US20140364882A1 - Blood vessel connectors and methods for blood vessel connection - Google Patents

Blood vessel connectors and methods for blood vessel connection Download PDF

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Publication number
US20140364882A1
US20140364882A1 US14/369,649 US201214369649A US2014364882A1 US 20140364882 A1 US20140364882 A1 US 20140364882A1 US 201214369649 A US201214369649 A US 201214369649A US 2014364882 A1 US2014364882 A1 US 2014364882A1
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United States
Prior art keywords
clip
vessel
ring
closed position
examples
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Abandoned
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US14/369,649
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English (en)
Inventor
Cornelis Antonius Franciscus Tulleken
Jappe Onno Tunnis Noest
Hendricus Jacobus Mansvelt Beck
Alexander Cornelis Elisabeth Van Thoor
David Stecher
Glenn Bronkers
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Amt Medical Bv
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CORVASCO MEDICAL BV
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Priority to US14/369,649 priority Critical patent/US20140364882A1/en
Assigned to JONG, C. DE reassignment JONG, C. DE ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: AMJ BV
Assigned to CORVASCO MEDICAL B.V. reassignment CORVASCO MEDICAL B.V. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: JONG, C. DE
Publication of US20140364882A1 publication Critical patent/US20140364882A1/en
Assigned to AMT MEDICAL B.V. reassignment AMT MEDICAL B.V. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: CORVASCO MEDICAL B.V.
Abandoned legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/08—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound
    • A61B17/083—Clips, e.g. resilient
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1103—Approximator
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1107—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis for blood vessels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1121—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis adapted for performing tissue or graft eversion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1132—End-to-end connections
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1135—End-to-side connections, e.g. T- or Y-connections
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1139—Side-to-side connections, e.g. shunt or X-connections

Definitions

  • the present subject matter relates to the field of surgery, including methods for fusing or otherwise connecting body tissues, such as blood vessels.
  • the invention is useful during vascular surgery for creating anastomoses and for vascular reconstruction.
  • tissue connections In vascular surgery, anastomoses need to be made to join vessels with other vessels or open volumes through which blood can flow. Such tissue connections should be made blood-tight, and be able to withstand the pressures and forces acting on them in vivo.
  • tissue joints such as the ones required in an anastomosis are created when the surgeon sutures or staples tissues, such as vessel wall tissues, together.
  • tissue soldering, tissue welding, and the use of adhesives have also been discussed, but the first two methods are not widely used, while adhesives are generally only used in combination with sutures, clips, or mechanical closures.
  • using adhesives alone to join body tissues can result in mechanically unsafe connections or connections with insufficient patency.
  • the tissues to be joined can be under a different tension during surgery than in vivo, or can be subject to varying tensions, which can result in the weakening or breaking of an adhesive bond between the tissues or a change in the form of a connection.
  • the present invention addresses the above-described needs by providing improved methods for attaching body vessels to each other as well as for improved anastomotic surgery aids.
  • an apparatus comprises a clip which includes a first side including a first ring configured to pass over an end of a first vessel, the first ring configured to engage the first side with the first vessel; and a second side coupled to the first side, the second side including a second ring configured to pass over an end of a second vessel, the second ring configured to engage the second side with the second vessel, the first and second sides, when in a closed position, being configured to maintain the first and second vessels in substantially end-to-end contact.
  • an apparatus comprises a clip including a first side including a first attachment portion configured to engage a side wall of a first vessel; and a second side coupled to the first side, the second side including a second attachment portion configured to engage a side wall or an end of a second vessel, the first and second sides, when in a closed position, being configured to maintain the first and second vessels in side-to-side contact, or in side-to-end contact, respectively.
  • An apparatus comprising a clip including a first side including a first ring configured to pass over an end of a first vessel, the first ring configured to engage the first side with the first vessel; and a second side coupled to the first side, the second side including a second ring configured to pass over an end of a second vessel, the second ring configured to engage the second side with the second vessel, the first and second sides, when in a closed position, being configured to maintain the first and second vessels in substantially end-to-end contact.
  • a first or second side of the clip includes respective first or second attachment features configured to attach the first or second side of the clip with the first or second vessel.
  • first or second attachment features include points configured to puncture a wall of the respective first or second vessel, thereby to attach the first or second side of the clip with the respective first or second vessel.
  • first side of the clip and the second side of the clip are hinged to each other to be movable between the closed position and an open position
  • first ring and second ring are arranged mutually parallel, wherein in the open position the first ring and second ring are arranged at an angle with respect to each other.
  • a method for facilitating connection of first and second vessels comprising obtaining a clip including a first side including a first ring configured to pass over an end of the first vessel, the first ring configured to engage the first side with the first vessel, and a second side coupled to the first side, the second side including a second ring configured to pass over an end of the second vessel, the second ring configured to attach the second side with the second vessel; passing the first ring over the end of the first vessel; passing the second ring over the end of the second vessel; and closing the sides of the clip to bring the first and second vessels in substantially end-to-end contact.
  • first or second side of the clip includes respective first or second attachment features, the first or second attachment features including points configured to puncture a wall of the first or second vessel.
  • An apparatus comprising a clip including a first side including a first attachment portion configured to engage a side wall of a first vessel; and a second side coupled to the first side, the second side including a second attachment portion configured to engage a side wall or an end of a second vessel, the first and second sides, when in a closed position, being configured to maintain the first and second vessels in side-to-side contact, or in side-to-end contact, respectively.
  • first side of the clip and the second side of the clip are movable with respect to each other between the closed position and an open position
  • first attachment portion and second attachment portion are arranged at an angle with respect to each other.
  • first or second attachment portion includes at least one fork or point configured to puncture the side wall or end of the respective first or second vessel, thereby to engage the first or second side of the clip with the side wall or end of the respective first or second vessel.
