Granted Patent B2

US 12,708,503 · App. 18/046,376 · Granted Aug 18, 2026

Inventors: Robert Julian Dickinson (London, GB); Roberto Ferraresi (Milan, IT); Steven Kum (Singapore, SG); Timothy Lenihan (Hradec Kralove, CZ); Andrew Robert Pacey (Stevenage, GB); Martin Terry Rothman (Santa Rosa, CA)

Assignee: LimFlow GmbH

A61F2/07A61B8/0841A61B8/12A61B17/11A61B17/22A61B17/3478A61B18/245A61F2/064A61F2/844A61F2/90A61F2/95A61F2/958A61M27/002A61B2017/00252A61B2017/1103A61B2017/1107A61B2017/1139A61B2017/22095A61B2017/22097A61B18/1492A61B2034/2063A61F2002/068A61F2/915A61F2/962A61F2230/0067A61F2230/0069A61F2250/001A61F2250/0017A61F2250/0029A61F2250/0031A61F2250/0039

Abstract

Claims (51)

1 . A method of targeting a second passage to effect retroperfusion in the second passage, the method comprising:

expanding an expandable device in the second passage;

advancing a needle into the second passage to form a fistula between a first passage and the second passage, wherein, after advancing the needle, a first portion of the needle is in the first passage, a second portion of the needle is in the second passage, and a third portion of the needle is in the fistula;

advancing a guidewire through the needle into the expandable device;

closing the expandable device to grip the guidewire; and

making a valve in the second passage incompetent to reduce inhibition of retroperfusion through the second passage by the valve.

2 . The method of claim 1 , wherein the first passage comprises a tibial artery, and wherein the second passage comprises a tibial vein.

3 . The method of claim 1 , wherein expanding the expandable device comprises permitting the expandable device to self-expand.

4 . The method of claim 1 , wherein making the valve in the second passage incompetent comprises advancing a valvulotome in the second passage in a direction opposite native fluid flow.

5 . The method of claim 1 , further comprising:

injecting contrast in the second passage; and

monitoring the contrast using fluoroscopy,

wherein disturbance of the contrast attributable to the needle advancing into the second passage confirms advancement of the needle into the second passage.

6 . The method of claim 1 , wherein the expandable device comprises a mesh.

7 . The method of claim 6 , further comprising:

pulling the guidewire in a direction opposite native fluid flow in the second passage,

wherein the first passage comprises a tibial artery, and

wherein the second passage comprises a tibial vein.

8 . A method of targeting a second passage to effect retroperfusion in the second passage, the method comprising:

expanding an expandable device in the second passage, the expandable device comprising radiopaque material visible under fluoroscopy;

advancing a needle into the second passage to form a fistula between a first passage and the second passage,

wherein advancing the needle comprises:

targeting the expandable device under fluoroscopy; and

monitoring the needle to confirm advancement of the needle into the second passage;

making a valve in the second passage incompetent to reduce inhibition of retroperfusion through the second passage by the valve;

advancing a guidewire through the needle into the expandable device; and

closing the expandable device to grip the guidewire.

9 . The method of claim 8 , wherein the first passage comprises a tibial artery, and wherein the second passage comprises a tibial vein.

10 . The method of claim 8 , wherein making the valve in the second passage incompetent comprises advancing a valvulotome in the second passage in a direction opposite native fluid flow.

11 . The method of claim 8 , further comprising injecting contrast in the second passage, wherein monitoring the needle to confirm advancement comprises:

monitoring the contrast using fluoroscopy, and

monitoring disturbance of the contrast attributable to the needle advancing into the second passage.

12 . The method of claim 8 , wherein the expandable device comprises a mesh.

13 . The method of claim 12 , wherein the first passage comprises a tibial artery, and wherein the second passage comprises a tibial vein.

14 . A method of targeting a second passage to effect retroperfusion in the second passage, the method comprising:

inserting an expandable device in the second passage;

advancing a needle into the second passage to form a fistula between a first passage and the second passage, wherein advancing the needle comprises targeting the expandable device;

monitoring the expandable device as the needle is advanced towards the expandable device to confirm advancement of the needle into the second passage;

making a valve in the second passage incompetent to reduce inhibition of retroperfusion through the second passage by the valve;

advancing a guidewire through the needle into the expandable device; and

closing the expandable device to grip the guidewire.

15 . The method of claim 14 , wherein the first passage comprises a tibial artery, and wherein the second passage comprises a tibial vein.

16 . The method of claim 14 , wherein making the valve in the second passage incompetent comprises using a cutting balloon or valvulotome.

17 . The method of claim 14 , wherein the expandable device comprises radiopaque material.

18 . The method of claim 14 , further comprising:

orienting the needle towards the expandable device;

injecting contrast in the second passage; and

monitoring the contrast,

wherein disturbance of the contrast attributable to the needle advancing into the second passage confirms advancement of the needle into the second passage.

19 . The method of claim 14 , wherein the expandable device comprises a mesh.

20 . The method of claim 19 , wherein the first passage comprises a tibial artery, and wherein the second passage comprises a tibial vein.

Assignments (2)

Continuity (10)

References Cited (400)