ANCHORING MECHANISMS AND SYSTEMS FOR ENDOLUMINAL DEVICES
Devices and methods for occluding airways in at least one direction are disclosed. In some cases, the devices include anchoring mechanisms configured to keep an operative portion of the device (e.g., a valve) in position along a length of a lumen in which the device is deployed. The anchoring mechanisms can include anchors configured to settle into the lumen walls with little or no axial movement of the operative portion of the device. In some embodiments, the anchoring mechanisms include a secondary set of anchors configured to engage with the lumen wall to reduce, inhibit, or prevent axial movement of the operative portion of the device when the primary anchors settle into the walls of the lumen.
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Any and all applications for which a foreign or domestic priority claim is identified in the Application Data Sheet as filed with the present application are hereby incorporated by reference under 37 CFR 1.57. This application claims priority to U.S. Provisional Patent Application No. 61/973,142, filed Mar. 31, 2014 (Atty. Ref. No. SPIRTN.106PR). The entire disclosure of the foregoing application is hereby made part of this specification as if set forth fully herein and incorporated by reference for all purposes, for all that each contain.
BACKGROUNDThis disclosure relates to anchoring mechanisms for devices used inside lung airways.
RELATED ARTStruts having anchors are typically used to anchor devices used inside airways to lungs. However, provided herein are devices and methods that can help anchor devices used inside airways to lungs using springs, for example.
SUMMARYThe present technology relates to anchoring mechanisms and systems for endoluminal devices.
A mechanism for anchoring endoluminal devices to a lumen can comprise a hub member. The hub member can be configured to be located at a predetermined location inside the lumen. The mechanism can comprise a plurality of anchoring struts. The plurality of anchoring struts can comprise a spring portion. The spring portion can be attached to the hub member. The spring portion can be configured to extend or contract during expansion and contraction of the lumen. The mechanism can comprise an anchoring portion. The anchoring portion can connect the spring portion to the lumen. The anchoring portion can be configured to penetrate a portion of the lumen. The hub member can be positioned on a plane with the anchoring portions of the plurality of anchoring struts.
The anchoring portion can comprise a bi-directional anchoring tip. The bi-directional anchoring tip can comprise a first tip pointed to a first direction. The bi-directional anchoring tip can comprise a second tip pointed to a second direction at an angle from the first direction. At least a portion of the first tip can penetrate the lumen in a transverse direction to the lumen. The plurality of anchoring struts can comprise equal lengths.
Each of the spring portions of the plurality of anchoring struts can extend radially outward from the hub member. Each of the spring portion of the plurality of anchoring struts can comprise a helically coiled spring. Each of the spring portion of the plurality of anchoring struts can comprise bent strut members configured to straighten during expansion of the lumen and bend during contraction of the lumen.
The bent strut members can comprise a vortex shape when viewed along a longitudinal axis of the lumen. The bent strut members can comprise a spiral shape when viewed along a longitudinal axis of the lumen. Each of the bent strut members can comprise undulating strut members having a substantially straight shape when viewed in a transverse direction.
The bent strut members can comprise one or more thin portions and one or more thick portions thicker than the thin portions. The hub member can comprise a first hub and a second hub collinear and connected to the first hub. The plurality of anchoring struts can be connected to the first hub.
An endoluminal device can comprise an operative portion. The operative portion can be configured to obstruct fluid flow inside the lumen. The endoluminal device can comprise a hub member. The hub member can be connected to the operative portion. The hub member can comprise a hub and a centering rod. The endoluminal device can comprise a plurality of anchoring struts. The plurality of anchoring struts can comprise a strut portion. The strut portion can be attached to the hub member. The strut portion can be configured to expand and contract in response to expansion and contraction of the lumen. The anchoring portion can connect the deflectable portion to the lumen. The hub member can substantially remain on or near an axial line of the lumen during movement of the lumen.
The strut portion can be connected to a sliding hub configured to slide along a length of the centering rod. The plurality of anchoring struts can comprise a plurality of quadrilateral-shaped members. Each of the quadrilateral-shaped members can lie on a separate plane parallel to a longitudinal axis of the device.
A mechanism for anchoring endoluminal devices to a lumen can comprise a hub member. A plurality of distal anchoring struts can be connected to the hub member. The plurality of distal anchoring struts can extend radially and distally from the hub member and bend in a proximal direction. Each of the plurality of distal anchoring struts can comprise anchoring tips. The mechanism for anchoring endoluminal devices can comprise a plurality of opposing anchor struts. The plurality of opposing anchoring struts can be connected to the hub member. The plurality of opposing anchoring struts can extend proximally and radially from the hub member and bend in a distal direction. Each of the plurality of opposing anchor struts can comprise opposing anchor tips. The distal anchoring struts and the opposing anchoring struts can be configured to pinch a portion of the lumen.
A mechanism for anchoring endoluminal devices to a lumen can comprise a hub member. A plurality of anchoring struts can extend radially outward and distally from the hub member. Each of the plurality of anchoring struts can be configured to transition from a straightened configuration to a curved configuration when deployed in the lumen. Each of the plurality of anchoring struts can have a length when in the straightened configuration. The length of one or more of the plurality of anchor struts in the straightened configuration can be at least 1.5 times the fully expanded diameter of the lumen.
A mechanism for anchoring endoluminal devices to a lumen can comprise an operative portion. The operative portion can comprise a plurality of frame struts. Each frame strut can comprise a frame strut tip. A hub member can be connected to a distal end of the operative portion. A plurality of distal anchoring struts can extend radially from the hub member and bend in a proximal direction. Each distal anchoring strut can comprise an anchoring tip. The anchor tips can be positioned between the hub member and the frame strut tips. The frame strut tips and the anchoring tips can be interposed when viewed in a transverse direction.