  • first or second attachment portion includes a pair of forks for insertion into the side wall of the first or second vessel.
  • each fork has a curved section where the prongs are outwardly curved with respect to each other.
  • each fork has a rectilinear section where the prongs are substantially parallel to each other.
  • prongs of the fork have a pointed distal end to puncture a vessel
  • the fork has a first prong section, a second prong section arranged between the first prong section and the distal ends of the prongs, and a third prong section, which is arranged between the second prong section and the distal ends of the prongs and extends up to the distal ends of the prongs,
  • the prongs diverge with respect to each other.
  • first attachment portion includes a first loop having a first leg, a second leg and a reverse bend connecting the first and second leg and extending 180°
  • first leg extends from an end of the loop coupled to the second side to the reverse bend
  • the second attachment portion includes a second loop having a first leg, a second leg and a reverse bend connecting the first and second leg and extending 180°
  • first leg extends from an end of the loop coupled to the second side to the reverse bend
  • any of examples 38-39 further comprising a second retainer member, such as a second ring structure, interposable between the first and second sides of the clip, the second retainer member being configured to engage with a side of the clip to open or close a connection between the first and second vessels.
  • a second retainer member such as a second ring structure
  • a method for facilitating connection of first and second vessels comprising obtaining a clip including a first side including a first attachment portion configured to engage a side wall of a first vessel, and a second side coupled to the first side, the second side including a second attachment portion configured to engage a side wall or an end of a second vessel, the first and second sides, when in a closed position, being configured to maintain the first and second vessels in side-to-side contact, or in side-to-end contact, respectively; engaging the first attachment portion with the side wall of the first vessel; engaging the second attachment portion with the side wall or the end of the second vessel; and closing the sides of the clip to bring the first and second vessels in substantially side-to-side or side-to-end contact.
  • first or second attachment portion includes points or at least one fork configured to puncture the side wall or end of the respective first or second vessel
  • the method further includes inserting the points or the at least one fork into the side wall or end of the first or second vessel thereby to engage the first or second side of the clip with the respective side wall or end of the first or second vessel.
  • the first or second attachment portion includes a pair of forks for piercing the side wall of the first or second vessel, the pair of forks defining an outline that can stretch or support a portion of the side wall disposed between the forks when the forks are embedded in the side wall of the first or second vessel; and wherein the method further comprises inserting the pair of forks into the side wall of the respective first or second vessel, and supporting or stretching a portion of the side wall disposed between the inserted forks.
  • any one of examples 42-44 wherein the clip includes a retainer member interposable between the first and second side soft the clip, the retainer member being configured to engage with a side of the clip to open or close a connection between the first and second vessels, the method further comprising opening or closing at least one of the sides of the clip to open or close the connection.
  • FIGS. 1A-1E show aspects of an anastomosis clip, according to example embodiments.
  • FIGS. 2A-2C show aspects of a method for facilitating connection of first and second vessels, according to example embodiments.
  • FIGS. 3A-3C show aspects of an anastomosis clip, according to example embodiments.
  • FIG. 4A-4D show aspects of an anastomosis clip, according to example embodiments.
  • FIGS. 5A-5F show aspects of a method for facilitating connection of first and second vessels, according to example embodiments.
  • FIGS. 6A-6B show aspects of an anastomosis clip, according to example embodiments.
  • FIGS. 7A-7C show aspects of an anastomosis clip, according to example embodiments.
  • FIGS. 8A-8H show aspects of an anastomosis clip, according to example embodiments.
  • FIGS. 9A-9B are block flow diagrams depicting aspects of methods for facilitating connection of first and second vessels, according to example method embodiments.
  • the accompanying figures illustrate generally an example anastomosis clip.
  • the anastomosis clip can be used to connect two vessels together.
  • the anastomosis clip can be used to connect two vessels substantially end to end, as shown for example in FIG. 1E .
  • the anastomosis clip can be used to connect various vessels together.
  • the vessels may be connected in occlusive or non-occlusive manner.
  • the anastomosis clip can be used in a bypass procedure.
  • an example anastomosis clip 10 includes two rings 16 and 18 coupled together by a hinge shown generally by numeral 20 .
  • the hinge 20 includes opposed gripping formations 22 that allow the rings 16 and 18 to be manipulated by a suitable applicator (not shown).
  • the applicator may have jaws that can engage with the gripping formations 22 to open and close the clip, for example.
  • at least one of the sides of the clip, and in some cases both sides, is biased to a closed position.
  • the hinge 20 of the anastomosis clip 10 is biased to a closed position ( FIG. 1B ).
  • the gripping formations 22 can be squeezed together against the bias by an applicator to move the rings 16 and 18 apart ( FIG. 1A ).
  • biasing mechanisms or features can include or use springs or spring-like elements, clamps, “memory” steel or deformable material, and manual clip-closing systems.
  • the rings 16 and 18 can be held in a closed or open position by deformation of material included in the hinge 20 or biasing mechanism.
  • the rings 16 and 18 have attachment features in the form of points 24 extending radially outwardly from the rings 16 and 18 .
  • the points 24 are configured to puncture the vessel wall, such as, for instance, the folded-over vessel wall 26 of one or more of the vessels to be joined ( FIGS. 1B-1C ).
  • the points 24 puncture the vessel wall completely such that ends of the points 24 can be seen at exit puncture marks 28 ( FIG. 1C ).
  • the points do not puncture the vessel wall completely.
  • the rings 16 and 18 have eight points 24 , although it is contemplated that the rings include more or less than eight points, or no points (i.e.
  • the rings have different numbers of points from one another.
  • the surface of the rings may be roughened to provide a textured surface.
  • the points or roughened surface can assist in avoiding slippage of the connected vessels or avoid slippage of the vessels relative to the rings.
  • the points can also improve the stability of the connected vessels leading to improved hemastosis.
