WO2002013699A1 - Elements anastomotiques extravasculaires et methodes de formation d'anastomoses magnetiques - Google Patents

Elements anastomotiques extravasculaires et methodes de formation d'anastomoses magnetiques Download PDF

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Publication number
WO2002013699A1
WO2002013699A1 PCT/US2001/025197 US0125197W WO0213699A1 WO 2002013699 A1 WO2002013699 A1 WO 2002013699A1 US 0125197 W US0125197 W US 0125197W WO 0213699 A1 WO0213699 A1 WO 0213699A1
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WO
WIPO (PCT)
Prior art keywords
vessel
component
anastomotic
secured
magnetic
Prior art date
Application number
PCT/US2001/025197
Other languages
English (en)
Inventor
David Cole
Michael Reo
Dean Carson
Darin Gittings
A. Adam Sharkawy
Mark Foley
Original Assignee
Ventrica, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from US09/638,805 external-priority patent/US6719768B1/en
Priority claimed from US09/851,400 external-priority patent/US20020072758A1/en
Priority claimed from US09/915,226 external-priority patent/US6802847B1/en
Application filed by Ventrica, Inc. filed Critical Ventrica, Inc.
Priority to CA002387048A priority Critical patent/CA2387048A1/fr
Priority to EP01959718A priority patent/EP1311193A4/fr
Priority to AU81244/01A priority patent/AU8124401A/en
Priority to JP2002518849A priority patent/JP2004505711A/ja
Priority to US10/022,187 priority patent/US20020143347A1/en
Publication of WO2002013699A1 publication Critical patent/WO2002013699A1/fr
Priority to US10/450,989 priority patent/US7909837B2/en
Priority to US11/039,705 priority patent/US20050192603A1/en

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Classifications

    • H—ELECTRICITY
    • H01—ELECTRIC ELEMENTS
    • H01F—MAGNETS; INDUCTANCES; TRANSFORMERS; SELECTION OF MATERIALS FOR THEIR MAGNETIC PROPERTIES
    • H01F41/00—Apparatus or processes specially adapted for manufacturing or assembling magnets, inductances or transformers; Apparatus or processes specially adapted for manufacturing materials characterised by their magnetic properties
    • H01F41/02—Apparatus or processes specially adapted for manufacturing or assembling magnets, inductances or transformers; Apparatus or processes specially adapted for manufacturing materials characterised by their magnetic properties for manufacturing cores, coils, or magnets
    • H01F41/0253—Apparatus or processes specially adapted for manufacturing or assembling magnets, inductances or transformers; Apparatus or processes specially adapted for manufacturing materials characterised by their magnetic properties for manufacturing cores, coils, or magnets for manufacturing permanent magnets
    • H01F41/026—Apparatus or processes specially adapted for manufacturing or assembling magnets, inductances or transformers; Apparatus or processes specially adapted for manufacturing materials characterised by their magnetic properties for manufacturing cores, coils, or magnets for manufacturing permanent magnets protecting methods against environmental influences, e.g. oxygen, by surface treatment
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B17/0643—Surgical staples, i.e. penetrating the tissue with separate closing member, e.g. for interlocking with staple
    • 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
    • A61B17/00491—Surgical glue applicators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238—Type of minimally invasive operation
    • A61B2017/00243—Type of minimally invasive operation cardiac
    • A61B2017/00247—Making holes in the wall of the heart, e.g. laser Myocardial revascularization
    • A61B2017/00252—Making holes in the wall of the heart, e.g. laser Myocardial revascularization for by-pass connections, i.e. connections from heart chamber to blood vessel or from blood vessel to blood vessel
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00876—Material properties magnetic
    • 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
    • A61B2017/1135—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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2/064—Blood vessels with special features to facilitate anastomotic coupling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/3006—Properties of materials and coating materials
    • A61F2002/30079—Properties of materials and coating materials magnetic
    • 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
    • A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/009—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof magnetic