The following drawings and the associated descriptions are provided to illustrate the present disclosure and do not limit the scope of the claims.
These and other features will now be described with reference to the drawings summarized above. The drawings and the associated descriptions are provided to illustrate embodiments and not to limit the scope of any claim. Throughout the drawings, reference numbers may be reused to indicate correspondence between referenced elements.
DETAILED DESCRIPTION OF EMBODIMENTSCertain anchoring mechanisms for devices used inside airways to lungs can have anchoring struts that can apply an outward force to a lumen (e.g., a lung airway). Such anchoring mechanisms can allow devices to be securely positioned during expansion and contraction of the lumen. Anchoring mechanisms can enter the lumen in a compressed state when devices having valves are being inserted into the lumen. Outward force of the anchoring mechanism can allow the anchoring mechanism to reach its fully expanded state during operation within the lumen. The outward force can maintain a slight outward pressure on the lumen during exhalation.
In some cases, the outward force of the anchors can deform the lumen walls. For example, the outward force can push the lumen walls radially outward from a central axis of the lumen. Expansion of the anchors and/or deformation of the lumen walls can cause an operative portion (e.g., a valve portion) of the device to be pulled towards the anchors (e.g., in a distal direction) as the anchors move outward and away from the axis of the lumen. Such “settling” of the anchors and operative portion of the device can occur gradually or quickly, depending on the geometry, elasticity, and/or other features of the lumen in which the device is implanted.
Pulling of the operative portion during lumen expansion can cause the operative portion to move longitudinally from its initial placement position. The dimensions of the device can be calibrated to account for such movement before placing the device in the lumen. Such calibration can be done by, for example, adjusting the placement of the operative portion (e.g., by placing the operative portion proximal of the intended final location), though a precise adjustment to account for the movement can be difficult. In some cases, movement of the device occurs over a time period beyond which the physician can reasonably observe using a visualization device such as a bronchoscope. In some cases, it can be difficult for the physician to approximate the final resting place of the device. A displacement of a device resulting from the bodily movement can result in unwanted side-branch ventilation due to the sealing portion being moved from its original position, which can compromise the effectiveness of such devices. In some cases, the valve of a device can become over-compressed when moved (e.g., in a distal direction). In some cases, the valve of a device can be moved to a portion of a lumen larger than the valve, thereby reducing or eliminating the efficacy of the valve.
Some mechanisms use stent anchoring designs that can overpower the lumen wall and press against the lumen wall to about the full diameter of the device. Such mechanisms can become affixed to the final resting position in the lumen immediately upon placing the device inside the lumen. However, such mechanisms can present problems over time because those mechanisms may not adjust properly with the expansion and contraction of airways to lungs caused by breathing. The tissue of the lumen may remodel to accommodate the device diameter, possibly causing the device to be loosened and/or coughed out.
Disclosed herein are anchoring mechanisms that can track the movement of a lumen wall (e.g., during breathing and/or coughing) and can allow the sealing portion of a valve to remain at a substantially consistent position in the airway as the anchoring mechanisms transition to a final resting position. In some cases, the anchoring mechanisms apply a vortexly expanding outward force with little or no axial component to the lumen wall. In some cases, the anchoring mechanisms apply a force with an axial vector in the proximal direction to push the device in the proximal direction as the lumen lengthens (e.g., during re-expansion of a collapsed lung).
Spring-Type Anchoring MechanismAn anchoring mechanism that can adapt to change in lumen dimensions can be used to place a medical device to a lumen. The medical device can be an endoluminal medical device. The endoluminal medical device used with an anchoring mechanism can include, for example, stents, sensors, valves, etc. The lumen can include, for example, veins, airways, digestive tracts, etc.
The hub 120 can be a collet configured to bundle the plurality of spring-type anchoring struts 130. The hub 120 can comprise a centering rod and a forceps knob, not shown. The spring-type anchoring struts 130 can be arranged radially from the hub 120. The spring-type anchoring struts 130 can comprise coiled springs, bent springs, or other expandable geometries and configurations. The anchoring struts 130 used in the spring-type anchoring mechanism 100 can comprise an elastic structure configured to expand or contract according to the movement of the lumen. For example, the plurality of anchoring struts 130 can comprise an expansion spring, such as the spring-type anchoring mechanism shown schematically in
The anchoring tip 140 can be configured to removably attach to the lumen 110. In some embodiments, the anchoring tip 140 can be configured to penetrate a portion of the lumen 110. For example, the anchoring tip 140 can comprise a tapered shape. The anchoring tip 140 can comprise a first piercing mechanism. The first piercing mechanism can comprise a shank. The anchoring tip 140 can comprise an anchor projection 150. The anchor projection 150 can comprise a second piercing mechanism forming an angle with the spring-type anchoring struts 130. For example, as shown schematically in
In some embodiments, the anchor projection 150 is configured to limit degree of penetration of the anchoring tip 140. For example, the anchor projection 150 can comprise an additional pad portion pointing in a vertical (e.g., circumferential) direction with respect to the hub 120. The anchor projection 150 can be positioned to rest against an inner surface of the lumen 110 to inhibit or prevent penetration of the anchoring tip 140 beyond a predetermined distance.
Dimensional changes of the lumen 110 can include changes in longitudinal dimension and changes in radial dimension. The lumen 110 can comprise a largest fully expanded diameter and a smallest fully contracted diameter. The plurality of spring-type anchoring struts 130 can extend radially from the hub 120 to contact the lumen 110. Each of the struts 130 can have an extended length (e.g., a length to which the struts 130 extend if unobstructed). In some embodiments, the extended length of the struts is greater than an expanded radius of the lumen 110 in which the struts 130 are deployed. In some embodiments, the extended length of the struts 130 is greater than 1.1 times, greater than 1.25 times, greater than 1.4 times, greater than 2 times, and/or greater than 4 times the expanded radius of the lumen 100. Many variations are possible.