  • Some points 24 might be configured to extend in different directions or angles relative a plane or axis of the ring.
  • the points 24 include different point configurations of features, for example a pin configuration, or a hook configuration, or one or more teeth, or a hardened surface (for example, diamond), or may include biocompatible or bio-absorbable material.
  • FIG. 2A shows two vessel ends 12 and 14 in contact with the anastomosis clip 10 , with one vessel end placed through each of the rings 16 and 18 of the anastomosis clip 10 .
  • FIG. 2B shows the ends of the vessels 12 and 14 being folded over, shown generally at 26 , with the points of one of the rings penetrating through the vessel wall at 28 to attach the ring of the anastomosis clip 10 with the vessel wall. This connection can avoid slippage.
  • FIG. 2A shows two vessel ends 12 and 14 in contact with the anastomosis clip 10 , with one vessel end placed through each of the rings 16 and 18 of the anastomosis clip 10 .
  • FIG. 2B shows the ends of the vessels 12 and 14 being folded over, shown generally at 26 , with the points of one of the rings penetrating through the vessel wall at 28 to attach the ring of the anastomosis clip 10 with the vessel wall. This connection can avoid slippage.
  • FIG. 2C shows each vessel wall folded over and attached to the corresponding ring of the anastomosis clip 10 , with the anastomosis clip 10 in the closed position to connect the vessels 12 and 14 substantially end-to-end. Since both vessel walls are folded an intima to intima contact is facilitated. This can be important in surgical procedures.
  • the anastomosis clip 10 (and the hinge 20 thereof) is sufficient to maintain the vessels 12 and 14 in end-to-end contact without the need of separate fasteners, such as sutures, for instance.
  • one or more additional fasteners can be used with the anastomosis clip.
  • FIGS. 3A-3B show an example of a side of the anastomosis clip 10 of FIGS. 1A-2C .
  • Each side of the anastomosis clip 10 can be identical, in some examples.
  • the sides of the anastomosis clip can differ in shape, size, or configuration.
  • a circular shape is shown for both rings in the accompanying drawings, but other shapes for the rings individually or collectively are possible.
  • the overall or greatest size of a clip 10 can range from a couple of millimeters to a couple of centimeters.
  • the sides of the clip 10 can have different dimensions, for instance, to fit the vessels intended to be attached.
  • the anastomosis clip has the dimensions indicated in the table appearing in FIG. 3C .
  • the numerals listed in that table are marked in FIGS. 3A-3B .
  • FIGS. 4A-4D generally depict an example anastomosis clip 10 .
  • the clip can include two sides 16 and 18 coupled together. In an example, the two sides are hinged together shown generally at 20 . In some examples, the hinge 20 of the anastomosis clip 10 is biased to a closed position.
  • the clip 10 can include gripping formations and can be manipulated with a suitable applicator, for example in similar manner to the clip 10 described above.
  • the present clip 10 includes one or more biasing mechanisms or features, for example biasing mechanisms or features of the type described above.
  • At least one of the sides 16 and 18 of the clip includes an attachment portion configured to attach the side to a corresponding vessel.
  • the attachment portion includes attachment features such as forks 30 and 32 configured to pierce the vessel wall. While each side is shown with a two-prong (or paired) fork, it is contemplated that the sides of the anastomosis clip 10 include differently configured attachment features.
  • FIGS. 5A-5F show an example procedure for joining two vessels 12 and 14 together.
  • an anastomosis clip 10 can be used to connect the two vessels.
  • the two-pronged forks 30 and 32 are pushed through the walls of a donor and recipient vessel and then the clip 10 is closed.
  • the anastomosis clip 10 can be used to connect two vessels side to side.
  • the anastomosis clip 10 can be used to connect various vessels together, including, but not limited to vessels in the brain.
  • the anastomosis clip can be used in a bypass procedure.
  • FIGS. 5A-5D show a first side 18 of the anastomosis clip attached to a first vessel 12 (for instance, a donor vessel).
  • the forks 32 of the first side 18 of the clip 10 have been inserted into the wall of the vessel 12 and therefore the side 18 and the forks 32 are not directly visible in these views.
  • the outwardly curved configuration of the forks 32 serves to stretch the wall of the vessel 12 somewhat.
  • the stretched wall defines a substantially planar or level surface 36 in the vessel wall.
  • the planar or level surface 36 can facilitate the ability to cut an incision or a hole in, or a flap from, the vessel wall using a laser catheter, a puncher or scissors, for example.
  • the region 36 is generally bounded by the contours of the underlying forks 32 and the wall of the vessel is stretched or at least supported in that region.
  • a laser catheter (or other device) can be passed through the first vessel 12 to align a tip of the laser catheter with the surface 36 and to cut through the wall of the first vessel lying within that region.
  • a laser other devices may be used like punchers or scissors to create an incision or hole in, or flap from, the vessel wall.
  • the laser catheter can be of conventional type. Appropriate cuts by the laser form a hole in the vessel wall allowing the passage of blood. In some examples, a hole is not formed in the region 36 until the two vessels 12 and 14 have first been joined together in the following manner.
  • the clip 10 can be placed in an open position such that a second side 16 of the clip which includes the forks 30 is moved away from the wall of the vessel 12 .
  • the standing configuration of the forks 30 in an open clip 10 can facilitate entry of the forks into an adjacent vessel wall, but depending on the configuration of the forks 30 , or the overall configuration of the clip 10 , or the configuration of the sides 16 and 18 , the need to open the clip 10 to join one side to another vessel may not always be required.
  • sharp ends of the forks may stand proud of the clip even in a closed position such that the sharp ends are free to be inserted, by sliding action of the clip along the vessel wall, into the vessel wall.
  • the second side 16 of the anastomosis clip is then connected with a second vessel 14 (for instance, a recipient vessel) by inserting the forks 30 into the wall of the vessel 14 .
