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    • 44. 发明申请
    • Method and apparatus for percutaneous wound sealing
    • 用于经皮伤口密封的方法和装置
    • US20080046005A1
    • 2008-02-21
    • US11880591
    • 2007-07-23
    • Jay LenkerWilliam Mezger
    • Jay LenkerWilliam Mezger
    • A61B17/03
    • A61B17/0057A61B17/00491A61B2017/00495A61B2017/00637A61B2017/0065A61B2017/00672
    • Devices and methods are disclosed for achieving hemostasis at a wound site following an endovascular procedure. Such wound sealing is necessary generally following a percutaneous procedure where a percutaneous cannula is withdrawn from the vasculature leaving an entry site to the vessel that could bleed if steps are not taken to stop said bleeding. The devices and methods disclosed herein are especially useful in the catheterization laboratory following interventional cardiology or interventional neuroradiology procedures. The devices utilize the introduction sheath that was originally used for the procedure as a guide for the closure. The closure device is inserted through the introduction sheath once any therapeutic or diagnostic devices have been removed. The closure device comprises a two-part sealing material housed in a reservoir system, a mixing chamber, a delivery cannula, exit ports, and a vessel location device. The sealing material generally comprises materials such as albumin and polyethylene glycol, or the like. The sealing device works in conjunction with the already placed sheath to eliminate the step of replacing said sheath, an action that increases procedural time and may contribute to further wound damage and reduced sealing effectiveness.
    • 公开了用于在血管内手术后在伤口部位止血的装置和方法。 这种伤口密封通常需要经皮操作,其中经皮插管从脉管系统中取出,留下进入血管的进入部位,如果不采取步骤来停止所述出血,则可能出血。 本文公开的装置和方法在介入心脏病学或介入性神经放射学程序之后在导管实验室中特别有用。 这些装置使用最初用于该过程的引入护套作为关闭的指导。 一旦任何治疗或诊断装置被去除,封闭装置就插入导入鞘中。 闭合装置包括容纳在储存器系统中的两部分密封材料,混合室,输送套管,出口和容器定位装置。 密封材料通常包括诸如白蛋白和聚乙二醇的材料等。 密封装置与已经放置的护套一起工作以消除更换所述护套的步骤,增加程序时间的作用并且可能有助于进一步的伤口损伤和降低的密封效果。
    • 45. 发明申请
    • Method and apparatus for solid organ tissue approximation
    • 用于实体器官组织近似的方法和装置
    • US20070255315A1
    • 2007-11-01
    • US11821323
    • 2007-06-23
    • Robert BuckmanJay Lenker
    • Robert BuckmanJay Lenker
    • A61B17/08
    • A61B17/08A61B6/12A61B6/485A61B2017/081A61B2017/088
    • Devices and methods are disclosed for achieving hemostasis in solid visceral wounds. Such devices and methods are especially useful in the emergency, trauma surgery or military setting. In such cases, the patient may have received trauma to the abdominal viscera. The devices utilize flexible, variable depth transfixing bolts that penetrate the viscera. These bolts are pulled tight to bring the tissue into apposition and hold said tissue in apposition while the wound heals. These bolts, or soft tissue rivets, overcome the limitations of sutures that are currently used for the same purposes. The bolts come in a variety of lengths and diameters. Since the bolts are flexible, the curvature can be adjusted by the surgeon. The devices are flexible, bendable, and conformable in their wet or dry state. They can be used either straight or configured in a broad range of curvatures to suit the needs of various pathologies. The bolts include pressure plates that are capable of exerting compressive pressure over broad areas of visceral wounds without causing tearing of the friable parenchyma. The bolts may be placed and removed by open surgery or laparoscopic access. The bolts can be placed into tissue where both sides of the bolt are exposed, or the bolts can be placed blindly into tissue where the bolt does not protrude out of the tissue at its distal end.