The length of the plurality of spring-type anchoring struts 130 can comprise a coiled length (e.g., a minimum length the struts 130 can assume when the struts 130 are compressed). In some embodiments, the coiled length of the struts 130 is less than the radius of the lumen 110 in the smallest fully contracted diameter of the lumen 110. For example, the coiled length of the struts 130 can be less than about 0.9 times the contracted diameter, less than about 0.75 times the contracted diameter, less than 0.6 times the contracted diameter, and/or less than about 0.5 times the contracted diameter of the lumen 100. Many variations are possible.
The spring type anchoring mechanism 100 can comprise an even number of spring-type anchoring struts 130. For example, as shown in
The spring-type anchoring struts 130 can comprise varying lengths. For example, two or more spring-type anchoring struts 130 can have an equal length and a third spring-type anchoring strut 130 can have a length greater than or equal to the other two. In some cases, each of the struts 130 has a different length.
The hub 120 can be disposed on or near the longitudinal axis of the lumen 110 when the anchoring mechanism 100 is deployed. The spring-type anchoring struts 130 can at least partially uncoil during expansion of the lumen 110 and maintain contact with the lumen 110. The spring-type anchoring struts 130 can coil during contraction of the lumen 110 and apply a radial outward force to the lumen 110.
The struts 130 can be configured to maintain the hub 120 in a relatively stable position along a length of the lumen 110 in which the anchoring mechanism 100 before and/or after settling (e.g., expansion of the airway due to outward force of the struts 130) of the anchoring mechanism 100. The longitudinal movement (e.g., movement along a length of the lumen 110) of the hub 120 during and/or before settling can be limited to be within about 1 mm. The movement of the hub 120 can be limited to be, within about 2 mm, within about 0.5 mm, within about 0.3 mm, and/or within about 0.2 mm during and/or before settling.
A user may deploy the anchoring mechanism 100 by using a delivery device, such as an endoscope. The spring type anchoring mechanism 100 can be folded and transported within a catheter used with an endoscope. The spring type anchoring mechanism 100 can be deployed by being pushed out of the catheter. In some embodiments, the anchoring mechanism 100 can be deployed by withdrawing the catheter from the anchoring mechanism 100 at a deployment site. The spring-type anchoring struts 130 can expand radially outward to contact the lumen 110 once placed outside the catheter. The spring-type anchoring struts 130 can exert a radial outward force on the lumen wall 110. The radial outward force can allow each of the anchoring tips 140 to penetrate the lumen 110.
The hub 120 and the anchoring tip 140 can be on the same or substantially same transverse plane upon deployment. In some embodiments, the anchoring mechanism 100 can comprise two or more anchoring struts 130. The spring-type anchoring struts 130 can comprise a combination of elastic and static anchoring struts. For example, the spring-type anchoring struts 130 can comprise two spring-shaped elastic anchoring struts and one stiff, static anchoring strut. The hub 120 can comprise an axial bearing. The hub 120 can be positioned off-center. For example, the hub 120 can be located adjacent to wall of the lumen 110. The hub 120 can comprise various different shapes. For example, the hub can have a round, polygonal, oval-shaped, or other-shaped cross-section in a plane perpendicular to a longitudinal axis of the lumen 110. The anchoring tip 140 can comprise a blunt tip, such that no portion of the anchoring tip penetrates the lumen 110. The anchoring tip 140 having a blunt tip can comprise a traction surface. For example, the traction surface can comprise a plurality of cleats.
Spiral-Type Anchoring MechanismAnchoring struts can comprise a spiral shape, or a torsion spring shape. The spiral shape can be used, for example, to exert torsional force during expansion and contraction of the lumen.
The hub 220 can be placed on or near the longitudinal axis of the lumen 210. The hub 220 of the spiral type anchoring mechanism 200 can remain substantially in the same axial position irrespective of the movement of the lumen. The hub 120 can rotate as the spirals expand. For example, the hub 120 can rotate independently from an operative portion of the medical device during lumen expansion or contraction. In some embodiments, the hub 120 is rotatably locked with and connected to the operative portion. The operative portion can be, for example, a lung airway valve.
During an expansion and contraction of the lumen 110, the spiral type anchoring mechanism 200 can inhibit, reduce, or prevent displacement of a medical device while allowing the hub 220 to remain substantially at its original position. For example, during expansion of the lumen, the spiral portion 233 of the anchoring struts 230 can straighten. The hub 220 can remain suspended from the lumen wall and remain substantially at its original position. In some embodiments, the anchoring mechanism 200 is configured to maintain the hub 200 (e.g., and, consequently, the operative portion) in a relatively constant position along a length of the lumen 210 in which the mechanism 200 is deployed.
The plurality of anchoring struts 230 can be made of shape memory material, such as Nitinol. In some embodiments, the struts 230 are constructed from another, resilient and/or flexible material. The plurality of anchoring struts 230 can comprise a coiled length. The coiled length can comprise the shortest length between the hub 220 and the end of the anchoring tip 240 when the struts 230 are radially compressed. In some embodiments, the coiled length of the struts 230 is less than about 0.9 times, less than about 0.75 times, less than about 0.6 times, less than about 0.4 times, and/or less than about 0.25 times a radius of the lumen 210. The plurality of anchoring struts 230 can comprise an uncoiled length larger than a radius of lumen 210. For example, the straight length of the anchoring struts 230 can be more than 2 times larger, more than 1.5 times larger, and/or more than 1.1 times larger than a radius of the lumen 210.