  • a second vessel 14 for instance, a recipient vessel
  • the anastomosis clip 10 can be placed in the closed position to abut the sides of the first and second vessels together, as shown in FIG. 5F .
  • the laser catheter (or other device) can then be used to cut a second hole in the side of the second vessel 14 to allow fluid to pass between the first and second vessels 12 and 14 through the now-aligned holes in their sides. If a hole has not previously been formed in the first vessel 12 , the laser catheter (or other device) can then be used at this time to cut a “joint” hole in abutting sides of both of the first and second vessels 12 and 14 to allow fluid to pass between the first and second vessels through the “joint” hole.
  • the anastomosis clip 10 in the closed position connects the vessels side-to-side, and can disconnect the vessels in the open position.
  • the anastomosis clip 10 (and the hinge 20 thereof) is sufficient to maintain the vessels in side-to-side contact without the need of separate fasteners, such as sutures, for instance.
  • one or more additional fasteners can be used with the anastomosis clip.
  • the sides and/or forks of the clip 10 can assume different configurations or be of different sizes relative to one another.
  • the forks 30 and 32 can have an open ring shape in plan outline, with the diameter of the outer open ring of the forks 32 being larger than the diameter of the inner open ring of the forks 30 .
  • This configuration allows an attachment feature on one side of the clip 10 (inserted, for example, into a recipient vessel) to nest within, or at least partially lie inside, an attachment feature on the other side of the clip 10 (inserted, for example, into a donor vessel).
  • one side or attachment feature of the clip 10 can lie within the other side or attachment feature of the clip 10 in a “side-by-side” general configuration when the clip 10 is closed.
  • the contours of the forks 30 are configured or bent out of plane as appropriate to allow such nesting. The nesting configuration can improve fixation of the vessel walls to each other and allow improved hemostasis.
  • the rings or attachment features are of similar size and assume an overlapping or “ring-on-ring” general configuration when the clip 10 is closed.
  • FIGS. 6A-6B generally depict an example anastomosis clip 10 .
  • the clip can include two sides 16 and 18 coupled together by means of an applicator shown generally at 38 .
  • the two sides 16 and 18 can be held and manipulated using opposed jaws 40 of the applicator 38 .
  • the sides 16 and 18 can move about a pivot axis 20 defined by the applicator 38 .
  • the sides of the clip 10 are biased to a closed position by the applicator 38 .
  • the jaws 40 are detachable from the applicator 38 and, in some examples, the sides 16 and 18 are detachable from the jaws 40 .
  • the clip 10 or applicator 38 can include one or more biasing mechanisms of features of the type described above.
  • One or both sides 16 and 18 include attachment features configured to attach the side to a corresponding vessel.
  • attachment features are provided on both sides and include forks 30 and 32 configured to pierce the vessel wall.
  • the forks 30 and 32 are two-pronged and assume a “bull-horn” configuration as shown.
  • An example function of the bull horn is to match the puncture holes to the size of maximum lateral size of the metal ring in order to avoid extra stretch of the vessel wall, which potentially can reduce the chance of vessel damage during device positioning.
  • Other configurations are possible.
  • the bull-horn forks are configured to assume a “side-by side” ( FIG. 6B ) configuration, or in some examples a “ring-on-ring” configuration, when the clip 10 is closed.
  • the substantially parallel, rectilinear portions 42 of the bull-horn forks 30 and 32 do not stretch the walls of the vessel as much as the rounder ring-shaped forks of the example clip 10 discussed further above, when inserted into the walls of a vessel.
  • the narrower or straighter fork configuration can allow easier entry of the forks into the walls of a corresponding vessel.
  • distal portions 44 of the opposed forks 30 and 32 are shaped inwardly to define a substantially enclosed region 36 lying within the forks 30 and 32 .
  • the region 36 can, in similar manner to that described above, be used to provide a supported area for joining the walls of abutting vessels in “side-to-side” manner, or the end of a vessel to the wall of another vessel in “end-to-side” manner. While each side of the clip 10 is shown with a two-prong fork, it is contemplated that the sides of the anastomosis clip 10 include differently configured attachment features.
  • a clip 10 includes a fork-ring combination such that a first side of the clip 10 includes attachment features (such as the example forks 30 and 32 of FIGS. 4A-6B ), while a second side of the clip 10 includes a ring formation so that vessels can be joined in “side-to-end” manner.
  • the second side of the clip may include a “closed ring” of the type shown in FIGS. 1A-3C , or in some examples may include an “open ring” forked configuration of the type shown in FIGS. 4A-6B (or any of the other examples described further below).
  • the second or “ring” side of the clip is used to secure a folded-over portion of an end of a vessel against the walls of another vessel which has been pierced and secured by the first or “forked” side of the clip.
  • the clip 10 holds the two vessels together.
  • a laser catheter or other device can be used to form a hole in the wall of the second vessel to allow passage of blood from the open end of the one vessel through the wall of the other vessel.
  • either side of the clip 10 can include attachment features or rings of any of the example embodiments described herein.
  • FIGS. 7A-7C generally depict an example anastomosis clip 10 .
  • the illustrated example clip 10 is of a general “paper-clip” configuration and includes two legs or loops that define (when the clip 10 is open) sides 16 and 18 of the clip 10 ( FIG. 7C ).
  • the legs of the sides 16 and 18 assume a nesting “side-by-side” configuration when the clip 10 is closed ( FIG. 7A ), while in some examples, the legs of the sides 16 and 18 lie one on top of another in a “ring-on-ring” configuration when the clip 10 is closed.
  • Each side of the clip 10 has only one vessel penetration pin or tip, in one example.
  • the other aspects of the clip operate in similar manner to other examples described in this specification.
  • the sides 16 and 18 of the clip are joined together by a central hinge portion 20 formed integrally with the material of the clip 10 , similar again to the structure of a paper-clip.
