The present invention relates generally to medical devices, and more particular to methods and apparatuses to reduce a dimension of an implantable device in a smaller state.
Catheterization and interventional procedures, such as angioplasty or stenting, generally are performed by inserting a hollow needle through a patient's skin and tissue into the vascular system. A guide wire may be advanced through the needle and into the patients blood vessel accessed by the needle. The needle is then removed, enabling an introducer sheath to be advanced over the guide wire into the vessel, e.g., in conjunction with or subsequent to a dilator. Because these procedures are generally performed in arteries and other vasculature, it may be desirable to reduce the size of any components involved.
A catheter or other device may then be advanced through a lumen of the introducer sheath and over the guide wire into a position for performing a medical procedure. Thus, the introducer sheath may facilitate introducing various devices into the vessel, while minimizing trauma to the vessel wall and/or minimizing blood loss during a procedure.
Upon completing the procedure, the devices and introducer sheath would be removed, leaving a puncture site in the vessel wall. Traditionally, external pressure would be applied to the puncture site until clotting and wound sealing occur; however, the patient must remain bedridden for a substantial period of time after clotting to ensure closure of the wound. This procedure, however, may be time consuming and expensive, requiring as much as an hour of a physician's or nurse's time. It is also uncomfortable for the patient, and requires that the patient remain immobilized in the operating room, catheter lab, or holding area. In addition, a risk of hematoma exists from bleeding before hemostasis occurs.
Various apparatus have been suggested for percutaneously sealing a vascular puncture by occluding the puncture site. For example, U.S. Pat. Nos. 5,192,302 and 5,222,974, issued to Kensey et al., describe the use of a biodegradable plug that may be delivered through an introducer sheath into a puncture site. Another technique has been suggested that involves percutaneously suturing the puncture site, such as that disclosed in U.S. Pat. No. 5,304,184, issued to Hathaway et al.
Accordingly, it may be desirable to provide apparatus and methods to reduce a dimension of an implantable device in a smaller state.
An embodiment of a method of fabricating an implantable device is described. The method includes positioning a planar base material having a first inner surface having a first inner surface dimension and a first outer surface having a first outer surface dimension. A portion of the first inner surface of the base material is removed to define an annular body movable from a first state towards a second state. The annular body includes a second inner surface having a second inner surface dimension and a second outer surface having a second outer surface dimension. The second inner surface dimension is smaller than the first inner surface dimension, the first outer surface dimension, and the second outer surface dimension.
Another embodiment of a method of fabricating an implantable device is described. The method includes extruding a base material having an inner surface and an outer surface to form a cross-section. The cross section is selected from the following: an isosceles trapezoid, a semipolygon, a triangle, or a semiellipse. The outer surface defines a base of the cross-section. An implantable device is formed from the extruded base material. The implantable device includes an annular body movable from a first state towards a second state. The implantable device is deformed from the first state where the implantable device has a first dimension to the second state where the implantable device has a second dimension. The first dimension in the first state is substantially larger than the second dimension in the second state.
In some embodiments, the second inner surface and the second outer surface define a cross-section. The shape of the cross-section, in further embodiments, is selected from the following: an isosceles trapezoid, a semipolygon, a triangle, or a semiellipse. The second outer surface, in some configurations, defines a base of the cross-section.
Removing a portion of the base material, in some embodiments, includes removing one or more portions from the base material using laser cutting. In further embodiments, removing a portion of the base material includes using a laser at an angle that is not perpendicular to the first outer surface or second outer surface.
In some embodiments, removing a portion of the base material includes removing a portion from the base material using photochemical etching. Removing a portion of the base material, in further embodiments, includes selectively adding an outer mask having an outer mask dimension to the first outer surface of the base material and selectively adding an inner mask having an inner mask dimension to the first inner surface of the base material to form the cross-section. In some embodiments, the outer mask dimension is larger than the inner mask dimension.
The first inner surface dimension and the first outer surface dimension, in some embodiments, are substantially the same dimension. In further embodiments, the method includes removing a portion of the first outer surface of the base material and the first outer surface dimension is substantially larger than the second outer surface dimension.
In some embodiments, the annular body includes a plurality of adjacent support members. The method, in further embodiments, includes before removing a portion of the base material, forming a precursor of the implantable device and after removing a portion of the base material, moving the formed precursor from a first position having a first dimension to a second position having a second dimension that is smaller than the first dimension and heat treating the implantable device.