Definitions

  • the invention relates to forming anastomoses between two hollow bodies, and more specifically, using magnetic force to form such anastomoses.
  • One embodiment of the invention provides an anastomotic component that is coupled or attached to the wall of a vessel without protruding into the lumen of the vessel or penetrating the vessel wall. That is, substantially none of the anastomotic component or assembly is located within the vessel lumen (i.e., after the anastomosis has been formed). As a result, there is preferably no foreign structure or material disposed within the target vessel lumen after creating the anastomosis.
  • biocompatible adhesive is used to secure a component to the exterior of the target vessel wall without extending into the lumen. This component is coupled to a magnetic or ferromagnetic assembly carried on a graft vessel.
  • Another embodiment uses adhesive to secure the anastomotic components to both vessels.
  • magnetic force is used in combination with an additional locking force, for example, a mechanical connection, to maintain the vessels in proper position and provide heightened resistance to pressure fluctuations that might occur post-formation of the anastomosis.
  • additional locking force for example, a mechanical connection
  • FIGS. 1 A and IB are, respectively, plan and elevation views of a magnetic anastomotic component constructed according to one embodiment of the invention
  • Fig. 1C is an elevation view of a magnetic anastomotic component constructed according to an alternative embodiment of the invention.
  • Figs. 2A and 2B are, respectively, perspective and elevation views of a magnetic anastomotic component constructed according to another embodiment of the invention.
  • Figs. 3 A and 3B are, respectively, perspective and elevation views of a magnetic anastomotic component constructed according to yet another embodiment of the invention
  • Fig. 4 is a perspective view showing the anastomotic component of Figs. 3 A and 3B attached to a vessel;
  • FIGs. 5 A and 5B are perspective views showing an anastomotic component being secured to a vessel according to another embodiment of the invention.
  • Figs. 6A-6C are elevation views showing anastomotic components constructed according to different embodiments of the invention being used to form an anastomosis between two vessels;
  • Figs. 7A-7C are elevation views showing an anastomotic component being secured to a vessel according to another embodiment of the invention.
  • Fig. 7D is an elevation view showing the component of Figs. 7A-7C being secured to an end of a vessel;
  • FIGs. 8 A and 8B are perspective views of magnetic anastomotic components provided with tissue anchoring elements according to another embodiment of the invention.
  • Figs. 9A-9C are elevation views, in section, showing magnetic anastomotic components provided with tissue traction-enhancing structure according to another embodiment of the invention.
  • Figs. 10 A- IOC are, respectively, perspective views and a sectional view of one of the magnetic anastomotic components shown in Fig. 9C;
  • Figs. 11 A and 1 IB are, respectively, plan and sectional views of a magnetic anastomotic component provided with tissue gripping structure according to another embodiment of the invention.
  • Fig. 11C is a sectional view of an anastomotic component having an alternative tissue gripping structure
  • Figs. 12A-12D are, respectively, perspective, side elevation, end elevation and plan views of a magnetic anastomotic component constructed according to another embodiment of the invention.
  • Figs. 13A-13C are, respectively, perspective, side elevation and end elevation views of an anastomosis formed by a pair of magnetic anastomotic components constructed according to another embodiment of the invention.
  • Figs. 14A-14D are, respectively, plan, perspective, end elevation and side elevation views of a magnetic anastomotic component constructed according to another embodiment of the invention
  • Figs. 15A-15D are, respectively, plan, perspective, end elevation and side elevation views of a magnetic anastomotic component having a similar construction as the component shown in Figs. 14A-14D;
  • FIGs. 16A-16B perspective views showing an anastomotic component being mounted to the exterior surface of a hollow body according to one embodiment of the invention
  • FIGs. 16C-16D perspective views showing an anastomotic component being mounted to the exterior surface of a hollow body according to one embodiment of the invention
  • FIGs. 17A and 17B are, respectively, perspective and end elevation views of an extravascular anastomosis created according to one embodiment of the invention
  • Figs. 18A-18D are perspective views showing an anastomotic component being mounted to the exterior surface of a hollow body according to another embodiment of the invention.
  • Fig. 19 is an end elevation view of a magnetic anastomotic component mounted to the exterior of a vessel according to one embodiment of the invention.
  • Figs. 1 A and IB show a first embodiment of a magnetic anastomotic component 10 having a ring-shaped body 12 and an opening 14. As shown in Fig. IB the component body 12 is generally flat. However, as shown in Fig. 1C, the body 12 may be curved, for example, to match the curvature of a vessel to which it is secured.
  • Fig. 2 A shows a magnetic anastomotic component 16 with an opening 18.
  • the body of the component 16 has an oval or elliptical shape with leading edges 20 for facilitating atraumatic introduction into a vessel.
  • the component 16 is flat.
  • the component 16 could be curved instead, for example, in a manner similar to the curvature of the anastomotic component 22 shown in Figs. 3A-3B.
  • the curvature may extend over all or a portion of the length (or width) of the component.
  • Fig. 4 shows the anastomotic component 22 of Figs. 3 A and 3B mounted on the side wall of a vessel V.
  • the component is secured to the vessel without projecting into the vessel lumen, thereby avoiding potential problems associated with foreign material located in the vessel lumen.
