Development Collaborative Corporation Apparatus, and method for chemical contact dissolution of gallstones
US5632762A (en) * 1995-11-09 1997-05-27 Hemodynamics, Inc. Ostial stent balloon
US5643254A (en) * 1994-03-03 1997-07-01 Target Therapeutics, Inc. Endovascular embolic device detachment detection method
US5709224A (en) * 1995-06-07 1998-01-20 Radiotherapeutics Corporation Method and device for permanent vessel occlusion
US5741333A (en) * 1995-04-12 1998-04-21 Corvita Corporation Self-expanding stent for a medical device to be introduced into a cavity of a body
US5743905A (en) * 1995-07-07 1998-04-28 Target Therapeutics, Inc. Partially insulated occlusion device
US5755769A (en) * 1992-03-12 1998-05-26 Laboratoire Perouse Implant Expansible endoprosthesis for a human or animal tubular organ, and fitting tool for use thereof
US5776126A (en) * 1993-09-23 1998-07-07 Wilk; Peter J. Laparoscopic surgical apparatus and associated method
US5817046A (en) * 1997-07-14 1998-10-06 Delcath Systems, Inc. Apparatus and method for isolated pelvic perfusion
US5860426A (en) * 1996-11-06 1999-01-19 Kleiman; Aldo Sergio Cholecystoscopic cannula and cholecystoscopic gallbladder laser-sclerosis procedure
US5876432A (en) * 1994-04-01 1999-03-02 Gore Enterprise Holdings, Inc. Self-expandable helical intravascular stent and stent-graft
US6019757A (en) * 1995-07-07 2000-02-01 Target Therapeutics, Inc. Endoluminal electro-occlusion detection apparatus and method
US6077271A (en) * 1998-03-06 2000-06-20 Acumed, Inc. Bone plate vise
US6241762B1 (en) * 1998-03-30 2001-06-05 Conor Medsystems, Inc. Expandable medical device with ductile hinges
US6245101B1 (en) * 1999-05-03 2001-06-12 William J. Drasler Intravascular hinge stent
US6246914B1 (en) * 1999-08-12 2001-06-12 Irvine Biomedical, Inc. High torque catheter and methods thereof
US6283992B1 (en) * 1995-11-27 2001-09-04 Schneider (Europe) Gmbh Conical stent
US6348066B1 (en) * 1995-11-07 2002-02-19 Corvita Corporation Modular endoluminal stent-grafts and methods for their use
US6406491B1 (en) * 1999-05-04 2002-06-18 Heartstent Corporation Compliant transmyocardial implant
US6409755B1 (en) * 1997-05-29 2002-06-25 Scimed Life Systems, Inc. Balloon expandable stent with a self-expanding portion
US6416545B1 (en) * 1996-04-09 2002-07-09 Endocare, Inc. Urological stent therapy system and method
US20020095110A1 (en) * 2000-10-11 2002-07-18 Vanney Guy P. Stabilized transmyocardial implant
US6468303B1 (en) * 2000-03-27 2002-10-22 Aga Medical Corporation Retrievable self expanding shunt
US20020156523A1 (en) * 1994-08-31 2002-10-24 Lilip Lau Exterior supported self-expanding stent-graft
US20030045828A1 (en) * 1998-01-30 2003-03-06 Wilk Peter J. Left ventricular conduits to coronary arteries and methods for coronary bypass
US20030055484A1 (en) * 1994-08-31 2003-03-20 Lilip Lau Exterior supported self-expanding stent-graft
US6544291B2 (en) * 1997-12-09 2003-04-08 Thomas V. Taylor Sutureless gastroesophageal anti-reflux valve prosthesis and tool for peroral implantation thereof
US20030069533A1 (en) * 2001-10-10 2003-04-10 Hiroshi Kakutani Endoscopic transduodenal biliary drainage system
US20030069606A1 (en) * 2001-06-15 2003-04-10 Girouard Steven D. Pulmonary vein stent for treating atrial fibrillation
US20030083734A1 (en) * 2001-10-25 2003-05-01 Curative Ag Stent
US6585754B2 (en) * 2001-05-29 2003-07-01 Scimed Life Systems, Inc. Absorbable implantable vaso-occlusive member
US6610100B2 (en) * 1998-09-10 2003-08-26 Percardia, Inc. Designs for left ventricular conduit
US20030163079A1 (en) * 2002-02-25 2003-08-28 Burnett Daniel Rogers Vesicular shunt for the drainage of excess fluid
US6616675B1 (en) * 1996-02-02 2003-09-09 Transvascular, Inc. Methods and apparatus for connecting openings formed in adjacent blood vessels or other anatomical structures
US20040073317A1 (en) * 2001-06-26 2004-04-15 Schultz Leonard S. Device and method for body lumen occlusion
