US 6,248,117 B1 · Anastomosis apparatus for use in intraluminally directed vascular anastomosis

Abstract

The present invention relates to new and useful apparatus for use with an intraluminally directed anvil apparatus for intraluminally directed vascular anastomosis of an end of a graft vessel to the wall of a receiving blood vessel that is performed according to a minimally invasive procedure. The intraluminally directed vascular anastomosis does not require the interruption of blood flow in the receiving blood vessel and it is versatile enough to suitably combine a variety of cutting, welding, soldering, sealing, and joining techniques such as stapling. The intraluminally directed anvil apparatus comprises an anvil and a wire used for signaling the optimal anastomosis site; this signaling can be performed when the initial exploration is performed. The intraluminally directed anvil apparatus is typically used with a catheter.

Claims79

Dependent claims

An anastomosis apparatus for use with an intraluminally directed anvil apparatus, the anastomosis apparatus comprising:

attachment means for attaching an end of a graft vessel to a wall of a receiving blood vessel;
centering means for centering the anastomosis apparatus over an anastomosis site by receiving a piercing wire extending from an anvil of an intraluminally directed anvil apparatus and then engaging the piercing wire to enable the wall of the receiving blood vessel to be moved as needed at an anastomosis site as the intraluminal directed anvil apparatus is moved via the anastomosis apparatus;
and
cutting means for forming an opening in the wall of the receiving blood vessel at the anastomosis site through engagement with the anvil of the intraluminally directed anvil apparatus after the centering means has received and engaged the piercing wire, such that the opening is generally cylindrical, generally corresponds with the circumference of the end of the graft vessel and is centered on the piercing wire.

1 more element

An anastomosis apparatus for use with an intraluminally directed anvil apparatus, the anastomosis apparatus comprising:

an anastomosis ring having a plurality of pairs of staple prong passages extending from an outer wall to an inner wall;
a staple guide ring coaxially disposed around the anastomosis ring, the staple guide having a plurality of staple grooves aligned with a pair of passages in the anastomosis ring such that a staple can be pushed along within the grooves and into the pair of passages in the anastomosis ring,
a plurality of staples, each staple being positioned to be pushed through a groove in the staple guide ring and into a pair of passages in the anastomosis ring;
a centering core coaxially positioned within the anastomosis ring, the centering core having a centrally and longitudinally located conduit configured to receive a piercing wire extending from an anvil of an intraluminally directed anvil apparatus such that the anastomosis apparatus can be centered over an anastomosis site and such that the piercing wire can be enraged by a locking mechanism of the centering core to enable a wall of the receiving blood vessel to be moved as needed at the anastomosis site as the intraluminally directed anvil apparatus is moved via the anastomosis apparatus;
and
a cutter coaxially disposed around the centering core and having a distal cutting end opposite a proximal end, wherein the cutter is adapted to engage the anvil of the intraluminally directed anvil apparatus after the piercing wire has been received and engaged, wherein the cutter is configured to form a generally cylindrical opening in the wall of the receiving blood vessel at the anastomosis site that generally corresponds with the circumference of the end of the graft vessel and is centered on the piercing wire;
a staple engaging device coaxially disposed around the cutter and having a plurality of staple pushing arms, each staple pushing arm having a proximal end opposite a distal pushing end positioned in contact with a staple;
and
an activation sheath coaxially disposed around the staple engaging device and being configured to slide on the staple pushing device such that the sheath can slide from the proximal ends of the staple pushing arms downward to force the pushing ends of the pushing arms against the staples and then back up the staple engaging device to release the pushing arms, thereby enabling the staples to be pushed through the anastomosis ring and into an end of the graft vessel and the wall of the receiving blood vessel.

6 more elements

An anastomosis apparatus for use with with an intraluminally directed anvil apparatus, the anastomosis apparatus comprising:

an anastomosis ring having an inner wall opposite an outer wall, a retention side opposite a bottom side, and a plurality of pairs of staple prong passages extending from the outer wall to the inner wall such that each pair of passages can receive opposing prongs of a staple;
the retention side of the anastomosis ring having a plurality of notches extending from the outer wall towards the inner wall;
a staple guide ring coaxially disposed around the anastomosis ring, the staple guide having an outer wall opposite an inner wall positioned adjacent to the outer wall of the anastomosis ring, a retention side opposite a bottom side, and a plurality of staple grooves extending through the retention side from the outer wall to the inner wall;
each staple groove being aligned with a pair of passages in the anastomosis ring such that a staple can be pushed along within the grooves and into a pair of passages in the anastomosis ring, the retention side of the staple guide ring having a plurality of notches extending from the inner wall towards the outer wall, each notch being configured to align with a notch in the anastomosis ring to yield a plurality of retention slots;
a plurality of staples, each staple having a driving portion between opposing prongs, each pair of prongs of each staple being positioned at least partially within one of the pairs of passages in the anastomosis ring and within one of the staple grooves of the staple guide ring;
a centering core having a distal coupling end opposite a proximal control end, the centering core being configured and sized for coaxial movement through the anastomosis ring, the centering core having a centrally and longitudinally located conduit configured to receive a catheter wire, the centering core having a locking element to retain the catheter wire in a fixed position within the conduit;
a cutter coaxially disposed around the centering core and having a distal cutting end opposite a proximal end;
a staple pushing device coaxially disposed around the cutter and having a plurality of staple pushing arms and a plurality of retention arms, each staple pushing arm having a distal pushing end opposite a proximal end, each retention arm having a retention end opposite a proximal end, the retention ends being positioned within the retention slots defined by the notches in the anastomosis ring and the staple guide ring, each staple pushing end being positioned in contact with a driving portion of a staple;
and
an activation sheath coaxially disposed around the staple pushing device and being configured to slide on the staple pushing device such that the sheath can slide from the proximal ends of the staple pushing arms and the retention arms downward to force the pushing ends of the pushing arms against the driving portions of the staples and then back up the staple pushing device to release the pushing arms, thereby enabling the staples to be pushed through the anastomosis ring and into an end of the graft vessel and the wall of the receiving blood vessel.

7 more elements

Dependencies are inferred from the claim text.

Anastomosis apparatus for use in intraluminally directed vascular anastomosis

Life of this patent

Anastomosis apparatus for use in intraluminally directed vascular anastomosis

Life of this patent

Abstract

Claims79