  • the sides 16 and 18 of the clip can be urged apart manually.
  • the sides 16 and 18 can be urged apart by an operator using the jaws 40 of an applicator 48 which engage with areas of the hinge portion 20 ( FIGS. 7B-7C ).
  • the hinge portion 20 is deformed and the restorative force generated by the deformed material biases the sides 16 and 18 back into a closed position of the clip 10 ( FIG. 7A ).
  • Other biasing mechanisms or features are possible, such as those described further above.
  • the deformed hinge portion 20 does not bias the clip but is sufficient to hold the clip in a desired position.
  • the hinge portion 20 is formed separately from the clip 10 .
  • a leg of each side 16 and 18 of the clip terminates at a proximal end in a curved, sharp portion indicated respectively by numerals 16 A and 18 A in FIGS. 7A-7C .
  • the distal ends (i.e. away from the applicator) of each side 16 and 18 of the clip form hoops, similar again to a paper-clip.
  • the sharp portions 16 A and 18 A are carried by respective straight pin portions of the legs marked 16 B and 18 B in FIG. 7B .
  • the sides 16 and 18 of the clip 10 can then be moved or released to hold the walls of the joined vessels together.
  • the entry of a single leg alone into each vessel results in only one point of entry in each vessel being formed accordingly. Reduction of entry points can be less traumatic to the vessel wall and can provide an advantage for the operator in being able to focus on one entry point only when inserting the clip.
  • the legs of the sides 16 and 18 assume round, oval, rectilinear, or other shapes or configurations in outline or cross-section. The legs may be of different sizes with respect to one another.
  • FIGS. 8A-8H generally depict an example anastomosis clip 10 .
  • This example clip is sometimes referred to as a “trinity” clip in that it can comprise three parts: two sides 16 and 18 , and a retainer member 46 .
  • the clip nevertheless operates in similar manner to other examples described in this specification, and can provide the same advantages.
  • the shape of the sides and/or forks of the clip can be as shown in the example drawings in FIGS. 8A-8H or can have the bull horn configuration or paper clip configuration or a combination of the configurations for each side, ring, or fork.
  • a retainer member 46 is interposed, or at least interposable, between the sides 16 and 18 of the clip 10 .
  • the retainer member 46 can allow a donor vessel connection and a recipient vessel connection to be opened or closed independently of each other.
  • One side 16 of an installed clip 10 acting, for instance, against the retainer member 46 to close a donor vessel connection (with or without closing bias), can be left intact (i.e. in closed position) while the other side 18 of the clip can be opened or moved away from the retainer member 46 to open, for instance, a recipient vessel connection.
  • the thus-opened recipient connection can be closed again, as desired, without disturbing the donor connection on the other side of the clip 10 .
  • the independent opening and closing of connections can allow improved fixation and stability of a surgical site while allowing more control of blood flow, the introduction of catheters, and so forth.
  • an example anastomosis clip 10 includes two sides 16 and 18 coupled together.
  • the two sides are hinged together shown generally at 20 .
  • the hinge 20 of the clip 10 is biased to a closed position.
  • the clip 10 includes formations or mechanisms so that one or more of the sides 16 and 18 can be manipulated, with or without associated movement of the retainer member 46 .
  • the sides 16 and 18 of the clip 10 can be manipulated with an applicator.
  • the clip 10 can include one or more biasing mechanisms or features, including for example the biasing mechanisms of features described further above.
  • each of the sides 16 and 18 includes attachment features configured to attach each of the sides to a corresponding vessel.
  • the attachment features include forks 30 and 32 configured to pierce the vessel wall. While each side is shown with a two-prong (or paired) fork, it is contemplated that the sides of the anastomosis clip 10 include differently configured attachment features. In some embodiments, the ends of the forks 30 and 32 are sharp to pierce the vessel wall.
  • the retainer member 46 is fixed to the clip, or may be attached to or form part of the hinge 20 . In some examples, the retainer member 46 is free and unattached to the clip.
  • a clip kit including a clip 10 (as described in any of the examples above) and a separate retainer member 46 (configured to be interposable between the sides) may be provided.
  • the retainer member includes a ring structure, including for example a structure substantially as shown in FIGS. 8A-8H .
  • Other configurations, structures and shapes of retainer member 46 are possible.
  • the configurations, structures and shapes of the retainer member may be selected to cooperate with the attachment features of the clip, or the size of the vessels to be joined, for example.
  • an attachment feature of one or both sides 16 and 18 of the clip 10 is shaped or bent (for example, at 31 in FIG. 8H ) so that at least a portion of the attachment feature lies within the retainer member 46 when the clip 10 is closed.
  • the sides 16 and 18 of the clip 10 may, in conjunction with the retainer member 46 or independently thereof, form “side-by-side” or “ring-on-ring” configurations of the type described above when brought together.
  • Each or both of the sides 16 and 18 of the clip 10 may include one or more of the example rings and attachment features described herein, or variants thereof.
  • a second or more retainer members 46 are provided.
  • a clip 10 may include two ring structures 46 interposed between the sides 16 and 18 of the clip 10 , and hence comprise four parts.
  • installation of the clip 10 can proceed as follows.
  • the clip 10 is opened (or otherwise manipulated when closed, depending on the overall configuration of the clip 10 , or its respective sides 16 and 18 and attachment features, and so forth) so that one side 16 of the clip 10 is inserted into the wall of a first vessel (such as a donor vessel), and the other side 18 of the clip is inserted into the wall of a second vessel (such as a recipient vessel).
  • the clip 10 can be used as appropriate to form end-to-end, side-to-side, or end-to-side vessel connections.
  • the retainer member 46 lies in use between the outer surfaces of the walls of the adjoining vessels and defines a reaction surface against which the sides 16 and 18 of the clip 10 (inserted within the corresponding vessel wall) can push or engage the vessel walls to close a corresponding vessel connection.
