CA2682592A1 - Device and method for establishing an artificial arterio-venous fistula - Google Patents

Device and method for establishing an artificial arterio-venous fistula Download PDF

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Publication number
CA2682592A1
CA2682592A1 CA002682592A CA2682592A CA2682592A1 CA 2682592 A1 CA2682592 A1 CA 2682592A1 CA 002682592 A CA002682592 A CA 002682592A CA 2682592 A CA2682592 A CA 2682592A CA 2682592 A1 CA2682592 A1 CA 2682592A1
Authority
CA
Canada
Prior art keywords
connector
pair
vessel
clinch members
members
Prior art date
Legal status (The legal status 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 status listed.)
Granted
Application number
CA002682592A
Other languages
French (fr)
Other versions
CA2682592C (en
Inventor
Rodney A. Brenneman
J. Christopher Flaherty
Dean Schaefer
Peter Davis
Brad Kellerman
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Rox Medical Inc
Original Assignee
Rox Medical, Inc.
Rodney A. Brenneman
J. Christopher Flaherty
Dean Schaefer
Peter Davis
Brad Kellerman
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
Application filed by Rox Medical, Inc., Rodney A. Brenneman, J. Christopher Flaherty, Dean Schaefer, Peter Davis, Brad Kellerman filed Critical Rox Medical, Inc.
Priority to CA2741063A priority Critical patent/CA2741063C/en
Publication of CA2682592A1 publication Critical patent/CA2682592A1/en
Application granted granted Critical
Publication of CA2682592C publication Critical patent/CA2682592C/en
Active legal-status Critical Current
Anticipated expiration legal-status Critical

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
    • 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
    • C—CHEMISTRY; METALLURGY
    • C09—DYES; PAINTS; POLISHES; NATURAL RESINS; ADHESIVES; COMPOSITIONS NOT OTHERWISE PROVIDED FOR; APPLICATIONS OF MATERIALS NOT OTHERWISE PROVIDED FOR
    • C09K—MATERIALS FOR MISCELLANEOUS APPLICATIONS, NOT PROVIDED FOR ELSEWHERE
    • C09K8/00—Compositions for drilling of boreholes or wells; Compositions for treating boreholes or wells, e.g. for completion or for remedial operations
    • C09K8/50—Compositions for plastering borehole walls, i.e. compositions for temporary consolidation of borehole walls
    • C09K8/504—Compositions based on water or polar solvents
    • C09K8/506—Compositions based on water or polar solvents containing organic compounds
    • C09K8/508—Compositions based on water or polar solvents containing organic compounds macromolecular compounds
    • C09K8/5083—Compositions based on water or polar solvents containing organic compounds macromolecular compounds obtained by reactions only involving carbon-to-carbon unsaturated bonds
    • C—CHEMISTRY; METALLURGY
    • C09—DYES; PAINTS; POLISHES; NATURAL RESINS; ADHESIVES; COMPOSITIONS NOT OTHERWISE PROVIDED FOR; APPLICATIONS OF MATERIALS NOT OTHERWISE PROVIDED FOR
    • C09K—MATERIALS FOR MISCELLANEOUS APPLICATIONS, NOT PROVIDED FOR ELSEWHERE
    • C09K8/00—Compositions for drilling of boreholes or wells; Compositions for treating boreholes or wells, e.g. for completion or for remedial operations
    • C09K8/50—Compositions for plastering borehole walls, i.e. compositions for temporary consolidation of borehole walls
    • C09K8/516—Compositions for plastering borehole walls, i.e. compositions for temporary consolidation of borehole walls characterised by their form or by the form of their components, e.g. encapsulated material
    • C09K8/518—Foams
    • C—CHEMISTRY; METALLURGY
    • C09—DYES; PAINTS; POLISHES; NATURAL RESINS; ADHESIVES; COMPOSITIONS NOT OTHERWISE PROVIDED FOR; APPLICATIONS OF MATERIALS NOT OTHERWISE PROVIDED FOR
    • C09K—MATERIALS FOR MISCELLANEOUS APPLICATIONS, NOT PROVIDED FOR ELSEWHERE
    • C09K8/00—Compositions for drilling of boreholes or wells; Compositions for treating boreholes or wells, e.g. for completion or for remedial operations
    • C09K8/56—Compositions for consolidating loose sand or the like around wells without excessively decreasing the permeability thereof
    • C09K8/57—Compositions based on water or polar solvents
    • C09K8/575—Compositions based on water or polar solvents containing organic compounds
    • C09K8/5751—Macromolecular compounds
    • C09K8/5753—Macromolecular compounds obtained by reactions only involving carbon-to-carbon unsaturated bonds
    • C—CHEMISTRY; METALLURGY
    • C09—DYES; PAINTS; POLISHES; NATURAL RESINS; ADHESIVES; COMPOSITIONS NOT OTHERWISE PROVIDED FOR; APPLICATIONS OF MATERIALS NOT OTHERWISE PROVIDED FOR
    • C09K—MATERIALS FOR MISCELLANEOUS APPLICATIONS, NOT PROVIDED FOR ELSEWHERE
    • C09K8/00—Compositions for drilling of boreholes or wells; Compositions for treating boreholes or wells, e.g. for completion or for remedial operations
    • C09K8/60—Compositions for stimulating production by acting on the underground formation
    • C09K8/62—Compositions for forming crevices or fractures
    • C—CHEMISTRY; METALLURGY
    • C09—DYES; PAINTS; POLISHES; NATURAL RESINS; ADHESIVES; COMPOSITIONS NOT OTHERWISE PROVIDED FOR; APPLICATIONS OF MATERIALS NOT OTHERWISE PROVIDED FOR
    • C09K—MATERIALS FOR MISCELLANEOUS APPLICATIONS, NOT PROVIDED FOR ELSEWHERE
    • C09K8/00—Compositions for drilling of boreholes or wells; Compositions for treating boreholes or wells, e.g. for completion or for remedial operations
    • C09K8/60—Compositions for stimulating production by acting on the underground formation
    • C09K8/62—Compositions for forming crevices or fractures
    • C09K8/66—Compositions based on water or polar solvents
    • C09K8/68—Compositions based on water or polar solvents containing organic compounds
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/10—Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
    • 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
    • A61B2017/00243—Type of minimally invasive operation cardiac
    • 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
    • A61B2017/1107—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis for blood vessels
    • 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