  • the component may be secured to the exterior of the vessel by suitable means, for example, adhesive, mechanical fasteners, or both.
  • Figs. 5 A and 5B show the anastomotic component 16 of Figs. 2 A and 2B mounted on a side wall of a vessel V.
  • Fig. 5B shows mechanical fastening means, the illustrated means being in the form of sutures S, which are used to attach the component 16 to the vessel V. While sutures S are shown, it will be recognized that any suitable mechanical fastener may be used, e.g., clips, stents, barbs, hooks, wires, etc.
  • FIGs. 6A and 6B show anastomoses between two vessels VI and V2.
  • the vessels have mounted thereto, respectively, magnetically attracted anastomotic components 24, 26.
  • the components 24, 26 are rectangular in cross- section.
  • the vessels VI, V2 have mounted thereto, respectively, components 28, 30.
  • the components 28, 30 are provided with a curved exterior surface that generally corresponds to the curvature of the walls of vessels VI and V2.
  • FIG. 6C shows an embodiment wherein a vessel VI has an anastomotic component 32 secured thereto, while a vessel V2 has an anastomotic component comprising portions 34 A and 34B secured thereto. Unlike the embodiments of Figs. 6A and 6B, thought, the portion 34B of the one component is disposed within the lumen of vessel V2.
  • Fig. 7A shows a vessel V prior to forming an opening in the wall thereof.
  • Fig. 7B shows the vessel V after an opening O has been formed therein.
  • Fig. 7C shows an anastomotic component 36 positioned around the outside of the opening in the vessel V.
  • An internal locking member 38 which may be in the form of a snap ring, is positioned within the vessel lumen and cooperates with a groove in component 36 to secure the vessel and component together.
  • Fig. 7D shows an anastomotic component 40 positioned around the end of a vessel V.
  • the internal locking component 38 cooperates with a groove in the component 40 to secure the component to the end of the vessel (as opposed to the side wall of the vessel, as in the previous embodiments).
  • Fig. 8A shows a magnetic anastomotic component 42 having an opening 44 and a pair of attachment tabs 46 with openings 48.
  • the component 42 is mounted to the exterior of a vessel (not shown), for example, by passing a fastener (also not shown) through each opening 48 into engagement with the vessel tissue.
  • the tabs 46 and openings 48 may be used as secondary securing means, for example, if the component 42 is secured to the vessel by other means, e.g., adhesive.
  • Fig. 8B shows a magnetic anastomotic component 50 having an opening 52 and attachment structure 54 to facilitate securing the component to a vessel (not shown).
  • the structure 54 may be used alone or in combination with other means for securing the component to the vessel.
  • the attachment structure 54 is affixed to the component 50 to define a plurality of openings 56 which may be use to receive sutures, clips, clamps, pins, barbs, or other securing or fastening means.
  • the attachment structure is disposed away from (or below) the magnetic coupling surface of the component. That is, the exposed surface of the first component is free to mate with the exposed surface of the second component without interference from the attachment structure. As a result, one or both components can be firmly affixed to its vessel without adversely affecting the anastomosis.
  • Figs. 9A-9C show three embodiments of magnetic anastomotic components that are provided with structure for increasing the traction or gripping force between the components and a vessel to which they are secured.
  • anastomotic component portions 58A, 58B sandwich a vessel wall W and are preferably provided with a layer of material to enhance engagement with the tissue.
  • Fig. 9B shows component portions 60A and 60B, each of which includes a projection 62 at the end thereof which grabs the tissue of the vessel wall W, thereby enhancing securement.
  • Fig. 9C shows anastomotic component portions 64A and 64B, each of which is provided with a series of grooves or annulations 66 that grippingly engage the tissue of the vessel wall W.
  • Figs. 10A-10C show an anastomotic component 68 with an opening 70 and a plurality of grooves or bumps 72.
  • the grooves or bumps 72 which may also be in the forms of ridges, serrations, sharp or dull edges, etc., grab the tissue of the vessel to which the component is secured, which provides additional attachment force.
  • Fig. IOC shows the ridges 72 having sharp points 74 to further enhance engagement with the tissue.
  • Figs. 11 A-l IC show a magnetic anastomotic component 74 with an opening 76 and a peripheral edge 76 that defines a sharp point 78.
  • a second anastomotic component 80 may be used with the component 74, the component 80 having a complimentary-shaped edge 82 which cooperates with the edge 76 to sealingly and grippingly grab tissue of a vessel to which the components are secured.
  • Fig. 1 IC shows a variation of the component 74 wherein a plurality of edges 74' and 76' are provided.
  • a modified second component 80' has a plurality of complimentary edges 82' that mate with the edges 76' of component 74'.
  • the force-increasing structure is shown running along the entire length of the component. It will be appreciated that such structure may be extend along all or any portion of the component, and could extend across the width or longitudinal axis of the component, rather than along the axis, as in Figs. lOA-lOC.
  • the attachment force-increasing embodiments of Figs. 9A-9C, 10A-10C and 11 A-l IC provide several benefits.
  • the resulting anastomosis may have higher resistance to bursting under high pressures, e.g., acute pressure increases.
  • high pressures e.g., acute pressure increases.
  • placing a rough or bumpy parylene coating on the surface of a magnetic component produces higher burst pressure resistance than using a smooth surface. It is desirable to increase pressure resistance, preferably without increasing the risk of occlusion.