The method, in some embodiments, includes moving the implantable device from a first position to a second position and heat treating the implantable device. In further embodiments, moving the implantable device from a first position to a second position includes compressing the implantable device.
In some embodiments, tissue engaging portions and a plurality of support members are formed and a first end of the extruded base material is joined to a second end of the extruded base material. In the first state, an inner edge of the inner surface of a first support member and an inner edge of the inner surface of a second support member, in further embodiments, are separated by a first edge dimension. In still further embodiments, in the second state, the inner edge of the inner surface of the first support member and the inner edge of the inner surface of the second support member are separated by a second edge dimension and the second edge dimension is substantially smaller than the first edge dimension.
An embodiment of an implantable device is described. The implantable device includes a planar annular body movable from a first state towards a second state. The annular body includes a plurality of support members. The support members define a cross-section that includes an outer surface having an outer surface dimension and an inner surface having an inner surface dimension. The inner surface dimension is substantially smaller than the outer surface dimension.
In some embodiments, the shape of the cross-section of the support members is selected from the following: an isosceles trapezoid, a semipolygon, a triangle, or a semiellipse and the outer surface defines a base of the cross-section. The implantable device, in some embodiments is a closure element for engaging tissue.
The annular body, in some embodiments, is movable from a pre-deployed configuration towards a deployed configuration and the annular body includes a plurality of tissue engaging portions extending from the annular body. At least two of the tissue engaging portions are separated by a first distance in a deployed configuration and a second distance in a pre-deployed configuration. The first distance in the deployed configuration is smaller than the second distance in the pre-deployed configuration.
In some embodiments, the annular body defines a plane. The annular body is disposed about a central axis extending substantially normal to the plane in the deployed configuration. The annular body is disposed out of the plane in the pre-deployed configuration. The tissue engaging portions are oriented generally towards the central axis in the deployed configuration and generally parallel to the central axis in the pre-deployed configuration.
The annular body, in some embodiments, is biased towards the deployed configuration for biasing at least one of the tissue engaging portions towards another tissue engaging portion. In the first state, an inner edge of the inner surface of a first support member and an inner edge of the inner surface of a second support member, in further embodiments, are separated by a first edge dimension. In the second state, the inner edge of the inner surface of the first support member and the inner edge of the inner surface of the second support member are separated by a second edge dimension. The second edge dimension is substantially smaller than the first edge dimension.
It is to be understood that both the foregoing general description and the following detailed description are exemplary and are intended to provide further explanation of the invention claimed.
The accompanying Figures, which are incorporated in and constitute part of this specification, are included to illustrate and provide a further understanding of the method and system of the invention. Together with the description, the Figures serve to explain the principles of the invention.
In order to describe the manner in which the above-recited and other advantages and features of the invention can be obtained, a more particular description of the invention briefly described above will be rendered by reference to specific embodiments thereof which are illustrated in the appended drawings. Understanding that these drawings depict only typical embodiments of the invention and are not therefore to be considered to be limiting of its scope, the invention will be described and explained with additional specificity and detail through the use of the accompanying drawings.
It should be noted that the figures are not drawn to scale and that elements of similar structures or functions are generally represented by like reference numerals for illustrative purposes throughout the figures. It also should be noted that the figures are only intended to facilitate the description of embodiments of the present invention.
The embodiments described herein extend to methods, systems, and apparatus for managing access through tissue. Some of the apparatuses of the present invention are configured to deliver a device for managing access through tissue into an opening formed in and/or adjacent to tissue.
Medical devices may be used in a variety of spaces. It may be desirable to generally reduce the size of medical devices. For example, stents may be inserted into smaller and smaller vasculature, thus making it generally desirable to reduce the pre-deployment size of a stent. In another example, a closure device may be used to close tissue in, for example, a body lumen. In order to reach the desired body lumen, typically a delivery device may be used to reach an access point in the body lumen. To minimize the effects of a procedure on a patient, the reduction in size of the access point may be desirable.
For example, when a stent is deployed, it is initially in a collapsed or smaller state. Once the stent is properly positioned, it can then be expanded to a larger or expanded state. Embodiments of the invention relate to systems and methods that can reduce the size of the collapsed or smaller state of the stent or other medical device. By reducing the size of the collapsed or smaller state, the size of the access point into the body lumen can be similarly reduced. This can advantageously reduce the effects of a procedure on a patient.
These results, whether individually or collectively, can be achieved, according to one embodiment of the present invention, by employing methods, systems, and/or apparatus as shown in the figures and described in detail below.