  • This arrangement is shown for example in schematic sectional outline in FIG. 8H .
  • the vessel walls have been omitted in this view in the interest of clarity, but it will be appreciated that the “upper” side 16 of the clip can be moved (as desired) towards or away from the retainer member 46 and independently of the “lower” side 18 of the clip 10 , which can do the same.
  • a hole can be formed (by a laser catheter or other device, for example) to pass though through the walls of the adjoining vessel walls and through the center of the retainer member 46 .
  • the pins or forks on a side 16 or 18 of the clip 10 are first advanced into a donor vessel. The clip 10 is closed and the donor vessel wall is captured between the retainer member (e.g. ring 46 ) of the clip and the pins in the donor vessel wall.
  • a hole can be formed or burned by advancing a laser catheter (or other device, for example) via the distal end of the donor vessel.
  • the other side of the clip ( 18 or 16 , respectively—lower part of the clip 10 in the view)can be opened while donor vessel (which has already been holed) is held in place by the retainer member 46 .
  • the pins or forks on the other side of the clip 10 can be introduced into a recipient vessel and clip 10 can be closed.
  • the catheter (or other device) can be positioned again and will form or burn a hole in the recipient vessel.
  • the retainer member 46 will give stability to the recipient vessel and the introduced pins or forks.
  • the shape of the clip sides 16 and 18 , the pins or forks, and the retainer member 46 can be configured in such a way that the vessel walls are pushed on top of each other so that good connection is facilitated.
  • a method 900 includes: at element 902 , obtaining a clip including a first side including a first ring configured to pass over an end of the first vessel, the first ring configured to engage the first side with the first vessel, and a second side coupled to the first side, the second side including a second ring configured to pass over an end of the second vessel, the second ring configured to attach the second side with the second vessel; at element 904 , passing the first ring over the end of the first vessel; at element 906 , passing the second ring over the end of the second vessel; and, at element 908 , closing the sides of the clip to bring the first and second vessels in substantially end-to-end contact.
  • the method 900 further comprises folding a portion of the end of the first or second vessel over the first or second ring; and attaching the first or second ring to the folded-over portion of the first or second end, respectively.
  • the first or second side of the clip may include respective first or second attachment features, the first or second attachment features including points configured to puncture a wall of the first or second vessel.
  • the wall is a wall of the first or second folded-over portion
  • the method 900 further comprises inserting the points into the wall to attach the first or second ring to the folded-over portion of the first or second vessel end, respectively.
  • the first and second sides of the obtained clip may be biased to a closed position, and the method 900 may further comprise closing the sides of the clip to maintain the first and second vessels in substantially end-to-end contact.
  • a method 1000 includes: at element 1002 , obtaining a clip including a first side including a first attachment portion configured to engage a side wall of a first vessel, and a second side coupled to the first side, the second side including a second attachment portion configured to engage a side wall or an end of a second vessel, the first and second sides, when in a closed position, being configured to maintain the first and second vessels in side-to-side contact, or in side-to-end contact, respectively; at element 1004 , engaging the first attachment portion with the side wall of the first vessel; at element 1006 , engaging the second attachment portion with the side wall or the end of the second vessel; and, at element 1008 , closing the sides of the clip to bring the first and second vessels in substantially side-to-side or side-to-end contact.
  • the first and second sides of the obtained clip are biased to a closed position, and wherein closing the sides of the clip includes maintaining the first and second vessels in substantially side-to-side or side-to-end contact.
  • the first or second attachment portion may include points or at least one fork configured to puncture the side wall or end of the respective first or second vessel, and wherein the method further includes inserting the points or the at least one fork into the side wall or end of the first or second vessel thereby to engage the first or second side of the clip with the respective side wall or end of the first or second vessel.
  • the first or second attachment portion includes a pair of forks for piercing the side wall of the first or second vessel, the pair of forks defining an outline that can stretch or support a portion of the side wall disposed between the forks when the forks are embedded in the side wall of the first or second vessel.
  • the method 1000 may further comprise inserting the pair of forks into the side wall of the respective first or second vessel, and supporting or stretching a portion of the side wall disposed between the inserted forks.
  • the obtained clip includes a retainer member interposable between the first and second side soft the clip, the retainer member being configured to engage with a side of the clip to open or close a connection between the first and second vessels, the method further comprising opening or closing at least one of the sides of the clip to open or close the connection.
  • the method 1000 may further comprise forming a hole in the side wall of the first or second vessel.
  • the terms “a” or “an” are used, as is common in patent documents, to include one or more than one, independent of any other instances or usages of “at least one” or “one or more.”
  • the term “or” is used to refer to a nonexclusive or, such that “A or B” includes “A but not B,” “B but not A,” and “A and B,” unless otherwise indicated.
  • Method examples described herein can be machine or computer-implemented at least in part. Some examples can include a computer-readable medium or machine-readable medium encoded with instructions operable to configure an electronic device to perform methods as described in the above examples.
  • An implementation of such methods can include code, such as microcode, assembly language code, a higher-level language code, or the like. Such code can include computer readable instructions for performing various methods. The code may form portions of computer program products. Further, in an example, the code can be tangibly stored on one or more volatile, non-transitory, or non-volatile tangible computer-readable media, such as during execution or at other times.
  • Examples of these tangible computer-readable media can include, but are not limited to, hard disks, removable magnetic disks, removable optical disks (e.g., compact disks and digital video disks), magnetic cassettes, memory cards or sticks, random access memories (RAMs), read only memories (ROMs), and the like.

