The present embodiments relate generally to medical devices, and more particularly, to apparatus and methods for delivering therapeutic agents to a target site.
There are several instances in which it may become desirable to introduce therapeutic agents into the human or animal body. For example, therapeutic drugs or bioactive materials may be introduced to achieve a biological effect. The biological effect may include an array of targeted results, such as inducing hemostasis, sealing perforations, reducing restenosis likelihood, or treating cancerous tumors or other diseases.
Many of such therapeutic agents are injected using an intravenous (IV) technique and via oral medicine. While such techniques permit the general introduction of medicine, in many instances it may be desirable to provide localized or targeted delivery of therapeutic agents, which may allow for the guided and precise delivery of agents to selected target sites. For example, localized delivery of therapeutic agents to a tumor may reduce the exposure of the therapeutic agents to normal, healthy tissues, which may reduce potentially harmful side effects.
Localized delivery of therapeutic agents has been performed using catheters and similar introducer devices. By way of example, a catheter may be advanced towards a target site within the patient, then the therapeutic agent may be injected through a lumen of the catheter to the target site. Typically, a syringe or similar device may be used to inject the therapeutic agent into the lumen of the catheter. However, such a delivery technique may result in a relatively weak stream of the injected therapeutic agent.
Moreover, it may be difficult or impossible to deliver therapeutic agents in a targeted manner in certain forms, such as a powder form, to a desired site. For example, if a therapeutic powder is held within a syringe or other container, it may not be easily delivered through a catheter to a target site in a localized manner that may also reduce potentially harmful side effects.
The present embodiments provide apparatus and methods suitable for delivering a therapeutic agent to a target site. The apparatus generally comprises at least one container for holding a therapeutic agent, and a pressure source for facilitating delivery of the therapeutic agent.
In one embodiment, the pressure source may be placed in selective fluid communication with a proximal region of the container. Fluid from the pressure source may flow through at least a portion of the container to urge the therapeutic agent through a distal region of the container and towards the target site.
At least one tube member, such as a catheter, may be used to facilitate delivery of the therapeutic agent from the container to the target site. The tube member may be placed in fluid communication with the distal region of the container. In use, fluid from the pressure source urges the therapeutic agent through the distal region of the container, through the tube member, and then distally towards the target site.
The pressure source may comprise a compressed gas dispenser. Tubing may be disposed between the pressure source and the container, and optionally, a pressure relief valve may be disposed between the pressure source and the container. The pressure relief valve may ensure that the fluid from the pressure source flows through the container at a predetermined pressure.
In various other embodiments, a connecting member having first and second inlet ports and an outlet port is disclosed. The container and the pressure source may be coupled to the first and second inlet ports of the connecting member, respectively. In use, the provision of fluid from the pressure source through the second inlet port may suction the therapeutic agent from the container in a direction through the first inlet port. The fluid and the therapeutic agent then may flow through the outlet port of the connecting member and towards the target site. In this embodiment, at least one tube member may be coupled to the outlet port of the connecting member to facilitate delivery of the therapeutic agent from the connecting member to the target site.
In any of the embodiments disclosed, the distal region of the tube member may comprise an anti-reflux valve to inhibit flow of foreign substances, such as blood, proximally back into the system. The tube member also may be used in conjunction with a needle and may be configured to be delivered through a working lumen of an endoscope or similar device.
Other systems, methods, features and advantages of the invention will be, or will become, apparent to one with skill in the art upon examination of the following figures and detailed description. It is intended that all such additional systems, methods, features and advantages be within the scope of the invention, and be encompassed by the following claims.
The invention can be better understood with reference to the following drawings and description. The components in the figures are not necessarily to scale, emphasis instead being placed upon illustrating the principles of the invention. Moreover, in the figures, like referenced numerals designate corresponding parts throughout the different views.
In the present application, the term “proximal” refers to a direction that is generally towards a physician during a medical procedure, while the term “distal” refers to a direction that is generally towards a target site within a patient's anatomy during a medical procedure.
Referring now to
The container 30 may comprise any suitable size and shape for holding a therapeutic agent 38. In one embodiment, the container 30 may comprise a syringe having a reservoir 32. A plunger 40 having a main body 42, a proximal handle 43, and a distal head member 44 may be disposed for longitudinal movement within the reservoir 32, preferably in a manner such that the distal head member 44 forms a substantial sealing engagement with an inner surface of the container 30.
