US20160242886A1 - Method and apparatus for fixation of implantable devices adjacent a body lumen - Google Patents
Method and apparatus for fixation of implantable devices adjacent a body lumen Download PDFInfo
- Publication number
- US20160242886A1 US20160242886A1 US15/143,784 US201615143784A US2016242886A1 US 20160242886 A1 US20160242886 A1 US 20160242886A1 US 201615143784 A US201615143784 A US 201615143784A US 2016242886 A1 US2016242886 A1 US 2016242886A1
- Authority
- US
- United States
- Prior art keywords
- subject matter
- present subject
- implantable device
- expandable element
- shows
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/0004—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse
- A61F2/0022—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse placed deep in the body opening
- A61F2/0027—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse placed deep in the body opening inflatable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/0004—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse
- A61F2/0031—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra
- A61F2/0036—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra implantable
- A61F2/004—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra implantable inflatable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/0077—Special surfaces of prostheses, e.g. for improving ingrowth
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0017—Catheters; Hollow probes specially adapted for long-term hygiene care, e.g. urethral or indwelling catheters to prevent infections
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/0077—Special surfaces of prostheses, e.g. for improving ingrowth
- A61F2002/0086—Special surfaces of prostheses, e.g. for improving ingrowth for preferentially controlling or promoting the growth of specific types of cells or tissues
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special 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
- A61F2250/0018—Special 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 elasticity, stiffness or compressibility
Definitions
- the present subject matter relates to method and apparatus for fixation of implantable devices adjacent a body lumen.
- the present application relates to method and apparatus for reducing migration and rotation of implantable devices including an expandable element and an elongate portion.
- FIG. 1A shows an example of placement of implantable devices with respect to a human bladder and urethra according to one embodiment of the present subject matter.
- FIG. 1B demonstrates migration of one of the two implantable devices.
- FIG. 1C demonstrates rotation of one expandable element of one of the two implantable devices.
- FIG. 2 shows placement of a sleeve adapted to provide ingrowth to provide an adhesion according to one embodiment of the present subject matter.
- FIG. 3 shows a closeup of the sleeve of FIG. 2 .
- FIG. 4 shows a cross section of an implantable device including a sleeve attached using an adhesive according to one embodiment of the present subject matter.
- FIG. 5 shows a cross section of surface structure adapted to enhance ingrowth according to one embodiment of the present subject matter.
- FIG. 6 shows a cross section of surface structure adapted to enhance ingrowth and resist migration according to one embodiment of the present subject matter.
- FIG. 7 shows a cross section of a helical sleeve structure adapted to enhance ingrowth according to one embodiment of the present subject matter.
- FIG. 8 shows one example of a tool for removal of a helical sleeve structure according to one embodiment of the present subject matter.
- FIG. 9 shows one example of an expandable tool for removal of a helical sleeve structure according to one embodiment of the present subject matter.
- FIG. 10 shows one example of a split ring device adapted to enhance ingrowth according to one embodiment of the present subject matter.
- FIG. 11 shows one example of a segmented ring device adapted to enhance ingrowth according to one embodiment of the present subject matter.
- FIG. 12A shows one example of a hook adapted for fixation according to one embodiment of the present subject matter.
- FIG. 12B shows a cross section of a portion of the implantable device of FIG. 12A according to one embodiment of the present subject matter.
- FIG. 13 shows one example of a plurality of hooks adapted for fixation according to one embodiment of the present subject matter.
- FIGS. 14A and 14B show one example of use of ingrowth-promoting material at a distal end of an apparatus according to one embodiment of the present subject matter.
- FIGS. 15A to 15E show some examples of an implantable device featuring a variable stiffness design adapted to reduce rotation according to various embodiments of the present subject matter.
- FIG. 16A shows one example of an external stiffener for an implantable device according to one embodiment of the present subject matter.
- FIGS. 16B and 16C show one example of an externally coiled stiffener for an implantable device according to one embodiment of the present subject matter.
- FIGS. 16D and 16E show different examples of an internally coiled stiffener for an implantable device according to various embodiments of the present subject matter.
- FIG. 17 shows one example of a restraint on a proximal bond according to one embodiment of the present subject matter.
- FIG. 18A shows one embodiment of an irregular shape of an expandable element of the implantable device according to one embodiment of the present subject matter, as compared to that of FIG. 18B .
- FIG. 19 shows one embodiment of a microtextured expandable element according to one embodiment of the present subject matter.
- FIG. 20 shows one embodiment of an extra stabilizing balloon for an implantable device according to one embodiment of the present subject matter.
- the present subject matter relates to implantable devices which can be placed near a patient's urethra to improve continence.
- the implantable devices are described in applications such as such as the implantable devices described in U.S. Pat. Nos. 6,045,498, 5,964,806, 6,579,224, and 6,419,624 and their related patents and applications, the descriptions of which are hereby incorporated in their entirety.
- Such applications also contain information as to the placement of the implantable devices. Placement of such devices is also discussed in U.S. Provisional Patent Application Ser. No. 61/039,738, filed Mar. 26, 2008, entitled: METHOD AND APPARATUS FOR PLACEMENT OF IMPLANTABLE DEVICE ADJACENT A BODY LUMEN, which is incorporated by reference in its entirety.
- FIG. 1A shows an example of placement of implantable devices with respect to a human bladder and urethra according to one embodiment of the present subject matter.
- an expandable element 10 is connected to an elongate conduit 11 and terminates in a port 12 , such as a septum.
- the expandable element 10 is implanted proximal the urethra 6 near the bladder 5 .
- Such location is also referred to as the “bladder neck.”