  • the components described above may be secured to the vessel by various means.
  • the component may be adhesively attached to the exertion of the vessel so that the lumen of the vessel is free of any component portion.
  • any of the above-described traction or tissue-gripping structure may be used as well.
  • the component may be provided with tabs or other attachment structure as described above.
  • Figs. 12A-12D show a magnetic anastomotic component 84 having a rounded configuration designed to mate with the curvature of a vessel, and an opening 86 adapted to communicate with the vessel lumen.
  • the thickness of the component 84 is tapered across its width (Fig. 12C) and may be tapered more or less from the specific configuration shown.
  • Figs. 13A-13C show an anastomosis created according to another embodiment of the invention.
  • a first vessel VI and a second vessel V2 are provided with respective magnetically-attracted components 88, 90.
  • the component 88 has an intravascular portion 92 and an extravascular portion 94, while the component 90 has an intravascular portion 96 and an extravascular portion 98 as shown best in Figs. 13A and 13C.
  • the extravascular portions 94, 98 of the respective components are flat and provide a flat engagement to enhance the magnetic force holding the components together.
  • Figs. 14A-14D show a magnetic anastomotic component 100 having a luminal opening 102 and a plurality of slots 104.
  • the slots 104 serve any of several purposes including allowing tissue ingrowth to promote attachment to the vessel, enhance traction between the component 100 and the vessel to which it is attached, etc.
  • Figs. 15A-15D show a magnetic anastomotic component 106 with a luminal opening 108 and a plurality of apertures 110 disposed around its perimeter.
  • the apertures 110 give the component 106 a frame-like structure and may serve any of the purposes described above with respect to the previous embodiment.
  • the components 106 and 100 while illustrated as being curved to match the curvature of a vessel or mating component (not shown), they may instead be flat or otherwise configured.
  • Figs. 16A and 16B show a magnetic anastomotic component 112 being attached to a vessel V according to one embodiment of the inventions.
  • An opening O is formed in an opening of a side wall of the vessel V and a magnetic anastomotic component 112 is moved into position such that the luminal 114 of the component is aligned with the opening O (Fig. 16B).
  • Figs. 16C and 16D show a magnetic anastomotic component 116 being secured to a vessel V according to another embodiment of the invention.
  • the component 116 is lowered against and secured to the vessel wall as in the above embodiment.
  • an opening is formed in the vessel after placing the component in this embodiment.
  • a suitable instrument is used to remove the tissue circumscribed by the opening 116 of the component 116.
  • the components 112 and 116 may be secured to the exterior of the wall of vessel V by any suitable means disclosed herein.
  • Fig. 17A shows an anastomosis between first and second vessels VI and V2 which are provided, respectively, with magnetically attracted components 120, 122.
  • Fig. 17B of the components 120, 122 have mating surfaces which are positioned against each other and held by magnetism to create the anastomosis.
  • Figs. 18A-18D show a magnetic anastomotic component being secured to the exterior of a vessel wall according to still another embodiment of the invention.
  • Delivery device D includes an internal placement member 130 which is used to place a magnetic anastomotic component 132.
  • the placement member 130 is positioned within the lumen of the vessel through an incision in the wall, and the anastomotic component 132 is slid down against the exterior of the vessel. Magnetic attraction holds the component 132 in position around the incision.
  • the delivery device in positioning the placement member within the lumen of the vessel v, the delivery device is manipulated, typically by pulling up to tension the vessel wall, and the edges of the incision are positioned around a portion 134 of the delivery device D so as to make the incision the desired size.
  • the anastomotic component 132 is slid down and the magnetic attraction captures the edges of the incision, thereby maintaining a suitable size opening.
  • the delivery device D is removed as shown in Fig. 18C.
  • the internal placement member 130 is pushed distally and rotated and then removed (for example, by wires W) through the incision in the vessel V.
  • the magnetic anastomotic component 132 is preferably provided with adhesive to secure the component to the vessel. Alternatively, adhesive may be applied around the incision on the vessel and the component 132 moved into contact therewith.
  • Fig. 19 shows an embodiment of the invention where a magnetic anastomotic component 136 is secured to an intermediate member 138, for example a dacron blanket, which itself is secured to the wall of a vessel V.
  • intermediate member 138 for example a dacron blanket
  • a magnetic anastomotic component 136 is secured to an intermediate member 138, for example a dacron blanket, which itself is secured to the wall of a vessel V.
  • the invention may be practiced using any suitable biocompatible adhesives.
  • fibrin sealants and cyanoacrylate esters are the two types of adhesives widely used for biological bonding.
  • Gelatin-resorcinol-formaldehyde glues have limited use as well.
  • Other possible bioadhesives include gelatin-resorcinol-formaldehyde glue, bovine albumin, glutaraldehyde, marine organism (mussel) based, collagen and thrombin.
  • Fibrin sealants are biodegradable, adhere well to connective tissue, promote wound healing, and generally have less bond strength than cyanoacrylate esters.
  • a two-part system may be used to apply the sealant, or a one-part, ready-to-use formulation may be used instead.
  • the adhesives used may have or not have antifibrinolytic agents (e.g., aprotinin, etc.)