The container 30 may comprise a hollow proximal region 34, through which the therapeutic agent 38 and the plunger 40 may be loaded, as shown in
The container 30 also may comprise measurement indicia 39, which allow a user to determine a quantity of the therapeutic agent 38 that is held within the container 30. Optionally, a valve member 47 may be disposed between the reservoir 32 of the container 30 and the connecting member 70, as shown in
The pressure source 50 may comprise one or more components capable of producing or furnishing a fluid having a desired pressure. In one embodiment, the pressure source 50 may comprise a pressurized fluid, such as a liquid or gas. For example, as shown in
An actuator, such as a button, may be used to selectively actuate the pressure source 50. The pressurized fluid may flow from the pressurized fluid cartridge 52, and subsequently through the regulator valve 58 using an adapter 54. The adapter 54 may be configured to be sealingly coupled to the pressurized fluid cartridge 52, as shown in
The pressure source 50 optionally may comprise one or more commercially available components. Solely by way of example, the pressurized fluid cartridge 52 may comprise a disposable carbon dioxide cartridge, such as the Visage® commercial dispenser manufactured by Helen of Troy®, El Paso, Tex. The pressure source 50 therefore may comprise original or retrofitted components capable of providing a fluid or gas into the tubing 60 at a desired regulated pressure.
Referring still to
In the embodiment of
The system 20 further may comprise one or more tube members for delivering the therapeutic agent 38 to a target site. For example, the tube member may comprise a catheter 90 having a proximal end 92 that may be placed in fluid communication with the outlet port 76 of the connecting member 70 using a suitable coupling mechanism or arrangement. The catheter 90 further comprises a distal end 94 that may facilitate delivery of the therapeutic agent 38 to a target site, as set forth below. The catheter 90 may comprise a flexible, tubular member that may be formed from one or more semi-rigid polymers. For example, the catheter may be manufactured from polyurethane, polyethylene, tetrafluoroethylene, polytetrafluoroethylene, fluorinated ethylene propylene, nylon, PEBAX or the like.
The system 20 further may comprise a needle 95 suitable for penetrating tissue. As shown in the embodiment of
In operation, the system of
The catheter 90 may comprise one or more markers (not shown), which may be disposed near the distal end of the catheter 90. The markers may be configured to be visualized under fluoroscopy or other imaging techniques to facilitate location of the distal end 94 of the catheter 90. If the needle 95 is integral to the catheter 90, the needle 95 also may be visualized using the imaging techniques, thereby allowing placement of the distal end 94 of the catheter 90 in close proximity to the target site. If desired, the catheter 90 may be advances through a working lumen of an endoscope, as explained in further detail in
When the catheter 90 is positioned at the desired location, the pressure source 50 may be actuated. For example, a suitable actuator may be coupled to the pressurized fluid cartridge 52 to release a relatively high pressure fluid. As noted above, the pressurized fluid may flow through a regulator valve 58 and through the tubing 60, as depicted in
Fluid from the pressure source 50 flows through the tubing 60, through the second inlet port 74 of the connecting member 70, and then through the outlet port 76 of the connecting member 70 and through a lumen of the catheter 90. Fluid may exit the distal end 94 of the catheter 90, for example, through a bore formed in the needle 95.
As fluid from the pressure source 50 passes through the connecting member 70, a localized low pressure system will be provided in the vicinity of the second inlet port 72 in accordance with Bernoulli's principle of fluid dynamics. The low pressure system formed by the presence of the pressurized fluid passing through the connecting member 70 will form a strong suction force when it passes by the second inlet port 72. As a result, the therapeutic agent 38 may be suctioned out of the reservoir 32 of the container 30 and through the second inlet port 72. Moreover, the therapeutic agent 38 may be carried through the outlet port 76 of the connecting member 70 by the pressurized fluid, and subsequently through the catheter 90, thereby delivering the therapeutic agent 38 to the target site at a desired pressure.
The therapeutic agent 38 may be drawn out of the reservoir 32 by the mere presence of the pressurized fluid flow through the connecting member 70, i.e., with minimal or no user intervention. In this embodiment, the user simply may load the desired therapeutic agent 38 into the reservoir 32, then load the plunger 40 into the proximal region 34 of the container 30. The provision of the pressurized fluid flow through the connecting member 70 may suction the therapeutic agent 38 from the reservoir 32 and may urge the plunger 40 in a distal direction until the contents of the container 30 are dispensed.