US20040093058A1 (en) * 2002-01-28 2004-05-13 Cottone Robert J. Flared ostial endoprosthesis and delivery system
US20040102855A1 (en) * 2002-11-21 2004-05-27 Scimed Life Systems, Inc. Anti-reflux stent
US6746489B2 (en) * 1998-08-31 2004-06-08 Wilson-Cook Medical Incorporated Prosthesis having a sleeve valve
US6764519B2 (en) * 2000-05-26 2004-07-20 Scimed Life Systems, Inc. Ureteral stent
US20040181150A1 (en) * 1999-09-01 2004-09-16 Bacchus Vascular, Inc. Methods and apparatus for accessing and treating body lumens
US20040215331A1 (en) * 2001-12-03 2004-10-28 Xtent, Inc. Apparatus and methods for delivery of variable length stents
US20050010275A1 (en) * 2002-10-11 2005-01-13 Sahatjian Ronald A. Implantable medical devices
US20050010280A1 (en) * 2003-07-07 2005-01-13 Xiabin Jing Biodegradable common bile duct stent and the method for preparaing thereof
US20050107733A1 (en) * 2003-04-08 2005-05-19 Faul John L. Implantable arterio-venous shunt devices and methods for their use
US20050149166A1 (en) * 2003-11-08 2005-07-07 Schaeffer Darin G. Branch vessel prosthesis with anchoring device and method
US20050159726A1 (en) * 1997-10-29 2005-07-21 Kensey Nash Corporation Transmyocardial revascularization system and method of use
US20050192659A1 (en) * 2004-01-23 2005-09-01 Terry Dahl Apparatus and method for performing a surgical procedure
US20050216074A1 (en) * 2002-10-11 2005-09-29 Sahatjian Ronald A Implantable medical devices
US20050228413A1 (en) * 2004-04-12 2005-10-13 Binmoeller Kenneth F Automated transluminal tissue targeting and anchoring devices and methods
US7004949B2 (en) * 1998-08-12 2006-02-28 Cardica, Inc. Method and system for attaching a graft to a blood vessel
US20060047337A1 (en) * 2004-08-27 2006-03-02 Brenneman Rodney A Device and method for establishing an artificial arterio-venous fistula
US7011095B2 (en) * 1998-09-10 2006-03-14 Percardia, Inc. Valve designs for left ventricular conduits
US20060106455A1 (en) * 2004-11-12 2006-05-18 Icon Interventional Systems, Inc. Ostial stent
US20060129221A1 (en) * 2004-12-10 2006-06-15 Medtronic, Inc. Tunneling guide
US20060155369A1 (en) * 1998-09-30 2006-07-13 Bard Peripheral Vascular, Inc. Selective adherence of stent-graft coverings
US7118600B2 (en) * 1998-08-31 2006-10-10 Wilson-Cook Medical, Inc. Prosthesis having a sleeve valve
US20060235269A1 (en) * 2005-04-15 2006-10-19 The University Of Chicago Method, apparatus and kit for bile or pancreatic duct endoscopy
US20070016306A1 (en) * 1998-08-31 2007-01-18 Wilson-Cook Medical Inc. Prosthesis having a sleeve valve
US20070021828A1 (en) * 2005-05-23 2007-01-25 Jeff Krolik Mechanically actuated stents and apparatus and methods for delivering them
US20070038283A1 (en) * 2004-02-06 2007-02-15 Mustapha Jihad A Ostial stent and balloon
US20070043391A1 (en) * 2003-08-22 2007-02-22 Jen.Meditech Gmbh Occlusion device and method of for its production
US20070043381A1 (en) * 2005-08-19 2007-02-22 Icon Medical Corp. Medical device deployment instrument
US20070055358A1 (en) * 2005-08-22 2007-03-08 Krolik Jeffrey A Axially compressible flared stents and apparatus and methods for delivering them
US20070088425A1 (en) * 2005-10-13 2007-04-19 Cook Incorporated Endoluminal prosthesis
US20070173921A1 (en) * 2005-10-28 2007-07-26 Wholey Mark H Flared stents and apparatus and methods for delivering them
US20070173867A1 (en) * 2004-08-27 2007-07-26 Brenneman Rodney A Device and method for establishing an artificial arterio-venous fistula
US20070249985A1 (en) * 2004-08-27 2007-10-25 Rox Medical, Inc. Device and method for establishing an artificial arterio-venous fistula
US20080243151A1 (en) * 2004-04-12 2008-10-02 Binmoeller Kenneth F Luminal Structure Anchoring Devices and Methods
US20090143760A1 (en) * 2007-11-30 2009-06-04 Jacques Van Dam Methods, Devices, Kits and Systems for Defunctionalizing the Gallbladder

Family Cites Families (76)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US701095A (en) * 1902-01-23 1902-05-27 Elmer S Shimer Platen-shift.
