WO2008036478A3 - Dispositifs pour réduire la dimension d'une ouverture de tissu interne - Google Patents

Dispositifs pour réduire la dimension d'une ouverture de tissu interne Download PDF

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Publication number
WO2008036478A3
WO2008036478A3 PCT/US2007/075611 US2007075611W WO2008036478A3 WO 2008036478 A3 WO2008036478 A3 WO 2008036478A3 US 2007075611 W US2007075611 W US 2007075611W WO 2008036478 A3 WO2008036478 A3 WO 2008036478A3
Authority
WO
WIPO (PCT)
Prior art keywords
closure device
internal tissue
tissue opening
tissue
reducing
Prior art date
Application number
PCT/US2007/075611
Other languages
English (en)
Other versions
WO2008036478A2 (fr
Inventor
Richard J Linder
Clark C Davis
Scott D Miles
Dewayne C Fox
Daryl R Edmiston
Original Assignee
Coherex Medical Inc
Richard J Linder
Clark C Davis
Scott D Miles
Dewayne C Fox
Daryl R Edmiston
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 US11/836,026 external-priority patent/US20080039743A1/en
Priority claimed from US11/836,000 external-priority patent/US9138208B2/en
Application filed by Coherex Medical Inc, Richard J Linder, Clark C Davis, Scott D Miles, Dewayne C Fox, Daryl R Edmiston filed Critical Coherex Medical Inc
Priority to JP2009524001A priority Critical patent/JP2010500130A/ja
Priority to NZ574737A priority patent/NZ574737A/en
Priority to CA002659109A priority patent/CA2659109A1/fr
Priority to AU2007297516A priority patent/AU2007297516A1/en
Priority to EP07840828.3A priority patent/EP2068777A4/fr
Publication of WO2008036478A2 publication Critical patent/WO2008036478A2/fr
Publication of WO2008036478A3 publication Critical patent/WO2008036478A3/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
    • A61B17/12122—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder within the heart
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A61B17/12168—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A61B17/12168—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure
    • A61B17/12172—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure having a pre-set deployed three-dimensional shape
    • 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
    • A61B17/0487—Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks
    • 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
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00084—Temperature
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A61B2017/00407—Ratchet means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A61B2017/00579—Barbed implements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A61B2017/00588—Rigid or stiff implements, e.g. made of several rigid parts linked by hinges
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A61B2017/00592—Elastic or resilient implements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A61B2017/00597—Implements comprising a membrane
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A61B2017/00601—Implements entirely comprised between the two sides of the opening
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A61B2017/00606—Implements H-shaped in cross-section, i.e. with occluders on both sides of the opening
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A61B2017/0061—Implements located only on one side of the opening
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A61B2017/00619—Locking means for locking the implement in expanded state
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A61B2017/00623—Introducing or retrieving devices therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00646—Type of implements
    • A61B2017/00654—Type of implements entirely comprised between the two sides of the opening
    • 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
    • A61B2017/00858—Material properties high friction or non-slip
    • 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
    • A61B2017/00862—Material properties elastic or resilient
    • 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
    • A61B2017/00867—Material properties shape memory effect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00884—Material properties enhancing wound closure
    • 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
    • A61B17/0487—Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks
    • A61B2017/0488—Instruments for applying suture clamps, clips or locks
    • 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
    • A61B2017/0496—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials for tensioning sutures
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B2017/1205—Introduction devices
    • A61B2017/12054—Details concerning the detachment of the occluding device from the introduction device

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Medical Informatics (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Molecular Biology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Reproductive Health (AREA)
  • Vascular Medicine (AREA)
  • Cardiology (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un système médical servant à traiter une ouverture de tissu interne, lequel système peut comprendre un dispositif de fermeture et un dispositif d'administration associé. Le dispositif de fermeture peut comprendre une partie de corps associée de façon fonctionnelle à une première et à une seconde ancre. La partie de corps peut comprendre une pluralité de segments définissant une structure multicellulaire. Le dispositif de fermeture peut être configuré pour appliquer une force latérale au tissu de l'ouverture de tissu interne pour rassembler le tissu. Le dispositif de fermeture peut avoir un aspect sensiblement plat, et avoir une épaisseur de profondeur sensiblement supérieure à l'épaisseur ou à la largeur d'une majorité des éléments formant le dispositif de fermeture pour réduire la courbure hors du plan. Le dispositif de fermeture peut également comprendre un élément conçu pour induire la croissance du tissu.
PCT/US2007/075611 2006-08-09 2007-08-09 Dispositifs pour réduire la dimension d'une ouverture de tissu interne WO2008036478A2 (fr)