Turning now to the drawings,
The implantable device 110 may represent an implantable device that has been processed according to an embodiment of a method of the present invention. The implantable device 10 may represent an implantable device prior to processing according to an embodiment of a method of the present invention.
In the present embodiment, the inner surface dimension 142 of the implantable device 110 is the distance between two edges 148a of the inner surface 140 of the implantable device 110. The inner surface dimension 42 of the implantable device 10 is the distance between two edges 48a of the inner surface 40 of the implantable device 10. The outer surface dimension 146 of the implantable device 110 is the distance between two edges 148b of the outer surface 144 of the implantable device 110. The outer surface dimension 46 of the implantable device 10 is the distance between two edges 48b of the outer surface 44 of the implantable device 10. In other embodiments, the inner and outer surface dimensions 42, 46, 142, 146 of the implantable devices 110, 10 may include other dimensions.
The implantable devices 10, 110 may include a cross-section 50, 150. In the present embodiment, the implantable device 110 has an isosceles trapezoid cross-section. In other embodiments, the implantable device 110 may include other cross-sections 150, such as a semipolygon, a triangle, a semiellipse and/or other cross-sections. The implantable device 10 is shown with a rectangular cross-section 50. Advantageously, an implantable device 110 having annular bodies with a cross section 150 can collapse further that the implantable device 10, which has a rectangular cross-section 50, thereby reducing the size of the collapsed state of the device 10 compared to the collapsed state of the device 10.
A portion of the inner surface of the base material may be removed, as represented by block 204. The portion of the inner surface of the base material may be removed using various techniques. For example, the portion of the inner surface of the base material may be removed using laser cutting, photolithography, chemical etching, EDM, milling, hydro-cutting, other removal processes, or combinations thereof.
For example, the base material may be removed by laser cutting. To achieve the desired cross sectional shape, the laser, in one embodiment, is angled. When using photolithography, the size of the mask on the inner surface 142 may be thinner than the mask on the surface 144. During photolithography, the desired cross-sectional shape, such as trapezoidal, can be obtained.
Removing a portion of the inner surface of the base material may define an implantable device. An implantable device may include a closure element, such as those described in U.S. patent application Ser. No. 11/767,818, entitled “Methods, Devices, and Apparatus for Managing Access Through Tissue”, and filed Jun. 25, 2007, which is hereby incorporated by reference in its entirety, a stent, or other implantable devices.
A portion of the inner surface of the base material may be removed, as represented by block 308. Removing a portion of the inner surface of the base material may define an implantable device, as described herein. Removing a portion of the inner surface typically results in a change to the shape of the base material and often changes at least one dimension, such as a diameter of a collapsed state of an implantable device or of a device for deploying an implantable device.
The implantable device may be moved from a first position to a second position, as represented by block 310. Moving the implantable device from a first position to a second position may include expanding, compressing, rotating, flexing, other movements of the implantable device, or combinations thereof.
The implantable device may be heat treated, as represented by block 312. In the present embodiment, the implantable device may be heat treated while it is moved from the first position to the second position. The implantable device may be fixed in the second position while it is being heat treated. Heat treating the implantable device may include heating the implantable device to a temperature above its austenitic finish temperature, followed by water quenching.
In the present embodiment, a laser cutter may be positioned at an angle that is not perpendicular to the base material, as represented by block 416. Positioning a laser cutter at an angle that is not perpendicular to the base material may include positioning the base material and/or the laser cutter relative to each other such that the laser may cut the base material in a non-perpendicular fashion.
A portion of the inner surface of the base material may be removed, as represented by block 418. In the present embodiment, the portion of the inner surface of the base material may be removed using laser cutting. Removing a portion of the inner surface of the base material may define an implantable device, as described herein. Additional portions of the inner surface of the base material may be removed or all portions to be removed may be removed at the same time.
The implantable device may be moved from a first position to a second position, as represented by block 420. Moving the implantable device from a first position to a second position may include expanding, compressing, rotating, flexing, other movements of the implantable device, or combinations thereof, as described herein.
The implantable device may be heat treated, as represented by block 422. In the present embodiment, the implantable device may be heat treated while it is moved from the first position to the second position, as described herein.
The implantable device 510 may include a plurality of tissue engaging portions 513 extending from the body 512. The tissue engaging portions 513 may include edges (not shown) and/or tip portions (not shown). Portions of the tissue engaging portions 513 may include edges and/or tip portions that are sharp and/or obtuse. In some embodiments, the tissue engaging portions 513 may not have edges such that they are generally rounded.