US3385300A (en) 1965-08-10 1968-05-28 Holter Company Cervical cannula
US3741333A (en) * 1969-01-23 1973-06-26 Geophysique Cie Gle Generators of fluid wave trains
US4348066A (en) * 1979-06-11 1982-09-07 The Garrett Corporation Foil bearing mounting
US4352358A (en) * 1979-12-28 1982-10-05 Angelchik Jean P Apparatus for effecting anastomotic procedures
US4699611A (en) 1985-04-19 1987-10-13 C. R. Bard, Inc. Biliary stent introducer
US5270805A (en) * 1986-05-16 1993-12-14 Canon Kabushiki Kaisha Data communication apparatus for converting data in accordance with a discriminated function of a destination station
JPH039746A (en) * 1989-03-27 1991-01-17 Olympus Optical Co Ltd In vivo stay type stent
US4955859A (en) 1989-07-07 1990-09-11 C. R. Bard, Inc. High-friction prostatic stent
US4966294A (en) * 1990-01-16 1990-10-30 Fabri-Kal Corporation Tamper-evident closure for wide mouth container
US5171311A (en) 1990-04-30 1992-12-15 Everest Medical Corporation Percutaneous laparoscopic cholecystectomy instrument
US5071419A (en) 1990-04-30 1991-12-10 Everest Medical Corporation Percutaneous laparoscopic cholecystectomy instrument
US5170805A (en) * 1990-12-11 1992-12-15 Kensey Nash Corporation Method of destroying tissue such as a gall bladder utilizing a sclerosing agent alone or with a symphysis agent
US5167614A (en) 1991-10-29 1992-12-01 Medical Engineering Corporation Prostatic stent
DE69321579T2 (en) 1992-02-14 1999-05-06 Smith & Nephew Inc Polymeric screws and coatings for surgical use
US5536248A (en) * 1992-05-11 1996-07-16 Arrow Precision Products, Inc. Method and apparatus for electrosurgically obtaining access to the biliary tree and placing a stent therein
US5259847A (en) 1992-06-25 1993-11-09 Montefiore Hospital And Medical Center Catheter to maintain minimally invasive access for exchanging internal biliary stents
US5261920A (en) 1992-08-21 1993-11-16 Ethicon, Inc. Anvil bushing for circular stapler
US5499994A (en) 1993-07-30 1996-03-19 American Medical Systems, Inc. Dilation device for the urethra
US5547455A (en) * 1994-03-30 1996-08-20 Medical Media Systems Electronically steerable endoscope
US20030005484A1 (en) * 1994-12-30 2003-01-02 Proguard, Inc. Microbiocidal and pesticidal aromatic aldehydes
DE69633411D1 (en) * 1995-10-13 2004-10-21 Transvascular Inc A device for avoidance of arterial constrictions and / or to perform other interventions transvaskularer
NL1001878C2 (en) 1995-12-12 1997-06-17 Cordis Europ A process for the manufacture of a stent and a tubular member, and catheter therefor.
US5769880A (en) 1996-04-12 1998-06-23 Novacept Moisture transport system for contact electrocoagulation
US5968069A (en) 1996-08-23 1999-10-19 Scimed Life Systems, Inc. Stent delivery system having stent securement apparatus
US5921971A (en) * 1996-09-13 1999-07-13 Boston Scientific Corporation Single operator exchange biliary catheter
US5655548A (en) 1996-09-16 1997-08-12 Circulation, Inc. Method for treatment of ischemic heart disease by providing transvenous myocardial perfusion
DE69736676D1 (en) * 1996-11-04 2006-10-26 Advanced Stent Tech Inc Expandable stent double
US6086582A (en) * 1997-03-13 2000-07-11 Altman; Peter A. Cardiac drug delivery system
US5853419A (en) * 1997-03-17 1998-12-29 Surface Genesis, Inc. Stent
US6030358A (en) 1997-08-08 2000-02-29 Odland; Rick Matthew Microcatheter and method for site specific therapy
JP3349072B2 (en) 1997-09-12 2002-11-20 オリンパス光学工業株式会社 Drainage tube
WO2000012832A3 (en) 1998-08-26 2000-06-15 Molecular Geodesics Inc Radially expandable device
US6458092B1 (en) 1998-09-30 2002-10-01 C. R. Bard, Inc. Vascular inducing implants
EP1044663A3 (en) 1999-04-14 2001-03-14 Marco Pasquinucci Intrahepatic endoprosthesis
US20020055768A1 (en) 1999-11-24 2002-05-09 Kathy Hess Method of manufacturing a thin-layered, endovascular, polymer-covered stent device
