# US 8,784,439 B1 · Percutaneous medical procedures and devices for closing vessels using mechanical closures

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- Number: US 8,784,439 B1
- Document ID: US8784439B1
- Status: Granted
- Kind: B1
- Application number: 13/413,156
- Filed: 2012-03-06
- Granted: 2014-07-22
- Earliest claimed: 2006-11-28
- Applicants: Stephen V. Ward; Kenneth Salce; Matt D. Pursley; Joe E. Brown
- Inventors: Stephen V. Ward; Kenneth Salce; Matt D. Pursley; Joe E. Brown
- Web page: https://patentgrep.com/patent/US8784439B1

## CPC

- A61B 17/12172: {having a pre-set deployed three-dimensional shape (methods of manufacturing A61B2017/00526)}
- A61B 17/0401: {Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors (A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811)}
- A61B 17/0469: {Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery}
- A61B 17/0482: {Needle or suture guides (guides for drills, pins or wire A61B17/17; guides for puncturing needles A61B17/3403)}
- A61B 17/06109: {Big needles, either gripped by hand or connectable to a handle}
- A61B 17/0644: {penetrating the tissue, deformable to closed position}
- A61B 17/068: Surgical staplers {, e.g. containing multiple staples or clamps}({staplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105;} for performing anastomosis A61B17/115; {staplers in general B25C5/00})
- A61B 17/12013: {for use in minimally invasive surgery, e.g. endoscopic surgery}
- A61B 17/12031: {complete occlusion}
- A61B 17/12036: {partial occlusion}
- A61B 17/12109: {in a blood vessel}
- A61B 17/12131: {characterised by the type of occluding device}
- 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 17/06066: {Needles, e.g. needle tip configurations}
- A61B 2017/00526: {Methods of manufacturing}
- A61B 2017/00778: {Operations on blood vessels (A61B2017/22097, A61B2017/320741 take precedence)}
- A61B 2017/00867: {shape memory effect}
- A61B 2017/0409: {Instruments for applying suture anchors}
- A61B 2017/0417: {T-fasteners}
- A61B 2017/0419: {H-fasteners}
- A61B 2017/0437: {the barbs being resilient or spring-like}
- A61B 2017/0445: {cannulated, e.g. with a longitudinal through-hole for passage of an instrument}
- A61B 2017/0448: {Additional elements on or within the anchor}
- A61B 2017/0464: {for soft tissue}
- A61B 2017/0472: {Multiple-needled, e.g. double-needled, instruments}
- A61B 2017/06052: {Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle}
- A61B 2017/0608: {J-shaped}
- A61B 2017/06095: {pliable}
- A61B 2017/061: {hollow or tubular}
- A61B 2017/0641: {having at least three legs as part of one single body}
- A61B 2017/0645: {being elastically deformed for insertion}
- A61B 2017/0649: {Coils or spirals}
- A61B 2017/12054: {Details concerning the detachment of the occluding device from the introduction device}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

Percutaneous medical procedures are provided, which use endovascular instruments to install mechanical closures for closing vessels, such as veins. The mechanical closures can be one or more sutures that are anchored to the vessel walls and then cinched to closed the vessel. The mechanical closures can also be resilient clips or stents that are expanded within the vessel to pierce the vessel walls, and are then contracted to pull the vessel closed. Various techniques for installing the mechanical closures are also described.

## Claims

### Claim 1

A percutaneous medical procedure, comprising:
inserting an endovascular instrument into a tubular vessel, said instrument comprising an inner torque tube and an outer guide tube having a pair of slots in a distal end thereof; and
using said instrument to install a mechanical closure for closing the vessel;
wherein said mechanical closure comprises a clip;
wherein said clip has an S-shape configuration with pointed ends, and wherein said clip is installed by rotating said inner torque tube relative to said outer guide tube to expand the clip radially outwardly until the pointed ends protrude outwardly from the slots and penetrate a wall of the vessel, and then allowing the clip to contract and close the vessel.

### Claim 2

A percutaneous medical procedure, comprising:
inserting an endovascular instrument into a vessel; and
using said instrument to install a clip having an S-shaped configuration with pointed ends for closing the vessel;
wherein said instrument comprises an inner torque tube and an outer guide tube having a pair of slots in a distal end thereof, said inner torque tube being disposed within said outer guide tube and rotatable relative thereto; and
wherein the clip is installed by placing a first portion of the clip in contact with said inner torque tube and a second portion of the clip in contact with said outer guide tube, rotating the inner torque tube relative to the outer guide tube to expand the clip until the pointed ends protrude radially outwardly from the slots of the outer guide tube and penetrate the wall of the vessel, and then allowing the clip to contract and close the vessel.

### Claim 3 (depends on 2)

The percutaneous medical procedure according to claim 2, wherein said pointed ends comprise barbs for anchoring the pointed ends in a wall of the vessel.

### Claim 4 (depends on 2)

The percutaneous medical procedure according to claim 2, further comprising:
providing a pusher tube inserted between said inner torque tube and said outer guide tube; and
using said pusher tube to push the clip out of contact with the inner torque tube and the outer guide tube.

### Claim 5

A percutaneous medical procedure, comprising:
inserting an endovascular instrument into a vessel; and
using said instrument to install a clip having an S-shaped configuration with pointed ends for closing the vessel;
wherein said instrument comprises an inner torque tube having a groove in a distal end thereof, and an outer guide tube having a pair of slots in a distal end thereof, said inner torque tube being disposed within said outer guide tube and rotatable relative thereto; and
wherein the clip is installed by placing the clip in said groove at the distal end of said inner torque tube with the pointed ends thereof fit within the slots in the distal end of the outer guide tube, rotating the inner torque tube relative to the outer guide tube to expand the clip until the pointed ends protrude outwardly from the slots in the outer guide tube and penetrate the wall of the vessel, and then allowing the clip to contract and close the vessel.

### Claim 6 (depends on 5)

The percutaneous medical procedure according to claim 5, further comprising:
providing a pusher tube inserted between said inner torque tube and said outer guide tube; and
using said pusher tube to push the clip out of the groove at the distal end of the inner torque tube and the slots of the outer guide tube.

### Claim 7 (depends on 5)

The percutaneous medical procedure according to claim 5, wherein said pointed ends comprise barbs for anchoring the pointed ends in a wall of the vessel.