- the actual positions of the expandable elements 10 of such devices with respect to the urethra 6 and bladder neck may vary; however, FIG. 1A shows the original position of the devices compared to the positions in FIGS. 1B and 1C for purposes of demonstration of the unwanted aspects of migration and rotation.
- FIG. 1B demonstrates migration of one of the two implantable devices.
- FIG. 1C demonstrates rotation of one expandable element of one of the two implantable devices.
- the expandable element 10 of implantable device 20 is shown as being rotated in position relative to its original placement.
- the rotation can result in displacement of the expandable element 10 , which may reduce the efficacy of the implantation for purposes of enhancing coaptation, and continence.
- rotation can be problematic even in cases where the expandable element 10 is not substantially displaced because the elongate conduit 11 can apply unwanted force on the expandable element 10 and may result in device failure over time due to erosion of material.
- FIG. 2 shows placement of a sleeve adapted to provide ingrowth to provide an adhesion according to one embodiment of the present subject matter.
- a small adhesion forms near the end of the tubing closest to the expandable element 10 by the use of an ingrowth collar or sleeve 30 .
- Different materials can be used, including but not limited to EPTFE (expanded polytetrafluoroethelene as used in some vascular grafts) to encircle the elongate conduit 11 near the expandable element 10 .
- the ingrowth collar or sleeve 30 allows the adhesion to form which is a form of fixation of the device to avoid migration and to avoid rotation.
- Other ingrowth materials may include polypropylene or polyethylene mesh as used for hernia repairs or open cell silicone or polyurethane foams.
- the ingrowth sleeve 30 as designed to have less than a 5 lb. pull strength. Other pull strength limits are possible without departing from the scope of the present subject matter.
- the ingrowth material is bioresorbable so that it fixes the device in place after a short time allowing the surrounding tissue to adapt and stabilize the device but would be resorbed over a longer timeframe and allow the device to be easily removed if need be.
- a bioresorbable material is polylactic acid.
- the implantable device 20 can be removed by cutting off the septum, feeding a cylindrical tool over the implantable device, and using the tool to go over the conduit, cutting the adhesion to facilitate removal of the implantable device at a pull strength that is less than what would destroy the implantable device.
- the cylindrical tool may also have a slot along its length so that it can be fit over and along the conduit so that the part need not be cut off.
- the tool can cut between the elongate conduit and the sleeve or the tool can cut the sleeve away from the tissue.
- One type of tool to accomplish the cutting is the use of a properly positioned beveled blade. Other tools and approaches are possible without departing from the scope of the present subject matter.
- FIG. 4 shows a cross section of an implantable device 44 including a sleeve 40 attached to elongate conduit 11 using an adhesive 42 according to one embodiment of the present subject matter.
- Such sleeves 40 provide adequate fixation of the implantable device 44 during its implantation.
- the adhesive has a tear strength which is less than the pull strength limit of the implantable device 44 .
- the sleeve 40 may stay in place while the glue 42 shears as the implantable device 44 is pulled out of the patient.
- the split ring or segmented ring sleeves as shown in FIGS. 10 and 11 may be used to allow the withdrawal of the implantable device. This is especially useful for devices where the cross section at the expandable element 10 is greater than the cross section for the elongate conduit 11 .
- Other types of split ring sleeves may be used without departing from the scope of the present subject matter.
- FIG. 5 shows a cross section of surface structure adapted to enhance ingrowth according to one embodiment of the present subject matter.
- the surface structure can be porous and is selected to provide the proper pull strength, yet retain the implantable device in position during its normal use.
- FIG. 6 shows a cross section of surface structure adapted to enhance ingrowth and resist migration according to one embodiment of the present subject matter.
- the angled nature of the structure forms additional resistance to migrations back down the dialation path.
- FIG. 7 shows a cross section of a helical sleeve structure adapted to enhance ingrowth according to one embodiment of the present subject matter.
- the helical sleeve structure 70 over the elongate conduit 11 acts to fix the implantable device. To remove the device, it is screwed out of the tissue.
- a pushwire or other rod is used to withdraw the device.
- the pushwire or rod can be keyed to facilitate application of torque to withdraw the device.
- a structure, such as that shown in FIG. 8 is used to lock the pushwire or rod with a channel or other receiver in the implantable device for withdrawal.
- FIG. 8 shows one example of a tool for removal of a helical sleeve structure according to one embodiment of the present subject matter.
- a collet-type device such as the expanding device shown in FIG. 9 is used to withdraw the device.
- FIG. 9 shows one example of an expandable tool for removal of a helical sleeve structure according to one embodiment of the present subject matter.
- a remote actuator (not shown) is used to expand distal ring 90 so as to engage with a lumen or other feature of the implantable device which is to be extracted.
- FIG. 12A shows one example of a hook adapted for fixation according to one embodiment of the present subject matter.
- a Nitinol hook 120 is threaded through an inner lumen 124 of the elongate conduit 11 of implantable device 122 to serve as a fixation to the local tissue.
- Other types of hooks may be used without departing from the scope of the present subject matter.
- the hook is placed near the expandable element 10 of the implantable device 122 to retain it in position.
- FIG. 12B shows a cross section of elongate conduit showing a cross section of hook 120 in the space of what was the inner lumen 124 and another inner lumen 126 in communication with expandable element 10 .
- inner lumen 126 is connected to a port with a septum (not shown) as described in the various documents incorporated by reference.
- inner lumen 124 is used with various implantation tools such as a pushrod or other tool to place implantable device 122 in position.
