摘要:
A method and apparatus for passing attachment apparatus (20), (e.g., connector devices, staples, etc.) or connector material (88), (e.g., suture thread, wire, cord, filament, monofilament, etc.) into or through the wall of a luminal anatomical structure (e.g., a blood vessel or other anatomical conduit), for the purpose of closing the lumen of the anatomical structure, forming an anastomotic junction between separate anatomical structures (or between approximated segments of the same anatomical structure), and/or attaching an article (e.g., an endoluminal, extraluminal or transluminal graft) or other apparatus to the wall of the anatomical structure.
摘要:
This invention is methods, apparatus, and systems for enlarging interstitial penetration tracts which have been formed between blood vessels or elsewhere within the body of a mammalian patient. Included are de-bulking type tract enlarging systems (10, 10a), dilation-type tract enlarging systems (10b), tissue-sclicing-type tract enlarging systems (10c), and two-catheter-type tract enlarging systems (17).
摘要:
The inventions described in this patent application include i) a torqueable introducer sheath which is useable in conjunction with a transvascular passageway forming catheter to effect precise rotational control of the catheter; ii) an anchorable guide catheter which is useable in conjunction with an intravascular imaging catheter and a transvascular passageway-forming catheter to effect precise positioning and aiming of the passageway-forming catheter; iii) a passageway forming catheter having a torqueable proximal portion to facilitate precise rotational positioning of the distal portion of the catheter; iv) a deflectable-tipped passageway forming catheter, v) various markers and other apparatus useable in conjunction with any of the passageway-forming catheters to facilitate precise positioning and aiming of the catheter, and vi) an apparatus which may be formed within a catheter to prevent a member, apparatus of flow of material from being inadvertently advanced through a lumen of the catheter.
摘要:
Methods and apparatus for delivery of substances or apparatus to target sites. A vessel wall penetrating catheter (11) is inserted into the vasculature, positioned and oriented with a blood vessel near the target extravascular site and a penetrator (85) is advanced from the catheter so as to penetrate outwardly through the wall of the blood vessel in the direction of the target site. Thereafter, a delivery catheter (12) is passed through a lumen of the penetrator to the target site. A desired substance or apparatus is then delivered to or obtained from the target site.
摘要:
This invention is methods and apparatus for direct coronary revascularization wherein a transmyocardial passageway (10) is formed between a chamber of the heart (LV) and a coronary blood vessel (CBV) to permit blood to flow therebetween. In some embodiments, the transmyocardial passageway (10) is formed between a chamber of the heart (LV) and a coronary vein (CV). The invention includes unstent transmyocardial passageways (10), as well as transmyocardial passageways (10) wherein protrusive stent devices (90) extend from the transmyocardial passageway (10) into an adjacent coronary vessel (CBV) or chamber of the heart (LV). The apparatus of the present invention includes protrusive stent devices (90) for stent of transmyocardial passageways (10), intraluminal valve devices (40) for valving of transmyocardial passageways (10), intra-cardiac valve devices (80) for valving of transmyocardial passageways (10), endogenous tissue valves (50) for valving of transmyocardial passageways (10), and ancillary apparatus for use in conjunction therewith.
摘要:
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.
摘要:
This invention is methods, devices, and systems for re-vascularization, and/or performing other medical procedures at a vascular or non-vascular intra-corporeal locations within a mammalian body. The methods generally comprise the formation of at least one extravascular passageway from a blood vessel to a vascular or non-vascular target location. In the re-vascularization methods the extravascular passageway is utilized as a conduit for accessing or performing procedures at the vascular or non-vascular target location. Also disclosed are catheter devices (100, 103) and systems (138) which are usable to form the extravascular passageways of the invention, as well as apparatus for modifying, maintaining and/or closing such extravascular passageways.
摘要:
This invention is methods and apparatus for connecting two anatomical passageways, such as blood vessels, in side-to-side fashion. Openings are formed in the sidewalls of the passageways, and a connector apparatus (10) of the present invention is implanted within such openings, and extends between the passageways or blood vessels (BV1, BV2) so as to connect the passageways or blood vessels (BV1, BV2) such that the openings are held in direct alignment with one another, thereby allowing body fluids to pass from one passageway into the other.
摘要:
This invention is devices, systems and methods for trans-vascular interstitial interventions, including trans-vascular, catheter based vascular bypass, transmyocardial re-vascularization, bypass grafting of blood vessels, and interstitial surgical/interventional procedures wherein a catheter is advanced trans-lumenal through the vasculature (2) to a desired location (OB) and an operative instrument (5) is passed through the wall (2) of a blood vessel (2) and to a target location (3) (e.g., another blood vessel, an organ, a tumor, another anatomical structure) such that one or more operative devices may be advanced to the target location to perform the desired operative or interventional procedure.
摘要:
Methods and devices for implanting pacing electrodes or other apparatus, or for delivering substances, to the heart of other tissues within the body. A guided tissue penetrating catheter (10) is inserted into a body lumen (e.g., blood vessel) or into a body cavity or space (e.g., the pericardial space) and a penetrator (14) is advanced from the catheter to a target location. In some embodiments, a substance or an apparatus (such as an electrode) may be delivered through a lumen in the penetrator. In other embodiments, a guidewire (GW) may be advanced through the penetrator, the penetrating catheter may then be removed and an apparatus (e.g., electrode) may then be advanced over that guidewire. Also disclosed are various implantable electrodes and electrode anchoring apparatus.