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Abstract

L'invention concerne des méthodes et des dispositifs utilisant la force magnétique pour former une anastomose entre des corps creux. Des anastomoses termino-latérales, latéro-latérales et termino-terminales peuvent être créés sans suture et sans aucun autre type de fixations mécaniques, bien que ces moyens d'attache peuvent être utilisés dans la mise en pratique de certains aspects de l'invention. Des éléments anastomotiques magnétiques (16) peuvent être attachés à l'extérieur d'un vaisseau, par exemple, par un adhésif, sans s'étendre dans la lumière du vaisseau. Différentes configurations d'éléments magnétiques sont prévues et peuvent présenter différentes caractéristiques, par exemple, la capacité de s'adapter à la courbure des vaisseaux ou de venir en contact de frottement avec le vaisseau.
PCT/US2001/025197 2000-08-12 2001-08-10 Elements anastomotiques extravasculaires et methodes de formation d'anastomoses magnetiques WO2002013699A1 (fr)

Priority Applications (7)

Application Number Priority Date Filing Date Title
CA002387048A CA2387048A1 (fr) 2000-08-12 2001-08-10 Elements anastomotiques extravasculaires et methodes de formation d'anastomoses magnetiques
EP01959718A EP1311193A4 (fr) 2000-08-12 2001-08-10 Elements anastomotiques extravasculaires et methodes de formation d'anastomoses magnetiques
AU81244/01A AU8124401A (en) 2000-08-12 2001-08-10 Extravascular anastomotic components and methods for forming magnetic anastomoses
JP2002518849A JP2004505711A (ja) 2000-08-12 2001-08-10 脈管外吻合構成要素および磁性吻合を形成するための方法
US10/022,187 US20020143347A1 (en) 2000-12-13 2001-12-13 Extravascular anastomotic components and methods for forming vascular anastomoses
US10/450,989 US7909837B2 (en) 2000-12-13 2002-09-16 Methods, devices and systems for forming magnetic anastomoses
US11/039,705 US20050192603A1 (en) 2000-12-13 2005-01-19 Extravascular anastomotic components and methods for forming magnetic anastomoses

