WO2011062831A1 - Endoprothèse d'anastomose - Google Patents

Endoprothèse d'anastomose Download PDF

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Publication number
WO2011062831A1
WO2011062831A1 PCT/US2010/056308 US2010056308W WO2011062831A1 WO 2011062831 A1 WO2011062831 A1 WO 2011062831A1 US 2010056308 W US2010056308 W US 2010056308W WO 2011062831 A1 WO2011062831 A1 WO 2011062831A1
Authority
WO
WIPO (PCT)
Prior art keywords
arches
plane
apical portions
generally
stent
Prior art date
Application number
PCT/US2010/056308
Other languages
English (en)
Inventor
Andres F. Aguirre
Original Assignee
Wilson-Cook Medical 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 US12/620,864 external-priority patent/US8834361B2/en
Application filed by Wilson-Cook Medical Inc. filed Critical Wilson-Cook Medical Inc.
Publication of WO2011062831A1 publication Critical patent/WO2011062831A1/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
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/08—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound
    • A61B17/083—Clips, e.g. resilient
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238—Type of minimally invasive operation
    • A61B2017/00278—Transorgan operations, e.g. transgastric
    • 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
    • A61B2017/00743—Type of operation; Specification of treatment sites
    • A61B2017/00818—Treatment of the gastro-intestinal system
    • 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
    • A61B17/08—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound
    • A61B2017/081—Tissue approximator
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1139—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
    • A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2493—Transmyocardial revascularisation [TMR] devices

