Endovascular aneurysm repair system
Method and apparatus for implanting radially expandable prostheses in the body lumens rely on tacking or anchoring of the prostheses with separately introduced fasteners. The prostheses may be self-expanding or balloon expandable. After initial placement, a fastener applier system is introduced within the expanded prostheses to deploy a plurality of fasteners at least one prosthesis end, usually as each end of the prosthesis. The fasteners are usually helical fasteners which are delivered from a helical track in the fastener applier by rotation with a rotator wire. The fasteners will be applied singly, typically in circumferentially spaced-apart patterns about the interior of each end of the prosthesis.
1. A system comprising:
an intraluminal directing device sized and configured for introduction from a remote access site to a location within a blood vessel lumen, the intraluminal directing device including a deflectable distal region sized and configured for manipulation to orient the distal region with respect to different desired fastening sites within the blood vessel lumen;
a single helical tissue-piercing fastener having a proximal diagonal component extending across the diameter of the helical tissue-piercing fastener; and
an intraluminal fastener applier including a driven component, a distal end of the intraluminal fastener applier comprising a lumen configured to receive the helical tissue-piercing fastener, the intraluminal fastener applier having internal helical grooves positioned along the entire length of the helical tissue-piercing fastener, the distal end of the driven component comprising a fastener driver, a first portion of which is positioned proximal to and immediately adjacent the helical grooves and the helical tissue-piercing fastener and is sized such that the helical tissue-piercing fastener cannot move proximally past the fastener driver within the lumen of the intraluminal fastener applier and a second portion of which is configured to engage the proximal diagonal component of the tissue-piercing fastener, the driven component being rotatable within the lumen to cause the helical tissue-piercing fastener to rotate along the internal helical grooves of the lumen and out of the distal end of the intraluminal fastener applier, and the intraluminal fastener applier being sized and configured to be introduced along the intraluminal directing device.
2. A system according to claim 1 wherein a desired plurality of tissue-piercing fasteners are introduced one fastener at a time in a circumferentially spaced-apart pattern at the different desired fastening sites within the blood vessel lumen.
3. A system according to claim 1 wherein the intraluminal directing device is sized and configured for rotation in concert with deflecting the distal region.
4. A system according to claim 1 wherein the intraluminal directing device includes a passage accommodating the intraluminal fastener applier.
5. A system comprising:
a prosthesis sized and configured for deployment within a blood vessel lumen,
an intraluminal directing device sized and configured for introduction from a remote access site to a location within the prosthesis, the intraluminal directing device including a deflectable distal region sized and configured for manipulation to orient the distal region with respect to different desired fastening sites to secure the prosthesis within the blood vessel lumen;
a single helical tissue-piercing fastener having a proximal diagonal component extending across the diameter of the helical tissue-piercing fastener; and
an intraluminal fastener applier including a driven component, a distal end of the intraluminal fastener applier comprising a lumen configured to receive the helical tissue-piercing fastener, the intraluminal fastener applier having internal helical grooves positioned along the entire length of the helical tissue-piercing fastener, the distal end of the driven component comprising a fastener driver, a first portion of which is positioned proximal to and immediately adjacent the helical grooves and the helical tissue-piercing fastener and is sized such that the helical tissue-piercing fastener cannot move proximally past the fastener driver within the lumen of the intraluminal fastener applier and a second portion of which is configured to engage the proximal diagonal component of the tissue-piercing fastener, the driven component being rotatable within the lumen to cause the helical tissue-piercing fastener to rotate along the internal helical grooves of the lumen and out of the distal end of the intraluminal fastener applier, and the intraluminal fastener applier being sized and configured to be introduced along the intraluminal directing device.
6. A system according to claim 5 wherein a desired plurality of tissue-piercing fasteners are introduced one fastener at a time in a circumferentially spaced-apart pattern at the different desired fastening sites to secure the prosthesis to the blood vessel lumen.
7. A system according to claim 5 wherein the intraluminal directing device is sized and configured for rotation in concert with deflecting the distal region.
8. A system according to claim 5 wherein the intraluminal directing device includes a passage accommodating the intraluminal fastener applier.
9. The system according to claim 1 , wherein the fastener driver comprises:
the second portion extending distally from the first portion, wherein the second portion is configured to be received within at least a portion of the helical tissue-piercing fastener.
10. The system according to claim 9 ,
wherein a proximal end of the helical tissue-piercing fastener comprises the proximal diagonal component, and
wherein the second portion of the fastener driver is configured to engage the proximal diagonal component to drive the helical tissue-piercing fastener out of the distal end of the intraluminal fastener applier.
11. The system according to claim 5 , wherein the fastener driver comprises:
the second portion extending distally from the first portion, wherein the second portion is configured to be received within at least a portion of the helical tissue-piercing fastener.
12. The system according to claim 5 ,
wherein a proximal end of the helical tissue-piercing fastener comprises the proximal diagonal component, and
wherein the second portion of the fastener driver is configured to engage the proximal diagonal component to cause the helical tissue-piercing fastener to rotate along the internal helical grooves of the lumen and out of the distal end of the intraluminal fastener applier.