The spiral shapes anchoring mechanism 200 can be transported across a catheter by being folded into the catheter prior to deployment. The anchoring struts 230 can be coiled further to be transported through the catheter. The spiral shape anchoring mechanism 200 can uncoil to its pre-formed spiral shape when pushed out of the catheter. In some embodiments, the anchoring mechanism 200 uncoils upon withdrawal of the catheter from the struts 230 at a deployment site in the lumen 210. The anchoring tips 240 can contact the lumen 210 once deployed, and exert an outward force from the hub 220 to the lumen 210. The anchoring tips 240 can penetrate the flesh of the lumen 210 by exerting outward force. In some embodiments, the anchoring tips 240 include pads or other mechanisms configured to limit the depth to which the tips 240 penetrate the lumen wall.
The anchoring struts 230 can be straightened to be transported through the catheter prior to deployment. The hub 220 can be a dual hub configured to allow rotation of the hub 220 without rotating the attached portion of the medical device (e.g. the operative portion). The spiral shaped anchoring mechanism 200 can comprise three or more anchoring struts 230. The anchoring struts 230 can comprise a combination of different spring shapes. For example, the anchoring struts 230 can comprise a plurality of spring-type anchoring struts 130 (e.g., shown in
An anchoring mechanism can comprise a plurality of flexible struts that are bent in a same circumferential direction to form a vortex shape when viewed in a transverse cross-section. The flexible vortex struts can bend or straighten, bending further during contraction of the lumen and straightening as the lumen expands.
The flexible anchoring struts 332 can extend radially outward from the distal hub 322. The proximal hub 324 can be connected to and/or form a monolithic part with the distal hub 322. The proximal struts 336 can extend radially and proximally from the proximal hub 324. The proximal struts 336 can form a basket. The proximal hub 324 can be a collet. The center rod 362 can be connected to the proximal hub 324 and extend proximally from the center hub. The center rod 362 can connect the hub 320 and the forceps knob 362. The forceps knob 362 can be shaped and sized to be grasped by a forceps. The plurality of flexible anchoring struts 332 can be configured to radially expand and exert an outward force on the lumen. The bent surface 338 of the plurality of proximal struts 336 can comprise portions of the proximal struts that bend at an angle from the rest of each proximal strut member 336 towards the longitudinal axis, or the center rod 360. The bent contact surface 338 can be used, for example, to inhibit or prevent trauma to the lumen wall by the proximal struts 336.
The distal hub 322 and the proximal hub 324 can comprise collinear cylindrical structures. The distal hub 322 and the proximal hub 324 can comprise cylindrical structures having different diameters. For example, the diameter of the distal hub 322 can be smaller than the diameter of the proximal hub 324. The smaller diameter of the distal hub 322 can be shaped and sized, for example, to allow the plurality of distal struts to coil and fit inside a delivery catheter. Each of the plurality of proximal struts 336 can have a straightened length. The straightened length can comprise the length of the proximal strut member at a fully straightened state with no bends. The straightened length can be less than 1.5 times the length of the center rod 362. The straightened length can be equal to or less than the length of the center rod 362. In some cases, the straightened length can be greater than 1.5 times the length of the center rod 362.
The stiffness of the flexible anchoring struts 332 can be tuned to counteract the forces (e.g., tension and compression) occurring during expansion of the struts 332. For example, stiffness of some portions in the struts 332 may be greater than the stiffness in other portions. Areas near the hub 320 and near the anchor tip 340 can be relatively stiff, while near the middle of the struts can be made more flexible to allow bending. The stiffness can be tuned by changing dimensions and/or shape of portions of the anchoring struts 332. For example, the plurality of anchoring struts 332 can comprise bent portions, thin portions, thick portions, and/or spiral portions.
The vortex shape anchoring mechanism 300 can be folded and transported across a delivery catheter. The flexible anchoring struts 332 can be coiled in the direction of the bend to fold and fit inside a catheter. For example, the flexible anchoring struts 332 shown in
The flexible anchoring struts 332 in a fully coiled state can have a cross-sectional diameter equal to or less than 1.5 times larger than the diameter of the proximal hub. The flexible anchoring struts 332 in a fully coiled state can have a cross-sectional diameter equal to or less than the diameter of the proximal hub. The plurality of proximal struts 336 in a fully straightened state can have a cross-sectional diameter equal to or less than 1.5 times larger than the diameter of the proximal hub. The plurality of proximal struts 336 in a fully straightened state can have a cross-sectional diameter equal to or less than the diameter of the proximal hub.
The vortex strut anchoring mechanism 300 can counteract movement of the lumen. For example, the vortex strut anchoring mechanism 300 can adjust to expand during lumen expansion and contract during lumen contraction. The anchoring tips 340 can remain in a substantially same transverse plane (e.g., perpendicular to the centerline of the lumen) during lumen expansion and contraction. For example, the flexible anchoring struts 330 can be bent further to have a smaller diameter, such that the anchoring tip 340 and the hub 320 can remain in a substantially constant transverse plane. The arc of the curvature of the anchoring struts 332 can straighten more as the lumen expands, while contact points and the hub remain in substantially the same plane. The stiffness of the anchoring struts can be tuned to counteract distal and proximal forces applied when the anchoring struts 330 expand. In some embodiments, the struts 332 are configured to remain in substantially the same transverse plane during and/or after settling of the device 300.
The plurality of proximal struts 336 can comprise two or more bent surfaces 338. For example, a proximal strut 336 can have two connected bent surfaces that form two included angles from the proximal strut 336. Two or more bent surfaces 338 can be used, for example, to allow different atraumatic contact surfaces to contact the lumen during expansion and contraction. For example, bent surfaces 338 can comprise a first surface configured to contact the lumen at an expanded state, and a second surface configured to contact the lumen at the contracted state.