Definitions

  • the invention relates generally to medical stent devices. More particularly, the invention pertains to a stent configured to maintain patency of an anastomosis or other surgery-related aperture.
  • Magnetic anastomosis devices are currently used to create an anastomotic channel across two viscera separating portions of a body lumen (e.g., the alimentary canal and bodily systems feeding thereinto) for the purpose of redirecting bodily fluids.
  • a body lumen e.g., the alimentary canal and bodily systems feeding thereinto
  • intestinal contents or bile may be redirected in patients who have developed an obstruction of the bowel or bile duct due to such conditions as tumor, ulcer, inflammatory strictures, or trauma.
  • the MAD includes first and second magnet assemblies comprising magnetic cores that are surrounded by thin metal rims. Due to the magnetic attraction between the two magnetic cores, the walls of two adjacent viscera may be sandwiched and compressed between the magnet assemblies, resulting in ischemic necrosis of the walls to produce an anastomosis between the two viscera.
  • the viscera treated by MADs include the gall bladder, the common bile duct, the stomach, the
  • An anastomosis created using MADs or other surgical means may be useful for facilitating a NOTES (natural orifice translumenal endoscopic surgery) procedure, whereby "scarless" abdominal operations can be performed with an endoscope passed through a natural orifice (mouth, urethra, anus, etc.) then through an internal incision in - for example - the stomach, vagina, bladder, or colon, thus avoiding any external incisions or scars.
  • NOTES natural orifice translumenal endoscopic surgery
  • translumenal anastomosis remain patent, whether it is configured for use to bypass other structures (e.g., bypassing a diseased or injured proximal portion of the duodenum by providing an aperture directly from the stomach lumen to a more distal portion of the duodenum) or for use in providing access for surgical devices, such as during a NOTES procedure.
  • Other natural, but surgically enhanced openings e.g., a cannulated Sphincter of Oddi
  • tubular stents are known for maintaining patency of generally tubular passages such as blood vessels or bile ducts.
  • tubular devices are not well suited to be maintained effectively in the relatively short longitudinal length of a translumenal anastomosis (e.g., gastro-duodenal anastomosis) or for maintaining the open patency of a cannulated sphincter. Accordingly, it would be useful to provide a device configured to effectively maintain patency of such openings.
  • stent configurations of the present invention may provide patency for surgical anastomosis created by MADs or other means.
  • a single nitinol wire or other biocompatible material having shape memory properties may be configured to define a flower-like configuration generally providing a proximal plane and a distal plane, with a generally cylindrical passage provided therebetween.
  • biocompatible material may include a shroud or other covering and may also include one or more loops configured to allow relatively secure engagement of sutures.
  • FIGS. 1 A-1 B show one embodiment of a stent device
  • FIGS. 2A-2B show the stent device of FIGS. 1 A-1 B, deployed in tissue to maintain open patency of an anastomosis;
  • FIG. 3A shows another stent device embodiment, having fewer arches than the embodiment of FIGS. 1A-1 B;
  • FIGS. 3B-3D show other stent device embodiments, each having a loop structure at the end of one or more arches;
  • FIGS. 4A-4B show, respectively, the stent embodiment of
  • FIG. 3D from a top plan view including a suture, and from a side view with the suture actuated to compress one set of arches together;
  • FIGS. 5A-5C show one method of deploying a stent device in an anastomosis or other aperture
  • FIG. 6 shows a multiband ligator device configured for deploying a stent device
  • FIG. 7 shows another multiband ligator device configuration for deploying a stent device
  • FIGS. 8A-8B show a stent device with the interior regions of its arches being occupied by a fabric or other material.
  • proximal refers to an end direction nearer a physician or other person administering a treatment or procedure
  • distal refers to an end direction nearer a patient receiving the treatment or procedure, opposite the proximal end.
  • wire refers to an elongate slender structure formed of a biocompatible shape memory material such as nitinol, another alloy, or an appropriate polymer; it may include an extruded fine, flexible rod-like structure, or may be laser- cut or otherwise formed from a sheet of material.
  • the stent 100 includes a single continuous unitary nitinol wire (e.g. pulled, extruded, laser-cut from a sheet) or another unitary structure formed from another elongate wire of biocompatible shape memory material.
  • the continuous unitary wire structure may be seamless, or may have its ends welded, crimped or otherwise connected at a one or more points, including that a plurality of components may be used (e.g., in an end-to-end configuration).
  • the stent 100 includes a flower-like configuration, shown in the top plan view of FIG. 1A.
  • a plurality of alternating conjoined arches 102, 104 generally define, respectively, an upper plane 112 and a lower plane 114.
  • the planes 112, 114 may be curved (e.g., so as to form, for example, a hemispherical or conoidal plane). It should be appreciated that the planes may also be generally flat or curved in a variety of other configurations, when the apical portions of the first and/or second sets arches 102, 104 are maximally separated from each other.
  • the upper arches 102 defining the upper plane 112 are shown as being shorter from a central longitudinal axis of the stent 100, relative to the lower arches, but it should be appreciated that the relative lengths of each arch may be varied to serve particular needs (e.g., to fit particular patient body structures) within the scope of the present invention.
  • the conjoined arch bases 106 are themselves arches that are generally transverse to, and that form transitional regions between, each of the adjacent arches 102, 104 when the stent is deplored.
  • the apical portions of those transitional curved base arches 106 form a generally cylindrical central passage 108 (circular as shown, but including that the central passage may have an elliptical, obround, rectilinear, or other geometrically-configured cross-section around which all of the arches are generally centered).
  • the generally circular central passage 108 formed thereby is configured to maintain open patency of an anastomosis, and preferably is about the same thickness as the anastomosis.
  • adjacent arches of each plane are connected to and continuous with arches of the other plan rather than with arches of the same plane. Also, it is preferable that, as viewed from a longitudinal end, the arches of each plane are offset from the arches of the other plane.
  • FIGS. 2A-2B show, respectively, top and top perspective views of a stent 100 disposed across an anastomosis 221 in a manner
  • anastomosis 221 is shown as an opening through tissue 223.
  • the stent upper arches 102 are disposed on the proximal face of the tissue 223, and the stent lower arches 104 (shown in dashed lines) are disposed on the distal face of the tissue 223.
  • the conjoined arch bases 106 retain the open configuration of the anastomosis 221.
  • the disposition of the upper and lower stent arches 102, 104 preferably distributes surface forces generally evenly around the length of the stent wire to minimize likelihood of the stent causing damage to the tissue 223.
  • FIGS. 8A-8B show a stent 800 of the present invention, configured like the stent 100, except that it also includes a shroud or other covering 819 formed of a biocompatible fabric such as, for example, a polymeric fabric of the type known and used in vascular stent grafts.
  • the covering is shown as just filling the inner portion of the arches, but it should be appreciated that a covering could be provided that would span spaces between two or more arches adjacent in one of the planes (e.g., using pleated or elastic material that would not interfere with deployment), or the space within at least one arch, up to and including a plurality of arches, and even all arches. That is, a covering may be provided across an inner portion of at least one of the first plurality of upper stent arches 102, one of the second plurality of lower stent arches 104, or any combination thereof, up to and including all of the arches. Alternatively or in addition, a covering may be provided between adjacent upper stent arches 102 and/or between lower stent arches 104, including any combination thereof.