GB0003387D0 (en) 2000-02-14 2000-04-05 Angiomed Ag Stent matrix
US6663663B2 (en) * 2001-05-14 2003-12-16 M.I. Tech Co., Ltd. Stent
US7144363B2 (en) * 2001-10-16 2006-12-05 Extensia Medical, Inc. Systems for heart treatment
US20060247575A1 (en) 2001-12-21 2006-11-02 Richard Cartledge Balloon cannulae
US6964681B2 (en) * 2002-01-29 2005-11-15 Medtronic Vascular, Inc. Flared stent and method of use
EP1469902A4 (en) 2002-02-01 2006-08-23 Robert J Goldman Multi-function catheter and use thereof
US7647891B2 (en) 2003-10-24 2010-01-19 Pathway Technologies, Llc Method and apparatus for creating a pathway in an animal
US6953461B2 (en) * 2002-05-16 2005-10-11 Tissuelink Medical, Inc. Fluid-assisted medical devices, systems and methods
US7422584B2 (en) 2002-07-05 2008-09-09 Broncus Technologies, Inc. Extrapleural airway device and method
RU2226364C1 (en) 2002-10-07 2004-04-10 Государственное учреждение Главный клинический госпиталь Министерства Внутренних дел Российской Федерации (некоммерческая организация) Method for indirect access into duodenal cavity
US20040097880A1 (en) 2002-11-19 2004-05-20 Angiodynamics, Inc. Combination thrombolytic infusion catheter and dilator system
US20040260386A1 (en) * 2003-01-31 2004-12-23 Shalaby Shalaby W. Absorbable / biodegradable tubular stent and methods of making the same
EP1620159B1 (en) 2003-04-14 2009-08-05 Cook Incorporated Large diameter delivery catheter/sheath
US7182744B2 (en) * 2003-04-25 2007-02-27 Medtronic Vascular Method and apparatus for aneurismal treatment
US20050021084A1 (en) 2003-05-19 2005-01-27 Lu William Weijia Bone treatment device and method
US7317951B2 (en) 2003-07-25 2008-01-08 Integrated Sensing Systems, Inc. Anchor for medical implant placement and method of manufacture
DE202004021703U1 (en) 2003-10-07 2010-05-27 Northgate Technologies Inc., Elgin A device for delivering a substance into a body cavity
US7255713B2 (en) 2003-12-18 2007-08-14 Malek Michel H Systems and methods for agent delivery
US7998060B2 (en) * 2004-04-19 2011-08-16 The Invention Science Fund I, Llc Lumen-traveling delivery device
WO2005120363A8 (en) 2004-06-03 2007-09-07 Mayo Foundation Obesity treatment and device
WO2005122919A3 (en) * 2004-06-14 2006-08-24 Rox Medical Inc Devices, systems, and methods for arterio-venous fistula creation
US7727225B2 (en) 2004-07-28 2010-06-01 University Of Virginia Patent Foundation Coaxial catheter systems for transference of medium
WO2006031596A3 (en) 2004-09-09 2007-03-01 Onset Medical Corp Expandable gastrointestinal sheath
US7938307B2 (en) 2004-10-18 2011-05-10 Tyco Healthcare Group Lp Support structures and methods of using the same
US7722629B2 (en) 2004-10-29 2010-05-25 Jeffrey W. Chambers, M.D. System and method for catheter-based septal defect repair
EP1858396A4 (en) 2004-12-08 2015-11-25 Inc Xlumena Method and apparatus for performing needle guided interventions
JP2008532568A (en) * 2005-01-18 2008-08-21 コーニンクレッカ フィリップス エレクトロニクス エヌ ヴィ Capsules are electronically controlled
EP1859408B1 (en) * 2005-03-16 2009-03-25 Consiglio Nazionale delle Ricerche Holographic method with numerical reconstruction for obtaining an image of a three-dimensional object in which even points out of the depth of field are in focus, and holographic apparatus using such a method
US7717936B2 (en) 2005-04-18 2010-05-18 Salviac Limited Device for loading an embolic protection filter into a catheter
CA2609360A1 (en) 2005-05-23 2006-11-30 Incept, Llc Mechanically actuated stents and apparatus and methods for delivering them
CA2613901C (en) 2005-06-29 2013-01-22 Bipin C. Patadia System and method for deploying a proximally-flaring stent
EP1912592A4 (en) 2005-07-26 2016-01-06 Rox Medical Inc Devices, systems, and methods for peripheral arteriovenous fistula creation