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Cited By (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20150094744A1 (en) * 2012-05-25 2015-04-02 H. Lee Moffitt Cancer Center And Research Institute, Inc. Vascular anastomosis stent
US9108018B2 (en) 2006-04-20 2015-08-18 Limflow Gmbh Methods for fluid flow through body passages
US20150289876A1 (en) * 2014-04-10 2015-10-15 Peter Lazic Gmbh Surgical clip with three clamping arms
US9314329B2 (en) 2013-03-08 2016-04-19 Limflow Gmbh Methods and systems for providing or maintaining fluid flow through body passages
US9545263B2 (en) 2014-06-19 2017-01-17 Limflow Gmbh Devices and methods for treating lower extremity vasculature
US10398580B2 (en) 2004-09-08 2019-09-03 Limflow Gmbh Minimally invasive surgical apparatus and methods
US10543308B2 (en) 2017-04-10 2020-01-28 Limflow Gmbh Methods for routing a guidewire from a first vessel and through a second vessel in lower extremity vasculature
WO2020225603A1 (en) * 2019-05-07 2020-11-12 Easyflomicro Inc. Apparatuses for anastomosis of tubular vessels and related methods
US10835367B2 (en) 2013-03-08 2020-11-17 Limflow Gmbh Devices for fluid flow through body passages
US10881415B2 (en) 2014-04-10 2021-01-05 Peter Lazic Gmbh Surgical clip with three clamping arms
US11116943B2 (en) 2018-10-09 2021-09-14 Limflow Gmbh Methods for accessing pedal veins
US11612397B2 (en) 2019-11-01 2023-03-28 Limflow Gmbh Devices and methods for increasing blood perfusion to a distal extremity
WO2023247508A1 (en) * 2022-06-20 2023-12-28 Amt Medical B.V. Anastomosis clip

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2022072041A1 (en) * 2020-09-30 2022-04-07 Boston Scientific Scimed, Inc. Repositionable closure device
WO2024020108A1 (en) * 2022-07-19 2024-01-25 Vanderbilt University An apparatus for anastomosing a cut vessel

Citations (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2627095A (en) * 1949-07-25 1953-02-03 Palmieri Jose Atilio Wire spring clip
US6036703A (en) * 1998-02-06 2000-03-14 Ethicon Endo-Surgery Inc. Method and apparatus for establishing anastomotic passageways
US20030088256A1 (en) * 2001-10-03 2003-05-08 Conston Stanley R. Devices and methods for interconnecting vessels
US20030229363A1 (en) * 2002-06-05 2003-12-11 Sharkawy A. Adam Methods and devices for facilitating the formation of connections between tissue structures
US20040102796A1 (en) * 2002-11-19 2004-05-27 J. Donald Hill Conduit coupling devices and methods for employing such devices
US6811555B1 (en) * 1996-09-16 2004-11-02 Origin Medsystems, Inc. Method and apparatus for performing anastomosis with eversion of tissue edges and joining of exposed intima of the everted tissue
US20050234483A1 (en) * 2000-11-06 2005-10-20 Cardica, Inc. Unitary anastomosis device
US7022131B1 (en) * 1998-05-29 2006-04-04 By-Pass Inc. Methods and devices for vascular surgery
US20070167964A1 (en) * 1996-09-16 2007-07-19 Willis Geoffrey H Tubular anastomosis ring having alternating flexible and rigid sections
US7311730B2 (en) * 2004-02-13 2007-12-25 Shlomo Gabbay Support apparatus and heart valve prosthesis for sutureless implantation
US7322995B2 (en) * 2002-09-13 2008-01-29 Damage Control Surgical Technologies, Inc. Method and apparatus for vascular and visceral clipping
US20110054501A1 (en) * 2008-04-03 2011-03-03 Amj B.V. Securing device and assembly comprising such a securing device
US8062313B2 (en) * 2000-08-11 2011-11-22 Edwards Lifesciences Corporation Device and a method for treatment of atrioventricular regurgitation

Family Cites Families (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3805793A (en) 1973-03-21 1974-04-23 S Wright Anastomotic apparatus
US4917087A (en) * 1984-04-10 1990-04-17 Walsh Manufacturing (Mississuaga) Limited Anastomosis devices, kits and method
US5964750A (en) 1994-03-15 1999-10-12 Medolas Gesellschaft Fuer Medizintechnik Gmbh Laser catheter for bypass surgery
IL119911A (en) * 1996-12-25 2001-03-19 Niti Alloys Tech Ltd Surgical clip
FR2777446B1 (fr) * 1998-04-17 2000-12-01 Perouse Implant Lab Organe de liaison pour l'anastomose, dispositif de mise en place d'attaches et implant les comportant
WO2004086985A1 (en) * 2003-03-28 2004-10-14 St Jude Medical Atg, Inc. Apparatus for making anastomotic connections larger than the graft conduit
US8080023B2 (en) * 2003-12-12 2011-12-20 Vitalitec International, Inc. Device and method for performing multiple anastomoses
US7828814B2 (en) * 2004-08-27 2010-11-09 Rox Medical, Inc. Device and method for establishing an artificial arterio-venous fistula
US8361092B1 (en) * 2007-06-18 2013-01-29 Wilson T. Asfora Vascular anastomosis device and method
US8328828B2 (en) * 2008-08-11 2012-12-11 Board Of Trustees Of The University Of Arkansas Device for performing an anastomosis
CN102686170A (zh) * 2009-11-19 2012-09-19 Amjb.V.公司 用于形成吻合连接的装置

Patent Citations (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2627095A (en) * 1949-07-25 1953-02-03 Palmieri Jose Atilio Wire spring clip
US20070167964A1 (en) * 1996-09-16 2007-07-19 Willis Geoffrey H Tubular anastomosis ring having alternating flexible and rigid sections
US6811555B1 (en) * 1996-09-16 2004-11-02 Origin Medsystems, Inc. Method and apparatus for performing anastomosis with eversion of tissue edges and joining of exposed intima of the everted tissue