The plurality of flexible anchoring struts 332 can comprise anchoring tips 340. For example, the plurality of flexible anchoring struts 332 can comprise multiple anchoring structures pointing in different directions. For example, the anchoring tip 340 can comprise a bi-directional anchoring tip 640 (shown in
The plurality of flexible anchoring struts 332 can comprise a spiral shape, such as the spiral-type anchoring struts 230 shown and described above in reference to
The position of the proximal struts 336 and the flexible anchoring struts 330 can be reversed. For example, the proximal struts 336 can be positioned distally relative to the flexible anchoring struts 330. The proximal struts 336 can extend in the opposite direction, such that the bent contact surface 338 can be positioned distally relative to the hub 320. The vortex strut anchoring mechanism 300 can comprise different number of flexible anchoring struts 330 as the number of proximal struts 336. The vortex strut anchoring mechanism 300 can comprise the same number of flexible anchoring struts 330 as the number of proximal struts 336. For example, where the vortex strut anchoring mechanism 300 has three flexible anchoring struts 330, the mechanism 300 can comprise three proximal struts 336. In some embodiments, each of proximal struts 336 and each of flexible anchoring struts 330 can be connected and can comprise portions of singular strut members. For example, a plurality of singular strut structures can be bundled together between the two ends of each strut structure by a collet.
Wave-Type Anchoring MechanismIn some embodiments, and anchoring mechanism 400 can include struts having a wave-like shape when viewed from a longitudinal cross-sectional view of the lumen.
The hub 420 can connect the plurality of undulating anchoring struts 430 to the center rod 460. For example, the wave-type anchoring mechanism 400 can comprise two undulating anchoring struts 430 connected to the center rod 460 via the hub 420. In some embodiments, the anchoring mechanism 400 includes three or more anchoring struts 430 emanating from the hub 420. The undulating anchoring struts 430 can comprise one or more inflection points and undulation points. For example, as shown in
The anchoring tip 440 can be located proximally to the location of the hub 420 at a distance D1 when the anchoring struts 430 are in a first, less-expanded configuration. For example, the distance between the anchoring tip 440 and the hub 420 in a fully contracted state lumen (
The anchor struts 430 can have non-uniform thickness between the hub 420 and the anchor tips 440. For example, the anchor struts 430 can include a thick portion 433A which can be more rigid than a thinner portion (e.g. having a greater degree of freedom). For example, the thick portion 433A can retain its bent shape while experiencing deflection during expansion of the lumen 410 and/or during settling of the anchoring mechanism 400. The anchoring mechanism 400 can include a thin portion 433B may deflect to a greater degree than the thick portion 433A during expansion of the lumen 410. The thick portion 433A and the thin portion 433B can comprise portions of undulating anchoring strut 430 having different structures and dimensions. For example, the thick portion 433A can comprise a portion of the strut member 430 having a greater thickness along a direction transverse to the longitudinal direction of the lumen 410 while the thin portion 433B comprises a strut portion having a greater thickness along a longitudinal direction of the lumen 410. Such a configuration can be used to allow the thick portion 433A to withstand stress from repeated expansion and contraction motion of the lumen 410.
As shown in
The undulating anchoring struts 430 can comprise struts having different lengths, shapes, points of inflection/undulation, stiffness, etc. For example,
The anchoring tip 440 can be located on the same transverse plane as the hub 420. The anchoring tip 440 can point in a proximal or distal direction. In some embodiments the anchoring tip 440 includes a pad portion configured to limit a depth to which the anchoring tip 440 penetrates the lumens 410. The wave-type anchoring struts 430 can extend radially from the hub 420. For example,
As shown in
The center rod 760 can connect the forceps knob 762 and the distal point 795. For example, the distal point of the struts 730 can be connected to the second hub 722. The proximal portion 734 and the distal portion 732 can comprise two sides of a diamond. The proximal portion 734 and the distal portion 732 can comprise a singular strut member wherein the proximal portion 734 is connected to the first hub 720.
The proximal portion 734 and the distal portion 732 can form an included angle. For example, in a first state (e.g. before settling of the device 700 and/or before expansion of the lumen 710), the proximal portion 734 and the distal portion 732 can form an angle less than about 150 degrees. The proximal portion 734 and the distal portion 732 can form an angle less than about 80 degrees in the original state. The proximal portion 734 and the distal portion 732 can form an angle less than about 60 degrees in the original state. The proximal portion 734 and the distal portion 732 can form an angle less than about 45 degrees in the original state.
The anchoring tip 740 can comprise an anchoring structure. For example, the anchoring tip can comprise a barb, high friction pad, or other structure configured to penetrate and/or frictionally engage with the lumen 710. The anchoring tip 740 can comprise a bi-directional anchoring tip. For example, the anchoring tip 740 can comprise bi-directional tip shown and described in reference to
As shown in
The struts 730 can be configured to expand/contract in a radial direction with limited or no movement of the center rod 760 along a length of the lumen 710. For example, the first hub 720 can be a sliding hub (
In some embodiments the second hub 722 is configured to slide along the center rod 760 (
In some cases, sliding of the first hub 720 or second hub 722 can permit radial expansion and contraction of the struts 730 (e.g., in reaction to inhalation/exhalation and/or settling of the mechanism 700) with little or no movement of the center rod 760 along a length of the lumen 710. Limiting or preventing movement of the center rod 760 along the length of the lumen 710 can facilitate constant or semi-constant positioning of the operative portion 750.
The proximal portion 734 and the distal portion 732 can have approximately equal lengths. In some embodiments, the proximal portion 734 and the distal portion 732 comprise different lengths. The diamond-shaped anchoring mechanism 700 can comprise a telescopically sliding rod. For example, a sliding rod can slidably connect the center rod 760 to the distal point 795. The center rod 760 can comprise a hollow center shaped and sized to accept the sliding rod.
