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US6626899B2 Expired / Lapsed US ⏱️ 0.0 years remaining

Apparatus and methods for treating tissue

Assignee: NIDUS MEDICAL Inc
•
Filing: 2001-07-03
•
Granted: 2003-09-30
•
Expires: 2021-07-03
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Abstract

Abstract Apparatus and methods are provided for thermally and/or mechanically treating tissue, such as valvular structures, to reconfigure or shrink the tissue in a controlled manner. The apparatus comprises a catheter in communication with an end effector which induces a temperature rise in an annulus of tissue surrounding the leaflets of a valve or in the chordae tendineae sufficient to cause shrinkage, thereby causing the valves to close more tightly. Mechanical clips can also be implanted over the valve either alone or after the thermal treatment. The clips are delivered by a catheter and may be configured to traverse directly over the valve itself or to lie partially over the periphery of the valve to prevent obstruction of the valve channel. The clips can be coated with drugs or a radiopaque coating. The catheter can also incorporate sensors or energy delivery devices, e.g., transducers, on its distal end.

Inventors

  • 👤 Russell A. Houser
  • 👤 Vahid Sadaat
  • 👤 Stephen R. Ramee

Bibliographic Details

Application Number —
Jurisdiction US
Data Source google_patents
Last Synchronized 2026-10-22 23:48
CPC Classifications
A; A61; A61B; A61B18/00; A61B17/00; A61B17/04; A61B17/0401; A61B18/04; A61B18/12; A61B18/14; A61B18/1442; A61B18/1477; A61B18/1492; A61B18/18; A61B18/20; A61B18/22; A61B18/24; A61F; A61F2/00; A61F2/02; A61F2/24; A61F2/2442; A61F2/2445; A61B17/0469; A61B17/0487; A61B17/12; A61B17/122; A61B17/128; A61B17/1285; A61B17/28; A61B17/29; A61B2017/00017; A61B2017/00022; A61B2017/00084; A61B17/00234; A61B2017/00238; A61B2017/00243; A61B2017/00831; A61B2017/00867; A61B2017/0409; A61B2017/0412; A61B2017/0414; A61B2017/0427; A61B2017/0437; A61B2017/044; A61B2017/0446; A61B2017/0448; A61B2017/0451; A61B2017/0454; A61B2017/0458; A61B2017/0461; A61B2017/0464; A61B2017/0496; A61B2017/2926; A61B2017/2945; A61B2018/00005; A61B2018/00011; A61B2018/00023; A61B2018/00053; A61B2018/00059; A61B2018/00071; A61B2018/00083; A61B2018/00214; A61B2018/0022; A61B2018/00232; A61B2018/00273; A61B2018/00315; A61B2018/00345; A61B2018/00351; A61B2018/00369; A61B2018/00636; A61B2018/00773; A61B2018/00791; A61B2018/00797; A61B18/1206; A61B2018/1246; A61B2018/1253; A61B2018/126; A61B2018/1405; A61B2018/1425; A61B2018/1432; A61B2018/1435; A61B90/00; A61B90/06; A61B2090/064; A61B90/39; A61F2/2451; A61F2/2454; A61N; A61N7/00; A61N7/02

