The present invention is a combination anastomosis device that both sutures and seals connections between two native body tubes and a graft—better proof against leaks than prior art of suturing alone or as some propose, by sealing. The invention is also a combination of supporting devices and methods that allow the anastomoses to be performed in seconds rather than the minutes required by present art, causing no more collateral bodily damage than percutaneous entry, requiring no time on a cardiac bypass system, either no heart stoppage or less than a minute thus potentially increasing the population who can tolerate coronary bypass as an out-patient procedure. The tract of application is not limited to coronary but includes vascular, urinary, pulmonary, alimentary, cerebral-spinal or other mammalian tract. May be manufactured of biodegradeable or biocompatible material and graft may be harvested or synthetic.
A hemostatic guiding catheter is biased to curve toward the artery wall and the distal opening is shaped so its edge is congruent with the artery wall. One or more annular balloons are inflated to produce a barrier between the guiding/catheter and the artery wall stopping the flow of blood and thus hemostasis. The annular balloons may be biased to inflate more on the side away from the distal opening thus imparting a force vector toward the distal opening and/or biased to overhang their line of attachment like a foreskin over a penis to allow the hemostatic guiding catheter to move a short distance while the biased balloons maintain hemostasis.
Suturing Graft Tubes To Lumen Walls Percutaneously
A graft tube is percutaneously placed inside the lumen of a vessel and attached to the lumen wall by loops of suture material. The plurality of short sutures are made in the shape of a loop with a sharp and a blunt end then forced into a plurality of first tunnels located in sections of circular cuffs that are attached to graft tube ends. The short sutures are pushed out the first tunnel by push rods and curve back to their original shape through the adjacent lumen wall and into a plurality of second tunnels where the short sutures are lodged.
Various cutting devices and systems are described that excise and/or incise tissue from a target site. For example, the wall of an artery and/or adventitial to the artery wall from inside the artery. According to embodiments of the invention, a lateral incision catheter device configured to be introduced intra-luminally to a pre-selected site in the body is provided, generally including a rotating first catheter, including a proximal end, a distal end and lumen positioned therebetween; a first shell to a first rotating catheter and having a cutting surface; a second shell attached to a second catheter, whereby rotation of the first rotating catheter causes the first shell to rotate with respect to the second shell so as to permit the cutting surface to cut tissue at the pre-selected site. According to embodiments of the invention, a lateral sliding incising/excising device configured to be introduced intra-luminally to a pre-selected site generally including a catheter, a lateral sliding cup including a cutting surface and at least one inflatable balloon attached to the outside of the cup and configured to push the cup laterally toward the target site.
Intravascular Suturing Device For Simultaneously Placing 3-7 Sutures With Ideal Spacing To Close Large Openings In Vessels Including Calfified
Centerboard entering vessel opening spreads it to a slit. Needle pairs in slots across centerboard width are at about 2 mm intervals inside vessel. Pushing a wedge or bridge wire between pairs spreads needle noses about 1 mm on either side of free edge of slit. Suture loop ends are attached to each pair. An outboard has legs on either side of centerboard with a foot on each leg that stands on either side of slit outside vessel. Needle nose housings in each foot are directly opposite needle noses. Operator turning a screw pushes needle noses through vessel wall overcoming resistance in calcified vessels and housings hold needle noses by detents. Removing device from body brings suture ends outside with suture loops across slit in ideal 2×2 pattern. Alternative configurations provide means of joining and cutting suture ends, with preformed knots slid to opening or clamping ends together with a clip.
Device To Steer Into Subintimal False Lumen And Parallel Park In True Lumen
A device for steering J-tip guidewire through true lumen of artery to puncture site where an occlusion abuts artery wall and stylet wire in lumen of J-tip guidewire provides axis for screwing it between intimal and medial layers of artery wall and stiffens it sufficiently to transform J-tip to loop that dissects a false lumen between intimal and medial layers around occlusion to its end where tamping balloons push aside intimal layer and occlusion so false lumen and true lumen coincide allowing intimal layer to be safely pierced by stylet wire allowing blood flow through previously occluded artery segment.