EP1948280A4 (en) * 2005-10-24 2011-07-06 Andrew Young Biliary/pancreatic shunt device and method for treatment of metabolic and other diseases
EP1795151A1 (en) 2005-12-07 2007-06-13 Dr. Karel Volenec - ELLA - CS Biodegradable stent
JP5025726B2 (en) * 2006-06-06 2012-09-12 ウィリアム・エイ・クック・オーストラリア・プロプライエタリー・リミテッドWilliam A. Cook Australia Pty. Ltd. Stent with a crush zone
WO2008100974A3 (en) 2007-02-13 2009-12-30 Sharma Virender K Method and apparatus for electrical stimulation of the pancreatico-biliary system
US20090073507A1 (en) * 2007-09-18 2009-03-19 Sharp Kabushiki Kaisha Document reading apparatus and document reading system
JP5082713B2 (en) * 2007-09-19 2012-11-28 コニカミノルタビジネステクノロジーズ株式会社 Image forming apparatus and image forming method
US9901347B2 (en) * 2009-05-29 2018-02-27 Terus Medical, Inc. Biliary shunts, delivery systems, and methods of using the same
WO2012071031A1 (en) 2010-11-23 2012-05-31 Treus Medical, Inc Biliary shunts, delivery systems, and methods of using the same

Patent Citations (99)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2127903A (en) * 1936-05-05 1938-08-23 Davis & Geck Inc Tube for surgical purposes and method of preparing and using the same
US3834394A (en) * 1969-11-21 1974-09-10 R Sessions Occlusion device and method and apparatus for inserting the same
US3818511A (en) * 1972-11-17 1974-06-25 Medical Prod Corp Medical prosthesis for ducts or conduits
US3933040A (en) * 1973-11-07 1976-01-20 Metco, Inc. Flowmeter
US4085757A (en) * 1976-04-29 1978-04-25 P Pevsner Miniature balloon catheter method and apparatus
US4900303A (en) * 1978-03-10 1990-02-13 Lemelson Jerome H Dispensing catheter and method
US4263917A (en) * 1979-04-06 1981-04-28 Moss James P Method of sealing bile duct during cholangiography
US4781677A (en) * 1985-07-17 1988-11-01 Wilcox Gilbert M Method of treatment utilizing a double balloon nasobiliary occlusion catheter
US5514088A (en) * 1986-06-09 1996-05-07 Development Collaborative Corporation Apparatus, and method for chemical contact dissolution of gallstones
US5159925A (en) * 1988-09-09 1992-11-03 Gynelab, Inc. Cauterizing apparatus and method for laparoscopic cholecystostomy, gallbladder ablation and treatment of benign prostate hypertrophy
US4994066A (en) * 1988-10-07 1991-02-19 Voss Gene A Prostatic stent
US4968294A (en) * 1989-02-09 1990-11-06 Salama Fouad A Urinary control valve and method of using same
US5197948A (en) * 1991-01-03 1993-03-30 Kamran Ghodsian Intra-abdominal organ manipulator, irrigator and aspirator
US5443449A (en) * 1991-03-01 1995-08-22 Applied Medical Resources Corporation Cholangiography catheter
US5454788A (en) * 1991-04-24 1995-10-03 Baxter International Inc. Exchangeable integrated-wire balloon catheter
US5201746A (en) * 1991-10-16 1993-04-13 United States Surgical Corporation Surgical hemostatic clip
US5755769A (en) * 1992-03-12 1998-05-26 Laboratoire Perouse Implant Expansible endoprosthesis for a human or animal tubular organ, and fitting tool for use thereof
US5334210A (en) * 1993-04-09 1994-08-02 Cook Incorporated Vascular occlusion assembly
US5776126A (en) * 1993-09-23 1998-07-07 Wilk; Peter J. Laparoscopic surgical apparatus and associated method
US5466242A (en) * 1994-02-02 1995-11-14 Mori; Katsushi Stent for biliary, urinary or vascular system
US5643254A (en) * 1994-03-03 1997-07-01 Target Therapeutics, Inc. Endovascular embolic device detachment detection method
US5876432A (en) * 1994-04-01 1999-03-02 Gore Enterprise Holdings, Inc. Self-expandable helical intravascular stent and stent-graft
US20020156523A1 (en) * 1994-08-31 2002-10-24 Lilip Lau Exterior supported self-expanding stent-graft
US20030055484A1 (en) * 1994-08-31 2003-03-20 Lilip Lau Exterior supported self-expanding stent-graft
US5741333A (en) * 1995-04-12 1998-04-21 Corvita Corporation Self-expanding stent for a medical device to be introduced into a cavity of a body