- various inner lumens for implantable devices are described in patent documents, including, but not limited to, U.S. Pat. Nos. 6,045,498, 5,964,806, 6,579,224, and 6,419,624 and their related patents and applications, the descriptions of which are hereby incorporated in their entirety. Such applications also contain information as to the placement of the implantable devices. Placement of devices is discussed in various documents, including, but not limited to U.S. Provisional Patent Application Ser. No. 61/039,738, filed Mar. 26, 2008, entitled: METHOD AND APPARATUS FOR PLACEMENT OF IMPLANTABLE DEVICE ADJACENT A BODY LUMEN, which is incorporated by reference in its entirety.
- FIG. 13 shows one example of a plurality of hooks adapted for fixation according to one embodiment of the present subject matter.
- fixation hooks 130 at the distal tip are deployed to provide fixation to the tissue after the implantable device 132 is placed in its desired position.
- the expandable element 10 is expanded and the hooks 130 are recessed to shield bladder from puncturing.
- Other hook positions, shapes, and numbers are possible without departing from the scope of the present subject matter.
- FIGS. 14A and 14B show one example of use of ingrowth-promoting material at a distal end of an implantable device according to one embodiment of the present subject matter.
- a patch or coating of ingrowth-promoting material 140 at the distal end of the device 142 provides adhesion at or near the distal end of the device 142 .
- the ingrowth material is bioresorbable so that it fixes the device in place after a short time allowing the surrounding tissue to adapt and stabilize the device but would be resorbed over a longer timeframe and allow the device to be easily removed if need be.
- a bioresorbable material is polylactic acid. It is understood that various materials, shapes and positions can be used without departing from the scope of the present subject matter.
- FIGS. 15A-E show some examples of an implantable device featuring a variable stiffness design adapted to reduce rotation according to various embodiments of the present subject matter.
- FIG. 15A different stiffeners are shown, which may be used individually, or in combination, in various applications.
- FIG. 15B is a cross section drawing showing stiffener 153 which is a form of annular ring with an aperture for filling expandable element 10 .
- FIG. 15C is a cross section showing a stiffening member 155 .
- FIG. 15D shows a cross section showing a separate lumen with a stiffening member 157 .
- FIG. 15E shows a cross section with an annular stiffening member 159 placed in inner lumen 124 .
- expansion of the expandable element 10 can also make tubing in central portion stretch and can also have a preferential force on the tubing and may cause it to rotate.
- a stiffener of varying stiffness can be inserted in a lumen of the elongate conduit to provide more stiffening at the distal end than at the proximal end of the implantable device 150 .
- a stiffener 157 is added to a third central lumen of the implantable device after it is deployed into position.
- the stiffening effect is built into the implantable device as it is manufactured.
- a stiffener 159 is placed in the same lumen 124 that is used to position the implantable device. This could be done by the surgeon after removing the pushwire at time of implant. Other types of stiffeners and deployments are possible without departing from the scope of the present subject matter.
- FIG. 16A shows one example of an external stiffener for an implantable device according to one embodiment of the present subject matter.
- sleeve 162 provides additional stiffness at the proximal bond area of elongate conduit 11 of the expandable element 10 .
- the sleeve 162 continues into the expandable element 10 portion of the elongate conduit 11 .
- the sleeve 162 is manufactured as an integral portion of elongate conduit 11 .
- a lubricious coating, sleeve, or material can be positioned anywhere along the elongate conduit or about the external stiffener in embodiments which employ a stiffener, or both, to reduce or eliminate wear should the expandable element 10 come in contact with the stiffener and/or the elongate conduit. In such events, the lubricious coating, sleeve, or material would prevent wear of the expandable element 10 .
- FIGS. 16B and 16C show one example of an externally coiled stiffener for an implantable device according to one embodiment of the present subject matter.
- coil 164 can be placed outside of elongate conduit 11 .
- a coil can also be displosed within the elongate conduit 11 as shown as coil 168 in FIGS. 16D and 16E .
- Coils 164 and 168 provide additional stiffness to prevent rotation of the expandable element 10 of implantable device 166 .
- FIG. 17 shows one example of a restraint on a proximal bond according to one embodiment of the present subject matter.
- the restraint 172 on the proximal bond of the expandable element 10 to elongate conduit 11 reduces or eliminates wear and/or erosion on the proximal bond.
- the restraint 172 is a collar that is attached to the implantable device 170 .
- the restraint 172 is generated by one or more additional dips in the coating process that produces the implantable device 170 .
- the restraint provides asymmetric balloon inflation of the expandable element 10 . Other shapes and constraints and asymmetries are possible without departing from the scope of the present subject matter.
- Expandable elements with asymmetrical shapes can be engineered to reduce the possibility of contact with the elongate conduit by the expandable element.
- the bulge shown in the example of FIG. 17 is larger at the distal end of the expandable element, which can reduce the tendency of the expandable element to come in contact with the elongate conduit.
- FIG. 18A shows one embodiment of an irregular shape of an expandable element of the implantable device according to one embodiment of the present subject matter, as compared to that of FIG. 18B .
- the irregular shape is made squarer than that of FIG. 18B to avoid rotation.
- Various different shapes may be used without departing from the scope of the present subject matter.
- FIG. 19 shows one embodiment of a microtextured expandable element according to one embodiment of the present subject matter.
- a portion of the wall of expandable element 192 is microtextured 194 to reduce rotation.
- a tool can be employed to remove the expandable element 10 .
- FIG. 20 shows one embodiment of an extra stabilizing balloon for an implantable device according to one embodiment of the present subject matter.
- Balloon 202 is placed to prevent the implantable device from migrating, and may avoid rotation by holding the elongate conduit in place and thereby limit the expandable element 10 from rotating.