  • FIGS. 3A-3D show other stent embodiments, each of which includes fewer, less symmetrical arches than the embodiment of FIGS. 1A- 1 B.
  • FIG. 3A shows a stent 310 with relatively long arches 302 and relatively short arches 304. This configuration may be placed with the longer arches 302 on a side of an opening best suited to prevent
  • preferred embodiments generally may include a plurality of arches including at least three arches forming the upper and/or lower planes, although, as shown in FIGS. 1 A-2B, each of the planes formed by the arches may include more than three arches.
  • FIGS. 3B-3D show loops 329 at the ends of the shorter and/or longer arches 304, 302.
  • the loops 329 have several potential applications.
  • stents of the present invention may serve to anchor other structures in or near an aperture such as an anastomosis, sphincter, or other opening. In either use, it may be advantageous to suture one or more of the arches to underlying tissue.
  • the loops 329 may provide an anchoring point for a suture 327, such as is shown in FIG. 3C.
  • the loop structure 329 will prevent the suture from migrating around the periphery of a stent 330, 340, particularly during placement (after which a suture placement device may be used to secure the suture to tissue).
  • FIGS. 4A-4B show one way in which a suture 355 directed through the loops 329 of the stent 350 (as in FIG. 3D).
  • FIG. 4A shows an end view with the suture 355 directed through the loops 329 of the stent 350, where the longer arches 302 are deployed (i.e., spread out to a broader radius). As shown in the side view of FIG.
  • a grasper 470 has been deployed, grasping and pulling the suture in drawstring fashion to radially collapse the arches 302 sufficiently that they can be withdrawn through the aperture in the tissue 475 where the stent 350 is deployed.
  • the suture may be included with the device and operate as a circumferential constraining structure in mechanical communication with apical portions of at least one plurality of arches.
  • a preferred construction includes a single nitinol wire having its ends welded together. In the embodiments described herein, this construction will provide a low profile and high resistance to migration of the stent device.
  • the planes formed by the upper and lower arches preferably are generally parallel, whether they are flat, curved, or partially spherical, but they spaced apart such that they do not intersect within the borders of the plane defined by apices of the arches.
  • One exemplary embodiment described with reference to FIGS. 1A-1 B may be configured to maintain a patent anastomosis between the stomach and duodenum of a patient.
  • the longer arches 104 defining the plane 114 each extend about 40 mm from the central longitudinal axis of the device, and the shorter arches 102 defining the plane 112 each extend about 20 mm from the central longitudinal axis of the device 100. As illustrated, this
  • exemplary embodiment will fit a 16 mm diameter anastomosis.
  • the shapes and dimensions of the arches, the shapes and dimensions of the central opening, the thickness and rigidity of the wire body, and other traits of the device may be altered within the scope of the present invention to provide desirable stiffness, fittedness to an anastomosis or other opening, and other adaptations for use to maintain a patent opening (e.g., that may be elliptical, adjacent to softer or harder tissues, etc.).
  • the number and relative proportions of the arches may be varied as well.
  • Biocompatible polymers having shape-memory characteristics, radio-opaque and/or echogenic markers, endoscopically-visualizable colors, or other features may also be used in stents constructed within the scope of the present invention.
  • stents of the present invention may be used hold two tissues together. For example, pancreatic
  • pseudocysts may be treated by cystgastronomy, cystjejunostomy, or cystduodenostomy (respectively, forming a surgical connection between the pseudocyst and the stomach, jejunum, or duodenum) to facilitate drainage of the cyst.
  • a stent device as disclosed herein may be used temporarily or permanently to maintain patency of an opening.
  • FIGS. 5A-5C As shown in FIG. 5A, a stent 500 is provided in a stent 500 .
  • This non- deployed configuration preferably is configured for substantially atraumatic passage through at least a portion of an anastomosis.
  • the shape-memory bias of the stent 500 toward an outward/expanded configuration will keep it retained in the lumen of the catheter 585 (in all embodiments, it is preferable that the stent be biased into a deployed/expanded configuration by heat-set or other means using shape-memory or other appropriate materials). As shown in FIG.
  • the distal end of the catheter 585 may be directed just through a pair of adjacent apertures between the stomach wall 590 and jejunal wall 592 (which aperture may have been formed and initially secured by MADs, not shown).
  • a pusher 587 may be deployed through the catheter lumen to push the stent 500 just far enough distally that its distal arched arms 502 are allowed to assume their expanded larger radius configuration. Then, as shown in FIG. 5C, the catheter 585 can be withdrawn proximally, bringing the distal arched arms 502 into contact with the jejunal wall 592.
  • That contact and/or additional distal motion from the pusher 587 will then deploy the proximal arched arms 504 of the stent 504, securing the gastric and jejunal walls 590, 592 together with a patent anastomotic aperture spanning them.
  • FIG. 6 Another deployment method, illustrated with reference to FIG. 6, allows deployment of a stent 600 using a multiband ligator (MBL) cap 623 (of the type sold by Cook Endoscopy, Inc., Winston-Salem, N.C.; cf. U.S. Pat. Nos. 5,624,453 and 6,149,659, each of which is incorporated herein by reference).
  • MBL multiband ligator
  • the stent 600 may be disposed within the cap 623 as shown in FIG. 6. Then, deployment may be effected using a pusher structure in much the same manner as described above with reference to FIGS. 5A-5C.
  • a catheter, MBL, or other cylindrical or tubular structure may be included with the device and operate as a circumferential constraining structure in mechanical communication with apical portions of at least one plurality of arches.
  • FIG. 7 Another deployment method is illustrated with reference to FIG. 7, also using an MBL cap 723 mounted to the distal end of an endoscope 725.
  • the distal arches 702 of the stent 700 are collapsed and disposed on the exterior of the MBL cap 723 mounted to the distal end of an endoscope or other device 725, where they are secured in a radially low profile by an MBL band ring 727.
  • the proximal arches 704 of the stent 700 may be disposed within the cap 723 as shown in FIG. 7.
  • the distal end of the assembly may be directed through a target aperture, then deployment may be effected by releasing the band ring 727 in the manner known in the art, thereby freeing the distal arches 702, after which the cap 723 and scope 724 can be withdrawn to complete stent deployment in the same manner as described above with reference to FIGS. 5A-5C.
  • At least a proximal portion of the stent is circumferentially constrained to present a radial profile that has a smaller outer diameter than when the arches are deployed. Specifically, in a fully deployed configuration, the outer ends of the arches will be at or near the furthest possible distance from each other allowed by the planar
  • the apices of the arches will all be drawn near each other to present a lower-profile that can be directed through, for example, body passages, an endoscope working channel, or be mounted for delivery into a structure such as is described above. In all embodiments, it is most preferable that the expanded/ deployed
  • diameter/circumference formed by the apices of one set of arches along one plane may be greater than or less than an outer diameter/ circumference formed by the apices of the set of arches along the opposite plane (e.g., lower arches 104, 302), and the difference between those diameters/circumferences may be slight or significant.