Priority Applications (5)

Application Number Priority Date Filing Date Title
JP2009524001A JP2010500130A (ja) 2006-08-09 2007-08-09 内部組織孔の寸法を減少させる装置
NZ574737A NZ574737A (en) 2006-08-09 2007-08-09 Planar or flat devices for reducing the size of an internal tissue opening
CA002659109A CA2659109A1 (fr) 2006-08-09 2007-08-09 Dispositifs pour reduire la dimension d'une ouverture de tissu interne
AU2007297516A AU2007297516A1 (en) 2006-08-09 2007-08-09 Devices for reducing the size of an internal tissue opening
EP07840828.3A EP2068777A4 (fr) 2006-08-09 2007-08-09 Dispositifs pour réduire la dimension d'une ouverture de tissu interne

Applications Claiming Priority (24)

Application Number Priority Date Filing Date Title
US82194906P 2006-08-09 2006-08-09
US82194706P 2006-08-09 2006-08-09
US60/821,949 2006-08-09
US60/821,947 2006-08-09
US82950706P 2006-10-13 2006-10-13
US60/829,507 2006-10-13
US86604706P 2006-11-15 2006-11-15
US60/866,047 2006-11-15
US94262507P 2007-06-07 2007-06-07
US60/942,625 2007-06-07
US11/836,026 US20080039743A1 (en) 2006-08-09 2007-08-08 Methods for determining characteristics of an internal tissue opening
US11/836,013 US8864809B2 (en) 2006-08-09 2007-08-08 Systems and devices for reducing the size of an internal tissue opening
US11/836,013 2007-08-08
US11/836,000 US9138208B2 (en) 2006-08-09 2007-08-08 Devices for reducing the size of an internal tissue opening
US11/836,037 US8979941B2 (en) 2006-08-09 2007-08-08 Devices for reducing the size of an internal tissue opening
US11/836,026 2007-08-08
US11/836,016 2007-08-08
US11/836,123 US8167894B2 (en) 2006-08-09 2007-08-08 Methods, systems and devices for reducing the size of an internal tissue opening
US11/836,123 2007-08-08
US11/836,016 US9220487B2 (en) 2006-08-09 2007-08-08 Devices for reducing the size of an internal tissue opening
US11/836,037 2007-08-08
US11/836,000 2007-08-08
US11/836,051 US8840655B2 (en) 2006-08-09 2007-08-08 Systems and devices for reducing the size of an internal tissue opening
US11/836,051 2007-08-08

Publications (2)

Publication Number Publication Date
WO2008036478A2 WO2008036478A2 (fr) 2008-03-27
WO2008036478A3 true WO2008036478A3 (fr) 2008-12-18

Family

ID=56291005

Family Applications (2)

Application Number Title Priority Date Filing Date
PCT/US2007/075611 WO2008036478A2 (fr) 2006-08-09 2007-08-09 Dispositifs pour réduire la dimension d'une ouverture de tissu interne
PCT/US2007/075608 WO2008021969A2 (fr) 2006-08-09 2007-08-09 Procédés, systèmes et dispositifs destinés à réduire la taille d'une ouverture de tissu interne

Family Applications After (1)

Application Number Title Priority Date Filing Date
PCT/US2007/075608 WO2008021969A2 (fr) 2006-08-09 2007-08-09 Procédés, systèmes et dispositifs destinés à réduire la taille d'une ouverture de tissu interne

Country Status (6)

Country Link
EP (2) EP2068759A4 (fr)
JP (2) JP2010500130A (fr)
AU (2) AU2007286171A1 (fr)
CA (2) CA2659109A1 (fr)
NZ (2) NZ574738A (fr)
WO (2) WO2008036478A2 (fr)

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NZ574737A (en) 2012-05-25
JP5334850B2 (ja) 2013-11-06
EP2068777A4 (fr) 2013-05-15
EP2068777A2 (fr) 2009-06-17
EP2068759A2 (fr) 2009-06-17
WO2008036478A2 (fr) 2008-03-27
EP2068759A4 (fr) 2013-04-10
NZ574738A (en) 2012-02-24
JP2010500129A (ja) 2010-01-07
AU2007297516A1 (en) 2008-03-27
WO2008021969A2 (fr) 2008-02-21
AU2007286171A1 (en) 2008-02-21
CA2659365A1 (fr) 2008-02-21
JP2010500130A (ja) 2010-01-07
WO2008021969A3 (fr) 2008-11-13
CA2659109A1 (fr) 2008-03-27

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