# US 10,945,737 B2 · Implant devices with a pre-set pulley system > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 10,945,737 B2 - Document ID: US10945737B2 - Status: Granted - Kind: B2 - Application number: 15/252,917 - Filed: 2016-08-31 - Published: 2017-05-04 - Granted: 2021-03-16 - Earliest claimed: 2015-10-29 - Assignees: Axogen Corporation - Applicants: AxoGen Corporation - Inventors: Curt Deister - Web page: https://patentgrep.com/patent/US10945737B2 ## CPC - A61B 17/1128: {of nerves} - A61B 17/00234: {for minimally invasive surgery (A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)} - A61B 17/0469: {Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery} - A61B 17/0487: {Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks (suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122)} - A61B 17/11: for performing anastomosis; Buttons for anastomosis - A61B 17/0466: {Suture bridges} - A61B 2017/0406: {Pledgets} - A61B 2017/0417: {T-fasteners} - A61B 2017/0475: {using sutures having a slip knot} - A61B 2017/0477: {with pre-tied sutures} - A61B 2017/0496: {for tensioning sutures} - A61B 2017/1132: {End-to-end connections} - A61B 2017/1142: {Purse-string sutures} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract The problem of positioning one or more nerve ends inside a sheathing implant is solved by the use of a pulley and cinching systems that pull a nerve end into an implant and that can adjust the diameter of an implant to conform the implant to the diameter of the nerve, respectively. The pulley system utilizes a suture that traverses the wall of an implant leaving one end outside the implant wall and another end that can be attached to a nerve. Pulling the suture end outside the wall pulls the nerve attached to the other end of the suture into the bore of the implant. A cinching system utilizes specially arranged sutures within the wall of an implant to tighten or cinch up the wall after a nerve is placed therein, so as to conform at least part of the implant to the diameter of the nerve. Methods are also disclosed by which such pulley systems can be formed during an intraoperative procedure. ## Claims ### Claim 1 An implant comprising: a wall that defines a bore having at least one aperture, the at least one aperture configured to receive at least a portion of a tissue; at least one pulley system pre-set into the wall, the at least one pulley system composing, at least one flexible strand having at least one tag end and at least one needle end, where the at least one flexible strand traverses the wall so that the at least one tag end extends out from the wall and the at least one needle end passes through the bore and out of the at least one aperture and where the at least one tag end of the at least one flexible strand is secured with an anchor, wherein the at least one pulley system is pre-set into the wall before delivery of the implant into a patient. ### Claim 2 (depends on 1) The implant according to claim 1, wherein the implant further comprises at least one closed end. ### Claim 3 (depends on 1) The implant according to claim 1, wherein the implant further comprises a second aperture. ### Claim 4 (depends on 3) The implant according to claim 3, wherein the at least one pulley system comprises at least two flexible strands pre-set into the wall so that the at least one tag end of each of the at least two flexible strands extends out from the wall and the at least one needle end of each of the at least two flexible strands extends out of each aperture. ### Claim 5 (depends on 4) The implant according to claim 4, wherein the at least one tag end of each of the at least two flexible strands are joined to form a pulley loop that extends from the wall. ### Claim 6 (depends on 3) The implant according to claim 3, wherein the at least one flexible strand is threaded to the second aperture to form a pulley loop. ### Claim 7 (depends on 1) The implant according to claim 1, wherein the implant comprises a cap or a sleeve. ### Claim 8 (depends on 1) The implant according to claim 1, wherein the at least one tag end of the at least one flexible strand comprises an anchor. ### Claim 9 (depends on 1) The implant according to claim 1, further comprising: at least one cinching system pre-set into the wall configured to reduce the size of the implant at at least one location, the at least one cinching system comprising: at least one flexible strand threaded through one side of the wall. ### Claim 10 (depends on 9) The implant according to claim 9, wherein the at least one flexible strand of the at least one cinching system comprises at least two tag ends, and traverses one side of the wall in at least two locations, so that the at least one flexible strand crosses the bore at least twice and traverses another side of the wall at least twice, such that each tag end of the at least one flexible strand extends from the same side of the wall, thereby forming a stitch on the wall opposite to the tag ends. ### Claim 11 (depends on 10) The implant according to claim 10, wherein two tag ends of the at least two tag ends are secured together to form a knot. ### Claim 12 (depends on 1) The implant according to claim 1, wherein the implant is made of a biomaterial. ### Claim 13 (depends on 12) The implant according to claim 12, wherein the biomaterial comprises one or more of high density polyethylene, polyethylene glycol hydrogel, purified proteins from one or more of human, animal, plant, fungus, bacterial and synthetic sources, and decellularized tissue constructs. ### Claim 14 (depends on 12) The implant according to claim 12, wherein the biomaterial is capable of tissue remodeling. ### Claim 15 (depends on 1) The implant according to claim 1, wherein the at least one flexible strand includes at least one of a suture, a thread, a line, a wire, and a filament. ### Claim 16 (depends on 1) The implant according to claim 1, wherein the at least one needle end of the at least one flexible strand is configured to pass through at least a portion of the tissue. ### Claim 17 (depends on 1) The implant according to claim 1, wherein the tissue comprises at least one of a nerve, a tendon, a blood vessel, an intestine, and a muscle. ### Claim 18 (depends on 1) The implant according to claim 1, wherein the implant comprises at least two pulley systems pre-set into the wall. ### Claim 19 (depends on 1) The implant according to claim 1, wherein the implant comprises at least three ends, wherein one or more of the at least three ends is closed. ### Claim 20 An implant comprising: a wall that defines a bore having at least one aperture, the at least one aperture configured to receive at least a portion of a tissue; at least one pulley system pre-set into the wall, the at least one pulley system comprising: at least one flexible strand having needle ends on opposing ends of each of the at least one flexible strand, where the at least one flexible strand traverses the wall twice forming a pulley loop that extends out from the wall and where the needle ends pass through the bore and out of the at least one aperture, wherein the at least one pulley system is pre-set into the wall before delivery of the implant into a patient. ### Claim 21 An implant comprising: a wall that defines a bore having at least one aperture, the at least one aperture configured to receive at least a portion of a tissue; at least one pulley system pre-set into the wall, the at least one pulley system composing, at least one flexible strand having at least one tag end and at least one needle end, where the at least one flexible strand traverses the wall so that the at least one tag end extends out from the wall and the at least one needle end passes through the bore and out of the at least one aperture, wherein the at least one pulley system is pre-set into the wall before delivery of the implant into a patient, wherein the at least one needle end of the at least one flexible strand is configured to pass through at least a portion of the tissue, and wherein movement of the at least one tag end of the at least one flexible strand in a direction away from the wall is configured to draw the at least one needle end of the at least one flexible strand and the portion of the tissue toward the aperture.