Bowtie-Shaped Anchoring MechanismAs illustrated, the mechanism 800 can include a plurality of bowtie-shaped anchoring struts 830. The struts 830 can be connected to and extend radially from the hub 820. The bowtie-shaped anchoring struts 830 can comprise a plurality of quadrilateral-shaped members. The struts 830 can each comprise a proximal portion 834, a distal portion 832, and anchoring tips 850. The proximal portion 834 can comprise a proximal point 835A. The distal portion 832 can comprise a distal point 835B. The proximal and distal points 835A, 835B can comprise bendable or articulated joints. The bowtie-shaped anchoring struts 800 can be used with an operative portion 825, such as a valve used in a lung airway valve.
The shape of the bowtie-shaped anchoring struts 830 can change during movement of the lumen 815 (e.g., during inhalation/exhalation and/or during settling of the mechanism 800). For example, the distance between axis of the lumen 815 and the anchoring tips 850 can grow larger during expansion of the lumen wall. The proximal point 835A and the distal point 835B can move away from each other during contraction of the lumen 810. The proximal point 835A and the distal point 835B can move closer during expansion of the lumen 810.
In some embodiments, the points 835A, 835B of each strut 830 lie on a plane substantially parallel a longitudinal axis of the lumen 815. In some cases, the points 835A, 835B of each strut 830 lie on a plane substantially perpendicular to the longitudinal axis of the lumen 815. In some embodiments, the points 835A, 835B of each strut 830 lie on planes neither perpendicular nor parallel to the longitudinal axis of the lumen 815. Many variations are possible.
The struts 830 can be configured to expand and/or contract with little or no movement of the hub 820 (e.g., and, consequently, the operative portion 825) along a length of the lumen 815. For example, radial movement of the anchor portions 850 of the struts 830 can occur on a substantially constant plane perpendicular to a length of the lumen 815.
Opposing Anchoring Struts MechanismIn some cases, an anchoring mechanism can include one or more anchors configured to engage with a lumen wall to inhibit or prevent movement of an operative portion of a device in a distal direction. For example, two or more anchoring struts can be used to pinch a portion of the lumen.
In some embodiments, the mechanism 900 includes a plurality of proximal struts 935 extending proximally from the hub 920. The plurality of proximal struts 935 can comprise frame struts of an operative portion 1235 (Shown in
The plurality of distal struts 934 can comprise a strut member comprising one or more bends. For example, as shown in
The hub 920 can comprise a dual-hub configuration, as described above in reference to
The opposing struts 933 can be configured to counteract forces created from movement of the pinch-type anchoring mechanism 900 in a distal direction (e.g., due to settling of the mechanism 900). The distal struts 934 and the opposing struts 933 can be configured for use inside a lumen while minimizing pinching of the lumen. Such configuration can be used, for example, to minimize trauma to the lumen.
The pinching of the distal struts 934 and the opposing struts 933 can cause the wall of the lumen to become pleated (see, e.g.,
The pinch-type anchoring mechanism 900 can be configured to fit inside a delivery catheter. For example, as illustrated in
The distal struts 934 and the opposing struts 933 can comprise struts having different lengths, shapes, points of inflection/undulation, stiffness, etc. For example, the distal struts 934 and the opposing struts 933 can comprise strut members having a curved shape, without bends.
Elongated Distal AnchorsAnchoring mechanisms having elongated strut members can be used to reduce movement of the medical device caused by bodily movements and/or settling of the anchoring mechanism. The degree of movement of a medical device can be less with anchoring mechanisms using longer strut members, compared to mechanisms using shorter strut members. Longer strut members can expand in a large arc, thereby reducing the axial movement of the endoluminal device as the strut members expand to an equilibrium position (e.g., settle).
The elongated anchoring struts 1034 can be configured to reduce or limit the amount of longitudinal movement of a device connected to the hub 1020. The plurality of elongated anchoring struts 1034 can comprise anchoring tips 1040. The anchoring tips 1040 can be in a first location P1 in a fully contracted lumen. The anchoring tips 1040 can be in a second location P2 in a fully expanded state. The anchoring tips 1040 can travel at a longitudinal travel distance D3 between P1 and P2. The longitudinal travel distance D3 can be reduced by having elongated anchoring struts 1040. For example, the longitudinal travel distance D3 can be less than 0.1 mm. The longitudinal travel distance D3 can be less than 0.05 mm. The longitudinal travel distance D3 can be less than 0.02 mm. In some cases, the longitudinal travel distance D3 can be less than 0.01 mm. Many variations are possible.
The elongated anchoring struts 1034 can comprise curved strut members, as shown schematically in
A user may select shape and dimension of the elongated struts anchoring mechanism 1000 based on the lumen 1010. The straight length and the curvature of the elongated anchoring struts 1034 can be adjusted to correspond to lumen size changes. For example, for a lumen that shows little change in size between its fully expanded state and fully contracted state, strut members having a greater degree of curvature, and/or having a shorter straightened length, can be used. A user may also calibrate the distance traveled by the hub 1020 by adjusting the straight length and/or the curvature. The user can limit the amount of longitudinal distance traveled by the hub 1020 to be less than 0.02 mm by selecting struts 1040 having a certain length, for example.
The elongated anchoring struts 1034 can comprise strut members of different lengths and configurations.
As illustrated in
In some embodiments, the distal anchoring tip 1136 can comprise a bi-directional anchoring tip (e.g., as shown in
As seen in
The elongated distal anchoring struts 1134 can comprise a memory shape material. The elongated distal anchoring struts 1134 can change shape in response to electronic actuation, temperature changes, physical manipulation, dimensional changes resulting from releasing the device from a catheter, etc. For example, the elongated distal anchoring struts 1134 in a straightened form as shown in
Bodily movements (e.g., inhalation and/or exhalation, coughing, etc.) can cause a medical device used inside the lumen to move in different directions. Anchoring tips pointing in different directions can anchor a device to counteract such movement of the device.
