Apparatus for in situ saphenous vein bypass and less-invasive varicose vein treatment

#The present invention relates generally to endoscopic surgical tools, and more particularly to endoscopic apparatus and methods for in situ saphenous vein bypass surgery and less invasive treatment of varicose veins.

#Many hundreds of thousands of people each year experience partial or complete blockage of the femoral artery attributable to plaque build-up in the artery. When this occurs, the supply of oxygen-rich arterial blood to the leg is reduced, causing pain and, if it is left untreated, eventually leads to amputation of the leg.

#For some blockages, it is possible to remove the blocking tissue by angioplasty or atherectomy, thereby preserving the functionality of the femoral artery. For more complex blockages, however, it is sometimes necessary to altogether bypass the blocked femoral artery. In other words, it is sometimes necessary to attach a substitute conduit to the femoral artery at a location that is upstream (proximal) to the blockage and a location that is downstream (distal) to the blockage, with the substitute conduit assuming the function of the femoral artery in delivering arterial blood to the leg. Such a bypass procedure may be required when the femoral artery has become too occluded or otherwise impaired between the upstream and downstream locations to transport the flow of blood required of it.

#FIG. 1 is a perspective view of the apparatus for in site saphenous vein bypass of the present invention, shown in one intended environment;

#FIG. 2 is a perspective detail view of the operating ends of the control catheter and operating catheter, with the valvulotome and electrode in their housed positions, showing the cap in an exploded relationship with the control catheter;

#FIG. 3 is a perspective detail view of the operating ends of the control catheter and operating catheter, with the valvulotome and electrode in their operating positions;

#Referring initially to FIG. 1, an apparatus is shown, generally designated 10, for in situ modification of a saphenous vein 12 for arterial use. As disclosed below, the apparatus 10 is used to modify the saphenous vein 12 by disrupting one-way valves 14 in the saphenous vein 12 and by electro-ligating side branches 16 to the saphenous vein 12. It is to be understood that the valves 14, until they are disrupted, permit only venous blood flow through the saphenous vein 12 and not arterial blood flow, i.e., undisrupted valves 14 permit blood flow through the saphenous vein 12 only toward the mink of the patient's body, in the direction indicated by the arrow 18, and prevent blood flow in the opposite direction.

#As shown in FIG. 1, the apparatus 10 includes an operating catheter 20 and a control catheter 22. A first end 20a of the operating catheter 20 is connected to a flat working hub 24 having opposed first and second flat surfaces 24a, 24b, while a first end 22a of the control catheter 22 is connected to a flat cutting hub 26 having opposed first and second flat surfaces 26a, 26b. Preferably, both catheters have a 1:1 torque ratio; consequently, turning a hub 24, 26 a predetermined number of degrees (e.g., flipping the hub 24 180 degrees to reverse the position of the first side 24a and second side 24b) will cause the associated catheter 20, 22 to rotate the same number of degrees along its entire length.

#A stainless steel guide wire 28 extends through both the catheters 20, 22 and the hubs 24, 26. The guide wire 28 has a diameter of approximately forty five hundredths of a millimeter (0.45 mm). Each hub 24, 26 includes a respective locking screw 30, 32 that can be manually tightened against the guide wire 28 to hold the guide wire 28 stationary relative to the hubs 24, 26 and catheters 20, 22.