In the present embodiment, the body 512 may include a plurality of looped or curved elements 530 that may be connected to one another to form the body 512. Each looped element 530 may include an inner or first curved region 532 and an outer or second curved region 534. The first and second curved regions 532, 534 may be out of phase with one another and/or may be connected alternately to one another, thereby defining an endless sinusoidal pattern. Alternatively, other generally zigzag patterns may be provided that repeat periodically, e.g., saw tooth or square tooth patterns (not shown), instead of a sinusoidal pattern, thereby defining inner and outer regions that may alternate about the body 512.
The plurality of tissue engaging portions 513 may be biased to extend towards one another. In the present embodiment, the tissue engaging portions 513 may be biased generally inwardly into the space bounded by the inner periphery 536. In further embodiments, the tissue engaging portions 513 may be biased toward the central axis 524. In further embodiments, at least two of the tissue engaging portions 513 may be biased to extend towards each other.
In the present embodiment, the tissue engaging portions 513 may be disposed on the first curved regions 532 and/or oriented toward the central axis 524 when the implantable device 510 is in the deployed configuration. The tissue engaging portions 513 may be provided in pairs opposite from one another, as in the present embodiment. The tissue engaging portions 513 may be provided symmetrically with respect to the central axis 524 or may not be provided symmetrically.
Additionally, as shown in
In the deployed configuration, shown in
The distances 526a, 526b may vary before deployment, pre-deployment, and/or when providing access through the tissue post deployment. In the present embodiment, before being deployed in tissue, the implantable device 510 may be substantially in the pre-deployed configuration such that two tissue engaging portions 513 may be separated by about the second distance 526b. When deployed in tissue, the implantable device 510 may be substantially in the deployed configuration such that the two tissue engaging portions 513 may be separated by about the first distance 526a. When providing access to the tissue after being deployed in tissue, the implantable device 510 may be moved from substantially the deployed configuration substantially toward and/or to the pre-deployed configuration.
As shown in
In the present embodiment, the tissue engaging portions 513 may be oriented substantially parallel to the central axis 524 in the pre-deployed configuration, as shown in
The tissue engaging portions 513 and/or body 512 may be biased to move from the pre-deployed configuration towards the deployed configuration of
The looped elements 530 may distribute stresses in the implantable device 510 as it is moved between the deployed and pre-deployed configurations, thereby generally minimizing localized stresses that may otherwise plastically deform, break, and/or otherwise damage the implantable device 510 during delivery. In addition, when the implantable device 510 is in the pre-deployed configuration, the looped elements 530 may be movable between a compressed state, such as that shown in
With the implantable device 510 in the pre-deployed configuration, the support members 531 may be moved (circumferentially and/or radially compressed in the present embodiment) to the compressed state until the device 510 defines a first distance 526b (i.e. diameter or circumference), such as that shown in
Referring generally to
An implantable device 510 with an inner surface dimension 542 that is smaller than an outer surface dimension 546 may provide the advantage of being smaller (i.e. having a smaller second distance 526b) in a compressed pre-deployed state than an implantable device 510′ with an inner surface dimension and an outer surface dimension that are substantially equal. For example, it may be desirable to have an implantable device 510 with a smaller second distance 526b in a compressed pre-deployed state to reduce the overall size of an apparatus for deploying an implantable device (not shown). This reduction in size may facilitate introducing the implantable device 510 through a smaller puncture or passage.
In the present embodiment the longer tissue engaging portion 513″ may extend from the body 512″. Longer tissue engaging portions 513″ may include edges and/or tip portions. Portions of the longer tissue engaging portions 513″ may include edges and/or tip portions that are sharp and/or obtuse. In some embodiments, the longer tissue engaging portions 513″ may not have edges such that they are generally rounded.
An outer mask may be applied to an outer surface of the base material, as represented by block 626. Applying an outer mask to an outer surface of the base material may include selecting a desired shape of an outer surface of an implantable device. For example, the general shape of the outer surface 544 of the implantable device 510 shown in
An inner mask may be applied to an inner surface of the base material, as represented by block 628. Applying an inner mask to an inner surface of the base material may include selecting a desired shape of an inner surface of an implantable device, a desired general cross-section of a portion (i.e. the body) of the implantable device, and/or other design considerations. For example, the general shape of the inner surface 540 of the implantable device 510 shown in
A portion of the inner surface of the base material may be removed, as represented by block 530. Removing a portion of the inner surface of the base material may define an implantable device. An implantable device may include a closure element, such as the implantable device 510 and/or other implantable devices (i.e. stents, etc.) as described above.
The base material that does not have either an inner or an outer mask may be generally removed. The material between the inner mask and outer mask may not be generally removed. However, in some embodiments, some portions of the base material covered by an inner and/or outer mask may be partially removed. For example, where chemical etching is used, the etching chemical may remove more material than the unmasked areas potentially removing a portion of the base material covered by an inner and/or outer mask. The inner and/or outer mask configurations may be designed to compensate for any overetching that may occur.
In the present embodiment, the inner mask may have a smaller dimension than the outer mask. For example, the overall surface area of the inner mask may be smaller than the overall surface area of the outer mask. In embodiments, where the inner mask has a smaller dimension than the outer mask, the material that is masked by the outer mask but not by the inner mask may generally taper from the outer mask to the inner mask. For example, if an inner mask were placed on the inner surface 540 of the implantable device 510 and an outer mask were placed on the outer surface 544 of the implantable device 510 shown in
In some embodiments, the implantable device may already be defined in shape, such as implantable device 10. In these embodiments, an inner and/or an outer mask may be applied to create a desired cross-section as described above although the body of the implantable device was previously defined.
The implantable device may be moved from a first position to a second position, as represented by block 632. Moving the implantable device from a first position to a second position may include expanding, compressing, rotating, flexing, other movements of the implantable device, or combinations thereof, as described herein. For example, the implantable device may be moved from a pre-deployed configuration to the deployed configuration. In another example, the implantable device may be formed in an expanded oversize configuration to provide space for removing material from a sheet of material such that the implantable device may be moved from the expanded oversize configuration to the deployed configuration.
The implantable device may be heat treated, as represented by block 634. In the present embodiment, the implantable device may be heat treated while it is moved from the first position to the second position, as described herein.
An implantable device may be formed from the extruded base material, as represented by block 738. Forming an implantable device from the extruded base material may include connecting two ends of the extruded base material, e.g., by welding, adhesive bonding, other connection processes, or combinations thereof.
The implantable device may be moved from a first position to a second position, as represented by block 740. Moving the implantable device from a first position to a second position may include expanding, compressing, rotating, flexing, other movements of the implantable device, or combinations thereof, as described herein.
The implantable device may be heat treated, as represented by block 742. In the present embodiment, the implantable device may be heat treated while it is moved from the first position to the second position, as described herein.
The implantable device may be deformed from a first state to a second state, as represented by block 744. For example, the implantable device may be deformed from a deployed state to a pre-deployed state, from an expanded pre-deployed state to a compressed pre-deployed state, from a compressed pre-deployed state to a deployed state, other deformations from a first to a second state, or combinations thereof.
An implantable device may be formed from the extruded base material. Forming an implantable device from the extruded base material may include forming an annular body, as represented by block 848, and/or forming tissue engaging portions, as represented by block 850.
Forming an annular body may include winding the extruded base material into an enclosed loop. For example, in embodiments where the implantable device is a closure element, such as implantable device 510 shown in
Forming tissue engaging portions may include bending the extruded base material to form tissue engaging portions using conventional methods. Alternatively or in addition, tissue engaging portions may be formed separately and attached to the body, for example, by welding.
A first end of the extruded base material may be connected to a second end of the extruded base material, as represented by block 852. Connecting a first and second end of the extruded base material may include joining the two ends by, for example, welding, other connection processes, or combinations thereof.
The inner surfaces 1040, 1140, 1240, 1340, 1440, 1540 may provide the advantage of being smaller in a compressed pre-deployed state than the implantable devices 10, 10′, 10″, 10′″ with an inner surface dimension (not shown) and an outer surface dimension (not shown) that are substantially equal.
The invention is susceptible to various modifications and alternative means, and specific examples thereof have been shown by way of example in the drawings and are herein described in detail. It should be understood, however, that the invention is not to be limited to the particular devices or methods disclosed, but to the contrary, the invention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the claims.
This application claims the benefit of and priority to U.S. Provisional Patent Application No. 61/015,144, filed Dec. 19, 2007, and entitled “Methods And Apparatus To Reduce A Dimension Of An Implantable Device In A Smaller State” which is incorporated herein by reference in its entirety. This application also incorporates U.S. patent application Ser. No. 11/767,818, entitled “Methods, Devices, and Apparatus for Managing Access Through Tissue”, and filed Jun. 25, 2007 by reference in its entirety.
Number | Date | Country | |
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61015144 | Dec 2007 | US |