Abstract
Description
- The present application is a continuation of U.S. patent application Ser. No. 14/169,988, filed Jan. 31, 2014, which application is a Continuation of U.S. patent application Ser. No. 12/467,257, filed on May 16, 2009, which claims the benefit under 35 U.S.C. 119(e) of U.S. Provisional Patent Application Ser. No. 61/053,758, filed May 16, 2008, which are incorporated herein by reference in their entirety.
- The present subject matter relates to method and apparatus for fixation of implantable devices adjacent a body lumen.
- The implantation of medical devices into the tissue of patients is complicated. The surgery can be partially or wholly ineffective if the implanted devices migrate or rotate within the body after implantation. Such devices need to be removed and reimplanted if possible. Each time a device is surgically implanted or explanted, the patient suffers risks of trauma and infection, which can sometimes be lethal to the patient.
- There is a need in the art for improved method and apparatus for fixation of implantable devices. Such approaches should provide an explantation option with minimal trauma to the tissue of the patient.
- The present application relates to method and apparatus for reducing migration and rotation of implantable devices including an expandable element and an elongate portion.
- This Summary is an overview of some of the teachings of the present application and is not intended to be an exclusive or exhaustive treatment of the present subject matter. Further details about the present subject matter are found in the detailed description and the appended claims. The scope of the present invention is defined by the appended claims and their legal equivalents.
-
FIG. 1A shows an example of placement of implantable devices with respect to a human bladder and urethra according to one embodiment of the present subject matter. -
FIG. 1B demonstrates migration of one of the two implantable devices. -
FIG. 1C demonstrates rotation of one expandable element of one of the two implantable devices. -
FIG. 2 shows placement of a sleeve adapted to provide ingrowth to provide an adhesion according to one embodiment of the present subject matter. -
FIG. 3 shows a closeup of the sleeve ofFIG. 2 . -
FIG. 4 shows a cross section of an implantable device including a sleeve attached using an adhesive according to one embodiment of the present subject matter. -
FIG. 5 shows a cross section of surface structure adapted to enhance ingrowth according to one embodiment of the present subject matter. -
FIG. 6 shows a cross section of surface structure adapted to enhance ingrowth and resist migration according to one embodiment of the present subject matter. -
FIG. 7 shows a cross section of a helical sleeve structure adapted to enhance ingrowth according to one embodiment of the present subject matter. -
FIG. 8 shows one example of a tool for removal of a helical sleeve structure according to one embodiment of the present subject matter. -
FIG. 9 shows one example of an expandable tool for removal of a helical sleeve structure according to one embodiment of the present subject matter. -
FIG. 10 shows one example of a split ring device adapted to enhance ingrowth according to one embodiment of the present subject matter. -
FIG. 11 shows one example of a segmented ring device adapted to enhance ingrowth according to one embodiment of the present subject matter. -
FIG. 12A shows one example of a hook adapted for fixation according to one embodiment of the present subject matter. -
FIG. 12B shows a cross section of a portion of the implantable device ofFIG. 12A according to one embodiment of the present subject matter. -
FIG. 13 shows one example of a plurality of hooks adapted for fixation according to one embodiment of the present subject matter. -
FIGS. 14A and 14B show one example of use of ingrowth-promoting material at a distal end of an apparatus according to one embodiment of the present subject matter. -
FIGS. 15A to 15E show some examples of an implantable device featuring a variable stiffness design adapted to reduce rotation according to various embodiments of the present subject matter. -
FIG. 16A shows one example of an external stiffener for an implantable device according to one embodiment of the present subject matter. -
FIGS. 16B and 16C show one example of an externally coiled stiffener for an implantable device according to one embodiment of the present subject matter. -
FIGS. 16D and 16E show different examples of an internally coiled stiffener for an implantable device according to various embodiments of the present subject matter. -
FIG. 17 shows one example of a restraint on a proximal bond according to one embodiment of the present subject matter. -
FIG. 18A shows one embodiment of an irregular shape of an expandable element of the implantable device according to one embodiment of the present subject matter, as compared to that ofFIG. 18B . -
FIG. 19 shows one embodiment of a microtextured expandable element according to one embodiment of the present subject matter. -
FIG. 20 shows one embodiment of an extra stabilizing balloon for an implantable device according to one embodiment of the present subject matter. - The following detailed description of the present invention refers to subject matter in the accompanying drawings which show, by way of illustration, specific aspects and embodiments in which the present subject matter may be practiced. These embodiments are described in sufficient detail to enable those skilled in the art to practice the present subject matter. References to “an”, “one”, or “various” embodiments in this disclosure are not necessarily to the same embodiment, and such references contemplate more than one embodiment. The following detailed description is, therefore, not to be taken in a limiting sense, and the scope is defined only by the appended claims, along with the full scope of legal equivalents to which such claims are entitled.
- The present subject matter relates to implantable devices which can be placed near a patient's urethra to improve continence. The implantable devices are described in applications such as such as the implantable devices described in U.S. Pat. Nos. 6,045,498, 5,964,806, 6,579,224, and 6,419,624 and their related patents and applications, the descriptions of which are hereby incorporated in their entirety. Such applications also contain information as to the placement of the implantable devices. Placement of such devices is also discussed in U.S. Provisional Patent Application Ser. No. 61/039,738, filed Mar. 26, 2008, entitled: METHOD AND APPARATUS FOR PLACEMENT OF IMPLANTABLE DEVICE ADJACENT A BODY LUMEN, which is incorporated by reference in its entirety.