US6036703A (en) * 1998-02-06 2000-03-14 Ethicon Endo-Surgery Inc. Method and apparatus for establishing anastomotic passageways
US7022131B1 (en) * 1998-05-29 2006-04-04 By-Pass Inc. Methods and devices for vascular surgery
US8062313B2 (en) * 2000-08-11 2011-11-22 Edwards Lifesciences Corporation Device and a method for treatment of atrioventricular regurgitation
US20050234483A1 (en) * 2000-11-06 2005-10-20 Cardica, Inc. Unitary anastomosis device
US20030088256A1 (en) * 2001-10-03 2003-05-08 Conston Stanley R. Devices and methods for interconnecting vessels
US20030229363A1 (en) * 2002-06-05 2003-12-11 Sharkawy A. Adam Methods and devices for facilitating the formation of connections between tissue structures
US7322995B2 (en) * 2002-09-13 2008-01-29 Damage Control Surgical Technologies, Inc. Method and apparatus for vascular and visceral clipping
US20040102796A1 (en) * 2002-11-19 2004-05-27 J. Donald Hill Conduit coupling devices and methods for employing such devices
US7311730B2 (en) * 2004-02-13 2007-12-25 Shlomo Gabbay Support apparatus and heart valve prosthesis for sutureless implantation
US20110054501A1 (en) * 2008-04-03 2011-03-03 Amj B.V. Securing device and assembly comprising such a securing device

Cited By (34)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11446170B2 (en) 2004-09-08 2022-09-20 Limflow Gmbh Minimally invasive surgical apparatus and methods
US10398580B2 (en) 2004-09-08 2019-09-03 Limflow Gmbh Minimally invasive surgical apparatus and methods
US10390933B2 (en) 2006-04-20 2019-08-27 Limflow Gmbh Devices for fluid flow through body vessels
US9108018B2 (en) 2006-04-20 2015-08-18 Limflow Gmbh Methods for fluid flow through body passages
US9326792B2 (en) 2006-04-20 2016-05-03 Limflow Gmbh Methods for fluid flow through body passages
US9532803B2 (en) 2006-04-20 2017-01-03 Limflow Gmbh Devices for fluid flow through body passages
US11241304B2 (en) 2006-04-20 2022-02-08 Limflow Gmbh Method for fluid flow through body passages
US9782201B2 (en) 2006-04-20 2017-10-10 Limflow Gmbh Methods for fluid flow through body passages
US10136987B2 (en) 2006-04-20 2018-11-27 Limflow Gmbh Devices for fluid flow through body passages
US20150094744A1 (en) * 2012-05-25 2015-04-02 H. Lee Moffitt Cancer Center And Research Institute, Inc. Vascular anastomosis stent
US10524894B1 (en) 2013-03-08 2020-01-07 Limflow Gmbh Methods for effecting retroperfusion in a body passage
US10285800B2 (en) 2013-03-08 2019-05-14 Limflow Gmbh Systems for providing or maintaining fluid flow through body passages
US9706998B2 (en) 2013-03-08 2017-07-18 Limflow Gmbh Methods for targeting body passages
US10405967B1 (en) 2013-03-08 2019-09-10 Limflow Gmbh Methods for puncturing an expandable member to confirm advancement into a body passage
US9314329B2 (en) 2013-03-08 2016-04-19 Limflow Gmbh Methods and systems for providing or maintaining fluid flow through body passages
US11471262B2 (en) 2013-03-08 2022-10-18 Limflow Gmbh Methods for targeting a body passage to effect fluid flow
US10835367B2 (en) 2013-03-08 2020-11-17 Limflow Gmbh Devices for fluid flow through body passages
US10226252B2 (en) * 2014-04-10 2019-03-12 Peter Lazic Gmbh Surgical clip with three clamping arms
US10881415B2 (en) 2014-04-10 2021-01-05 Peter Lazic Gmbh Surgical clip with three clamping arms
US20150289876A1 (en) * 2014-04-10 2015-10-15 Peter Lazic Gmbh Surgical clip with three clamping arms
US9545263B2 (en) 2014-06-19 2017-01-17 Limflow Gmbh Devices and methods for treating lower extremity vasculature
US10596356B2 (en) 2014-06-19 2020-03-24 Limflow Gmbh Methods for placing a stent-graft to cover collateral vessels in lower extremity vasculature
US10543308B2 (en) 2017-04-10 2020-01-28 Limflow Gmbh Methods for routing a guidewire from a first vessel and through a second vessel in lower extremity vasculature
US11826504B2 (en) 2017-04-10 2023-11-28 Limflow Gmbh Methods for routing a guidewire from a first vessel and through a second vessel in lower extremity vasculature
US11129965B2 (en) 2018-10-09 2021-09-28 Limflow Gmbh Devices and methods for catheter alignment
US11311700B2 (en) 2018-10-09 2022-04-26 Limflow Gmbh Methods for accessing pedal veins
US11116943B2 (en) 2018-10-09 2021-09-14 Limflow Gmbh Methods for accessing pedal veins
US11478614B2 (en) 2018-10-09 2022-10-25 Limflow Gmbh Method for accessing pedal veins for deep vein arterialization
US11850379B2 (en) 2018-10-09 2023-12-26 Limflow Gmbh Devices and methods for catheter alignment
WO2020225603A1 (en) * 2019-05-07 2020-11-12 Easyflomicro Inc. Apparatuses for anastomosis of tubular vessels and related methods
US11751876B2 (en) 2019-05-07 2023-09-12 Easyflomicro Inc. Apparatuses for anastomosis of tubular vessels and related methods
US11612397B2 (en) 2019-11-01 2023-03-28 Limflow Gmbh Devices and methods for increasing blood perfusion to a distal extremity
WO2023247508A1 (en) * 2022-06-20 2023-12-28 Amt Medical B.V. Anastomosis clip
NL2032224B1 (en) * 2022-06-20 2024-01-08 Amt Medical B V anastomosis clip

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WO2013105848A1 (en) 2013-07-18

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