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

Abstract

La présente invention concerne une endoprothèse constituée de fil de nitinol simple ou d'un autre matériau biocompatible ayant des propriétés de mémoire de forme qui peut être configurée pour définir une configuration en forme de fleur produisant généralement un plan proximal et un plan distal, chacun étant généralement centré autour d'un passage généralement cylindrique et configuré pour maintenir la perméabilité d'une anastomose ou une autre ouverture. Le fil ou autre matériau biocompatible peut comprendre une chemise ou une autre couverture et peut comprendre en outre une ou plusieurs boucles configurées pour permettre l'engagement relativement solide de sutures. La présente invention concerne en outre des procédés de déploiement.
PCT/US2010/056308 2009-11-18 2010-11-11 Endoprothèse d'anastomose WO2011062831A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US26232709P 2009-11-18 2009-11-18
US12/620,864 US8834361B2 (en) 2009-05-15 2009-11-18 Systems, devices and methods for accessing a bodily opening
US61/262,327 2009-11-18
US12/620,864 2009-11-18

Publications (1)

Publication Number Publication Date
WO2011062831A1 true WO2011062831A1 (fr) 2011-05-26

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PCT/US2010/056308 WO2011062831A1 (fr) 2009-11-18 2010-11-11 Endoprothèse d'anastomose

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WO (1) WO2011062831A1 (fr)