-
FIG. 1A shows an example of placement of implantable devices with respect to a human bladder and urethra according to one embodiment of the present subject matter. In one embodiment of the implantable devices, anexpandable element 10 is connected to anelongate conduit 11 and terminates in aport 12, such as a septum. Typically, theexpandable element 10 is implanted proximal theurethra 6 near the bladder 5. Such location is also referred to as the “bladder neck.” The actual positions of theexpandable elements 10 of such devices with respect to theurethra 6 and bladder neck may vary; however,FIG. 1A shows the original position of the devices compared to the positions inFIGS. 1B and 1C for purposes of demonstration of the unwanted aspects of migration and rotation. -
FIG. 1B demonstrates migration of one of the two implantable devices. Some time after implantation, it is possible to find that theexpandable element 10 ofimplantable device 20 has moved from its original implantation site. In some cases theexpandable element 10 will move down the dilation tract formed during implantation of the device. Once it has moved out of position, the implantation may no longer provide adequate tissue bulking in the vicinity of the bladder neck, and may fail to restore continence as needed. - Another unwanted effect that may be possible to find is rotation.
FIG. 1C demonstrates rotation of one expandable element of one of the two implantable devices. Theexpandable element 10 ofimplantable device 20 is shown as being rotated in position relative to its original placement. The rotation can result in displacement of theexpandable element 10, which may reduce the efficacy of the implantation for purposes of enhancing coaptation, and continence. However, rotation can be problematic even in cases where theexpandable element 10 is not substantially displaced because theelongate conduit 11 can apply unwanted force on theexpandable element 10 and may result in device failure over time due to erosion of material. - One way to reduce the chances of movement of the
expandable element 10 after implantation is to provide a means for adhesion of the implantable device to the tissue in which it is implanted.FIG. 2 shows placement of a sleeve adapted to provide ingrowth to provide an adhesion according to one embodiment of the present subject matter. In one embodiment a small adhesion forms near the end of the tubing closest to theexpandable element 10 by the use of an ingrowth collar orsleeve 30. Different materials can be used, including but not limited to EPTFE (expanded polytetrafluoroethelene as used in some vascular grafts) to encircle theelongate conduit 11 near theexpandable element 10. The ingrowth collar orsleeve 30 allows the adhesion to form which is a form of fixation of the device to avoid migration and to avoid rotation. Other ingrowth materials may include polypropylene or polyethylene mesh as used for hernia repairs or open cell silicone or polyurethane foams. In various embodiments it is beneficial to use a mesh or foam cell size and/or material and/or surface area selected to make the adhesion of limited strength so that theimplantable device 20 can be pulled out without breaking it during removal or causing trauma to surrounding tissue. In one embodiment, theingrowth sleeve 30 as designed to have less than a 5 lb. pull strength. Other pull strength limits are possible without departing from the scope of the present subject matter.FIG. 3 shows a closeup of the sleeve ofFIG. 2 , which is friction fit or otherwise secured to theelongate conduit 11 of theimplantable device 20 in various embodiments. In certain embodiments the ingrowth material is bioresorbable so that it fixes the device in place after a short time allowing the surrounding tissue to adapt and stabilize the device but would be resorbed over a longer timeframe and allow the device to be easily removed if need be. One example of a bioresorbable material is polylactic acid. - In one embodiment, the
implantable device 20 can be removed by cutting off the septum, feeding a cylindrical tool over the implantable device, and using the tool to go over the conduit, cutting the adhesion to facilitate removal of the implantable device at a pull strength that is less than what would destroy the implantable device. The cylindrical tool may also have a slot along its length so that it can be fit over and along the conduit so that the part need not be cut off In various embodiments, the tool can cut between the elongate conduit and the sleeve or the tool can cut the sleeve away from the tissue. One type of tool to accomplish the cutting is the use of a properly positioned beveled blade. Other tools and approaches are possible without departing from the scope of the present subject matter. -
FIG. 4 shows a cross section of animplantable device 44 including asleeve 40 attached to elongateconduit 11 using an adhesive 42 according to one embodiment of the present subject matter.Such sleeves 40 provide adequate fixation of theimplantable device 44 during its implantation. In such embodiments, the adhesive has a tear strength which is less than the pull strength limit of theimplantable device 44. Thus, to remove theimplantable device 44, thesleeve 40 may stay in place while theglue 42 shears as theimplantable device 44 is pulled out of the patient. In such embodiments, the split ring or segmented ring sleeves as shown inFIGS. 10 and 11 may be used to allow the withdrawal of the implantable device. This is especially useful for devices where the cross section at theexpandable element 10 is greater than the cross section for theelongate conduit 11. Other types of split ring sleeves may be used without departing from the scope of the present subject matter. -
FIG. 5 shows a cross section of surface structure adapted to enhance ingrowth according to one embodiment of the present subject matter. The surface structure can be porous and is selected to provide the proper pull strength, yet retain the implantable device in position during its normal use. -
FIG. 6 shows a cross section of surface structure adapted to enhance ingrowth and resist migration according to one embodiment of the present subject matter. The angled nature of the structure forms additional resistance to migrations back down the dialation path. -
FIG. 7 shows a cross section of a helical sleeve structure adapted to enhance ingrowth according to one embodiment of the present subject matter. Thehelical sleeve structure 70 over theelongate conduit 11 acts to fix the implantable device. To remove the device, it is screwed out of the tissue. In one embodiment a pushwire or other rod is used to withdraw the device. The pushwire or rod can be keyed to facilitate application of torque to withdraw the device. In one embodiment, a structure, such as that shown inFIG. 8 , is used to lock the pushwire or rod with a channel or other receiver in the implantable device for withdrawal.FIG. 8 shows one example of a tool for removal of a helical sleeve structure according to one embodiment of the present subject matter. - In various embodiments a collet-type device, such as the expanding device shown in
FIG. 9 is used to withdraw the device.FIG. 9 shows one example of an expandable tool for removal of a helical sleeve structure according to one embodiment of the present subject matter. A remote actuator (not shown) is used to expanddistal ring 90 so as to engage with a lumen or other feature of the implantable device which is to be extracted. -