Abstract

A shunt rivet for implantation in the aorta and inferior vena cava to treat chronic obstructive pulmonary disease, and a method of treating chronic obstructive pulmonary disease.

Claims (49)

1. An intravascular connector, comprising:
a first pair of clinch members comprising a first member and an apposed second member;
a second pair of clinch members opposite from the first pair of clinch members and comprising a first member and an apposed second member;
wherein the first and second pairs of clinch members has a deployed configuration longitudinally disposed relative to contiguous portions of a first vessel and a second vessel such that the first and second pairs of clinch members are biased to close upon contiguous parallel portions of the first and second vessels, and wherein the first and second members of the first pair of clinch members comprise non-uniform lengths relative to one another and the first and second members of the second pair of clinch members comprise non-uniform lengths relative to one another.
2. The connector of claim 1 further comprising at least a third pair of clinch members having a deployed configuration transverse to the first and second pairs such that the third pair of clinch members are biased to exert a nominal pressure on circumferentially spaced points on side walls of the first and second vessels.
3. The connector of claim 1 wherein each first member of the first and second pair of clinch members each have a length loss than each second member of the first and second pair of clinch members.
4. The connector of claim 3 wherein each first member of the first and second pair of clinch members are deployed on opposite ends of the connector within first and second vessels, respectively.
5. The connector of claim 4 wherein each second member of the first and second pair of clinch members are deployed on opposite ends of the connector within first and second vessels, respectively.
6. The connector of claim 1 further comprising a clip connector extending between the first and second pair of clinch members and defining a lumen therethrough fluidly coupling the first and second vessels.
7. The connector of claim 6 wherein the clip connector is angled relative to a centerline of the connector.
8. The connector of claim 6 wherein the clip connector defines a tapered cross-sectional area along its length.
9. The connector of claim 6 wherein the clip connector is angled relative to a centerline of the connector and defines a tapered cross-sectional area along its length.
10. The connector of claim 6 further comprising at least one deformable segment along a length of the clip connector.
11. The connector of claim 1 further comprising a hinge or flange between clinch members.
12. The connector of claim 1 further comprising at least one break-away or frangible segment along a periphery of the connector.
13. The connector of claim 1 further comprising at least one deformable segment along a periphery of the connector.
14. The connector of claim 1 further comprising a delivery instrument having an outer sheath and an inner shaft slidable within the outer sheath such that the connector is deployable from within the outer sheath.
15. The connector of claim 14 further comprising an inflatable member near or at a distal end of the outer sheath and/or inner shaft.
16. The connector of claim 14 wherein the outer sheath and/or inner shaft are articulatable.
17. The connector of claim 14 wherein the delivery instrument further comprises an inflatable balloon thereupon.
18. The connector of claim 17 wherein the balloon defines a circular cross-sectional area when inflated.
19. The connector of claim 17 wherein the balloon defines non-circular cross-sectional area when inflated.
20. The connector of claim wherein the first and second pairs of clinch member are biased to evert such that a distal portion of each apposed member is proximate to one another when released in its deployed configuration.
21. The connector of claim 1 wherein a distal portion of each apposed clinch member is configured to form an atraumatic bearing surface therebetween for impingement on the first and second vessels.
22. The connector of claim 1 wherein the first and second pairs of clinch members comprise a continuously formed clip absent an intervening waist segment.