Claims Analysis

Total Claims: 100
Claim 1
Independent Claim 99 words
An apparatus for treating tissue near a valve to modify flow through the valve, comprising: a cinching member having a central region and at least two anchoring regions on opposing ends of the central region, wherein each anchoring region is configured to be anchored to opposing areas of tissue against or adjacent to an annulus of the valve and urge the areas of tissue towards one another; the cinching member being further configured for delivery through a catheter to the tissue whereby the cinching member has a first shape during the delivery and a second shape after the delivery.
Claim 2
Independent Claim 99 words
An apparatus for treating tissue near a valve to modify flow through the valve, comprising: a cinching member having a central region and at least two anchoring regions on opposing ends of the central region, wherein each anchoring region is configured to be anchored to opposing areas of tissue against or adjacent to an annulus of the valve and urge the areas of tissue towards one another; the cinching member being further configured for delivery through a catheter to the tissue whereby the cinching member has a first shape during the delivery and a second shape after the delivery.
Claim 3
Dependent Claim 17 words
The apparatus of claim 1 wherein the tissue comprises an annulus of cardiac tissue surrounding the valve.
Claim 4
Dependent Claim 12 words
The apparatus of claim 1 wherein the valve comprises a cardiac valve.
Claim 5
Dependent Claim 14 words
The apparatus of claim 1 wherein the central region comprises a continuous alternating length.
Claim 6
Dependent Claim 14 words
The apparatus of claim 1 wherein each of the anchoring regions comprise a fastener.
Claim 7
Dependent Claim 31 words
The apparatus of claim 1 further comprising a plurality of additional cinching members, the cinching members being interwoven such that a plurality of spaces are defined therebetween in the second shape.
Claim 8
Dependent Claim 20 words
The apparatus of claim 1 further comprising a biocompatible fastener for attaching each of the anchoring regions to the tissue.
Claim 9
Dependent Claim 39 words
The apparatus of claim 7 wherein the biocompatible fastener comprises a distal end and a proximal end, the proximal end defining a projection for securing the anchoring region, and the distal end being configured for attachment to the tissue.
Claim 10
Dependent Claim 11 words
The apparatus of claim 8 wherein the projection comprises an eyelet.
Claim 11
Dependent Claim 30 words
The apparatus of claim 8 wherein the anchoring region is secured to the projection via a mechanical fastener selected from the group consisting of sutures, adhesives, welds, hooks, and clips.
Claim 12
Dependent Claim 29 words
The apparatus of claim 8 wherein the distal end comprises a fixation device selected from the group consisting of sutures, adhesives, barbs, screws, pivoting locks, hooks, clips, and tags.
Claim 13
Dependent Claim 40 words
The apparatus of claim 1 wherein the cinching member is configured to approximate a portion of periphery defined by the valve, the central region comprising an arcuate length whereby each of the anchoring regions is in apposition to each other.
Claim 14
Dependent Claim 21 words
The apparatus of claim 12 wherein the portion of the periphery approximated by the cinching member comprises at least about 50%.
Claim 15
Dependent Claim 21 words
The apparatus of claim 13 wherein the portion of the periphery approximated by the cinching member comprises about 50% to 75%.
Claim 16
Dependent Claim 17 words
The apparatus of claim 12 wherein each of the anchoring regions is biased towards the central region.
Claim 17
Dependent Claim 25 words
The apparatus of claim 1 wherein the cinching member comprises a biocompatible material selected from the group consisting of shape memory alloys and superelastic alloys.
Claim 18
Dependent Claim 13 words
The apparatus of claim 16 wherein the shape memory alloy comprises Nickel-Titanium alloy.
Claim 19
Dependent Claim 18 words
The apparatus of claim 1 wherein the cinching member is at least partially coated with a coating layer.
Claim 20
Dependent Claim 13 words
The apparatus of claim 18 wherein the coating layer comprises a therapeutic agent.
Claim 21
Dependent Claim 13 words
The apparatus of claim 19 wherein the therapeutic agent comprises an anti-thrombosis agent.
Claim 22
Dependent Claim 11 words
The apparatus of claim 18 wherein the coating layer is hydrophilic.
Claim 23
Dependent Claim 13 words
The apparatus of claim 18 wherein the coating layer comprises a radiopaque layer.
Claim 24
Dependent Claim 23 words
The apparatus of claim 22 wherein the radiopaque layer is selected from the group consisting of Nickel-Titanium alloy, Platinum, Palladium, Gold, and Tantalum.
Claim 25
Dependent Claim 32 words
The apparatus of claim 1 wherein the central region defines a first plane and the anchoring regions define a second plane, the second plane defining an angle relative to the first plane.
Claim 26
Dependent Claim 19 words
The apparatus of claim 24 wherein the central region is configured to lie over a periphery of the valve.
Claim 27
Dependent Claim 13 words
The apparatus of claim 24 wherein the angle is about 60° to 120°.
Claim 28
Dependent Claim 11 words
