Mechanical retraction via tethering for lung volume reduction

Patent metadata

Field	Value
Publication number	US-10194897-B2
Application number	US-201514795268-A
Country	US
Kind code	B2
Filing date	Jul 9, 2015
Priority date	Jul 18, 2014
Publication date	Feb 5, 2019
Grant date	Feb 5, 2019

Abstract

A device and method for reducing the volume of a tissue region, the device including a first fixation element, a second fixation element, and a tethering device, where the first and second fixation elements are slidably secured onto said tether, and the first and second fixation elements are radially self-expanding fixation elements.

First claim

What is claimed is:

1. A device for reducing the volume of a tissue region, the device comprising:
(a) a first fixation element,
(b) a second fixation element, and
(c) a tethering device, wherein the tethering device includes an internal channel configured to permit the delivery of a substance therein,
wherein said first and second fixation elements are slidably secured onto said tether such that at least one of the first and second fixation elements are configured to translate along the tether in a proximal direction and a distal direction in an unlocked configuration,
wherein said first and second fixation elements are radially self-expanding fixation elements,
wherein at least one of said first and second fixation elements comprises a tubular region at an end thereof,
said tubular region comprising a cylindrical wall and a hollow opening therethrough configured to include a portion of said tether,
said tubular region further comprising a tang formed into an opening defined through at least a portion of said cylindrical wall,
wherein said tang has a generally claw or hook shape biased into said hollow opening and toward said tether inside said tubular region,
said tang comprising an end integrated with or integrally formed with said sidewall and a depression end opposite thereof in contact with said tether in said hollow opening, and
wherein said depression end comprises a series of teeth or protrusions configured to grip a portion of said tether to restrict movement of said tether in said tubular region.

2. The device of claim 1 , wherein said first and second fixation elements comprise a shape memory material.

3. The device of claim 2 , wherein said shape memory material is nitinol.

4. The device of claim 1 , further comprising a tubular delivery device having an open interior into which said device may be held such that said first and second fixation elements are compressed within the open interior of said delivery device.

5. The device of claim 1 , wherein at least one of said fixation elements can be compressed after being expanded.

6. The device of claim 1 , further comprising a coating comprising an anti-microbial composition.

7. A method of achieving reduction of a volume of tissue, comprising:
(i) guiding a distal end of a tubular delivery device having an open interior region into a first target site of a tissue, wherein said tubular delivery device comprises an implantable device within the open interior of the tubular delivery device, the implantable device comprising:
(a) a first radially self-expanding fixation element;
(b) a second radially self-expanding fixation element; and
(c) a tethering device, wherein said first and second fixation elements are slidably secured onto said tether;

(ii) releasing said first radially self-expanding fixation element from the open interior of the tubular delivery device, such that the first radially self-expanding fixation element expands and exerts a first radially outward force on the first target site of tissue;
(iii) positioning said distal end of the tubular delivery device to a second target site within said tissue,
(iv) releasing said second radially self-expanding fixation element from the open interior of the tubular delivery device, such that the second radially self-expanding fixation element expands and exerts a second radially outward force on the second target site of tissue;
(v) pulling said tethering device such that the first radially self-expanding fixation element is pulled proximally towards the second fixation element to a desired length, wherein the first radially self-expanding fixation element proximally carries the first target site of tissue in response to being pulled proximally by the tethering device via the first radially outward force.

8. The method of claim 7 , further comprising locking said second radially self-expanding fixation element after pulling said tethering device.

9. The method of claim 7 , further comprising locking said second radially self-expanding fixation element prior to pulling said tethering device.

10. The method of claim 7 , wherein each of said first and second fixation elements is generally shaped so as to fit into a delivery device in a compressed state, wherein each of said first and second fixation elements has a first end and a second end and an intervening body therebetween, and wherein each intervening body has a plurality of slits cut therein to provide a plurality of axially configured struts.

11. The method of claim 10 , wherein said fixation elements are treated so as to be self-expanding in a radially outward direction.

12. The method of claim 11 , wherein said fixation elements comprise a shape memory material.

13. The method of claim 12 , wherein said fixation elements comprise nitinol.

14. The method of claim 7 , wherein said first fixation element is locked to said tethering device using said tang in said tubular region so as to restrict said first fixation element from sliding along said tethering device.

15. The method of claim 7 , further comprising compressing said first radially self-expanding fixation element after said step (ii) of releasing said first radially self-expanding fixation element.

16. The method of claim 15 , further comprising allowing said first radially self-expanding fixation element to expand radially after said step of compressing said first radially self-expanding fixation element after said step (ii) of releasing said first radially self-expanding fixation element.

17. A device for reducing the volume of a tissue region, the device comprising:
(a) a first fixation element;
(b) a second fixation element; and
(c) a tethering device, wherein the tethering device includes an internal channel configured to permit the delivery of a substance therein;
wherein said first and second fixation elements are slidably translatable along the tether, wherein the first and second fixation elements are configured to expand radially outwardly,
wherein at least one of the first and second fixation elements includes a tubular region, wherein the tubular region includes a cylindrical wall and a hollow opening therethrough, wherein the hollow opening is configured to slidably receive the tether;
wherein the tubular region further includes a lock abutting against the tether within the hollow opening, wherein the lock is configured to be actuated between an unlocked state and a locked state; and
wherein the lock is configured to allow slidable translation of the tether relative to the first and second fixational elements when in the unlocked state, wherein the lock is configured to inhibit slidable translation of the tether relative to the first and second fixational elements when in the locked state.

18. The device of claim 17 , wherein the lock comprises a series of teeth or protrusions configured to engage the tether.

19. The device of claim 17 , wherein the lock comprises a wedge configured to engage the tether.

20. The device of claim 17 , wherein the tether includes a braided or multifilament surface configured to engage the corresponding lock when in the locked state.

Assignees

• Ethicon Inc

Inventors

• Cedro Jr Rudolph
• Smith Daniel J

Classifications

• A61B2017/0496

  for tensioning sutures · CPC title

• A61B2017/0451

  Cams or wedges holding the suture by friction · CPC title

• A61B2017/0448

  Additional elements on or within the anchor · CPC title

• A61B2017/00867

  shape memory effect · CPC title

• A61B2017/00809

  Lung operations · CPC title