Applications Claiming Priority (8)

Application Number Priority Date Filing Date Title
US09/638,805 2000-08-12
US09/638,805 US6719768B1 (en) 2000-04-29 2000-08-12 Magnetic components for use in forming anastomoses, creating ports in vessels and closing openings in tissue
US25563500P 2000-12-13 2000-12-13
US60/255,635 2000-12-13
US09/851,400 US20020072758A1 (en) 2000-12-13 2001-05-07 Processes for producing anastomotic components having magnetic properties
US09/851,400 2001-05-07
US09/915,226 2001-07-23
US09/915,226 US6802847B1 (en) 2000-04-29 2001-07-23 Devices and methods for forming magnetic anastomoses and ports in vessels

Publications (1)

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WO2002013699A1 true WO2002013699A1 (fr) 2002-02-21

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PCT/US2001/025132 WO2002013704A1 (fr) 2000-08-12 2001-08-10 Dispositifs et procedes permettant de former des anastomoses magnetiques et des orifices dans des vaisseaux
PCT/US2001/025197 WO2002013699A1 (fr) 2000-08-12 2001-08-10 Elements anastomotiques extravasculaires et methodes de formation d'anastomoses magnetiques
PCT/US2001/025116 WO2002013698A1 (fr) 2000-08-12 2001-08-10 Procedes de production de composants anastomotiques possedant des proprietes magnetiques
PCT/US2001/025113 WO2002013703A1 (fr) 2000-08-12 2001-08-10 Composants magnetiques permettant de former des anastomoses et de creer des orifices dans les vaisseaux

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PCT/US2001/025116 WO2002013698A1 (fr) 2000-08-12 2001-08-10 Procedes de production de composants anastomotiques possedant des proprietes magnetiques
PCT/US2001/025113 WO2002013703A1 (fr) 2000-08-12 2001-08-10 Composants magnetiques permettant de former des anastomoses et de creer des orifices dans les vaisseaux

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EP (4) EP1311193A4 (fr)
JP (4) JP2004505711A (fr)
AU (4) AU8327901A (fr)
CA (4) CA2387282A1 (fr)
WO (4) WO2002013704A1 (fr)

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EP1553877A4 (fr) * 2002-05-06 2007-04-04 Univ Drexel Dispositifs de liaison de tissu capables d'administrer des agents bioactifs et procedes d'utilisation associes
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US7001402B2 (en) 2002-09-04 2006-02-21 Cardica, Inc. Medical device having magnetic properties
WO2007081247A1 (fr) 2006-01-12 2007-07-19 Prozeo Vascular Implant Ab Appareil et méthode d’anastomose
EP1976440A1 (fr) * 2006-01-12 2008-10-08 Prozeo Vascular Implant AB Appareil et méthode d'anastomose
EP1976440A4 (fr) * 2006-01-12 2012-09-19 Vascuring Ab Appareil et méthode d'anastomose
WO2007101526A1 (fr) * 2006-03-07 2007-09-13 Ethicon Endo-Surgery, Inc. Dispositif d'anastomose
US8795300B2 (en) 2006-03-07 2014-08-05 Ethicon Endo-Surgery, Inc. Anastomotic device

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CA2387068A1 (fr) 2002-02-21
EP1311193A1 (fr) 2003-05-21
EP1307142A4 (fr) 2005-02-23
EP1307144A1 (fr) 2003-05-07
AU8327601A (en) 2002-02-25
WO2002013698A1 (fr) 2002-02-21
JP2004505713A (ja) 2004-02-26
JP2004505712A (ja) 2004-02-26
EP1307143A1 (fr) 2003-05-07
JP2004505711A (ja) 2004-02-26
AU8124401A (en) 2002-02-25
CA2387050A1 (fr) 2002-02-21
WO2002013703A9 (fr) 2003-03-27
EP1307142A1 (fr) 2003-05-07
CA2387048A1 (fr) 2002-02-21
CA2387282A1 (fr) 2002-02-21
WO2002013703A1 (fr) 2002-02-21
EP1307144A4 (fr) 2005-02-23
WO2002013704A1 (fr) 2002-02-21
AU8328901A (en) 2002-02-25
EP1311193A4 (fr) 2005-02-23
JP2004505710A (ja) 2004-02-26
AU8327901A (en) 2002-02-25
EP1307143A4 (fr) 2005-02-23

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