The apparatus of claim 24 wherein the angle is about 90°.
Claim 29
Dependent Claim 25 words
The apparatus of claim 24 wherein the central region comprises a shape selected from the group consisting of semi-circles, arcs, half-ellipses, triangles, rectangles, and loops.
Claim 30
Dependent Claim 16 words
The apparatus of claim 1 wherein each of the anchoring regions are configured to pierce tissue.
Claim 31
Dependent Claim 27 words
The apparatus of claim 29 wherein each of the anchoring regions comprise a shape selected from the group consisting of semi-circles, triangles, arcs, half-ellipses, hooks, and V-shapes.
Claim 32
Dependent Claim 25 words
The apparatus of claim 29 wherein each of the anchoring regions is selected from the group consisting of barbs, screws, pivoting locks, clips, and tags.
Claim 33
Dependent Claim 24 words
The apparatus of claim 1 wherein the first shape comprises a geometric shape selected from the group consisting of U shapes and V shapes.
Claim 34
Dependent Claim 39 words
The apparatus of claim 1 wherein the catheter comprises an elongate tubular member having a distal end and a proximal end with a lumen therebetween, the distal end defining a delivery port configured to pass the cinching member therethrough.
Claim 35
Dependent Claim 39 words
The apparatus of claim 33 wherein the catheter further comprises a stylet having a distal end and a proximal end with a length therebetween, the stylet being slidingly disposed in the lumen and being manipulatable from its proximal end.
Claim 36
Dependent Claim 12 words
The apparatus of claim 34 wherein the stylet distal end is angled.
Claim 37
Dependent Claim 22 words
The apparatus of claim 34 wherein the catheter further comprises a linear advancement mechanism connected to the proximal end of the stylet.
Claim 38
Dependent Claim 22 words
The apparatus of claim 36 wherein the linear advancement mechanism is selected from the group consisting of thumb-slides, screws, ratchets, and gears.
Claim 39
Dependent Claim 23 words
The apparatus of claim 33 wherein the catheter further comprises a radiopaque tip disposed on the distal end of the elongate tubular member.
Claim 40
Dependent Claim 25 words
The apparatus of claim 38 wherein the radiopaque tip comprises a metal selected from the group consisting of Nickel-Titanium alloy, Platinum, Palladium, Gold, and Tantalum.
Claim 41
Dependent Claim 20 words
The apparatus of claim 38 wherein the radiopaque tip defines a lumen therethrough in communication with the elongate tubular member.
Claim 42
Dependent Claim 21 words
The apparatus of claim 33 wherein the catheter further comprises a liner disposed in the lumen proximal of the distal end.
Claim 43
Dependent Claim 23 words
The apparatus of claim 41 wherein the liner comprises a material selected from the group consisting of shape memory alloys and superelastic alloys.
Claim 44
Dependent Claim 29 words
The apparatus of claim 33 wherein the catheter further comprises a device disposed on the distal end, the device being selected from the group consisting of sensors and transducers.
Claim 45
Dependent Claim 25 words
The apparatus of claim 43 wherein the sensor is of a type selected from the group consisting of ultrasound sensors, Doppler, electrodes, and pressure sensors.
Claim 46
Dependent Claim 27 words
The apparatus of claim 43 wherein the transducer is configured to deliver energy of a type selected from the group consisting of RF, electrical, and heat energy.
Claim 47
Dependent Claim 13 words
The apparatus of claim 43 wherein the sensor is connected to a monitor.
Claim 48
Independent Claim 148 words
A method for treating tissue near a valve to modify flow through the valve, comprising: providing a cinching member having a central region, a first anchoring region, and a second anchoring region, each of the anchoring regions being attached to opposing ends of the central region; placing a delivery catheter near the tissue; urging the cinching member through a distal opening defined in the catheter such that the first anchoring region exits the distal opening and attaches to a first area of the tissue against or adjacent to an annulus of the valve; and further urging the cinching member through the distal opening such that second anchoring region exits the distal opening and attaches to a second area of the tissue against or adjacent to the annulus of the valve such that the first area and the second area are urged towards one another by the cinching member.
Claim 49
Independent Claim 148 words
A method for treating tissue near a valve to modify flow through the valve, comprising: providing a cinching member having a central region, a first anchoring region, and a second anchoring region, each of the anchoring regions being attached to opposing ends of the central region; placing a delivery catheter near the tissue; urging the cinching member through a distal opening defined in the catheter such that the first anchoring region exits the distal opening and attaches to a first area of the tissue against or adjacent to an annulus of the valve; and further urging the cinching member through the distal opening such that second anchoring region exits the distal opening and attaches to a second area of the tissue against or adjacent to the annulus of the valve such that the first area and the second area are urged towards one another by the cinching member.