US5709224A (en) * 1995-06-07 1998-01-20 Radiotherapeutics Corporation Method and device for permanent vessel occlusion
US6077261A (en) * 1995-06-07 2000-06-20 Radiotherapeutics Corporation Device for permanent vessel occlusion
US6019757A (en) * 1995-07-07 2000-02-01 Target Therapeutics, Inc. Endoluminal electro-occlusion detection apparatus and method
US5743905A (en) * 1995-07-07 1998-04-28 Target Therapeutics, Inc. Partially insulated occlusion device
US6348066B1 (en) * 1995-11-07 2002-02-19 Corvita Corporation Modular endoluminal stent-grafts and methods for their use
US20030149472A1 (en) * 1995-11-07 2003-08-07 Leonard Pinchuk Modular endluminal stent-grafts and methods for their use
US5632762A (en) * 1995-11-09 1997-05-27 Hemodynamics, Inc. Ostial stent balloon
US6283992B1 (en) * 1995-11-27 2001-09-04 Schneider (Europe) Gmbh Conical stent
US6616675B1 (en) * 1996-02-02 2003-09-09 Transvascular, Inc. Methods and apparatus for connecting openings formed in adjacent blood vessels or other anatomical structures
US6416545B1 (en) * 1996-04-09 2002-07-09 Endocare, Inc. Urological stent therapy system and method
US5860426A (en) * 1996-11-06 1999-01-19 Kleiman; Aldo Sergio Cholecystoscopic cannula and cholecystoscopic gallbladder laser-sclerosis procedure
US6409755B1 (en) * 1997-05-29 2002-06-25 Scimed Life Systems, Inc. Balloon expandable stent with a self-expanding portion
US5817046A (en) * 1997-07-14 1998-10-06 Delcath Systems, Inc. Apparatus and method for isolated pelvic perfusion
US20050159726A1 (en) * 1997-10-29 2005-07-21 Kensey Nash Corporation Transmyocardial revascularization system and method of use
US6558429B2 (en) * 1997-12-09 2003-05-06 Reflux Corporation Perorally insertable gastroesophageal anti-reflux valve prosthesis and tool for implantation thereof
US6544291B2 (en) * 1997-12-09 2003-04-08 Thomas V. Taylor Sutureless gastroesophageal anti-reflux valve prosthesis and tool for peroral implantation thereof
US20030045828A1 (en) * 1998-01-30 2003-03-06 Wilk Peter J. Left ventricular conduits to coronary arteries and methods for coronary bypass
US6077271A (en) * 1998-03-06 2000-06-20 Acumed, Inc. Bone plate vise
US6241762B1 (en) * 1998-03-30 2001-06-05 Conor Medsystems, Inc. Expandable medical device with ductile hinges
US7004949B2 (en) * 1998-08-12 2006-02-28 Cardica, Inc. Method and system for attaching a graft to a blood vessel
US7041110B2 (en) * 1998-08-12 2006-05-09 Cardica, Inc. Method and system for attaching a graft to a blood vessel
US7118600B2 (en) * 1998-08-31 2006-10-10 Wilson-Cook Medical, Inc. Prosthesis having a sleeve valve
US6746489B2 (en) * 1998-08-31 2004-06-08 Wilson-Cook Medical Incorporated Prosthesis having a sleeve valve
US20040199262A1 (en) * 1998-08-31 2004-10-07 Wilson-Cook Medical Incorporated Prosthesis having a sleeve valve
US20070016306A1 (en) * 1998-08-31 2007-01-18 Wilson-Cook Medical Inc. Prosthesis having a sleeve valve
US6610100B2 (en) * 1998-09-10 2003-08-26 Percardia, Inc. Designs for left ventricular conduit
US7011095B2 (en) * 1998-09-10 2006-03-14 Percardia, Inc. Valve designs for left ventricular conduits
US20060155369A1 (en) * 1998-09-30 2006-07-13 Bard Peripheral Vascular, Inc. Selective adherence of stent-graft coverings
US6245101B1 (en) * 1999-05-03 2001-06-12 William J. Drasler Intravascular hinge stent
US6406491B1 (en) * 1999-05-04 2002-06-18 Heartstent Corporation Compliant transmyocardial implant
US6246914B1 (en) * 1999-08-12 2001-06-12 Irvine Biomedical, Inc. High torque catheter and methods thereof
US20040181150A1 (en) * 1999-09-01 2004-09-16 Bacchus Vascular, Inc. Methods and apparatus for accessing and treating body lumens
US6468303B1 (en) * 2000-03-27 2002-10-22 Aga Medical Corporation Retrievable self expanding shunt
US6764519B2 (en) * 2000-05-26 2004-07-20 Scimed Life Systems, Inc. Ureteral stent
