Percutaneous tissue anchor techniques

Patent metadata

Field	Value
Publication number	US-11344310-B2
Application number	US-201916427061-A
Country	US
Kind code	B2
Filing date	May 30, 2019
Priority date	Oct 23, 2012
Publication date	May 31, 2022
Grant date	May 31, 2022

Abstract

An example anchor-manipulation tool includes (i) at a distal portion of the tool, an anchor-engaging element and an actuator, (ii) at an extracorporeal proximal portion of the tool, a controller, and (iii) a flexible longitudinal member extending between the proximal portion and the distal portion. The distal portion of the tool can be transluminally advanced to an anchor that is intracorporeally implanted in a subject. Subsequently, the anchor-engaging element can be engaged with an eyelet defined by a head of the anchor. Subsequently, the controller can be used to transition the tool into an articulatably-coupled state in which: (i) the eyelet at least in part inhibits movement of the anchor-engaging element away from the anchor, and (ii) the distal portion of the anchor-manipulation tool is deflectable with respect to the anchor. Subsequently, the anchor can be de-anchored by using the anchor-manipulation tool to apply a de-anchoring force to the eyelet.

First claim

The invention claimed is:

1. A method, comprising:
transluminally advancing a distal portion of an anchor-manipulation tool to an anchor that is intracorporeally implanted in a subject, a tissue-coupling element of the anchor being anchored within tissue of the subject, and the anchor-manipulation tool including:
at the distal portion, an anchor-engaging element and an actuator, the actuator configured to actuate the anchor-engaging element,
at an extracorporeal proximal portion of the anchor-manipulation tool, a controller, and
a flexible longitudinal member extending between the proximal portion and the distal portion;

subsequently, engaging the anchor-engaging element with an eyelet defined by a head of the anchor;
subsequently, using the controller to transition the tool into an articulatably-coupled state in which:
the eyelet at least in part inhibits movement of the anchor-engaging element away from the anchor, and
the distal portion of the anchor-manipulation tool is deflectable with respect to the anchor; and

subsequently, de-anchoring the anchor by unscrewing the tissue-coupling element from the tissue by using the anchor-manipulation tool to apply a de-anchoring rotational force to the eyelet.

2. The method according to claim 1 , wherein de-anchoring the anchor comprises de-anchoring the anchor while the tool is in the articulatably-coupled state.

3. The method according to claim 1 , further comprising, prior to de-anchoring the anchor, using the controller to transition the tool into a rigidly-coupled state in which the distal portion of the anchor-manipulation tool is inhibited from deflecting with respect to the tissue anchor.

4. The method according to claim 3 , wherein using the controller to transition the tool into the rigidly-coupled state comprises using the controller to transition the tool from the articulatably-coupled state into the rigidly-coupled state.

5. The method according to claim 3 , wherein de-anchoring the anchor comprises de-anchoring the anchor while the tool is in the rigidly-coupled state.

6. The method according to claim 3 , wherein de-anchoring the anchor comprises de-anchoring the anchor while the tool is in the articulatably-coupled state.

7. The method according to claim 3 , wherein:
the actuator is a housing that defines a compartment, and
using the controller to transition the tool into the rigidly-coupled state comprises using the controller to transition the tool into the rigidly-coupled state by sliding the eyelet into the compartment.

8. The method according to claim 7 , wherein sliding the eyelet into the compartment comprises sliding the eyelet into the compartment such that a central longitudinal axis of the anchor becomes axially aligned with the distal portion of the tool.

9. The method according to claim 7 , wherein:
the eyelet is dimensioned to fit snugly within the compartment, and
using the controller to transition the tool into the rigidly-coupled state by sliding the eyelet into the compartment comprises using the controller to transition the tool into the rigidly-coupled state by sliding the eyelet snugly into the compartment.