Claim 50
Dependent Claim 17 words
The method of claim 47 wherein the tissue comprises an annulus of cardiac tissue surrounding the valve.
Claim 51
Dependent Claim 12 words
The method of claim 47 wherein the valve comprises a cardiac valve.
Claim 52
Dependent Claim 19 words
The method of claim 47 wherein providing a cinching member further comprises providing a plurality of additional cinching members.
Claim 53
Dependent Claim 29 words
The method of claim 47 further comprising providing a biocompatible fastener for attaching the first and the second anchoring regions to the first and the second areas of tissue.
Claim 54
Dependent Claim 40 words
The method of claim 51 wherein the biocompatible fastener is attached to the first and the second areas of tissue via a fixation device selected from the group consisting of sutures, adhesives, barbs, screws, pivoting locks, hooks, clips, and tags.
Claim 55
Dependent Claim 16 words
The method of claim 47 wherein the cinching member is comprised of a shape memory alloy.
Claim 56
Dependent Claim 13 words
The method of claim 53 wherein the shape memory alloy comprises Nickel-Titanium alloy.
Claim 57
Dependent Claim 28 words
The method of claim 47 wherein the first anchoring region forms a shape configured for attachment to the first area of the tissue upon exiting the distal opening.
Claim 58
Dependent Claim 22 words
The method of claim 55 wherein the shape is selected from the group consisting of semi-circles, triangles, arcs, half-ellipses, hooks, and V-shapes.
Claim 59
Dependent Claim 28 words
The method of claim 47 wherein the second anchoring region forms a shape configured for attachment to the second area of the tissue upon exiting the distal opening.
Claim 60
Dependent Claim 22 words
The method of claim 57 wherein the shape is selected from the group consisting of semi-circles, triangles, arcs, half-ellipses, hooks, and V-shapes.
Claim 61
Dependent Claim 25 words
The method of claim 47 wherein the central region forms a shape selected from the group consisting of semi-circles, arcs, half-ellipses, triangles, rectangles, and loops.
Claim 62
Dependent Claim 41 words
The method of claim 47 further comprising forming a first plane defined by the central region and forming a second plane defined by the first and the second anchoring regions, the second plane defining an angle relative to the first plane.
Claim 63
Dependent Claim 13 words
The method of claim 60 wherein the angle is about 60° to 120°.
Claim 64
Dependent Claim 11 words
The method of claim 60 wherein the angle is about 90°.
Claim 65
Dependent Claim 28 words
The method of claim 47 wherein the first anchoring region traverses the valve and attaches to the first area of the tissue located opposite of the delivery catheter.
Claim 66
Dependent Claim 24 words
The method of claim 47 wherein the second anchoring region attaches to the second area of the tissue located adjacent to the delivery catheter.
Claim 67
Dependent Claim 18 words
The method of claim 47 wherein the first area and the second area are located about 180° apart.
Claim 68
Dependent Claim 43 words
The method of claim 47 wherein urging the cinching member through the distal opening defined in the catheter comprises advancing a stylet having a distal end and a proximal end with a length therebetween through the delivery catheter to urge the cinching member.
Claim 69
Dependent Claim 12 words
The method of claim 66 wherein the stylet distal end is angled.
Claim 70
Dependent Claim 23 words
The method of claim 66 wherein the stylet is advanced by a linear advancement mechanism connected at the proximal end of the stylet.
Claim 71
Dependent Claim 22 words
The method of claim 68 wherein the linear advancement mechanism is selected from the group consisting of thumb-slides, screws, ratchets, and gears.
Claim 72
Dependent Claim 31 words
The method of claim 47 wherein placing the delivery catheter near the tissue comprises visualizing the delivery catheter via a radiopaque tip disposed on a distal end of the delivery catheter.
Claim 73
Dependent Claim 25 words
The method of claim 70 wherein the radiopaque tip comprises a metal selected from the group consisting of Nickel-Titanium alloy, Platinum, Palladium, Gold, and Tantalum.
Claim 74
Dependent Claim 39 words
The method of claim 47 further comprising sensing the first area or the second area with a device disposed on a distal end of the delivery catheter, the device being selected from the group consisting of sensors and transducers.
Claim 75
Dependent Claim 25 words
The method of claim 72 wherein the sensor is of a type selected from the group consisting of ultrasound sensors, Doppler, electrodes, and pressure sensors.
Claim 76
Dependent Claim 29 words
The method of claim 47 further comprising delivering energy to the first area or the second area with a transducer disposed on a distal end of the delivery catheter.
Claim 77
Dependent Claim 23 words
The method of claim 74 wherein the energy is of a type selected from the group consisting of RF, electrical, and heat energy.
Claim 78
Independent Claim 159 words