23. The connector of claim 1 wherein the first vessel comprises an artery.
24. The connector of claim wherein the second vessel comprises a vein.
25. The connector of claim 2 wherein the third pair of clinch members are biased to establish a slight compliance mismatch between the first and second vessels.
26. The connector of claim 2 wherein the third pair of clinch members each define a distal portion which is spaced apart from one another in the deployed configuration.
27. The connector of claim 1 wherein the third pair of clinch members comprise a continuously formed clip absent an intervening waist segment.
28. The connector of claim 1 further comprising a therapeutic drug coating or membrane at least partially covering the connector.
29. A method for creating an intravascular connection, comprising:
advancing an intravascular connector through first vessel, the intravascular connector having a first pair of clinch members comprising a first member and an apposed second member and a second pair of clinch members opposite from the first pair of clinch members and also comprising a first member and an apposed second member;
introducing the second member of the first pair and the first member of the second pair into a second vessel from the first vessel such that the respective members deploy into contact against an inner wall of the second vessel; and deploying the first member of the first pair and the second member of the second pair into contact against an inner wall of the first vessel, wherein the first and second members of the first pair of clinch members comprise non-uniform lengths relative to one another and the first and second members of the second pair of clinch members comprise non-uniform lengths relative to one another.
30. The method of claim 29 wherein advancing an intravascular connector comprises advancing the connector within an outer sheath.
31. The method of claim 29 wherein prior to introducing, intravascularly crossing guidewire from the first vessel into the second vessel such that the guidewire is disposed within the first and second vessels.
32. The method of claim 31 wherein introducing comprises advancing the intravascular connector at least partially from the first vessel and into the second vessel over or along the guidewire.
33. The method of claim 29 wherein introducing comprises releasing the first member of the second pair in an arc contained within the second vessel into contact against the inner wall of the second vessel.
34. The method of claim 29 wherein deploying comprises releasing the first member of the first pair in an arc contained within the first vessel into contact against the inner wall of the first vessel.
35. The method of claim 29 further comprising adjusting a physical parameter of the intravascular connector to modify a flow rate between the first and second vessels through the connector.
36. The method of claim 35 wherein adjusting a physical parameter comprises modifying a configuration of the intravascular connector via break-away, frangible, or deformable segments comprising at least a portion of the connector.
37. The method of claim 35 wherein adjusting a physical parameter comprises adjusting a cross-sectional area of the intravascular connector to adjust the flow rate therethrough.
38. The method of claim 35 wherein adjusting a physical parameter comprises adjusting a lumen length of the intravascular connector between the first and second vessels.
39. The method of claim 35 wherein adjusting a physical parameter comprises adjusting an angle of the intravascular connector extending between the first and second vessels.
40. The method of claim 29 further comprising deploying at least a third pair of clinch members having a deployed configuration transverse to the first and second pairs such that the third pair of clinch members are biased to exert a nominal pressure on circumferentially spaced points on side walls of the first and second vessels.
41. A method for implanting an intravascular connector, comprising:
advancing an intravascular connector through a first vessel, the intravascular connector having a first pair of clinch members comprising a first member and an apposed second member and a second pair of clinch members opposite from the first pair of clinch members and also comprising a first member and an apposed second member;