In addition to the automatic withdrawal of the therapeutic agent 38 from the container 30 in accordance with Bernoulli's principle, a user may manually actuate the proximal handle 43 of the plunger 40 to dispense the therapeutic agent 38. For example, in this instance, after a user has loaded a desired amount of the therapeutic agent 38 into the reservoir 32, the user may manually actuate the proximal handle 43 of the plunger 40 to dispense the therapeutic agent 38 from the container 30 and at least partially into interior regions of the connecting member 70 and/or the catheter 90. The plunger 40 may be manually actuated in this manner before, during or after the pressure source 50 has been actuated to deliver pressurized fluid through the connecting member 70 and the catheter 90.
As noted above, a valve member 47 optionally may be disposed between the reservoir 32 of the container 30 and the connecting member 70, as shown in
As noted above, a control mechanism coupled to the pressure source 50 may variably permit fluid flow into the tubing 60 from the pressurized fluid cartridge 52 at a desired time interval, for example, a predetermined quantity of fluid per second. In this manner, pressurized fluid may flow through the connecting member 70 periodically, and the therapeutic agent 38 may be suctioned from the reservoir 32 and delivered to a target site at a predetermined interval or otherwise periodic basis.
The system 20 may be used to delivery the therapeutic agent 38 in a wide range of procedures and the therapeutic agent 38 may be chosen to perform a desired function upon ejection from the distal end 94 of the catheter 90. Solely by way of example, and without limitation, the provision of the therapeutic agent 38 may be used for providing hemostasis, closing perforations, performing lithotripsy, treating tumors and cancers, treat renal dialysis fistulae stenosis, vascular graft stenosis, and the like. The therapeutic agent 38 can be delivered during procedures such as coronary artery angioplasty, renal artery angioplasty and carotid artery surgery, or may be used generally for treating various other cardiovascular, respiratory, gastroenterology or other conditions. The above-mentioned systems also may be used in transvaginal, umbilical, nasal, and bronchial/lung related applications.
For example, if used for purposes of hemostasis, thrombin, epinephrine, or a sclerosant may be provided to reduce localized bleeding. Similarly, if used for closing a perforation, a fibrin sealant may be delivered to a localized lesion. In addition to the hemostatic properties of the therapeutic agent 38, it should be noted that the relatively high pressure of the fluid and therapeutic agent, by itself, may act as a mechanical tamponade by providing a compressive force, thereby reducing the time needed to achieve hemostasis.
The therapeutic agent 38 may be selected to perform one or more desired biological functions, for example, promoting the ingrowth of tissue from the interior wall of a body vessel, or alternatively, to mitigate or prevent undesired conditions in the vessel wall, such as restenosis. Many other types of therapeutic agents 38 may be used in conjunction with the system 20.
The therapeutic agent 38 may be delivered in any suitable form. For example, the therapeutic agent 38 may comprise a powder, liquid, gel, aerosol, or other substance. Advantageously, the pressure source 50 may facilitate delivery of the therapeutic agent 38 in any one of these forms.
The therapeutic agent 38 employed also may comprise an antithrombogenic bioactive agent, e.g., any bioactive agent that inhibits or prevents thrombus formation within a body vessel. Types of antithrombotic bioactive agents include anticoagulants, antiplatelets, and fibrinolytics. Anticoagulants are bioactive materials which act on any of the factors, cofactors, activated factors, or activated cofactors in the biochemical cascade and inhibit the synthesis of fibrin. Antiplatelet bioactive agents inhibit the adhesion, activation, and aggregation of platelets, which are key components of thrombi and play an important role in thrombosis. Fibrinolytic bioactive agents enhance the fibrinolytic cascade or otherwise aid in dissolution of a thrombus. Examples of antithrombotics include but are not limited to anticoagulants such as thrombin, Factor Xa, Factor VIIa and tissue factor inhibitors; antiplatelets such as glycoprotein IIb/IIIa, thromboxane A2, ADP-induced glycoprotein IIb/IIIa, and phosphodiesterase inhibitors; and fibrinolytics such as plasminogen activators, thrombin activatable fibrinolysis inhibitor (TAFI) inhibitors, and other enzymes which cleave fibrin.