The first anchoring tip 1335A and the second anchoring tip 1335B can extend from the fork body 1337. The fork body 1337 can connect the first anchoring tip 1335A and the second anchoring tip 1335B to the strut member 1330. In some embodiments, the anchoring tips 1335A, 1335B are formed from introducing a slit to a distal end of the strut member 1330 to split the distal end of the strut member 1330 into two separate portions (e.g., the first and second tips 1335A, 1335B). The first anchoring tip 1335A can extend generally in the same direction as the strut member 1330. For example, the first anchoring tip 1335A can extend in a radial direction from the hub 1375. The second anchoring tip 1335B can comprise a bend. The second anchoring tip 1335B can form an angle with the first anchoring tip 1335A. For example, the second anchoring tip 1335B can bend at about 10 degrees to about 170 degrees from the fork body 1337. The first anchoring tip 1335A and the second anchoring tip 1335B can comprise different tip structures. For example, the first anchoring tip 1335A can comprise a sharp tip structure, such as the tip structure for the first anchoring tip 1335A shown in
The first anchoring tip 1335A can be configured to penetrate the lumen. The second anchoring tip 1335B can be configured to limit depth of penetration by the first anchoring tip 1335A. The second anchoring tip 1335B can point proximally, as shown in
The second anchoring tip 1335B can be located on the strut member 1330, away from the first anchoring tip 1335A. The second anchoring tip 1335B can comprise a sharp-edged bend. The first anchoring tip 1335A can form an angle with the fork body 1337.
Membrane-Frame StrutsAn endoluminal device having a shorter overall axial length can be useful. For example, an endoluminal device with shorter axial length can be used in a short lumen. The shorter axial length of the device can be used where the anchoring portion needs to be close to the operative portion, for example, to avoid anchoring a device on abraded patches of lumen wall. In some cases, use of a shorter device can be beneficial when the device is implanted adjacent an intersection of multiple branches of an airway or other body lumen.
The anchoring struts 1432 can comprise a bent shape having anchoring tips 1440 pointing in a radially-outward direction, as shown in
The anchoring struts 1432 can extend outward from the hub 1475 and bend in a proximal direction as shown in
Positioning the anchoring tips 1440 near the frame strut tips 1436 can reduce movement of the operative portion 1425 when the anchor tips 1440 settle in the walls of the lumen in which the device 1400 is deployed. For example, the anchoring struts 1432 can be configured to limit movement of the operative portion 1435 to be less than about 0.2 mm. The anchoring struts 1432 can be configured to limit movement of the operative portion 1435 to be less than about 0.15 mm. The anchoring struts 1432 can be configured to limit movement of the operative portion 1435 to be less than about 0.05 mm. The anchoring struts 1432 can be configured to limit movement of the operative portion 1435 to be less than about 0.02 mm. The anchoring struts 1432 can be configured to limit movement of the operative portion 1435 to be less than about 0.01 mm.
The anchoring struts 1432 can comprise a plurality of pre-formed bends. In some cases, anchoring struts 1432 can have a curved shape without identifiable bends. The anchoring struts 1432 can have uniform thickness along a length of the struts 1432. In some embodiments, some portion of the struts 1432 is thicker than another portion of the struts 1432. The thick portions can be configured to have less flexibility than thinner portions. For example, the thinner portions can be configured to allow greater bending than the thicker portions.
The endoluminal device 1400 can be transported using a delivery catheter. For example, the interposing anchoring struts 1432 can be folded together with the frame struts 1435 while interposing the frame struts 1435 to fit inside the catheter. The endoluminal device 1400 can be deployed by being pushed out of the catheter. In some embodiments, the endoluminal device 1400 is deployed by withdrawing the catheter from the endoluminal device 1400 when the device 1400 is positioned at the deployment site. The endoluminal device 1400 can be pushed out such that the hub 1475, the anchoring tip 1440, and the membrane strut tips 1432 can leave the catheter sequentially. Once the anchoring tip 1440 leaves the catheter, the anchoring tip 1440 can latch onto the surface of the lumen 1410. A user can pull the catheter away from the frame struts 1435 once the anchoring tip 1440 is latched onto the lumen 1410.
In some embodiments, the anchoring struts 1432 having a pre-formed bent shape can be straightened to extend at a distal direction from the hub 1475 to fit inside and be transported across the catheter. The anchoring struts 1432 can comprise a different number of struts as the number of the frame struts 1435A.
Connecting MemberAnchoring struts can be coupled to an operative portion by an extendable and/or flexible connecting member.
The anchoring portion 1530 can be disposed distally from the operative portion 1535. The anchoring struts 1530 can extend radially from the distal hub 1575B and generally in a distal direction. The frame struts 1535A can comprise a bent surface 938 (as shown in
In a first configuration shown in FIG. ISA, the connecting member 1560 can contract to bring the operative portion 1535 and the anchoring portion 1530 close together. In a second configuration shown in
The connecting member 1560 can be extended and/or contracted in response to change in lumen dimension. The connecting member 1560 can be sufficiently elastic to allow axial movement of the anchoring portion 1530 without displacing the operative portion 1535. In some embodiments, the anchoring portion 1530 can move away from the operative portion 1535, as the anchor struts 1532 and lumen walls 1515 expand outward. In some cases, movement of the anchoring portion 1530 away from the operative portion 1535 can be accomplished with little or no movement of the operative portion 1535 toward the anchoring portion 1530.
The connecting member 1560 can comprise a tensile strength sufficient to hold the operative portion 1535 in place, regardless of change in lumen 1510 dimension. For example, the connecting member 1560 can be configured to counteract the contraction of the lumen 1510, such that while the connecting mechanism 1560 initially extends during lumen contraction, the strength of the connecting mechanism 1560 can spring back to its original length and re-expand the lumen 1510. The spring portion 1560 can comprise an elastic structure, such as an elastomer. For example, the spring portion 1560 can comprise synthetic rubber, silicone, etc.