introducing the second member of the first pair and the first member of the second pair into a second vessel from the first vessel;
visualizing a deflection of the second member of the first pair against a tissue wall of the second vessel to determine suitable positioning of the connector relative to the second vessel;
deploying the first member of the second pair such that the first member of the second pair swings from a distal position to a proximal position against the tissue wall of the second vessel; and deploying the first member of the first pair and the second member of the second pair into contact against an inner wall of the first vessel such that the first vessel and second vessel are in fluid communication with one another.
42. The method of claim 41 wherein the first and second members of the first pair of clinch members comprise non-uniform lengths relative to one another and the first and second members of the second pair of clinch members comprise non-uniform lengths relative to one another.
43. The method of claim 41 wherein advancing an intravascular connector comprises advancing the connector within an outer sheath.
44. The method of claim 41 wherein prior to introducing, intravascularly crossing a guidewire from the first vessel into the second vessel such that the guidewire is disposed within the first and second vessels.
45. The method of claim 41 further comprising adjusting physical parameter of the intravascular connector to modify a flow rate between the first and second vessels through the connector.
46. The method of claim 45 wherein adjusting a physical parameter comprises modifying a configuration of the intravascular connector via break-away, frangible, or deformable segments comprising at least a portion of the connector.
47. The method of claim 41 wherein visualizing a deflection comprises determining when deflection of the second member of the first pair is minimizing relative to the tissue wall of the second vessel as indicative of suitable connector positioning.
48. The method of claim 47 further comprising perceiving force feedback of the connector against the tissue wall of the second vessel.
49. The method of claim 41 further comprising deploying at least a third pair of clinch members having a deployed configuration transverse to the first and second pairs such that the third pair of clinch members are biased to exert a nominal pressure on circumferentially spaced points on side walls of the first and second vessels.
CA2682592A 2007-04-04 2008-03-26 Device and method for establishing an artificial arterio-venous fistula Active CA2682592C (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CA2741063A CA2741063C (en) 2007-04-04 2008-03-26 Device and method for establishing an artificial arterio-venous fistula

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US11/696,635 US7828814B2 (en) 2004-08-27 2007-04-04 Device and method for establishing an artificial arterio-venous fistula
US11/696,635 2007-04-04
PCT/US2008/058315 WO2008124314A1 (en) 2007-04-04 2008-03-26 Device and method for establishing an artificial arterio-venous fistula

Related Child Applications (1)

Application Number Title Priority Date Filing Date
CA2741063A Division CA2741063C (en) 2007-04-04 2008-03-26 Device and method for establishing an artificial arterio-venous fistula

Publications (2)

Publication Number Publication Date
CA2682592A1 true CA2682592A1 (en) 2008-10-16
CA2682592C CA2682592C (en) 2011-07-12

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CA2682592A Active CA2682592C (en) 2007-04-04 2008-03-26 Device and method for establishing an artificial arterio-venous fistula

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US (7) US7828814B2 (en)
EP (1) EP2136734B1 (en)
JP (1) JP4806100B2 (en)
AU (1) AU2008237498B2 (en)
CA (2) CA2741063C (en)
WO (1) WO2008124314A1 (en)

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US20150164505A1 (en) 2015-06-18
US20070249985A1 (en) 2007-10-25
US20110015657A1 (en) 2011-01-20
EP2136734B1 (en) 2013-06-12
US8273095B2 (en) 2012-09-25
US20140031842A1 (en) 2014-01-30
EP2136734A1 (en) 2009-12-30
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US9820745B2 (en) 2017-11-21
CA2741063A1 (en) 2008-10-16
AU2008237498A1 (en) 2008-10-16
CA2741063C (en) 2014-12-09
CA2682592C (en) 2011-07-12
JP4806100B2 (en) 2011-11-02
JP2010523209A (en) 2010-07-15
US8734472B2 (en) 2014-05-27
US9023097B2 (en) 2015-05-05
EP2136734A4 (en) 2011-06-08
US10751057B2 (en) 2020-08-25
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US7828814B2 (en) 2010-11-09
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US20180049742A1 (en) 2018-02-22
US20130060186A1 (en) 2013-03-07

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