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2013029571A1 (fr) 2011-08-26 2013-03-07 Ella-Cs, S.R.O. Endoprothèse biodégradable auto-expansible fabriquée en fibres radio-opaques revêtues recouverte d'une feuille élastique biodégradable et d'un agent thérapeutique et procédé pour sa préparation
US10154844B2 (en) 2016-07-25 2018-12-18 Virender K. Sharma Magnetic anastomosis device and delivery system
US10561423B2 (en) 2016-07-25 2020-02-18 Virender K. Sharma Cardiac shunt device and delivery system
US11304698B2 (en) 2016-07-25 2022-04-19 Virender K. Sharma Cardiac shunt device and delivery system

Citations (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5624453A (en) 1993-02-23 1997-04-29 Wilson-Cook Medical, Inc. Endoscopic ligating instrument
US5690656A (en) 1995-06-27 1997-11-25 Cook Incorporated Method and apparatus for creating abdominal visceral anastomoses
US6149659A (en) 1993-02-23 2000-11-21 Dabegran Technologies, Inc. Endoscopic ligating apparatus
US20020082627A1 (en) * 1998-01-30 2002-06-27 Berg Todd Allen Medical graft connector or plug structures, and methods of making and installing same
US6712836B1 (en) * 1999-05-13 2004-03-30 St. Jude Medical Atg, Inc. Apparatus and methods for closing septal defects and occluding blood flow
US20050056292A1 (en) * 1999-08-05 2005-03-17 Cooper Joel D. Devices for maintaining patency of surgically created channels in tissue
US20070123917A1 (en) * 2005-11-29 2007-05-31 Ortiz Mark S Anastomotic device promoting tissue necrosis
US20070129755A1 (en) * 2005-12-05 2007-06-07 Ovalis, Inc. Clip-based systems and methods for treating septal defects
US20070173867A1 (en) * 2004-08-27 2007-07-26 Brenneman Rodney A Device and method for establishing an artificial arterio-venous fistula
US20070191872A1 (en) * 2003-04-24 2007-08-16 Medtronic Vascular, Inc. Membrane eyelet
US20080171944A1 (en) * 2005-07-26 2008-07-17 Rox Medical, Inc. Devices, systems, and methods for peripheral arteriovenous fistula creation

Patent Citations (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5624453A (en) 1993-02-23 1997-04-29 Wilson-Cook Medical, Inc. Endoscopic ligating instrument
US6149659A (en) 1993-02-23 2000-11-21 Dabegran Technologies, Inc. Endoscopic ligating apparatus
US5690656A (en) 1995-06-27 1997-11-25 Cook Incorporated Method and apparatus for creating abdominal visceral anastomoses
US20020082627A1 (en) * 1998-01-30 2002-06-27 Berg Todd Allen Medical graft connector or plug structures, and methods of making and installing same
US6712836B1 (en) * 1999-05-13 2004-03-30 St. Jude Medical Atg, Inc. Apparatus and methods for closing septal defects and occluding blood flow
US20050056292A1 (en) * 1999-08-05 2005-03-17 Cooper Joel D. Devices for maintaining patency of surgically created channels in tissue
US20070191872A1 (en) * 2003-04-24 2007-08-16 Medtronic Vascular, Inc. Membrane eyelet
US20070173867A1 (en) * 2004-08-27 2007-07-26 Brenneman Rodney A Device and method for establishing an artificial arterio-venous fistula
US20080171944A1 (en) * 2005-07-26 2008-07-17 Rox Medical, Inc. Devices, systems, and methods for peripheral arteriovenous fistula creation
US20070123917A1 (en) * 2005-11-29 2007-05-31 Ortiz Mark S Anastomotic device promoting tissue necrosis
US20070129755A1 (en) * 2005-12-05 2007-06-07 Ovalis, Inc. Clip-based systems and methods for treating septal defects

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2013029571A1 (fr) 2011-08-26 2013-03-07 Ella-Cs, S.R.O. Endoprothèse biodégradable auto-expansible fabriquée en fibres radio-opaques revêtues recouverte d'une feuille élastique biodégradable et d'un agent thérapeutique et procédé pour sa préparation
US10154844B2 (en) 2016-07-25 2018-12-18 Virender K. Sharma Magnetic anastomosis device and delivery system
US10561423B2 (en) 2016-07-25 2020-02-18 Virender K. Sharma Cardiac shunt device and delivery system
US11304698B2 (en) 2016-07-25 2022-04-19 Virender K. Sharma Cardiac shunt device and delivery system

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