FIG. 12A shows one example of a hook adapted for fixation according to one embodiment of the present subject matter. In one embodiment, after theimplantable device 122 is placed in position, aNitinol hook 120 is threaded through aninner lumen 124 of theelongate conduit 11 ofimplantable device 122 to serve as a fixation to the local tissue. Other types of hooks may be used without departing from the scope of the present subject matter. The hook is placed near theexpandable element 10 of theimplantable device 122 to retain it in position.FIG. 12B shows a cross section of elongate conduit showing a cross section ofhook 120 in the space of what was theinner lumen 124 and anotherinner lumen 126 in communication withexpandable element 10. In various embodimentsinner lumen 126 is connected to a port with a septum (not shown) as described in the various documents incorporated by reference. In various embodimentsinner lumen 124 is used with various implantation tools such as a pushrod or other tool to placeimplantable device 122 in position. Various inner lumens for implantable devices are described in patent documents, including, but not limited to, U.S. Pat. Nos. 6,045,498, 5,964,806, 6,579,224, and 6,419,624 and their related patents and applications, the descriptions of which are hereby incorporated in their entirety. Such applications also contain information as to the placement of the implantable devices. Placement of devices is discussed in various documents, including, but not limited to U.S. Provisional Patent Application Ser. No. 61/039,738, filed Mar. 26, 2008, entitled: METHOD AND APPARATUS FOR PLACEMENT OF IMPLANTABLE DEVICE ADJACENT A BODY LUMEN, which is incorporated by reference in its entirety. -
FIG. 13 shows one example of a plurality of hooks adapted for fixation according to one embodiment of the present subject matter. In various embodiments, fixation hooks 130 at the distal tip are deployed to provide fixation to the tissue after theimplantable device 132 is placed in its desired position. In various embodiments, theexpandable element 10 is expanded and thehooks 130 are recessed to shield bladder from puncturing. Other hook positions, shapes, and numbers are possible without departing from the scope of the present subject matter. -
FIGS. 14A and 14B show one example of use of ingrowth-promoting material at a distal end of an implantable device according to one embodiment of the present subject matter. In various embodiments, a patch or coating of ingrowth-promotingmaterial 140 at the distal end of thedevice 142 provides adhesion at or near the distal end of thedevice 142. Such approaches can reduce migration and rotation ofexpandable element 10. In certain embodiments the ingrowth material is bioresorbable so that it fixes the device in place after a short time allowing the surrounding tissue to adapt and stabilize the device but would be resorbed over a longer timeframe and allow the device to be easily removed if need be. One example of a bioresorbable material is polylactic acid. It is understood that various materials, shapes and positions can be used without departing from the scope of the present subject matter. -
FIGS. 15A-E show some examples of an implantable device featuring a variable stiffness design adapted to reduce rotation according to various embodiments of the present subject matter. InFIG. 15A different stiffeners are shown, which may be used individually, or in combination, in various applications.FIG. 15B is a cross sectiondrawing showing stiffener 153 which is a form of annular ring with an aperture for fillingexpandable element 10.FIG. 15C is a cross section showing a stiffeningmember 155.FIG. 15D shows a cross section showing a separate lumen with a stiffeningmember 157.FIG. 15E shows a cross section with anannular stiffening member 159 placed ininner lumen 124. In some embodiments, expansion of theexpandable element 10 can also make tubing in central portion stretch and can also have a preferential force on the tubing and may cause it to rotate. In various embodiments a stiffener of varying stiffness can be inserted in a lumen of the elongate conduit to provide more stiffening at the distal end than at the proximal end of theimplantable device 150. In one application, astiffener 157 is added to a third central lumen of the implantable device after it is deployed into position. In varying embodiments, the stiffening effect is built into the implantable device as it is manufactured. In various embodiments, astiffener 159 is placed in thesame lumen 124 that is used to position the implantable device. This could be done by the surgeon after removing the pushwire at time of implant. Other types of stiffeners and deployments are possible without departing from the scope of the present subject matter. -
FIG. 16A shows one example of an external stiffener for an implantable device according to one embodiment of the present subject matter. In such embodiments,sleeve 162 provides additional stiffness at the proximal bond area ofelongate conduit 11 of theexpandable element 10. In various embodiments, thesleeve 162 continues into theexpandable element 10 portion of theelongate conduit 11. In various embodiments thesleeve 162 is manufactured as an integral portion ofelongate conduit 11. - In various embodiments, a lubricious coating, sleeve, or material can be positioned anywhere along the elongate conduit or about the external stiffener in embodiments which employ a stiffener, or both, to reduce or eliminate wear should the
expandable element 10 come in contact with the stiffener and/or the elongate conduit. In such events, the lubricious coating, sleeve, or material would prevent wear of theexpandable element 10. -
FIGS. 16B and 16C show one example of an externally coiled stiffener for an implantable device according to one embodiment of the present subject matter. As shown inFIGS. 16B and 16C ,coil 164 can be placed outside ofelongate conduit 11. A coil can also be displosed within theelongate conduit 11 as shown ascoil 168 inFIGS. 16D and 16E .Coils expandable element 10 ofimplantable device 166. -
FIG. 17 shows one example of a restraint on a proximal bond according to one embodiment of the present subject matter. Therestraint 172 on the proximal bond of theexpandable element 10 to elongateconduit 11 reduces or eliminates wear and/or erosion on the proximal bond. In various embodiments, therestraint 172 is a collar that is attached to theimplantable device 170. In various embodiments, therestraint 172 is generated by one or more additional dips in the coating process that produces theimplantable device 170. In various embodiments, the restraint provides asymmetric balloon inflation of theexpandable element 10. Other shapes and constraints and asymmetries are possible without departing from the scope of the present subject matter. - Expandable elements with asymmetrical shapes can be engineered to reduce the possibility of contact with the elongate conduit by the expandable element. For example, the bulge shown in the example of
FIG. 17 is larger at the distal end of the expandable element, which can reduce the tendency of the expandable element to come in contact with the elongate conduit. -
FIG. 18A shows one embodiment of an irregular shape of an expandable element of the implantable device according to one embodiment of the present subject matter, as compared to that ofFIG. 18B . The irregular shape is made squarer than that ofFIG. 18B to avoid rotation. Various different shapes may be used without departing from the scope of the present subject matter. -
FIG. 19 shows one embodiment of a microtextured expandable element according to one embodiment of the present subject matter. A portion of the wall ofexpandable element 192 is microtextured 194 to reduce rotation. A tool can be employed to remove theexpandable element 10. -
FIG. 20 shows one embodiment of an extra stabilizing balloon for an implantable device according to one embodiment of the present subject matter.Balloon 202 is placed to prevent the implantable device from migrating, and may avoid rotation by holding the elongate conduit in place and thereby limit theexpandable element 10 from rotating. - It is understood that various combinations of the foregoing aspects of the present subject matter can be combined to provide apparatus having multiple benefits.