US20020095110A1 (en) * 2000-10-11 2002-07-18 Vanney Guy P. Stabilized transmyocardial implant
US6585754B2 (en) * 2001-05-29 2003-07-01 Scimed Life Systems, Inc. Absorbable implantable vaso-occlusive member
US20030069606A1 (en) * 2001-06-15 2003-04-10 Girouard Steven D. Pulmonary vein stent for treating atrial fibrillation
US20040073317A1 (en) * 2001-06-26 2004-04-15 Schultz Leonard S. Device and method for body lumen occlusion
US20030069533A1 (en) * 2001-10-10 2003-04-10 Hiroshi Kakutani Endoscopic transduodenal biliary drainage system
US20030083734A1 (en) * 2001-10-25 2003-05-01 Curative Ag Stent
US20040215331A1 (en) * 2001-12-03 2004-10-28 Xtent, Inc. Apparatus and methods for delivery of variable length stents
US20040093058A1 (en) * 2002-01-28 2004-05-13 Cottone Robert J. Flared ostial endoprosthesis and delivery system
US20030163079A1 (en) * 2002-02-25 2003-08-28 Burnett Daniel Rogers Vesicular shunt for the drainage of excess fluid
US20050010275A1 (en) * 2002-10-11 2005-01-13 Sahatjian Ronald A. Implantable medical devices
US20050216074A1 (en) * 2002-10-11 2005-09-29 Sahatjian Ronald A Implantable medical devices
US20040102855A1 (en) * 2002-11-21 2004-05-27 Scimed Life Systems, Inc. Anti-reflux stent
US20050107733A1 (en) * 2003-04-08 2005-05-19 Faul John L. Implantable arterio-venous shunt devices and methods for their use
US7094260B2 (en) * 2003-07-07 2006-08-22 Changhun Institute of Applied Chemistry Chinese Academy of Science Biodegradable common bile duct stent and the method for preparing thereof
US20050010280A1 (en) * 2003-07-07 2005-01-13 Xiabin Jing Biodegradable common bile duct stent and the method for preparaing thereof
US20070043391A1 (en) * 2003-08-22 2007-02-22 Jen.Meditech Gmbh Occlusion device and method of for its production
US20060058864A1 (en) * 2003-11-08 2006-03-16 Schaeffer Darin G Balloon flareable branch vessel prosthesis and method
US20050171598A1 (en) * 2003-11-08 2005-08-04 Schaeffer Darin G. Aorta and branch vessel stent grafts and method
US20050149166A1 (en) * 2003-11-08 2005-07-07 Schaeffer Darin G. Branch vessel prosthesis with anchoring device and method
US20070179592A1 (en) * 2003-11-08 2007-08-02 Schaeffer Darin G Branch vessel prosthesis with positional indicator system and method
US20050192659A1 (en) * 2004-01-23 2005-09-01 Terry Dahl Apparatus and method for performing a surgical procedure
US20070038283A1 (en) * 2004-02-06 2007-02-15 Mustapha Jihad A Ostial stent and balloon
US20080243151A1 (en) * 2004-04-12 2008-10-02 Binmoeller Kenneth F Luminal Structure Anchoring Devices and Methods
US20050228413A1 (en) * 2004-04-12 2005-10-13 Binmoeller Kenneth F Automated transluminal tissue targeting and anchoring devices and methods
US20070173867A1 (en) * 2004-08-27 2007-07-26 Brenneman Rodney A Device and method for establishing an artificial arterio-venous fistula
US20060047337A1 (en) * 2004-08-27 2006-03-02 Brenneman Rodney A Device and method for establishing an artificial arterio-venous fistula
US20070249985A1 (en) * 2004-08-27 2007-10-25 Rox Medical, Inc. Device and method for establishing an artificial arterio-venous fistula
US20060106455A1 (en) * 2004-11-12 2006-05-18 Icon Interventional Systems, Inc. Ostial stent
US20060129221A1 (en) * 2004-12-10 2006-06-15 Medtronic, Inc. Tunneling guide
US20060235269A1 (en) * 2005-04-15 2006-10-19 The University Of Chicago Method, apparatus and kit for bile or pancreatic duct endoscopy
US20070021828A1 (en) * 2005-05-23 2007-01-25 Jeff Krolik Mechanically actuated stents and apparatus and methods for delivering them
US20070043381A1 (en) * 2005-08-19 2007-02-22 Icon Medical Corp. Medical device deployment instrument
US20070073388A1 (en) * 2005-08-22 2007-03-29 Krolik Jeffrey A Flared stents and apparatus and methods for delivering them
US20070073376A1 (en) * 2005-08-22 2007-03-29 Krolik Jeffrey A Steep-taper flared stents and apparatus and methods for delivering them
