US6068637A
Expired / Lapsed
US
⏱️ 0.0 years remaining
Method and devices for performing vascular anastomosis
Assignee: Cedars-Sinai Medical Center
•
Filing: 1996-08-29
•
Granted: 2000-05-30
•
Expires: 2016-08-29
Abstract
Abstract A method and devices are provided for performing end-to-side anastomoses between the severed end of a first hollow organ and the side-wall of a second hollow organ utilizing transluminal approach with endoscopic assistance, wherein the first and second hollow organs can be secured utilizing a biocompatible glue, clips or by suturing. In an alternative embodiment, the method utilizes a modified cutter catheter which is introduced into the first hollow organ in combination with a receiver catheter which is introduced into the second hollow organ. The distal end of the receiver catheter includes a receiver cavity and a selectively activatable magnetic material. The magnetic material is selected so that it will interact with a magnetically susceptible material disposed in the distal end of the modified cutter catheter when the modified cutter catheter is disposed in proximity to the proposed site for anastomosis whereby the severed end of the first hollow organ is matingly engaged with the sidewall of the second hollow organ. Thereafter, the severed end of the first hollow organ can be attached in sealing engagement with the side-wall utilizing clips, a biocompatible glue, or other suitable methods. The cutter is then activated to remove a portion of the side-wall of the second hollow organ, thereby creating an opening within the region of securement and establishing the anastomosis. In the preferred embodiment, the portion of the sidewall of the second hollow organ is engaged in the receiver cavity by the attractive force between the magnetically susceptible material and the magnetic material. The magnetically susceptible material is then released from the modified cutter catheter and withdrawn along with the portion of the sidewall removed by the cutter when the receiver catheter is withdrawn from the second hollow organ. These methods and devices find particular utility in coronary bypass surgery, including, in particular, where the first hollow organ is the left internal mammary artery (LIMA) and the second hollow organ is the left anterior descending coronary artery (LAD).
Inventors
- 👤 Alexander Popov
- 👤 Peter A. Barath
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-23 12:25
CPC Classifications
A; A61; A61M; A61M25/00; A61M25/01; A61M25/0105; A61M25/0127; A61B; A61B17/00; A61B17/11; A61B2017/1103; A61B2017/1107; A61B2017/1135
Claims Analysis
Total Claims: 99
Claim 1
Independent Claim
189 words
A method for establishing an end-to-side anastomosis between a severed end of a first hollow organ and a side-wall of a second hollow organ, the method comprising: (a) introducing a catheter, having proximal and distal ends, into the first hollow organ and passing the catheter through the first organ until the distal end of the catheter is substantially adjacent to the severed end of the first hollow organ, the catheter having a selectively operable cutter adapted to remove a portion of the side-wall of the second hollow organ; (b) positioning the severed end of the first hollow organ in proximity with the site for anastomosis of the second hollow organ; (c) adhering the severed end of the first hollow organ to the side-wall of the second hollow organ, thereby defining a region of securement on a side-wall of the second hollow organ; and (d) activating the cutter to remove a portion of a side-wall of the second hollow organ thereby creating an opening within the region of securement defined by the engagement of the severed end of the first hollow organ with the side-wall of the second hollow organ.
Claim 2
Independent Claim
189 words
A method for establishing an end-to-side anastomosis between a severed end of a first hollow organ and a side-wall of a second hollow organ, the method comprising: (a) introducing a catheter, having proximal and distal ends, into the first hollow organ and passing the catheter through the first organ until the distal end of the catheter is substantially adjacent to the severed end of the first hollow organ, the catheter having a selectively operable cutter adapted to remove a portion of the side-wall of the second hollow organ; (b) positioning the severed end of the first hollow organ in proximity with the site for anastomosis of the second hollow organ; (c) adhering the severed end of the first hollow organ to the side-wall of the second hollow organ, thereby defining a region of securement on a side-wall of the second hollow organ; and (d) activating the cutter to remove a portion of a side-wall of the second hollow organ thereby creating an opening within the region of securement defined by the engagement of the severed end of the first hollow organ with the side-wall of the second hollow organ.
Claim 3
Dependent Claim
16 words
The method of claim 1, wherein the first and second hollow organs are both vascular lumens.
Claim 4
Dependent Claim
25 words
The method of claim 1, wherein the first hollow organ is the left internal mammary artery and the second hollow organ is a coronary artery.
Claim 5
Dependent Claim
17 words
The method of claim 3, wherein the catheter is first introduced into and through the femoral artery.
Claim 6
Dependent Claim
17 words
The method of claim 3, wherein the catheter is first introduced into and through the brachial artery.
Claim 7
Dependent Claim
24 words
The method of claim 1, wherein the adhering of the severed end of the first hollow organ is effectuated by applying a biocompatible glue.
Claim 8
Independent Claim
188 words
A method for performing a coronary bypass by establishing an end-to-side anastomosis between an arterial source of oxygenated blood and a coronary artery having a stenosis, the method comprising: (a) introducing a catheter, having proximal and distal ends, into the arterial source and passing the catheter through the arterial source until the distal end of the catheter is substantially adjacent to the severed end of the arterial source, the catheter having a selectively operable cutter adapted to remove a portion of the side-wall of the coronary artery; (b) severing the arterial source; (c) positioning the severed end of the arterial source in proximity with the site for anastomosis of the coronary artery; (d) adhering the severed end of the first hollow organ to the side-wall of the second hollow organ, thereby defining a region of securement on a side-wall of the second hollow organ; and (e) activating the cutter to remove a portion of a side-wall of the coronary artery thereby creating an opening within the region of securement defined by the engagement of the severed end of the arterial source with the side-wall of the coronary artery.
Claim 9
Independent Claim
188 words
A method for performing a coronary bypass by establishing an end-to-side anastomosis between an arterial source of oxygenated blood and a coronary artery having a stenosis, the method comprising: (a) introducing a catheter, having proximal and distal ends, into the arterial source and passing the catheter through the arterial source until the distal end of the catheter is substantially adjacent to the severed end of the arterial source, the catheter having a selectively operable cutter adapted to remove a portion of the side-wall of the coronary artery; (b) severing the arterial source; (c) positioning the severed end of the arterial source in proximity with the site for anastomosis of the coronary artery; (d) adhering the severed end of the first hollow organ to the side-wall of the second hollow organ, thereby defining a region of securement on a side-wall of the second hollow organ; and (e) activating the cutter to remove a portion of a side-wall of the coronary artery thereby creating an opening within the region of securement defined by the engagement of the severed end of the arterial source with the side-wall of the coronary artery.
Claim 10
Dependent Claim
16 words
The method of claim 7, wherein the first and second hollow organs are both vascular lumens.
Claim 11
Dependent Claim
25 words
The method of claim 7, wherein the first hollow organ is the left internal mammary artery and the second hollow organ is a coronary artery.
Claim 12
Dependent Claim
17 words
The method of claim 7, wherein the catheter is first introduced into and through the femoral artery.
Claim 13
Dependent Claim
17 words
The method of claim 7, wherein the catheter is first introduced into and through the brachial artery.
Claim 14
Dependent Claim
30 words
The method of claim 7, wherein the adhering of the severed end of the first hollow organ to the side-wall of the second hollow organ includes applying a biocompatible glue.
Claim 15
Independent Claim
291 words
A method for performing coronary bypass by effecting an end-to-side anastomoses between a arterial source of oxygenated blood and a coronary artery, the method comprising: (a) introducing a plurality of trocar ports through the intercostal spaces of a patient; (b) performing gas dissection of the thoracic cavity; (c) isolating an arterial source of oxygenated blood; (d) severing the arterial source; (e) introducing a catheter, having proximal and distal ends, into the arterial source and passing the catheter through the arterial source until the distal end of the catheter is substantially adjacent to the severed end of the arterial source, the catheter having a corkscrew element adapted to penetrate and secure the side wall of the coronary artery, and a selectively operable cutter adapted to remove a portion of the side-wall of the coronary artery; (f) performing endoscopic dissection of the parietal pleura; (g) opening the pericardial sac; (h) isolating the coronary artery proximally and distally to the site for anastomosis; (i) placing the severed end of the arterial source in proximity to the site of anastomosis; (j) activating the corkscrew element whereby the severed end of the arterial source is held in mating relationship with the coronary artery; (k) adhering the severed end of the arterial source to the side wall of the coronary artery, and thereby placing the severed end of the arterial source in sealing engagement with the side wall of the coronary artery; (l) activating the cutter whereby a portion of the side wall of the coronary artery engaged by the corkscrew element is removed; (m) removing the cutter catheter and the portion of the side wall engaged by the corkscrew element; (n) closing the pericardial sac; (o) removing the trocar ports; and (p) evacuating the thoracic cavity.
Claim 16
Independent Claim
291 words
A method for performing coronary bypass by effecting an end-to-side anastomoses between a arterial source of oxygenated blood and a coronary artery, the method comprising: (a) introducing a plurality of trocar ports through the intercostal spaces of a patient; (b) performing gas dissection of the thoracic cavity; (c) isolating an arterial source of oxygenated blood; (d) severing the arterial source; (e) introducing a catheter, having proximal and distal ends, into the arterial source and passing the catheter through the arterial source until the distal end of the catheter is substantially adjacent to the severed end of the arterial source, the catheter having a corkscrew element adapted to penetrate and secure the side wall of the coronary artery, and a selectively operable cutter adapted to remove a portion of the side-wall of the coronary artery; (f) performing endoscopic dissection of the parietal pleura; (g) opening the pericardial sac; (h) isolating the coronary artery proximally and distally to the site for anastomosis; (i) placing the severed end of the arterial source in proximity to the site of anastomosis; (j) activating the corkscrew element whereby the severed end of the arterial source is held in mating relationship with the coronary artery; (k) adhering the severed end of the arterial source to the side wall of the coronary artery, and thereby placing the severed end of the arterial source in sealing engagement with the side wall of the coronary artery; (l) activating the cutter whereby a portion of the side wall of the coronary artery engaged by the corkscrew element is removed; (m) removing the cutter catheter and the portion of the side wall engaged by the corkscrew element; (n) closing the pericardial sac; (o) removing the trocar ports; and (p) evacuating the thoracic cavity.
Claim 17
Independent Claim
311 words
A method for establishing an end-to-side anastomosis between a severed end of a first hollow organ and a side-wall of a second hollow organ, the method comprising: (a) introducing a first catheter, having proximal and distal ends, into the first hollow organ and passing the first catheter through the first hollow organ until the distal end of the first catheter is substantially adjacent to the severed end of the first hollow organ, wherein the first catheter includes a selectively operable cutter, adapted to remove a portion of the side-wall of the second hollow organ, and a magnetically susceptible material disposed near the distal end of the first catheter; (b) introducing a second catheter, having proximal and distal ends, into the second hollow organ and passing the second catheter through the second hollow organ until the distal end of the second catheter is substantially adjacent to the proposed site for anastomosis, wherein the second catheter includes a magnetic material disposed near the distal end of the second catheter; (c) positioning the severed end of the first hollow organ in proximity to the proposed site for anastomosis and thereby placing the magnetically susceptible material in proximity to the magnetic material whereby the magnetic material engages the magnetically susceptible material, and the severed end of the first hollow organ engages the side-wall of the second hollow organ at the site for anastomosis; (d) securing the severed end of the first hollow organ in sealing engagement with the side-wall of the second hollow organ, thereby defining a region of securement on a side-wall of the second hollow organ; and (e) activating the cutter to remove a portion of a side-wall of the second hollow organ thereby creating an opening within the region of securement defined by the engagement of the severed end of the first hollow organ with the side-wall of the second hollow organ.
Claim 18
Independent Claim
311 words
A method for establishing an end-to-side anastomosis between a severed end of a first hollow organ and a side-wall of a second hollow organ, the method comprising: (a) introducing a first catheter, having proximal and distal ends, into the first hollow organ and passing the first catheter through the first hollow organ until the distal end of the first catheter is substantially adjacent to the severed end of the first hollow organ, wherein the first catheter includes a selectively operable cutter, adapted to remove a portion of the side-wall of the second hollow organ, and a magnetically susceptible material disposed near the distal end of the first catheter; (b) introducing a second catheter, having proximal and distal ends, into the second hollow organ and passing the second catheter through the second hollow organ until the distal end of the second catheter is substantially adjacent to the proposed site for anastomosis, wherein the second catheter includes a magnetic material disposed near the distal end of the second catheter; (c) positioning the severed end of the first hollow organ in proximity to the proposed site for anastomosis and thereby placing the magnetically susceptible material in proximity to the magnetic material whereby the magnetic material engages the magnetically susceptible material, and the severed end of the first hollow organ engages the side-wall of the second hollow organ at the site for anastomosis; (d) securing the severed end of the first hollow organ in sealing engagement with the side-wall of the second hollow organ, thereby defining a region of securement on a side-wall of the second hollow organ; and (e) activating the cutter to remove a portion of a side-wall of the second hollow organ thereby creating an opening within the region of securement defined by the engagement of the severed end of the first hollow organ with the side-wall of the second hollow organ.
Claim 19
Dependent Claim
16 words
The method of claim 14, wherein the first and second hollow organs are both vascular lumens.
Claim 20
Dependent Claim
25 words
The method of claim 14, wherein the first hollow organ is the left internal mammary artery and the second hollow organ is a coronary artery.
Claim 21
Dependent Claim
19 words
The method of claim 14, wherein the magnetic material used to engage the magnetically susceptible material is selectively activatable.
Claim 22
Dependent Claim
20 words
The method of claim 17, wherein the selectively activatable magnetic material used to engage the magnetically susceptible material comprises neodymium-iron-boron.
Claim 23
Dependent Claim
42 words
The method of claim 14, wherein the securing of the severed end of the first hollow organ in sealing engagement with the side-wall of the second hollow organ, includes adhering the first hollow organ to the sidewall of the second hollow organ.
Claim 24
Dependent Claim
33 words
The method of claim 19, wherein securing the severed end of the first hollow organ in sealing engagement with the side wall of the second hollow organ is effected with a biocompatible glue.
Claim 25
Dependent Claim
42 words
The method of claim 14, wherein the securing of the severed end of the first hollow organ in sealing engagement with the side-wall of the second hollow organ, includes stapling the first hollow organ to the sidewall of the second hollow organ.
Claim 26
Dependent Claim
42 words
The method of claim 14, wherein the securing of the severed end of the first hollow organ in sealing engagement with the side-wall of the second hollow organ, includes suturing the first hollow organ to the sidewall of the second hollow organ.
Claim 27
Dependent Claim
33 words
The method of claim 14, wherein the second catheter further includes a means for securing the distal end of the second catheter within the second hollow organ near the proposed site for anastomosis.
Claim 28
Dependent Claim
42 words
The method of claim 23, wherein the means for securing the distal end of the second catheter within the second hollow organ near the proposed site for anastomosis is a balloon adapted to engage the side walls of the second hollow organ.
Claim 29
Independent Claim
311 words
A method for establishing an end-to-side anastomosis between a severed end of a first hollow organ and a side-wall of a second hollow organ, the method comprising: (a) introducing a first catheter, having proximal and distal ends, into the first hollow organ and passing the first catheter through the first hollow organ until the distal end of the first catheter is substantially adjacent to the severed end of the first hollow organ, wherein the first catheter includes a selectively operable cutter, adapted to remove a portion of the side-wall of the second hollow organ, and a magnetic material disposed near the distal end of the first catheter; (b) introducing a second catheter, having proximal and distal ends, into the second hollow organ and passing the second catheter through the second hollow organ until the distal end of the second catheter is substantially adjacent to the proposed site for anastomosis, wherein the second catheter includes a magnetically susceptible material disposed near the distal end of the second catheter; (c) positioning the severed end of the first hollow organ in proximity to the proposed site for anastomosis and thereby placing the magnetic material in proximity to the magnetically susceptible material, whereby the magnetic material engages the magnetically susceptible material, and the severed end of the first hollow organ engages the side-wall of the second hollow organ at the site for anastomosis; (d) securing the severed end of the first hollow organ in sealing engagement with the side-wall of the second hollow organ, thereby defining a region of securement on a side-wall of the second hollow organ; and (e) activating the cutter to remove a portion of a side-wall of the second hollow organ thereby creating an opening within the region of securement defined by the engagement of the severed end of the first hollow organ with the side-wall of the second hollow organ.
Claim 30
Independent Claim
311 words
A method for establishing an end-to-side anastomosis between a severed end of a first hollow organ and a side-wall of a second hollow organ, the method comprising: (a) introducing a first catheter, having proximal and distal ends, into the first hollow organ and passing the first catheter through the first hollow organ until the distal end of the first catheter is substantially adjacent to the severed end of the first hollow organ, wherein the first catheter includes a selectively operable cutter, adapted to remove a portion of the side-wall of the second hollow organ, and a magnetic material disposed near the distal end of the first catheter; (b) introducing a second catheter, having proximal and distal ends, into the second hollow organ and passing the second catheter through the second hollow organ until the distal end of the second catheter is substantially adjacent to the proposed site for anastomosis, wherein the second catheter includes a magnetically susceptible material disposed near the distal end of the second catheter; (c) positioning the severed end of the first hollow organ in proximity to the proposed site for anastomosis and thereby placing the magnetic material in proximity to the magnetically susceptible material, whereby the magnetic material engages the magnetically susceptible material, and the severed end of the first hollow organ engages the side-wall of the second hollow organ at the site for anastomosis; (d) securing the severed end of the first hollow organ in sealing engagement with the side-wall of the second hollow organ, thereby defining a region of securement on a side-wall of the second hollow organ; and (e) activating the cutter to remove a portion of a side-wall of the second hollow organ thereby creating an opening within the region of securement defined by the engagement of the severed end of the first hollow organ with the side-wall of the second hollow organ.
Claim 31
Dependent Claim
16 words
The method of claim 25, wherein the first and second hollow organs are both vascular lumens.
Claim 32
Dependent Claim
25 words
The method of claim 25, wherein the first hollow organ is the left internal mammary artery and the second hollow organ is a coronary artery.
Claim 33
Dependent Claim
19 words
The method of claim 25, wherein the magnetic material used to engage the magnetically susceptible material is selectively activatable.
Claim 34
Dependent Claim
20 words
The method of claim 28, wherein the selectively activatable magnetic material used to engage the magnetically susceptible material comprises neodymium-iron-boron.
Claim 35
Dependent Claim
42 words
The method of claim 25, wherein the securing of the severed end of the first hollow organ in sealing engagement with the side-wall of the second hollow organ, includes adhering the first hollow organ to the sidewall of the second hollow organ.
Claim 36
Dependent Claim
32 words
The method of claim 30, wherein securing the severed of the first hollow organ in sealing engagement with the side wall of the second hollow organ is effected with a biocompatible glue.
Claim 37
Dependent Claim
42 words
The method of claim 25, wherein the securing of the severed end of the first hollow organ in sealing engagement with the side-wall of the second hollow organ, includes stapling the first hollow organ to the sidewall of the second hollow organ.
Claim 38
Dependent Claim
42 words
The method of claim 25, wherein the securing of the severed end of the first hollow organ in sealing engagement with the side-wall of the second hollow organ, includes suturing the first hollow organ to the sidewall of the second hollow organ.
Claim 39
Independent Claim
390 words
A method for establishing an end-to-side anastomosis between a severed end of a first hollow organ and a side-wall of a second hollow organ, the method comprising: (a) introducing a first catheter, having proximal and distal ends, into the first hollow organ and passing the first catheter through the first hollow organ until the distal end of the first catheter is substantially adjacent to the severed end of the first hollow organ, wherein the first catheter includes a selectively operable cutter adapted to remove a portion of the side-wall of the second hollow organ and a releasable magnetically susceptible material disposed near the distal end; (b) introducing a second catheter, having proximal and distal ends, into the second hollow organ and passing the second catheter through the second hollow organ until the distal end of the second catheter is substantially adjacent to the proposed site for anastomosis, wherein the second catheter includes a magnetic material disposed near the distal end of the second catheter and a cavity formed in the distal end of the catheter configured to receive the releasable magnetically susceptible material of the first catheter; (c) positioning the severed end of the first hollow organ in proximity to the proposed site for anastomosis and thereby placing the magnetically susceptible material in proximity to the magnetic material, whereby the magnetically susceptible material engages the magnetic material, and the severed end of the first hollow organ engages the side-wall of the second hollow organ at the site for anastomosis; (d) securing the severed end of the first hollow organ in sealing engagement with the side-wall of the second hollow organ, thereby defining a region of securement on a side-wall of the second hollow organ; (e) activating the cutter to remove a portion of a side-wall of the second hollow organ thereby creating an opening within the region of securement defined by the engagement of the severed end of the first hollow organ with the side-wall of the second hollow organ; and (f) releasing the releasable magnetically susceptible material of the first catheter whereby the portion of the side-wall of the second hollow organ removed by activation of the cutter is engaged between the magnetically susceptible material from the first catheter and the magnetic material of the second catheter within the cavity in the distal end of the second hollow organ.
Claim 40
Independent Claim
390 words
A method for establishing an end-to-side anastomosis between a severed end of a first hollow organ and a side-wall of a second hollow organ, the method comprising: (a) introducing a first catheter, having proximal and distal ends, into the first hollow organ and passing the first catheter through the first hollow organ until the distal end of the first catheter is substantially adjacent to the severed end of the first hollow organ, wherein the first catheter includes a selectively operable cutter adapted to remove a portion of the side-wall of the second hollow organ and a releasable magnetically susceptible material disposed near the distal end; (b) introducing a second catheter, having proximal and distal ends, into the second hollow organ and passing the second catheter through the second hollow organ until the distal end of the second catheter is substantially adjacent to the proposed site for anastomosis, wherein the second catheter includes a magnetic material disposed near the distal end of the second catheter and a cavity formed in the distal end of the catheter configured to receive the releasable magnetically susceptible material of the first catheter; (c) positioning the severed end of the first hollow organ in proximity to the proposed site for anastomosis and thereby placing the magnetically susceptible material in proximity to the magnetic material, whereby the magnetically susceptible material engages the magnetic material, and the severed end of the first hollow organ engages the side-wall of the second hollow organ at the site for anastomosis; (d) securing the severed end of the first hollow organ in sealing engagement with the side-wall of the second hollow organ, thereby defining a region of securement on a side-wall of the second hollow organ; (e) activating the cutter to remove a portion of a side-wall of the second hollow organ thereby creating an opening within the region of securement defined by the engagement of the severed end of the first hollow organ with the side-wall of the second hollow organ; and (f) releasing the releasable magnetically susceptible material of the first catheter whereby the portion of the side-wall of the second hollow organ removed by activation of the cutter is engaged between the magnetically susceptible material from the first catheter and the magnetic material of the second catheter within the cavity in the distal end of the second hollow organ.
Claim 41
Dependent Claim
16 words
The method of claim 34, wherein the first and second hollow organs are both vascular lumens.
Claim 42
Dependent Claim
25 words
The method of claim 34, wherein the first hollow organ is the left internal mammary artery and the second hollow organ is a coronary artery.
Claim 43
Dependent Claim
19 words
The method of claim 34, wherein the magnetic material used to engage the magnetically susceptible material is selectively activatable.
Claim 44
Dependent Claim
20 words
The method of claim 37, wherein the selectively activatable magnetic material used to engage the magnetically susceptible material comprises neodymium-iron-boron.
Claim 45
Dependent Claim
42 words
The method of claim 34, wherein the securing of the severed end of the first hollow organ in sealing engagement with the side-wall of the second hollow organ, includes adhering the first hollow organ to the sidewall of the second hollow organ.
Claim 46
Dependent Claim
33 words
The method of claim 39, wherein securing the severed end of the first hollow organ in sealing engagement with the side wall of the second hollow organ is effected with a biocompatible glue.
Claim 47
Dependent Claim
42 words
The method of claim 34, wherein the securing of the severed end of the first hollow organ in sealing engagement with the side-wall of the second hollow organ, includes clipping the first hollow organ to the sidewall of the second hollow organ.
Claim 48
Dependent Claim
42 words
The method of claim 34, wherein the securing of the severed end of the first hollow organ in sealing engagement with the side-wall of the second hollow organ, includes suturing the first hollow organ to the sidewall of the second hollow organ.
Claim 49
Dependent Claim
32 words
The method of claim 34, wherein the second catheter further includes means for securing the distal end of the second catheter within the second hollow organ near the proposed site for anastomosis.
Claim 50
Dependent Claim
43 words
The method of claim 43, wherein the means for securing the distal end of the second catheter within the second hollow organ near the proposed site for anastomosis is an inflatable balloon adapted to engage the side walls of the second hollow organ.
Claim 51
Independent Claim
390 words
A method for establishing an end-to-side anastomosis between a severed end of a first hollow organ and a side-wall of a second hollow organ, the method comprising: (a) introducing a first catheter, having proximal and distal ends, into the first hollow organ and passing the first catheter through the first hollow organ until the distal end of the first catheter is substantially adjacent to the severed end of the first hollow organ, wherein the first catheter includes a selectively operable cutter adapted to remove a portion of the side-wall of the second hollow organ and a releasable magnetic material disposed near the distal end; (b) introducing a second catheter, having proximal and distal ends, into the second hollow organ and passing the second catheter through the second hollow organ until the distal end of the second catheter is substantially adjacent to the proposed site for anastomosis, wherein the second catheter includes a magnetically susceptible material disposed near the distal end of the second catheter and a cavity formed in the distal end of the catheter configured to receive the releasable magnetically susceptible material of the first catheter; (c) positioning the severed end of the first hollow organ in proximity to the proposed site for anastomosis thereby placing the magnetic material in proximity to the magnetically susceptible material whereby the magnetic material engages the magnetically susceptible material, thereby engaging the severed end of the first hollow organ with the side-wall of the second hollow organ at the site for anastomosis; (d) securing the severed end of the first hollow organ in sealing engagement with the side-wall of the second hollow organ, thereby defining a region of securement on a side-wall of the second hollow organ; (e) activating the cutter to remove a portion of a side-wall of the second hollow organ thereby creating an opening within the region of securement defined by the engagement of the severed end of the first hollow organ with the side-wall of the second hollow organ; and (f) releasing the releasable magnetically susceptible material of the first catheter whereby the portion of the side-wall of the second hollow organ removed by activation of the cutter is engaged between the magnetically susceptible material from the first catheter and the magnetic material of the second catheter within the cavity in the distal end of the second hollow organ.
Claim 52
Independent Claim
390 words
A method for establishing an end-to-side anastomosis between a severed end of a first hollow organ and a side-wall of a second hollow organ, the method comprising: (a) introducing a first catheter, having proximal and distal ends, into the first hollow organ and passing the first catheter through the first hollow organ until the distal end of the first catheter is substantially adjacent to the severed end of the first hollow organ, wherein the first catheter includes a selectively operable cutter adapted to remove a portion of the side-wall of the second hollow organ and a releasable magnetic material disposed near the distal end; (b) introducing a second catheter, having proximal and distal ends, into the second hollow organ and passing the second catheter through the second hollow organ until the distal end of the second catheter is substantially adjacent to the proposed site for anastomosis, wherein the second catheter includes a magnetically susceptible material disposed near the distal end of the second catheter and a cavity formed in the distal end of the catheter configured to receive the releasable magnetically susceptible material of the first catheter; (c) positioning the severed end of the first hollow organ in proximity to the proposed site for anastomosis thereby placing the magnetic material in proximity to the magnetically susceptible material whereby the magnetic material engages the magnetically susceptible material, thereby engaging the severed end of the first hollow organ with the side-wall of the second hollow organ at the site for anastomosis; (d) securing the severed end of the first hollow organ in sealing engagement with the side-wall of the second hollow organ, thereby defining a region of securement on a side-wall of the second hollow organ; (e) activating the cutter to remove a portion of a side-wall of the second hollow organ thereby creating an opening within the region of securement defined by the engagement of the severed end of the first hollow organ with the side-wall of the second hollow organ; and (f) releasing the releasable magnetically susceptible material of the first catheter whereby the portion of the side-wall of the second hollow organ removed by activation of the cutter is engaged between the magnetically susceptible material from the first catheter and the magnetic material of the second catheter within the cavity in the distal end of the second hollow organ.
Claim 53
Dependent Claim
16 words
The method of claim 45, wherein the first and second hollow organs are both vascular lumens.
Claim 54
Dependent Claim
25 words
The method of claim 45, wherein the first hollow organ is the left internal mammary artery and the second hollow organ is a coronary artery.
Claim 55
Dependent Claim
19 words
The method of claim 45, wherein the magnetic material used to engage the magnetically susceptible material is selectively activatable.
Claim 56
Dependent Claim
20 words
The method of claim 48, wherein the selectively activatable magnetic material used to engage the magnetically susceptible material comprises neodymium-iron-boron.
Claim 57
Dependent Claim
33 words
The method of claim 49, wherein securing the severed end of the first hollow organ in sealing engagement with the side wall of the second hollow organ is effected with a biocompatible glue.
Claim 58
Dependent Claim
42 words
The method of claim 45, wherein the securing of the severed end of the first hollow organ in sealing engagement with the side-wall of the second hollow organ, includes gluing the first hollow organ to the sidewall of the second hollow organ.
Claim 59
Dependent Claim
42 words
The method of claim 45, wherein the securing of the severed end of the first hollow organ in sealing engagement with the side-wall of the second hollow organ, includes stapling the first hollow organ to the sidewall of the second hollow organ.
Claim 60
Dependent Claim
42 words
The method of claim 45, wherein the securing of the severed end of the first hollow organ in sealing engagement with the side-wall of the second hollow organ, includes suturing the first hollow organ to the sidewall of the second hollow organ.
Claim 61
Dependent Claim
33 words
The method of claim 45, wherein the second catheter further includes a means for securing the distal end of the second catheter within the second hollow organ near the proposed site for anastomosis.
Claim 62
Dependent Claim
42 words
The method of claim 54, wherein the means for securing the distal end of the second catheter within the second hollow organ near the proposed site for anastomosis is a balloon adapted to engage the side walls of the second hollow organ.
Claim 63
Independent Claim
409 words
A method for performing coronary bypass by effecting an end-to-side anastomoses between a arterial source of oxygenated blood and a coronary artery, the method comprising: (a) introducing a plurality of trocar ports through the intercostal spaces of a patient; (b) performing gas dissection of the thoracic cavity; (c) isolating an arterial source of oxygenated blood; (d) severing the arterial source; (e) introducing a first catheter, having proximal and distal ends, into the arterial source and passing the catheter through the arterial source until the distal end of the catheter is substantially adjacent to the severed end of the arterial source, the catheter having a releasable magnetically susceptible material adapted to engage a magnetic material disposed within the coronary artery and a selectively operable cutter adapted to remove a portion of the side-wall of the coronary artery; (f) introducing a second catheter, having proximal and distal ends, into the coronary artery and passing the second catheter through the coronary artery until the distal end of the second catheter is substantially adjacent to the proposed site for anastomosis, wherein the second catheter includes a selectively activatable magnetic material disposed near the distal end of the second catheter and a cavity formed in the distal end of the catheter configured to receive the releasable magnetically susceptible material of the first catheter; (g) performing endoscopic dissection of the parietal pleura; (h) opening the pericardial sac; (i) isolating the coronary artery proximally and distally to the site for anastomosis; (j) positioning the severed end of the arterial source in proximity to the proposed site for anastomosis whereby the magnetically susceptible material is placed in proximity to the magnetic material; (k) activating the magnetic material whereby the severed end of the arterial source is held in mating relationship with the coronary artery; (l) securing the severed end of the arterial source in sealing engagement with the side wall of the coronary artery; (m) activating the cutter whereby a portion of the side wall of the coronary artery is removed; (n) releasing the magnetically susceptible material whereby the magnetically susceptible material and the portion of the sidewall removed by the cutter are engaged within the cavity in the distal end of the second catheter; (o) withdrawing the second catheter, thereby removing the magnetically susceptible material and the portion of the sidewall removed by the cutter; (p) withdrawing the first catheter; (q) closing the pericardial sac; (r) removing the trocar ports; and (s) evacuating the thoracic cavity.
Claim 64
Independent Claim
409 words
A method for performing coronary bypass by effecting an end-to-side anastomoses between a arterial source of oxygenated blood and a coronary artery, the method comprising: (a) introducing a plurality of trocar ports through the intercostal spaces of a patient; (b) performing gas dissection of the thoracic cavity; (c) isolating an arterial source of oxygenated blood; (d) severing the arterial source; (e) introducing a first catheter, having proximal and distal ends, into the arterial source and passing the catheter through the arterial source until the distal end of the catheter is substantially adjacent to the severed end of the arterial source, the catheter having a releasable magnetically susceptible material adapted to engage a magnetic material disposed within the coronary artery and a selectively operable cutter adapted to remove a portion of the side-wall of the coronary artery; (f) introducing a second catheter, having proximal and distal ends, into the coronary artery and passing the second catheter through the coronary artery until the distal end of the second catheter is substantially adjacent to the proposed site for anastomosis, wherein the second catheter includes a selectively activatable magnetic material disposed near the distal end of the second catheter and a cavity formed in the distal end of the catheter configured to receive the releasable magnetically susceptible material of the first catheter; (g) performing endoscopic dissection of the parietal pleura; (h) opening the pericardial sac; (i) isolating the coronary artery proximally and distally to the site for anastomosis; (j) positioning the severed end of the arterial source in proximity to the proposed site for anastomosis whereby the magnetically susceptible material is placed in proximity to the magnetic material; (k) activating the magnetic material whereby the severed end of the arterial source is held in mating relationship with the coronary artery; (l) securing the severed end of the arterial source in sealing engagement with the side wall of the coronary artery; (m) activating the cutter whereby a portion of the side wall of the coronary artery is removed; (n) releasing the magnetically susceptible material whereby the magnetically susceptible material and the portion of the sidewall removed by the cutter are engaged within the cavity in the distal end of the second catheter; (o) withdrawing the second catheter, thereby removing the magnetically susceptible material and the portion of the sidewall removed by the cutter; (p) withdrawing the first catheter; (q) closing the pericardial sac; (r) removing the trocar ports; and (s) evacuating the thoracic cavity.
Claim 65
Dependent Claim
42 words
The method of claim 56, wherein the stage of securing the severed end of the first hollow organ in sealing engagement with the side-wall of the coronary artery, includes stapling the first hollow organ to the side-wall of the second hollow organ.
Claim 66
Dependent Claim
42 words
The method of claim 56, wherein the securing of the severed end of the first hollow organ in sealing engagement with the side-wall of the second hollow organ, includes adhering the first hollow organ to the sidewall of the second hollow organ.
Claim 67
Dependent Claim
33 words
The method of claim 56, wherein securing the severed end of the first hollow organ in sealing engagement with the side wall of the second hollow organ is effected with a biocompatible glue.
Claim 68
Dependent Claim
42 words
The method of claim 56, wherein the stage of securing the severed end of the first hollow organ in sealing engagement with the side-wall of the coronary artery, includes suturing the first hollow organ to the side-wall of the second hollow organ.
Claim 69
Dependent Claim
136 words
A catheter for performing an end-to-side anastomosis between a severed end of a first hollow organ and a side-wall of a second hollow organ of a patient, comprising: an elongated body having proximal and distal ends and adapted for introduction into and through the first hollow organ; a selectively operable cutter disposed within the body and having a cutting surface at the distal end which is configured to remove a portion of a side-wall of the second hollow organ; and a magnetically susceptible material disposed within the body wherein the magnetically susceptible material is adapted to engage a magnetic material disposed within the second hollow organ in proximity to the proposed site for anastomosis whereby the severed end of the first hollow organ is held in mating engagement with the side-wall of the second hollow organ.
Claim 70
Dependent Claim
136 words
A catheter for performing an end-to-side anastomosis between a severed end of a first hollow organ and a side-wall of a second hollow organ of a patient, comprising: an elongated body having proximal and distal ends and adapted for introduction into and through the first hollow organ; a selectively operable cutter disposed within the body and having a cutting surface at the distal end which is configured to remove a portion of a side-wall of the second hollow organ; and a magnetically susceptible material disposed within the body wherein the magnetically susceptible material is adapted to engage a magnetic material disposed within the second hollow organ in proximity to the proposed site for anastomosis whereby the severed end of the first hollow organ is held in mating engagement with the side-wall of the second hollow organ.
Claim 71
Dependent Claim
38 words
The catheter of claim 61, wherein the distal end of the catheter defines a bore having an aperture in the distal end of the catheter and the cutter and the magnetically susceptible material are disposed within the bore.
Claim 72
Dependent Claim
50 words
The catheter of claim 61, wherein the cutter includes: an elongated cutter body disposed axially within the elongated catheter body and extendable along a longitudinal axis of the elongated catheter body; and a cutting element associated with the elongated cutter body and configured for engagement with the second hollow organ.
Claim 73
Dependent Claim
17 words
The catheter of claim 63, wherein the catheter further includes a controller adapted to control the cutter.
Claim 74
Dependent Claim
19 words
The catheter of claim 61, wherein the catheter further includes a controller adapted to control the magnetically susceptible material.
Claim 75
Dependent Claim
59 words
The catheter of claim 65, wherein the controller includes a control wire disposed within the elongated body and movable along the longitudinal axis of the body of the catheter, the control wire further being connected to a control handle at the proximal end of the catheter and to the magnetically susceptible material at the distal end of the catheter.
Claim 76
Dependent Claim
20 words
The catheter of claim 65, wherein the controller is adapted to selectively release the magnetically susceptible material from the catheter.
Claim 77
Dependent Claim
32 words
The catheter of claim 61, wherein the proximate end of the catheter includes a first controller adapted to control the magnetically susceptible material and a second controller adapted to control the cutter.
Claim 78
Independent Claim
131 words
A system for performing an end-to-side anastomosis between a severed end of a first hollow organ and a side-wall of a second hollow organ of a patient, comprising: a first catheter, including (a) a first elongated body having proximal and distal ends and configured for insertion within the first hollow organ; (b) a selectively operable cutter disposed within the body and having a cutting surface at the distal end which is configured to remove a portion of a side-wall of the second hollow organ, and (c) a magnetically susceptible material disposed within the first elongated body; and a second catheter, including (d) a second elongated body having proximal and distal ends and configured for insertion within the second hollow organ, and (e) a magnetic material associated with the second elongated body.
Claim 79
Independent Claim
131 words
A system for performing an end-to-side anastomosis between a severed end of a first hollow organ and a side-wall of a second hollow organ of a patient, comprising: a first catheter, including (a) a first elongated body having proximal and distal ends and configured for insertion within the first hollow organ; (b) a selectively operable cutter disposed within the body and having a cutting surface at the distal end which is configured to remove a portion of a side-wall of the second hollow organ, and (c) a magnetically susceptible material disposed within the first elongated body; and a second catheter, including (d) a second elongated body having proximal and distal ends and configured for insertion within the second hollow organ, and (e) a magnetic material associated with the second elongated body.
Claim 80
Dependent Claim
39 words
The system of claim 69, wherein the distal end of the first catheter defines a bore having an aperture in the distal end of the catheter and the cutter and the magnetically susceptible material are disposed within the bore.
Claim 81
Dependent Claim
50 words
The system of claim 69, wherein the cutter includes: an elongated cutter body disposed axially within the elongated catheter body and extendable along a longitudinal axis of the elongated catheter body; and a cutting element associated with the elongated cutter body and configured for engagement with the second hollow organ.
Claim 82
Dependent Claim
18 words
The system of claim 71, wherein the first catheter further includes a controller adapted to control the cutter.
Claim 83
Dependent Claim
20 words
The system of claim 69, wherein the first catheter further includes a controller adapted to control the magnetically susceptible material.
Claim 84
Dependent Claim
59 words
The system of claim 73, wherein the controller includes a control wire disposed within the elongated body and movable along the longitudinal axis of the body of the catheter, the control wire further being connected to a control handle at the proximal end of the catheter and to the magnetically susceptible material at the distal end of the catheter.
Claim 85
Dependent Claim
20 words
The system of claim 74, wherein the controller is adapted to selectively release the magnetically susceptible material from the catheter.
Claim 86
Dependent Claim
34 words
The system of claim 74, wherein the second catheter further includes an inflatable balloon attached to the distal end of the catheter, the balloon defining a cavity within which the magnetic material is disposed.
Claim 87
Dependent Claim
18 words
The system of claim 74, wherein magnetic material used to engage the magnetically susceptible material is selectively activatable.
Claim 88
Dependent Claim
20 words
The system of claim 70, wherein the selectively activatable magnetic material used to engage the magnetically susceptible material comprises neodymium-iron-boron.
Claim 89
Independent Claim
131 words
A system for performing an end-to-side anastomosis between a severed end of a first hollow organ and a side-wall of a second hollow organ of a patient, comprising: a first catheter, including (a) a first elongated body having proximal and distal ends and configured for insertion within the first hollow organ; (b) a selectively operable cutter disposed within the body and having a cutting surface at the distal end which is configured to remove a portion of a side-wall of the second hollow organ, and (c) a magnetic material disposed within the first elongated body; and a second catheter, including (d) a second elongated body having proximal and distal ends and configured for insertion within the second hollow organ, and (e) a magnetically susceptible material associated with the second elongated body.
Claim 90
Independent Claim
131 words
A system for performing an end-to-side anastomosis between a severed end of a first hollow organ and a side-wall of a second hollow organ of a patient, comprising: a first catheter, including (a) a first elongated body having proximal and distal ends and configured for insertion within the first hollow organ; (b) a selectively operable cutter disposed within the body and having a cutting surface at the distal end which is configured to remove a portion of a side-wall of the second hollow organ, and (c) a magnetic material disposed within the first elongated body; and a second catheter, including (d) a second elongated body having proximal and distal ends and configured for insertion within the second hollow organ, and (e) a magnetically susceptible material associated with the second elongated body.
Claim 91
Dependent Claim
38 words
The system of claim 79, wherein the distal end of the first catheter defines a bore having an aperture in the distal end of the catheter and the cutter and the magnetic material are disposed within the bore.
Claim 92
Dependent Claim
50 words
The system of claim 79, wherein the cutter includes: an elongated cutter body disposed axially within the elongated catheter body and extendable along a longitudinal axis of the elongated catheter body; and a cutting element associated with the elongated cutter body and configured for engagement with the second hollow organ.
Claim 93
Dependent Claim
18 words
The system of claim 81, wherein the first catheter further includes a controller adapted to control the cutter.
Claim 94
Dependent Claim
19 words
The system of claim 79, wherein the first catheter further includes a controller adapted to control the magnetic material.
Claim 95
Dependent Claim
58 words
The system of claim 83, wherein the controller includes a control wire disposed within the elongated body and movable along the longitudinal axis of the body of the catheter, the control wire further being connected to a control handle at the proximal end of the catheter and to the magnetic material at the distal end of the catheter.
Claim 96
Dependent Claim
19 words
The system of claim 84, wherein the controller is adapted to selectively release the magnetic material from the catheter.
Claim 97
Dependent Claim
35 words
The system of claim 84, wherein the second catheter further includes an inflatable balloon attached to the distal end of the catheter, the balloon defining a cavity within which the magnetically susceptible material is disposed.
Claim 98
Dependent Claim
19 words
The system of claim 84, wherein the magnetic material used to engage the magnetically susceptible material is selectively activatable.
Claim 99
Dependent Claim
20 words
The system of claim 87, wherein the selectively activatable magnetic material used to engage the magnetically susceptible material comprises neodymium-iron-boron.
References Cited (Backward Citations)
US4018228A
Cited
US4216776A
Cited
US4210132A
Cited
WO1981000668A1
Cited
US4368736A
Cited
US5220928A
Cited
US4929240A
Cited
US4745919A
Cited
EP0422689A2
Cited
US5041082A
Cited
US4809713A
Cited
US5047040A
Cited
SU1635966A1
Cited
US5174276A
Cited
EP0373927A2
Cited
US4930674A
Cited
US4983176A
Cited
US5078723A
Cited
US5015249A
Cited
US5234447A
Cited
US5366462A
Cited
US5047039A
Cited
US5170925A
Cited
US5188638A
Cited
US5258008A
Cited
US5330486A
Cited
US5376095A
Cited
WO1995017127A1
Cited
EP0672386A1
Cited
DE4408746A1
Cited
USPTO Annuity & Maintenance Windows
| Annuity Stage | Window Opens | Payment Deadline | Surcharge Period Until | Estimated Fee | Status |
|---|---|---|---|---|---|
| 3.5 Years (Year 4) | 2003-05-30 | 2003-11-29 | 2004-05-30 | $2000.00 | Window Closed / Lapsed |
| 7.5 Years (Year 8) | 2007-05-30 | 2007-11-29 | 2008-05-30 | $3760.00 | Window Closed / Lapsed |
| 11.5 Years (Year 12) | 2011-05-30 | 2011-11-29 | 2012-05-30 | $7700.00 | Window Closed / Lapsed |