- This application is intended to cover adaptations and variations of the present subject matter. It is to be understood that the above description is intended to be illustrative, and not restrictive. The scope of the present subject matter should be determined with reference to the appended claim, along with the full scope of legal equivalents to which the claims are entitled.
Claims (1)
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US15/143,784 US20160242886A1 (en) | 2008-05-16 | 2016-05-02 | Method and apparatus for fixation of implantable devices adjacent a body lumen |
US15/371,591 US20170079762A1 (en) | 2008-05-16 | 2016-12-07 | Method and apparatus for fixation of implantable devices adjacent a body lumen |
US16/532,811 US20200022796A1 (en) | 2008-05-16 | 2019-08-06 | Method and apparatus for fixation of implantable devices adjacent a body lumen |
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US5375808P | 2008-05-16 | 2008-05-16 | |
US12/467,257 US20100292530A1 (en) | 2009-05-16 | 2009-05-16 | Method and apparatus for fixation of implantable devices adjacent a body lumen |
US14/169,988 US20140148794A1 (en) | 2008-05-16 | 2014-01-31 | Method and apparatus for fixation of implantable devices adjacent a body lumen |
US15/143,784 US20160242886A1 (en) | 2008-05-16 | 2016-05-02 | Method and apparatus for fixation of implantable devices adjacent a body lumen |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US14/169,988 Continuation US20140148794A1 (en) | 2008-05-16 | 2014-01-31 | Method and apparatus for fixation of implantable devices adjacent a body lumen |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US15/371,591 Continuation US20170079762A1 (en) | 2008-05-16 | 2016-12-07 | Method and apparatus for fixation of implantable devices adjacent a body lumen |
Publications (1)
Publication Number | Publication Date |
---|---|
US20160242886A1 true US20160242886A1 (en) | 2016-08-25 |
Family
ID=43069056
Family Applications (5)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US12/467,257 Abandoned US20100292530A1 (en) | 2008-05-16 | 2009-05-16 | Method and apparatus for fixation of implantable devices adjacent a body lumen |
US14/169,988 Abandoned US20140148794A1 (en) | 2008-05-16 | 2014-01-31 | Method and apparatus for fixation of implantable devices adjacent a body lumen |
US15/143,784 Abandoned US20160242886A1 (en) | 2008-05-16 | 2016-05-02 | Method and apparatus for fixation of implantable devices adjacent a body lumen |
US15/371,591 Abandoned US20170079762A1 (en) | 2008-05-16 | 2016-12-07 | Method and apparatus for fixation of implantable devices adjacent a body lumen |
US16/532,811 Pending US20200022796A1 (en) | 2008-05-16 | 2019-08-06 | Method and apparatus for fixation of implantable devices adjacent a body lumen |
Family Applications Before (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US12/467,257 Abandoned US20100292530A1 (en) | 2008-05-16 | 2009-05-16 | Method and apparatus for fixation of implantable devices adjacent a body lumen |
US14/169,988 Abandoned US20140148794A1 (en) | 2008-05-16 | 2014-01-31 | Method and apparatus for fixation of implantable devices adjacent a body lumen |
Family Applications After (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US15/371,591 Abandoned US20170079762A1 (en) | 2008-05-16 | 2016-12-07 | Method and apparatus for fixation of implantable devices adjacent a body lumen |
US16/532,811 Pending US20200022796A1 (en) | 2008-05-16 | 2019-08-06 | Method and apparatus for fixation of implantable devices adjacent a body lumen |
Country Status (1)
Country | Link |
---|---|
US (5) | US20100292530A1 (en) |
Families Citing this family (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2014506156A (en) * | 2010-12-23 | 2014-03-13 | エル ウント エム コンスルティンク ウント トラディンク ゲゼルシャフト ミット ベシュレンクテル ハフツング ウント コンパニー コマンディトゲゼルシャフト | Urine incontinence prevention device comprising a fixation device immovably embedded in body tissue |
US11510766B2 (en) | 2019-02-14 | 2022-11-29 | Uromedica, Inc. | Method and apparatus for monitoring implantable device for urinary continence |
US20210030544A1 (en) * | 2019-07-31 | 2021-02-04 | Boston Scientific Scimed, Inc. | Penile implant outer support structure within neophallus for neophallus surgery |
US11759301B2 (en) * | 2020-06-23 | 2023-09-19 | Uromedica, Inc. | Method and apparatus for fixation of implantable device for urinary continence |
CA3230287A1 (en) * | 2021-09-14 | 2023-03-23 | John H. Burton | Implantable urinary continence device with helical anchor |