US20070067011A1 (en) * 2005-08-22 2007-03-22 Krolik Jeffrey A Steep-taper flared stents and apparatus and methods for delivering them
US20070055358A1 (en) * 2005-08-22 2007-03-08 Krolik Jeffrey A Axially compressible flared stents and apparatus and methods for delivering them
US20070088425A1 (en) * 2005-10-13 2007-04-19 Cook Incorporated Endoluminal prosthesis
US20070173921A1 (en) * 2005-10-28 2007-07-26 Wholey Mark H Flared stents and apparatus and methods for delivering them
US20090143713A1 (en) * 2007-11-30 2009-06-04 Jacques Van Dam Biliary Shunts, Delivery Systems, Methods of Using the Same and Kits Therefor
US20090143760A1 (en) * 2007-11-30 2009-06-04 Jacques Van Dam Methods, Devices, Kits and Systems for Defunctionalizing the Gallbladder

Cited By (23)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8425539B2 (en) 2004-04-12 2013-04-23 Xlumena, Inc. Luminal structure anchoring devices and methods
US20050228413A1 (en) * 2004-04-12 2005-10-13 Binmoeller Kenneth F Automated transluminal tissue targeting and anchoring devices and methods
US9486219B2 (en) 2007-11-30 2016-11-08 Treus Medical, Inc. Biliary shunts, delivery systems, methods of using the same and kits therefor
US20090143713A1 (en) * 2007-11-30 2009-06-04 Jacques Van Dam Biliary Shunts, Delivery Systems, Methods of Using the Same and Kits Therefor
US20090143760A1 (en) * 2007-11-30 2009-06-04 Jacques Van Dam Methods, Devices, Kits and Systems for Defunctionalizing the Gallbladder
US20110071350A1 (en) * 2007-11-30 2011-03-24 Jacques Van Dam Applicator for endoscopic treatment of biliary disease
US9282968B2 (en) 2007-11-30 2016-03-15 Treus Medical, Inc. Applicator for endoscopic treatment of biliary disease
US8454632B2 (en) 2008-05-12 2013-06-04 Xlumena, Inc. Tissue anchor for securing tissue layers
US20100222750A1 (en) * 2009-02-27 2010-09-02 Vanderbilt University Replenishable drug delivery implant for bone and cartilage
US9364259B2 (en) 2009-04-21 2016-06-14 Xlumena, Inc. System and method for delivering expanding trocar through a sheath
US9381041B2 (en) 2009-04-21 2016-07-05 Xlumena, Inc. Methods and devices for access across adjacent tissue layers
US20110137394A1 (en) * 2009-05-29 2011-06-09 Xlumena, Inc. Methods and systems for penetrating adjacent tissue layers
US20110054381A1 (en) * 2009-05-29 2011-03-03 Jacques Van Dam Biliary shunts, delivery systems, and methods of using the same
US8357193B2 (en) 2009-05-29 2013-01-22 Xlumena, Inc. Apparatus and method for deploying stent across adjacent tissue layers
US9888926B2 (en) 2009-05-29 2018-02-13 Boston Scientific Scimed, Inc. Apparatus and method for deploying stent across adjacent tissue layers
US9901347B2 (en) 2009-05-29 2018-02-27 Terus Medical, Inc. Biliary shunts, delivery systems, and methods of using the same
US20110100381A1 (en) * 2009-10-29 2011-05-05 Elmer Lucas B Method of Treating Metabolic Disorder By Severing the Bile Duct
US20110105985A1 (en) * 2009-10-29 2011-05-05 Elmer Lucas B Treatment For Metabolic Disorders By Diverting Bile To the Circulatory System
US20110106020A1 (en) * 2009-10-29 2011-05-05 Elmer Lucas B Catheter For Deactivating At Least A Portion of the Digestive Enzymes In An Amount Of Bile
US20110106225A1 (en) * 2009-10-29 2011-05-05 Elmer Lucas B Method For Surgically Treating A Patient By Deactivating A Portion Of The Digestive Enzymes
JP2013537434A (en) * 2010-05-08 2013-10-03 ザ ボード オブ トラスティーズ オブ ザ レランド スタンフォード ジュニア ユニバーシティー Device and method for treating gallstones
CN103068326A (en) * 2010-05-08 2013-04-24 小利兰斯坦福大学托管委员会 Devices and methods to treat gallstone disease
WO2011143137A3 (en) * 2010-05-08 2012-03-15 The Board Of Trustees Of The Leland Stanford Junior University Devices and methods to treat gallstone disease

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