Additionally, or alternatively, the therapeutic agent 38 may include thrombolytic agents used to dissolve blood clots that may adversely affect blood flow in body vessels. A thrombolytic agent is any therapeutic agent that either digests fibrin fibers directly or activates the natural mechanisms for doing so. Examples of commercial thrombolytics, with the corresponding active agent in parenthesis, include, but are not limited to, Abbokinase (urokinase), Abbokinase Open-Cath (urokinase), Activase (alteplase, recombinant), Eminase (anitstreplase), Retavase (reteplase, recombinant), and Streptase (streptokinase). Other commonly used names are anisoylated plasminogen-streptokinase activator complex; APSAC; tissue-type plasminogen activator (recombinant); t-PA; rt-PA. While a few exemplary therapeutic agents 38 have been listed, it will be apparent that numerous other suitable therapeutic agents may be used in conjunction with the system 20 and delivered through the catheter 90.
Advantageously, the system 20 permits localized delivery of a desired quantity of the therapeutic agent 38 at a desired pressure via the pressure source 50. Since the distal end 94 of the catheter 90 may be placed in relatively close proximity to a target site, the system 20 provides significant advantages over therapeutic agents delivered orally or through an IV system and may reduce accumulation of the therapeutic agent 38 in healthy tissues, thereby reducing side effects. Moreover, the delivery of the therapeutic agent 38 to the target site is performed in a relatively fast manner due to the relatively high pressure of the fluid, thereby providing a prompt delivery to the target site compared to previous devices.
Further, if the optional needle 95 is employed, the system 20 advantageously may be used to both perforate tissue at or near a target site, then deliver the therapeutic agent 38 at a desired pressure in the manner described above. For example, the needle 95 may comprise an endoscopic ultrasound (EUS) needle. Accordingly, in one exemplary technique, a sharpened tip of the needle 95 may be capable of puncturing through an organ or a gastrointestinal wall or tissue, so that the therapeutic agent 38 may be delivered at a predetermined pressure in various bodily locations that may be otherwise difficult to access. One or more delivery vehicles, such as an endoscope or sheath, may be employed to deliver the catheter 90 to a target site, particularly if the distal end 94 of the catheter 90 comprises the optional needle 95.
Referring now to
The endoscope 150 may be advanced through a bodily lumen such as the alimentary canal to a position proximate the target location. The catheter 90 then may be advanced through the working lumen 161 of the endoscope 150. If the needle 95 is employed, a sharpened tip 96 of the needle 95 may extend distal to the endoscope 150, as shown in
In
Referring now to
Referring now to
Referring now to
Additionally, in the embodiment of
Finally, the alternative system 420 further comprises an anti-reflux valve 480 coupled to the distal end 94 of the catheter 90, as shown in
While various embodiments of the invention have been described, the invention is not to be restricted except in light of the attached claims and their equivalents. Moreover, the advantages described herein are not necessarily the only advantages of the invention and it is not necessarily expected that every embodiment of the invention will achieve all of the advantages described.
This invention claims the benefit of priority of U.S. Provisional Application Ser. No. 61/050,906, entitled “Apparatus and Methods for Delivering Therapeutic Agents,” filed May 6, 2008, the disclosure of which is hereby incorporated by reference in its entirety.
Number | Name | Date | Kind |
---|---|---|---|
39678 | Russell | Aug 1863 | A |
170182 | Molesworth | Nov 1875 | A |
280202 | Mattson | Jun 1883 | A |
442785 | Schoettl | Dec 1890 | A |
460458 | Bates | Sep 1891 | A |
471865 | Howard | Mar 1892 | A |
533489 | Ogram | Feb 1895 | A |
566411 | Schoene | Aug 1896 | A |
576437 | Elliot | Feb 1897 | A |
693587 | Campbell | Feb 1902 | A |
775985 | McKain | Nov 1904 | A |
881238 | Hasbrouck | Mar 1908 | A |
904149 | Rachmann | Nov 1908 | A |
938648 | DeVilbiss | Nov 1909 | A |
1022601 | Rumberg et al. | Apr 1912 | A |
1114114 | Cochenour | Oct 1914 | A |
1145520 | Smith | Jul 1915 | A |
1261503 | Figgis | Apr 1918 | A |
1357452 | Hall | Nov 1920 | A |
1466119 | Claflin | Aug 1923 | A |
1521396 | Scott | Dec 1924 | A |
1685280 | Findley | Sep 1928 | A |
1934793 | Crain et al. | Nov 1933 | A |
2004402 | Conklin | Jun 1935 | A |
2151418 | Bolte | Mar 1939 | A |
2223611 | Gross | Dec 1940 | A |
2307986 | Bolte et al. | Jan 1943 | A |
2390313 | Macgill | Dec 1945 | A |
2507702 | Fields | May 1950 | A |
2519555 | Fields | Aug 1950 | A |
2609155 | Fosnaugh | Sep 1952 | A |
2632444 | Kas | Mar 1953 | A |
2805013 | Cordis | Sep 1957 | A |
2934314 | Chambers et al. | Apr 1960 | A |
2956579 | Moore et al. | Oct 1960 | A |
3016895 | Sein et al. | Jan 1962 | A |
3050261 | Littlefield | Aug 1962 | A |
3506008 | Huck | Apr 1970 | A |
3540444 | Moreland | Nov 1970 | A |
3572335 | Robinson | Mar 1971 | A |
3589363 | Banko et al. | Jun 1971 | A |
3599866 | Bolton | Aug 1971 | A |
3632046 | Hengesbach | Jan 1972 | A |
3647143 | Gauthier et al. | Mar 1972 | A |
3649299 | Sholl | Mar 1972 | A |
3667465 | Voss | Jun 1972 | A |
3710400 | Sparks | Jan 1973 | A |
3742955 | Battista et al. | Jul 1973 | A |
3744493 | Booher et al. | Jul 1973 | A |
3762410 | Bindel | Oct 1973 | A |
3788315 | Laurens | Jan 1974 | A |
3815595 | Bar | Jun 1974 | A |
3900022 | Widran | Aug 1975 | A |
3916896 | Ballard | Nov 1975 | A |
4017007 | Riccio | Apr 1977 | A |
4040420 | Speer | Aug 1977 | A |
4174811 | Binder et al. | Nov 1979 | A |
4184258 | Barrington et al. | Jan 1980 | A |
4204539 | Van Brugge | May 1980 | A |
4204645 | Hopp | May 1980 | A |
4210140 | James et al. | Jul 1980 | A |
4359049 | Redl et al. | Nov 1982 | A |
4423727 | Widran et al. | Jan 1984 | A |
4427650 | Stroetmann | Jan 1984 | A |
4516442 | Davis | May 1985 | A |
4534345 | Wetterlin | Aug 1985 | A |
4539716 | Bell | Sep 1985 | A |
4578067 | Cruz, Jr. | Mar 1986 | A |
4606501 | Bate et al. | Aug 1986 | A |
4620847 | Shishov et al. | Nov 1986 | A |
4631055 | Redl et al. | Dec 1986 | A |
4637816 | Mann | Jan 1987 | A |
H257 | Barditch et al. | Apr 1987 | H |
4655211 | Sakamoto et al. | Apr 1987 | A |
4735616 | Eibl et al. | Apr 1988 | A |
4738658 | Magro et al. | Apr 1988 | A |
4738740 | Pinchuk | Apr 1988 | A |
4752466 | Saferstein et al. | Jun 1988 | A |
4790819 | Li et al. | Dec 1988 | A |
4798606 | Pinchuk | Jan 1989 | A |
4803977 | Kremer, Jr. | Feb 1989 | A |
4846405 | Zimmermann | Jul 1989 | A |
D303139 | Morgan | Aug 1989 | S |
4872450 | Austad | Oct 1989 | A |
4874368 | Miller et al. | Oct 1989 | A |
4890612 | Kensey | Jan 1990 | A |
4900303 | Lemelson | Feb 1990 | A |
4902278 | Maget et al. | Feb 1990 | A |
4902281 | Avoy | Feb 1990 | A |
4927410 | Kovacs | May 1990 | A |
4929246 | Sinofsky | May 1990 | A |
4941874 | Sandow et al. | Jul 1990 | A |
4941880 | Burns | Jul 1990 | A |
4945050 | Sanford et al. | Jul 1990 | A |
4946870 | Partain, III. et al. | Aug 1990 | A |
4950234 | Fujioka et al. | Aug 1990 | A |
4969874 | Michel et al. | Nov 1990 | A |
4978336 | Capozzi et al. | Dec 1990 | A |
4994028 | Leonard et al. | Feb 1991 | A |
5009637 | Newman et al. | Apr 1991 | A |
5015580 | Christou et al. | May 1991 | A |
5021059 | Kensey et al. | Jun 1991 | A |
5053000 | Booth et al. | Oct 1991 | A |
5059187 | Sperry et al. | Oct 1991 | A |
5061180 | Wiele | Oct 1991 | A |
5063025 | Ito | Nov 1991 | A |
5064413 | McKinnon et al. | Nov 1991 | A |
5106370 | Stewart | Apr 1992 | A |
5116315 | Capozzi et al. | May 1992 | A |
5120657 | McCabe et al. | Jun 1992 | A |
5129825 | Discko, Jr. | Jul 1992 | A |
5129882 | Weldon et al. | Jul 1992 | A |
5133701 | Han | Jul 1992 | A |
5141515 | Eberbach | Aug 1992 | A |
5147292 | Kullas et al. | Sep 1992 | A |
5149655 | McCabe et al. | Sep 1992 | A |
5165604 | Copp, Jr. | Nov 1992 | A |
5176642 | Clement | Jan 1993 | A |
5179022 | Sanford et al. | Jan 1993 | A |
D333000 | Good et al. | Feb 1993 | S |
5204253 | Sanford et al. | Apr 1993 | A |
5219328 | Morse et al. | Jun 1993 | A |
5226567 | Sansalone | Jul 1993 | A |
5226877 | Epstein | Jul 1993 | A |
5273531 | Knoepfler | Dec 1993 | A |
5292309 | Van Tassel et al. | Mar 1994 | A |
5310407 | Casale | May 1994 | A |
5312333 | Churinetz et al. | May 1994 | A |
5328459 | Laghi | Jul 1994 | A |
5337740 | Armstrong et al. | Aug 1994 | A |
5391183 | Janzen et al. | Feb 1995 | A |
5392992 | Farnsteiner et al. | Feb 1995 | A |
5395326 | Haber et al. | Mar 1995 | A |
5405607 | Epstein | Apr 1995 | A |
5415631 | Churinetz et al. | May 1995 | A |
5429278 | Sansalone | Jul 1995 | A |
5445612 | Terakura et al. | Aug 1995 | A |
5447499 | Allaire et al. | Sep 1995 | A |
5469994 | Reh et al. | Nov 1995 | A |
5470311 | Setterstrom | Nov 1995 | A |
5484403 | Yoakum et al. | Jan 1996 | A |
5503623 | Tilton, Jr. | Apr 1996 | A |
5513630 | Century | May 1996 | A |
5520658 | Holm | May 1996 | A |
5538162 | Reh et al. | Jul 1996 | A |
5553741 | Sancoff et al. | Sep 1996 | A |
5558646 | Roche | Sep 1996 | A |
5582596 | Fukunaga et al. | Dec 1996 | A |
5584807 | McCabe | Dec 1996 | A |
5584815 | Pawelka et al. | Dec 1996 | A |
5594987 | Century | Jan 1997 | A |
5601603 | Illi | Feb 1997 | A |
5605541 | Holm | Feb 1997 | A |
5612050 | Rowe et al. | Mar 1997 | A |
5665067 | Linder et al. | Sep 1997 | A |
5697947 | Wolf et al. | Dec 1997 | A |
5707402 | Heim | Jan 1998 | A |
5749968 | Melanson et al. | May 1998 | A |
5759171 | Coelho | Jun 1998 | A |
5788625 | Plouhar et al. | Aug 1998 | A |
5865796 | McCabe | Feb 1999 | A |
5873530 | Chizinsky | Feb 1999 | A |
5902228 | Schulsinger et al. | May 1999 | A |
5919184 | Tilton, Jr. | Jul 1999 | A |
5951531 | Ferdman et al. | Sep 1999 | A |
6007515 | Epstein et al. | Dec 1999 | A |
6013050 | Bellhouse et al. | Jan 2000 | A |
6021776 | Allred | Feb 2000 | A |
6027471 | Fallon et al. | Feb 2000 | A |
6059749 | Marx | May 2000 | A |
6077217 | Love et al. | Jun 2000 | A |
6117150 | Pingleton et al. | Sep 2000 | A |
6123070 | Bruna et al. | Sep 2000 | A |
6165201 | Sawhney et al. | Dec 2000 | A |
6368300 | Fallon et al. | Apr 2002 | B1 |
6394975 | Epstein | May 2002 | B1 |
6454786 | Holm et al. | Sep 2002 | B1 |
6461325 | Delmotte et al. | Oct 2002 | B1 |
6461361 | Epstein | Oct 2002 | B1 |
6478754 | Babaev | Nov 2002 | B1 |
6537246 | Unger et al. | Mar 2003 | B1 |
6610026 | Cragg et al. | Aug 2003 | B2 |
6616652 | Harper | Sep 2003 | B1 |
6641800 | Mistry et al. | Nov 2003 | B1 |
6689108 | Lavi et al. | Feb 2004 | B2 |
6716190 | Glines et al. | Apr 2004 | B1 |
6723067 | Nielson | Apr 2004 | B2 |
6811550 | Holland et al. | Nov 2004 | B2 |
6843388 | Hollars | Jan 2005 | B1 |
6863660 | Marx | Mar 2005 | B2 |
6939324 | Gonnelli et al. | Sep 2005 | B2 |
7101862 | Cochrum et al. | Sep 2006 | B2 |
7156880 | Evans et al. | Jan 2007 | B2 |
7291133 | Kindler et al. | Nov 2007 | B1 |
7334598 | Hollars | Feb 2008 | B1 |
7534449 | Saltzman et al. | May 2009 | B2 |
7544177 | Gertner | Jun 2009 | B2 |
7632245 | Cowan et al. | Dec 2009 | B1 |
7673783 | Morgan et al. | Mar 2010 | B2 |
7691244 | Levitan et al. | Apr 2010 | B2 |
7744526 | McAllister et al. | Jun 2010 | B2 |
7776822 | Terman | Aug 2010 | B2 |
7824373 | Kim | Nov 2010 | B2 |
7857167 | Hollars | Dec 2010 | B1 |
20020169416 | Gonnelli | Nov 2002 | A1 |
20030023202 | Nielson | Jan 2003 | A1 |
20030108511 | Sawhney | Jun 2003 | A1 |
20030170250 | Ezrin et al. | Sep 2003 | A1 |
20030181917 | Gertner | Sep 2003 | A1 |
20030216695 | Yang | Nov 2003 | A1 |
20040073863 | Moulsley | Apr 2004 | A1 |
20050070848 | Kim et al. | Mar 2005 | A1 |
20060002852 | Saltzman et al. | Jan 2006 | A1 |
20060052295 | Terman | Mar 2006 | A1 |
20060286664 | McAllister et al. | Dec 2006 | A1 |
20070240989 | Levitan et al. | Oct 2007 | A1 |
20070241119 | Durkin et al. | Oct 2007 | A1 |
20080027272 | Kadykowski | Jan 2008 | A1 |
20090234374 | Gabel et al. | Sep 2009 | A1 |
20090234380 | Gabel et al. | Sep 2009 | A1 |
20090248056 | Gabel et al. | Oct 2009 | A1 |
20100137796 | Perry et al. | Jun 2010 | A1 |
Number | Date | Country |
---|---|---|
15244 | Sep 1897 | CH |
257250 | Mar 1949 | CH |
3024749 | Feb 1982 | DE |
3108918 | Sep 1982 | DE |
3613762 | Nov 1987 | DE |
308269 | Mar 1989 | EP |
0 692 273 | Jan 1996 | EP |
0738498 | Oct 1996 | EP |
10563 | Jan 1896 | GB |
1254534 | Nov 1971 | GB |
4022109 | Apr 1992 | JP |
5-192404 | Aug 1993 | JP |
10-508790 | Sep 1998 | JP |
2001-520918 | Nov 2001 | JP |
2002-028224 | Jan 2002 | JP |
2004-521677 | Jul 2004 | JP |
978999 | Dec 1982 | SU |
WO8203545 | Oct 1982 | WO |
WO8502346 | Jun 1985 | WO |
WO9220312 | Nov 1992 | WO |
WO9428798 | Dec 1994 | WO |
WO9609085 | Mar 1996 | WO |
WO9625190 | Aug 1996 | WO |
WO9637245 | Nov 1996 | WO |
WO9640327 | Dec 1996 | WO |
WO9720585 | Jun 1997 | WO |
WO9921599 | May 1999 | WO |
WO02053014 | Jul 2002 | WO |
WO02055139 | Jul 2002 | WO |
WO2004073863 | Sep 2004 | WO |
WO2005100980 | Oct 2005 | WO |
WO2006090149 | Aug 2006 | WO |
WO2008008845 | Jan 2008 | WO |
Entry |
---|
International Search Report completed Sep. 22, 2009 for PCT/US2009/042781, 7 pgs. |
Hoshino, “Transendoscopic Projectile Drug Delivery”, Gastroenterologia Japonica, vol. 25, No. 5, Jun. 15, 1990, 1 page. |
Park et al., “A randomized comparison of a new flexible bipolar hemostasis forceps designed principally for NOTES versus a conventional surgical laparoscopic bipolar forceps for intra-abdominal vessel sealing in a porcine model”, Gastrointestinal Endoscopy 2010, vol. 71, No. 4, pp. 835-841. |
Fritscher-Ravens et al., “Beyond NOTES: randomized controlled study of different methods flexible endoscopic hemostasis of artifically induced hemorrhage, via NOTES access to the peritoneal cavity”, Endoscopy 2009, vol. 41, pp. 29-35. |
PCT International Search Report and Written Opinion for PCT/2009/067076, 23 pgs. |
International Search Report and Written Opinion for PCT/US2010/036381, dated Aug. 20, 2010, 16 pgs. |
International Preliminary Report on Patentability for PCT/US2009/042781, dated Nov. 18, 2010, 11 pgs. |
Alto Shooter Catalog, Kaigen, English and Japanese, Jun. 1994, 8 pgs. |
Decker, “An Efficient Method for the Application of Avitene Hemostatic Agent”, Surgery, Gynecology & Obstetrics, 1991, vol. 172, No. 6, 2 pgs. |
Endo-Avitene brochure, Med Chem Products, Inc., date unknown, 4 pgs. |
Fagelman, et al. “A Simple Method for Application of Microfibrilar Colagen”, Surgery, Gynecology & Obstetrics, Jun. 1980, vol. 150, No. 6, 3 pgs. |
Hoshino, et al. “Trans-endoscopic Drug Propulsion Therapy”, Diagnostic Endoscopy, 1993, vol. 5, 6 pgs. |
Surgical Armamentarium, Copyright 1973 V. Mueller, 3 pgs. |
Office Action dated Apr. 14, 2011 for U.S. Appl. No. 12/787,796, 9 pgs. |
Response to Office Action filed Jul. 14, 2011 for for U.S. Appl. No. 12/787,796, 11 pgs. |
Notice of Allowance dated Oct. 18, 2011 for U.S. Appl. No. 12/787,796, 10 pgs. |
Office Action for Japanese Patent Application No. 2011-508588 dated Mar. 25, 2014, 6 pgs. including English translation. |
Restriction Requirement for U.S. Appl. No. 12/633,027 dated May 25, 2012, 7 pgs. |
Response to Restriction Requirement for U.S. Appl. No. 12/633,027, filed Jul. 2, 2012, 7 pgs. |
Office Action dated Jun. 12, 2013 for Japanese Patent Application No. 2011-508588, 6 pages Including English translation. |
Response to Office Action dated Oct. 10, 2013 for Japanese Patent Application No. 2011-508588, 3 pages. |
Response dated Mar. 14, 2012 for European Patent Application No. 09743424.5, 10 pgs. |
Communication from European Patent Office dated Sep. 5, 2012 for European Patent Application No. 09743424.5, 6 pgs. |
Response dated Feb. 22, 2013 for European Patent Application No. 09743424.5, 4 pgs. |
Examination Report from European Patent Office dated Nov. 28, 2013 for European Patent Application No. 09743424.5, 6 pgs. |
Examiner's Report dated Aug. 17, 2012 for Canadian Patent Application No. 2723183, 2 pgs. |
Response to Examiner's Report dated Feb. 11, 2013 for Canadian Patent Application No. 2723183, 5 pgs. |
Notice of Allowance dated Jul. 31, 2013 for Canadian Patent Application No. 2723183, 1 pg. |
Examination Report No. 1 dated Sep. 27, 2012 for Australian Patent Application No. 2009244462, 4 pgs. |
Response to Examination Report No. 1 dated Feb. 19, 2013 for Australian Patent Application No. 2009244462, 6 pgs. |
Notice of Acceptance dated Apr. 2, 2013 for Australian Patent Application No. 2009244462, 3 pgs. |
Certificate of Grant dated Jul. 25, 2013 for Australian Patent Application No. 2009244462, 1 pg. |
Number | Date | Country | |
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20090281486 A1 | Nov 2009 | US |
Number | Date | Country | |
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61050906 | May 2008 | US |