A system for treating tissue near a valve to modify flow through the valve, comprising: a first catheter having a distal end region, the catheter being configured for transluminal delivery of the end region to the target site; an end effector in communication with the distal end region, the end effector being configured to transfer energy to the tissue at the target site to induce thermal shrinkage of collagen in the tissue, thereby modifying flow through the valve; and a cinching member having a central region and at least two anchoring regions on opposing sides of the central region, wherein each anchoring region is configured to be anchored to opposing areas of tissue and urge the areas of tissue towards one another, the cinching member being further configured for delivery through the first catheter or a second catheter to the tissue whereby the cinching member has a first shape during the delivery and a second shape after the delivery.
Claim 79
Independent Claim 159 words
A system for treating tissue near a valve to modify flow through the valve, comprising: a first catheter having a distal end region, the catheter being configured for transluminal delivery of the end region to the target site; an end effector in communication with the distal end region, the end effector being configured to transfer energy to the tissue at the target site to induce thermal shrinkage of collagen in the tissue, thereby modifying flow through the valve; and a cinching member having a central region and at least two anchoring regions on opposing sides of the central region, wherein each anchoring region is configured to be anchored to opposing areas of tissue and urge the areas of tissue towards one another, the cinching member being further configured for delivery through the first catheter or a second catheter to the tissue whereby the cinching member has a first shape during the delivery and a second shape after the delivery.
Claim 80
Dependent Claim 18 words
The system of claim 76 , wherein the tissue comprises an annulus of tissue surrounding a cardiac valve.
Claim 81
Dependent Claim 20 words
The system of claim 77 , wherein modifying flow through the valve comprises reducing a circumference of the cardiac valve.
Claim 82
Dependent Claim 17 words
The system of claim 78 , wherein the tissue comprises a support structure of a cardiac valve.
Claim 83
Dependent Claim 24 words
The system of claim 79 , wherein the support structure is chosen from the group consisting of a chordae tendineae and a papillary muscle.
Claim 84
Dependent Claim 24 words
The system of claim 80 , wherein modifying flow through the valve comprises shortening the chordae tendineae to properly align leaflets of the valve.
Claim 85
Dependent Claim 20 words
The system of claim 76 , wherein the tissue at the target site comprises a leaflet of a cardiac valve.
Claim 86
Dependent Claim 31 words
The system of claim 76 further comprising a plurality of additional cinching members, the cinching members being interwoven such that a plurality of spaces are defined therebetween in the second shape.
Claim 87
Dependent Claim 20 words
The system of claim 76 further comprising a biocompatible fastener for attaching each of the anchoring regions to the tissue.
Claim 88
Dependent Claim 40 words
The system of claim 76 wherein the cinching member is configured to approximate a portion of periphery defined by the valve, the central region comprising an arcuate length whereby each of the anchoring regions is in apposition to each other.
Claim 89
Dependent Claim 21 words
The system of claim 85 wherein the portion of the periphery approximated by the cinching member comprises at least about 50%.
Claim 90
Dependent Claim 21 words
The system of claim 86 wherein the portion of the periphery approximated by the cinching member comprises about 50% to 75%.
Claim 91
Dependent Claim 17 words
The system of claim 85 wherein each of the anchoring regions is biased towards the central region.
Claim 92
Dependent Claim 25 words
The system of claim 76 wherein the cinching member comprises a biocompatible material selected from the group consisting of shape memory alloys and superelastic alloys.
Claim 93
Dependent Claim 13 words
The system of claim 89 wherein the shape memory alloy comprises Nickel-Titanium alloy.
Claim 94
Dependent Claim 32 words
The system of claim 76 wherein the central region defines a first plane and the anchoring regions define a second plane, the second plane defining an angle relative to the first plane.
Claim 95
Dependent Claim 13 words
The system of claim 91 wherein the angle is about 60° to 120°.
Claim 96
Dependent Claim 11 words
The system of claim 91 wherein the angle is about 90°.
Claim 97
Dependent Claim 25 words
The system of claim 91 wherein the central region comprises a shape selected from the group consisting of semi-circles, arcs, half-ellipses, triangles, rectangles, and loops.
Claim 98
Dependent Claim 17 words
The system of claim 76 wherein each of the anchoring regions are configured to pierce the tissue.
Claim 99
Dependent Claim 27 words
The system of claim 95 wherein each of the anchoring regions comprise a shape selected from the group consisting of semi-circles, triangles, arcs, half-ellipses, hooks, and V-shapes.
Claim 100
Dependent Claim 25 words
The apparatus of claim 95 wherein each of the anchoring regions is selected from the group consisting of barbs, screws, pivoting locks, clips, and tags.

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3.5 Years (Year 4) 2006-09-29 2007-03-31 2007-09-30 $2000.00 Window Closed / Lapsed
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