Connecting Member in Bifurcating LumenThe endoluminal device 1500 can be used in bifurcating lumen, such as bifurcating airways. The extendable connecting member 1560 can be used in airways having small diameters.
The connecting portion 1560 can elastically extend to allow the operative portion 1535 to move proximally while the first lumen 1615A contracts. The connecting portion 1560 can pull the operative portion 1535 distally as the first lumen 1615A expands. The elastic extension and the pulling of the connecting portion can apply a sufficient counter force to keep the endoluminal device 1500 seated inside the airway, without causing the anchoring mechanism to be removed from its position. The distance which the connecting portion 1560 can extend can be determined by the angle of the cone of the valve portion and the diameter of the airway wall that the operative portion 1535 covers.
The struts 1535A in the operative portion 1535 can rest against an opening of the first lumen 1615A and into a larger lumen 1605 to counteract pulling from the anchoring portion 1530 as shown in
The operative portion 1535, while suited for a larger airway, can be used in a smaller airway with an opening to a larger airway. As shown in
Although these inventions have been disclosed in the context of certain preferred embodiments and examples, it will be understood by those skilled in the art that the present inventions extend beyond the specifically disclosed embodiments to other alternative embodiments and/or uses of the inventions and obvious modifications and equivalents thereof. In addition, while several variations of the inventions have been shown and described in detail, other modifications, which are within the scope of these inventions, will be readily apparent to those of skill in the art based upon this disclosure. It is also contemplated that various combinations or sub-combinations of the specific features and aspects of the embodiments can be made and still fall within the scope of the inventions. It should be understood that various features and aspects of the disclosed embodiments can be combined with or substituted for one another in order to form varying modes of the disclosed inventions. Thus, it is intended that the scope of at least some of the present inventions herein disclosed should not be limited by the particular disclosed embodiments described above.
Claims
1. A mechanism for anchoring endoluminal devices to a lumen, the mechanism comprising:
- a hub member configured to be located at a predetermined location inside the lumen; and
- a plurality of anchoring struts, the plurality of anchoring struts comprising:
- a spring portion attached to the hub member and configured to extend or contract during expansion and contraction of the lumen; and
- an anchoring portion connecting the spring portion to the lumen, the anchoring portion configured to penetrate a portion of the lumen;
- wherein the hub member is positioned on a plane with the anchoring portions of the plurality of anchoring struts.
2. The mechanism of claim 1, wherein the anchoring portion comprises a bidirectional anchoring tip comprising a first tip pointed to a first direction and a second tip pointed to a second direction at an angle from the first direction, wherein at least a portion of the first tip penetrates the lumen in a transverse direction to the lumen.
3. The mechanism of claim 1, wherein each of the plurality of anchoring struts comprise equal lengths.
4. The mechanism of claim 1, wherein each of the spring portions of the plurality of anchoring struts extends radially outward from the hub member.
5. The mechanism of claim 1, wherein each of the spring portion of the plurality of anchoring struts comprise a helically coiled spring.
6. The mechanism of claim 1, wherein each of the spring portion of the plurality of anchoring struts comprise bent strut members configured to straighten during expansion of the lumen and bend during contraction of the lumen.
7. The mechanism of claim 6, wherein the bent strut members comprise a vortex shape when viewed along a longitudinal axis of the lumen.
8. The mechanism of claim 6, wherein the bent strut members comprise a spiral shape when viewed along a longitudinal axis of the lumen.
9. The mechanism of claim 6, wherein each of the bent strut members comprise undulating strut members having a substantially straight shape when viewed in a transverse direction.
10. The mechanism of claim 6, wherein the bent strut members comprise one or more thin portions and one or more thick portions thicker than the thin portions.
11. The mechanism of claim 1, wherein the hub member comprises a first hub and a second hub collinear and connected to the first hub, wherein the plurality of anchoring struts are connected to the first hub.
12. An endoluminal device comprising:
- an operative portion configured to obstruct fluid flow inside the lumen;
- a hub member, the hub member connected to the operative portion and comprising a hub and a centering rod; and
- a plurality of anchoring struts, the plurality of anchoring struts comprising: a strut portion attached to the hub member and configured to expand and contract in response to expansion and contraction of the lumen; and an anchoring portion connecting the deflectable portion to the lumen;
- wherein the hub member substantially remains on or near an axial line of the lumen during movement of the lumen.
13. The device of claim 12, wherein the strut portion is connected to a sliding hub configured to slide along a length of the centering rod.
14. The device of claim 12, wherein the plurality of anchoring struts comprise a plurality of quadrilateral-shaped members.
15. The device of claim 14, wherein each of the quadrilateral-shaped members lies on a separate plane parallel to a longitudinal axis of the device.
16. A mechanism for anchoring endoluminal devices to a lumen, the mechanism comprising:
- a hub member;
- a plurality of distal anchoring struts connected to the hub member and extending radially and distally from the hub member and bending in a proximal direction, each of the plurality of distal anchoring struts comprising anchoring tips; and
- a plurality of opposing anchor struts connected to the hub member and extending proximally and radially from the hub member and bending in a distal direction, each of the plurality of opposing anchor struts comprising opposing anchor tips;
- wherein the distal anchoring struts and the opposing anchoring struts are configured to pinch a portion of the lumen.
17. (canceled)
18. (canceled)
Type: Application
Filed: Mar 30, 2015
Publication Date: Jun 22, 2017
Applicant: Spiration, Inc. d.b.a. Olympus Respiratory America (Redmond, WA)
Inventors: David H. Dillard (Grapeview, WA), Timothy J. Johnson (Kent, WA), Brandon James Shuman (Kirkland, WA), Jean-Martin Baillargeon (Seattle, WA), Lisa Lauer (Seattle, WA)
Application Number: 15/300,687