10. The method according to claim 7 , wherein:
the housing includes one or more protrusions that protrude radially inward into the compartment, and
using the controller to transition the tool into the rigidly-coupled state by sliding the eyelet into the compartment comprises using the controller to transition the tool into the rigidly-coupled state by sliding the eyelet into the compartment such that the eyelet becomes disposed in a circumferential space between the one or more protrusions.

11. The method according to claim 10 , wherein using the anchor-manipulation tool to apply the de-anchoring force to the eyelet comprises pressing the one or more protrusions against the eyelet by rotating the housing with respect to the anchor.

12. The method according to claim 7 , wherein:
the eyelet has an arch portion that has a generally parabolic shape, and
sliding the eyelet into the compartment comprises sliding, into the compartment, the arch portion that has the generally parabolic shape.

13. The method according to claim 7 , wherein:
the eyelet has an arch portion that has a height and a width, the height being at least 50% greater than the width, and
sliding the eyelet into the compartment comprises sliding, into the compartment, the arch portion that has the height that is at least 50% greater than the width.

14. The method according to claim 7 , wherein:
the eyelet has an arch portion that is defined by a bar that has a thickness of between 0.25 mm and 0.4 mm, and
sliding the eyelet into the compartment comprises sliding, into the compartment, the arch portion that is defined by the bar that has the thickness of between 0.25 mm and 0.4 mm.

15. The method according to claim 1 , wherein:
the articulatably-coupled state is an articulatably-coupled state in which the distal portion of the anchor-manipulation tool is rotatable with respect to the anchor, and
using the controller to control the actuator to transition the tool into the articulatably-coupled state comprises using the controller to control the actuator to transition the tool into the articulatably-coupled state in which the distal portion of the anchor-manipulation tool is rotatable with respect to the anchor.

16. The method according to claim 1 , wherein:
the articulatably-coupled state is an articulatably-coupled state in which the distal portion of the anchor-manipulation tool is deflectable in at least 1 steradian with respect to the tissue anchor, and
using the controller to control the actuator to transition the tool into the articulatably-coupled state comprises using the controller to control the actuator to transition the tool into the articulatably-coupled state in which the distal portion of the anchor-manipulation tool is deflectable in at least 1 steradian with respect to the tissue anchor.

17. The method according to claim 16 , wherein:
the articulatably-coupled state is an articulatably-coupled state in which the distal portion of the anchor-manipulation tool is deflectable in at least 3 steradians with respect to the tissue anchor, and
using the controller to control the actuator to transition the tool into the articulatably-coupled state comprises using the controller to control the actuator to transition the tool into the articulatably-coupled state in which the distal portion of the anchor-manipulation tool is deflectable in at least 3 steradians with respect to the tissue anchor.

18. The method according to claim 17 , wherein:
the articulatably-coupled state is an articulatably-coupled state in which the distal portion of the anchor-manipulation tool is deflectable in at least 7 steradians with respect to the tissue anchor, and
using the controller to control the actuator to transition the tool into the articulatably-coupled state comprises using the controller to control the actuator to transition the tool into the articulatably-coupled state in which the distal portion of the anchor-manipulation tool is deflectable in at least 7 steradians with respect to the tissue anchor.

19. The method according to claim 1 , wherein:
an implant includes a sleeve that defines a lumen and a proximal opening that provides access to the lumen,
the anchor that is intracorporeally implanted in the subject is anchoring the implant to the tissue, with:
the eyelet disposed within the lumen, and
the tissue-engaging element extending through the sleeve

Assignees

• Valtech Cardio Ltd

Inventors

• Herman Yaron
• Zipory Yuval
• Starobinsky Slava
• Reich Tal
• Iflah Ehud
• Koifman Alexei

Classifications

• A61B17/0401 Primary

  Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors (A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811) · CPC title

• A61B2017/0409

  Instruments for applying suture anchors · CPC title

• A61B17/12009 Primary

  Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot · CPC title

• A61F2/2445

  Annuloplasty rings in direct contact with the valve annulus · CPC title

• A61B2017/0441

  the shaft being a rigid coil or spiral · CPC title