Family Cites Families (10)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6733473B1 (en) * | 1991-04-05 | 2004-05-11 | Boston Scientific Corporation | Adjustably stiffenable convertible catheter assembly |
US5167614A (en) * | 1991-10-29 | 1992-12-01 | Medical Engineering Corporation | Prostatic stent |
US6579224B1 (en) * | 1999-10-11 | 2003-06-17 | Uromedica, Inc. | Apparatus and method for inserting an adjustable implantable genitourinary device |
US6045498A (en) * | 1997-06-12 | 2000-04-04 | Uromedica, Inc. | Method for adjustably restricting a body lumen |
US6196230B1 (en) * | 1998-09-10 | 2001-03-06 | Percardia, Inc. | Stent delivery system and method of use |
US20030083539A1 (en) * | 2000-11-17 | 2003-05-01 | Boris Leschinsky | Intra-aortic balloon catheter for long-term implantation |
US20040230282A1 (en) * | 2003-04-11 | 2004-11-18 | Cates Adam W. | Acute and chronic fixation for subcutaneous electrodes |
US20040215054A1 (en) * | 2003-04-24 | 2004-10-28 | Siegel Steven W. | Male urethral prosthesis |
US8128552B2 (en) * | 2005-08-22 | 2012-03-06 | O'donnell Pat D | Surgical instrument for treating female pelvic prolapse |
EP2617385B1 (en) * | 2006-03-16 | 2017-07-19 | Boston Scientific Limited | System for treating tissue wall prolapse |
-
2009
- 2009-05-16 US US12/467,257 patent/US20100292530A1/en not_active Abandoned
-
2014
- 2014-01-31 US US14/169,988 patent/US20140148794A1/en not_active Abandoned
-
2016
- 2016-05-02 US US15/143,784 patent/US20160242886A1/en not_active Abandoned
- 2016-12-07 US US15/371,591 patent/US20170079762A1/en not_active Abandoned
-
2019
- 2019-08-06 US US16/532,811 patent/US20200022796A1/en active Pending
Also Published As
Publication number | Publication date |
---|---|
US20140148794A1 (en) | 2014-05-29 |
US20200022796A1 (en) | 2020-01-23 |
US20100292530A1 (en) | 2010-11-18 |
US20170079762A1 (en) | 2017-03-23 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US20200022796A1 (en) | Method and apparatus for fixation of implantable devices adjacent a body lumen | |
US11850140B2 (en) | Devices, systems and methods for treating benign prostatic hyperplasia and other conditions | |
EP1599246B1 (en) | Medical device delivery system | |
JP2660101B2 (en) | Esophageal stent and delivery device | |
EP3020377B1 (en) | Apparatus for delivering endoluminal prosthesis | |
EP2088965B1 (en) | Segmented ring placement | |
US10888697B2 (en) | Fixation mechanism for an implantable lead | |
EP3496665A1 (en) | Apparatuses and methods for at least partially supporting a valve leaflet of a regurgitant heart valve | |
CN114224565A (en) | Mitral valve repair and replacement devices and methods | |
US10758217B2 (en) | Implantable sealing device | |
WO2012135693A2 (en) | Apical puncture access and closure system | |
EP1928357A1 (en) | System and method for delivering a mitral valve repair device | |
EP2012708A1 (en) | Apparatus and method for maintaining fluid flow through body passages | |
JP6431183B2 (en) | In-vivo prosthesis delivery system with improved storage | |
JP7182115B2 (en) | tubular medical device | |
US20170216068A1 (en) | Anti-migration stent deployment delivery systems and methods | |
JP7326255B2 (en) | Medical system for annuloplasty | |
US9867705B2 (en) | Penile surgery systems and methods | |
US20170209131A1 (en) | Vasculature closure devices and automatic deployment systems | |
US20170000632A1 (en) | System for connecting a medical implant to an insertion aid | |
JP2024511626A (en) | Apparatus and method for implant treatment of arteriovenous grafts | |
CN110603010B (en) | Prosthetic valve delivery systems and methods | |
CN109152649A (en) | A kind of inflatable insertion equipment for being percutaneously inserted into | |
JP2023503356A (en) | annuloplasty device | |
CN114007549A (en) | Medical arrangement for introducing an object into an anatomical target location |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
AS | Assignment |
Owner name: UROMEDICA, INC., MINNESOTA Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:BURTON, JOHN H.;COOK, TIMOTHY C.;REEL/FRAME:038433/0941 Effective date: 20090526 |
|
AS | Assignment |
Owner name: UROMEDICA, INC., MINNESOTA Free format text: CORRECTIVE ASSIGNMENT TO CORRECT THE INCORRECT APPLICATION NUMBER 14/089,609 PREVIOUSLY RECORDED AT REEL: 038433 FRAME: 0941. ASSIGNOR(S) HEREBY CONFIRMS THE ASSIGNMENT;ASSIGNORS:COOK, TIMOTHY C.;BURTON, JOHN H.;REEL/FRAME:038729/0362 Effective date: 20090526 |
|
STCB | Information on status: application discontinuation |
Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION |