US6068638A
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Device, system and method for interstitial transvascular intervention
Assignee: Medtronic Vascular Inc
•
Filing: 1998-10-27
•
Granted: 2000-05-30
•
Expires: 2018-10-27
Abstract
Abstract Method and apparatus for utilizing the vascular system as a conduit to reach other vascular and extravascular locations within the body. Included are methods for revascularization wherein the extravascular passageways are formed to permit blood flow between vascular locations. Also included are methods for performing transvascular interstitial surgery (TVIS) wherein extravascular passageways are formed from a blood vessel to another vascular or non-vascular intracorporeal location. Also disclosed are devices usable for forming extravascular passageways in accordance with the invention, or for modifying, valving, maintaining or closing such passageways.
Inventors
- 👤 Joshua Makower
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-22 23:49
CPC Classifications
A; A61; A61B; A61B17/00; A61B17/12; A61B17/12022; A61B1/00; A61B1/313; A61B1/3137; A61B17/0057; A61B17/11; A61B17/12027; A61B17/1204; A61B17/12045; A61B17/12099; A61B17/12109; A61B17/12131; A61B17/12136; A61B17/12181; A61B17/1219; A61B17/34; A61B17/3417; A61B18/00; A61B18/04; A61B18/12; A61B18/14; A61B18/1442; A61B18/1445; A61B18/1492; A61F; A61F2/00; A61F2/02; A61F2/24; A61F2/2493; A61F2/95; A61B17/00234; A61B17/00491; A61B17/064; A61B17/0643; A61B17/32; A61B17/3205; A61B17/3207; A61B17/320725; A61B17/3494; A61B17/3496; A61B18/1477; A61B18/18; A61B18/20; A61B18/22; A61B18/24; A61B2017/00238; A61B2017/00243; A61B2017/00247; A61B2017/00252; A61B2017/00292; A61B2017/003; A61B2017/00504; A61B2017/00641; A61B2017/0641; A61B2017/1107; A61B2017/1139; A61B2017/12127; A61B17/22; A61B2017/22038; A61B2017/22072; A61B2017/22074; A61B2017/22077; A61B17/30; A61B2017/306; A61B2017/347; A61B2017/348; A61B2017/3482; A61B2017/3484; A61B2017/3488; A61B2018/00315; A61B2018/00345; A61B2018/00351; A61B2018/00392; A61B2018/00636; A61B2018/00773; A61B2018/00869; A61B2018/1405; A61B2018/1425; A61B90/00; A61B90/36; A61B90/37; A61B2090/378; A61B90/39; A61B2090/3925; A61B2090/3929; A61B2090/3954; A61B2090/3958; A61B90/361; A61B90/40; A61F2/04; A61F2/06; A61F2/07; A61F2/82; A61F2/86; A61F2/90; A61F2/30; A61F2002/30001; A61F2002/30003; A61F2002/3006; A61F2002/30079; A61F2/848; A61F2002/8486; A61F2210/00; A61F2210/009; A61M; A61M25/00; A61M25/0067; A61M25/0074; A61M25/0075; A61M2025/0076; A61M25/01; A61M2025/018; A61M25/10; A61M2025/1043; A61M2025/1052
Claims Analysis
Total Claims: 51
Claim 1
Independent Claim
106 words
A method for revascularization, said method comprising the steps of: (A) providing channel forming apparatus that can be transluminally inserted into a first blood containing anatomical structure and is useable to form an extravascular channel from said first blood-containing anatomical structure to a second blood containing anatomical structure, wherein at least one of said anatomical structures contains oxygenated blood; (B) using said apparatus to form at least one non-valved blood flow channel from said first blood-containing anatomical structure to said second blood containing anatomical structure, said non-valved blood flow channel remaining open during systole and diastole such that oxygenated blood may flow continuously through said channel.
Claim 2
Independent Claim
106 words
A method for revascularization, said method comprising the steps of: (A) providing channel forming apparatus that can be transluminally inserted into a first blood containing anatomical structure and is useable to form an extravascular channel from said first blood-containing anatomical structure to a second blood containing anatomical structure, wherein at least one of said anatomical structures contains oxygenated blood; (B) using said apparatus to form at least one non-valved blood flow channel from said first blood-containing anatomical structure to said second blood containing anatomical structure, said non-valved blood flow channel remaining open during systole and diastole such that oxygenated blood may flow continuously through said channel.
Claim 3
Dependent Claim
12 words
The method of claim 1 wherein the artery is a coronary artery.
Claim 4
Dependent Claim
12 words
The method of claim 1 wherein the vein is a coronary vein.
Claim 5
Dependent Claim
37 words
The method of claim 1 wherein said method further comprises the step of: (C) placing at least one blocking apparatus in one of said first blood-containing anatomical structures to facilitate said continuous blood flow through said channel.
Claim 6
Dependent Claim
20 words
The method of claim 1 further comprising the step of: (C) placing a stent at least partially within said channel.
Claim 7
Dependent Claim
18 words
The method of claim 5 wherein said stent is valved to permit blood flow in only one direction.
Claim 8
Dependent Claim
14 words
The method of claim 5 wherein said stent is wholly located within said channel.
Claim 9
Dependent Claim
20 words
The method of claim 5 wherein said stent protrudes from said channel into at least one of said anatomical structures.
Claim 10
Dependent Claim
14 words
The method of claim 5 wherein said stent is an in-situ formed polymer stent.
Claim 11
Dependent Claim
16 words
The method of claim 5 wherein the stent is at least partially covered with a membrane.
Claim 12
Dependent Claim
28 words
The method of claim 10 wherein said membrane is disposed on said stent such that said membrane operates to block blood flow in at least one flow direction.
Claim 13
Dependent Claim
21 words
The method of claim 5 wherein said stent comprises a covering to form a barrier adjacent the wall of the channel.
Claim 14
Independent Claim
20 words
The method of the 12 wherein said covering is formed of material which will dissolve after a period of time.
Claim 15
Independent Claim
20 words
The method of the 12 wherein said covering is formed of material which will dissolve after a period of time.
Claim 16
Dependent Claim
42 words
The method of claim 1 wherein the channel forming apparatus provided in step (A) comprises: (i) an apparatus for forming an initial penetration tract between said anatomical structures and; (ii) an apparatus for enlarging the initial penetration tract to form said channel.
Claim 17
Dependent Claim
24 words
The method of claim 14 wherein the apparatus for enlarging the initial penetration tract is a balloon usable to enlarge said initial penetration tract.
Claim 18
Dependent Claim
26 words
The method of claim 14 wherein the apparatus for enlarging the initial penetration tract is a tissue cutting apparatus useable to enlarge said initial penetration tract.
Claim 19
Dependent Claim
26 words
The method of claim 14 wherein the apparatus for enlarging the initial penetration tract is an energy emitting apparatus useable to enlarge said initial penetration tract.
Claim 20
Dependent Claim
36 words
The method of claim 1 further comprising the step of: (C) placing a clip member at least partially in said channel to maintain approximation of said blood vessels such that flow is facilitated through said channel.
Claim 21
Dependent Claim
33 words
The method of claim 18 further comprising the step of: (C) heating tissue adjacent to said channel to a sufficient temperature for a sufficient period of time to cause fusion of said tissue.
Claim 22
Dependent Claim
21 words
The method of claim 19 wherein step C includes the act of longitudinally compressing said tissue while said tissue is heated.
Claim 23
Dependent Claim
91 words
The method of claim 1 wherein the channel forming apparatus provided in step (A) includes at least a first apparatus for forming an initial penetration tract between said anatomical structures, a guide wire; and a second apparatus for modifying the initial penetration tract, and wherein step (B) comprises: (i) using said first apparatus to form said initial penetration tract; (ii) placing said guide wire through said initial penetration tract; and, thereafter, (iii) advancing said second apparatus over said guide wire and using said second apparatus to modify said initial penetration tract.
Claim 24
Dependent Claim
24 words
The method of claim 21 wherein the guidewire is placed in the initial penetration tract as part of the operation of the first apparatus.
Claim 25
Dependent Claim
50 words
The method of claim 22 wherein the apparatus provided in step A comprises a tissue penetrating member having a lumen extending therethrough, and wherein the guidewire is advanced through the lumen of the tissue penetrating member after the tissue penetrating member has been used to form the initial penetration tract.
Claim 26
Dependent Claim
73 words
The method of claim 1 wherein the first blood-containing anatomical structure is of a first size, and wherein the second blood-containing anatomical structure is of a second size, and wherein the method further comprises: (C) placing a stent within the channel, said stent having a first end dimensioned to correspond to the size of the first anatomical structure, and a second end dimensioned to correspond to the size of the second anatomical structure.
Claim 27
Dependent Claim
32 words
The method of claim 24 wherein said stent extends through said channel and its first end protrudes into the first anatomical structure, and its second end protrudes into the second anatomical structure.
Claim 28
Dependent Claim
51 words
The method of claim 24 wherein the first end of the stent is expandable to a first diameter which corresponds to the size of the first anatomical strucutre, and the second end of the stent is expandable to a second diameter which corresponds to the size of the second anatomical structure.
Claim 29
Dependent Claim
29 words
The method of claim 1 wherein said method further comprises the step of: (C) injecting a flow of contrast material through said channel to facilitate imaging of said channel.
Claim 30
Independent Claim
116 words
A method for revascularization, said method comprising the steps of: (A) providing channel forming apparatus that can be transluminally inserted into a coronary blood vessel that has a vessel wall and is useable to penetrate through the wall of the coronary blood vessel in which it is positioned and into the myocardium thereby forming a dead-end channel from said coronary blood vessel into the myocardium; (B) transluminally inserting said channel forming apparatus into a coronary blood vessel; and, (C) causing the channel forming apparatus to penetrate through the wall of the coronary blood vessel in which it is positioned and into the myocardium, thereby forming said dead-end channel from said coronary blood vessel into the myocardium.
Claim 31
Independent Claim
116 words
A method for revascularization, said method comprising the steps of: (A) providing channel forming apparatus that can be transluminally inserted into a coronary blood vessel that has a vessel wall and is useable to penetrate through the wall of the coronary blood vessel in which it is positioned and into the myocardium thereby forming a dead-end channel from said coronary blood vessel into the myocardium; (B) transluminally inserting said channel forming apparatus into a coronary blood vessel; and, (C) causing the channel forming apparatus to penetrate through the wall of the coronary blood vessel in which it is positioned and into the myocardium, thereby forming said dead-end channel from said coronary blood vessel into the myocardium.
Claim 32
Dependent Claim
22 words
The method of claim 28 wherein the coronary blood vessel in which the channel forming apparatus is positioned is a coronary artery.
Claim 33
Dependent Claim
51 words
The method of claim 28 wherein the coronary blood vessel in which the channel forming apparatus is positioned is a coronary vein that has been connected to a source of arterial blood such that arterial blood is flowing through the region of said coronary vein wherein the interstitial channel is formed.
Claim 34
Independent Claim
140 words
A method for establishing a blood flow conduit between a first tubular blood vessel that has a vessel wall and a second tubular blood vessel that has a vessel wall, wherein at least one of said first and second tubular blood vessels contains oxygenated blood, said method comprising the steps of: (a) providing at least one apparatus that can be transluminally inserted into at least one of the tubular blood vessels and is useable to form openings in the walls of the first and second tubular blood vessels as well as a blood flow conduit between said openings; and, (b) using said at least one apparatus to form openings in the walls of the first and second blood vessels and to establish a blood flow conduit between said openings, such that oxygenated blood may flow through said blood flow conduit.
Claim 35
Independent Claim
140 words
A method for establishing a blood flow conduit between a first tubular blood vessel that has a vessel wall and a second tubular blood vessel that has a vessel wall, wherein at least one of said first and second tubular blood vessels contains oxygenated blood, said method comprising the steps of: (a) providing at least one apparatus that can be transluminally inserted into at least one of the tubular blood vessels and is useable to form openings in the walls of the first and second tubular blood vessels as well as a blood flow conduit between said openings; and, (b) using said at least one apparatus to form openings in the walls of the first and second blood vessels and to establish a blood flow conduit between said openings, such that oxygenated blood may flow through said blood flow conduit.
Claim 36
Dependent Claim
27 words
The method of claim 31 wherein the first blood vessel is an artery that contains oxygenated blood, and the second blood vessel is a coronary blood vessel.
Claim 37
Dependent Claim
13 words
The method of claim 31 wherein the second blood vessel is a vein.
Claim 38
Dependent Claim
14 words
The method of claim 33 wherein the second blood vessel is a coronary vein.
Claim 39
Dependent Claim
13 words
The method of claim 31 wherein the second blood vessel is an artery.
Claim 40
Dependent Claim
14 words
The method of claim 35 wherein the second blood vessel is a coronary artery.
Claim 41
Dependent Claim
34 words
The method of claim 35 wherein the second blood vessel is a coronary artery having an obstruction formed therein and wherein the opening in the second blood vessel is formed distal to said obstruction.
Claim 42
Dependent Claim
29 words
The method of claim 31 wherein said method farther comprises the step of: (c) placing at least one blocking apparatus in one of said first or second blood vessels.
Claim 43
Dependent Claim
27 words
The method of claim 38 wherein one of said first or second blood vessels is a vein and wherein the blocking apparatus is placed in the vein.
Claim 44
Dependent Claim
22 words
The method of claim 31 farther comprising the step of: (c) placing a stent at least partially within said blood flow conduit.
Claim 45
Dependent Claim
18 words
The method of claim 40 wherein the stent is valved to permit blood flow in only one direction.
Claim 46
Dependent Claim
47 words
The method of claim 31 wherein the apparatus provided in step (a) comprises: (1) apparatus for forming initial openings in the walls of the first and second blood vessels; and, (2) apparatus for enlarging the initial openings formed the walls of the first and second blood vessels.
Claim 47
Dependent Claim
69 words
The method of claim 39 wherein the apparatus for enlarging the initial penetrations formed in at least the walls of the first and second blood vessels is selected from the group consisting of: (1) a dilating apparatus usable to enlarge said initial penetration tract; (2) a tissue cutting apparatus useable to enlarge said initial penetration tract; and (3) an energy emitting apparatus useable to enlarge said initial penetration tract.
Claim 48
Dependent Claim
23 words
The method claim 43 wherein the dilating apparatus is selected from the group of dilating apparatus consisting of: a dilator; and, a balloon.
Claim 49
Dependent Claim
128 words
The method of claim 31 wherein Step (a) comprises: (1) providing apparatus for forming openings through the walls of the first and second blood vessels; and, (2) providing apparatus for deploying a tubular conduit between the openings formed in the walls of the first and second blood vessels, thereby establishing said blood flow conduit through which oxygenated blood may flow; and, wherein Step (b) comprises; (3) using the apparatus provided in Step A (1) to form said openings in the walls of the first and second blood vessels; and, (4) using the apparatus provided in Step A (2) to deploy the tubular conduit between the openings in the walls of the first and second blood vessels, thereby establishing said blood flow conduit through which oxygenated blood may flow.
Claim 50
Dependent Claim
93 words
The method of claim 45 wherein tissue exists between the locations at which the openings are to be formed in the first and second blood vessel walls, and wherein; the apparatus provided in Step A (1) is or are useable to penetrate through said tissue as well as through said first and second blood vessel walls, thereby forming an interstitial channel through said tissue; and, the apparatus provided in Step A (2) is or are useable to deploy said tubular conduit at least partially through the interstitial channel created by the first apparatus.
Claim 51
Dependent Claim
96 words
The method of claim 45 wherein, prior to deployment of said conduit, at least some open space exists between the locations on the first and second blood vessel walls at which the openings are formed and wherein; the apparatus provided in Step A (1) is or are useable to form said openings in the first and second blood vessel walls; and, the apparatus provided in Step A (2) is or are useable to deploy the tubular conduit through the open space between said openings, thereby establishing said blood flow conduit through which oxygenated blood may flow.
References Cited (Backward Citations)
US4098571A
Cited
SU891076A1
Cited
US4546499A
Cited
US4582067A
Cited
US4769031A
Cited
US4808153A
Cited
US4924863A
Cited
US4936281A
Cited
US5035702A
Cited
US5423805A
Cited
US5758663A
Cited
US5556377A
Cited
US5531677A
Cited
US5287861A
Cited
US5409019A
Cited
US5429144A
Cited
US5486161A
Cited
US5443497A
Cited
WO1995017131A1
Cited
US5725544A
Cited
US5549601A
Cited
US5591226A
Cited
US5755775A
Cited
US5695504A
Cited
US5676670A
Cited
WO1997047261A1
Cited
US5662124A
Cited
WO1998006356A1
Cited
US5755682A
Cited
WO1998019625A2
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 |