    • 公开了用于实现固体内脏伤口止血的装置和方法。 这种装置和方法在紧急,创伤手术或军事设置中特别有用。 在这种情况下,患者可能已经接受了腹部内脏的创伤。 这些装置使用穿透内脏的灵活,可变深度的穿透螺栓。 这些螺栓被拉紧以使组织并入并且在伤口愈合时保持所述组织。 这些螺栓或软组织铆钉克服了当前用于相同目的的缝合线的限制。 螺栓具有各种长度和直径。 由于螺栓是柔性的,因此外科医生可以调整曲率。 这些装置在湿或干态下是柔性的,可弯曲的和适应的。 它们可以直接使用或配置在广泛的曲率范围内,以适应各种病态的需要。 这些螺栓包括能够在宽范围的内脏伤口施加压力而不会导致脆性薄壁撕裂的压力板。 螺栓可以通过开放手术或腹腔镜进入来放置和移除。 螺栓可以放置在组织中,螺栓的两侧被暴露,或者螺栓可以盲目地放置在组织中,其中螺栓不在其远端处从组织突出。
    • 46. 发明申请
    • Method and apparatus for vascular and visceral clipping
    • 血管和内脏剪切的方法和装置
    • US20050251183A1
    • 2005-11-10
    • US10663038
    • 2003-09-15
    • Robert BuckmanJay LenkerDonald Kolehmainen
    • Robert BuckmanJay LenkerDonald Kolehmainen
    • A61B20060101A61B17/08A61B17/10A61B17/12A61B17/122A61B17/128
    • A61B17/083A61B17/08A61B17/10A61B17/122A61B17/1227A61B17/128A61B2017/12004Y10T24/44376
    • Devices and methods for achieving hemostasis and leakage control in hollow body vessels such as the small and large intestines, arteries and veins as well as ducts leading to the gall bladder and other organs. The devices and methods disclosed herein are especially useful in the emergency, trauma surgery or military setting, and most especially during damage control procedures. In such cases, the patient may have received trauma to the abdomen, extremities, neck or thoracic region. The devices utilize removable or permanently implanted, broad, soft, parallel jaw clips with minimal projections to maintain vessel contents without damage to the tissue comprising the vessel. These clips are applied using either standard instruments or custom devices that are subsequently removed leaving the clips implanted, on a temporary or permanent basis, to provide for hemostasis or leakage prevention, or both. These clips overcome the limitations of clips and sutures that are currently used for the same purposes. The clips come in a variety of shapes and sizes. The clips may be placed and removed by open surgery or laparoscopic access.
    • 用于在诸如小肠和大肠,动脉和静脉的中空体血管以及通向胆囊和其他器官的导管中实现止血和泄漏控制的装置和方法。 本文公开的装置和方法在紧急,创伤手术或军事设置中尤其有用,并且尤其是在损伤控制程序期间。 在这种情况下,患者可能已经受到腹部,四肢,颈部或胸部区域的创伤。 这些装置利用具有最小突起的可移除或永久植入的,宽的,柔软的平行颚夹,以维持血管内容物,而不损伤包含血管的组织。 这些夹子使用标准仪器或定制设备进行应用,随后移除,临时或永久地植入夹子,以提供止血或防漏,或两者兼有。 这些剪辑克服了目前用于相同目的的剪辑和缝合线的限制。 夹子有各种形状和尺寸。 夹子可以通过开放手术或腹腔镜手术进行放置和移除。
    • 47. 发明申请
    • Expandable medical access device
    • 可扩展医疗接入设备
    • US20050209627A1
    • 2005-09-22
    • US10841965
    • 2004-05-07
    • George KickJay Lenker
    • George KickJay Lenker
    • A61B17/22A61B17/34A61B19/00A61M29/00
    • A61B17/22A61B90/361A61B2017/22069A61B2017/22072A61B2017/3488A61M29/02
    • In one embodiment, an access sheath includes a movable coil sheath that is insertable into a patient through an endoluminal or surgical approach. The sheath is inserted into a patient in a flattened configuration. A plurality of separate coils, elements, or hoops are connected by a fixed member and a control member, which are moved relative to each other to flatten the coils or hoops. Once inserted and advanced to the target surgical site, the sheath is selectively, and controllably, unflattened or expanded to a desired diameter or cross-section. A control member is affixed to one edge of the sheath and runs in the axial direction. By translating the control member in a direction parallel to the axis of the sheath, the operator causes the hoops or coils to rotate into a plane perpendicular or lateral to the axis of the sheath. A mechanical lock at the proximal end of the sheath permits the control member to be selectively constrained from translation and thus lock the sheath diameter in place.
    • 在一个实施例中,进入护套包括可移动线圈护套,其通过腔内或手术方法可插入患者体内。 护套以扁平结构插入患者体内。 多个单独的线圈,元件或箍通过固定构件和控制构件连接,所述固定构件和控制构件相对于彼此移动以使线圈或箍平坦化。 一旦插入并推进到目标手术部位,护套被选择性地且可控地不平坦化或膨胀到期望的直径或横截面。 控制构件固定在护套的一个边缘上并在轴向方向上延伸。 通过将控制构件平行于护套的轴线平移,操作者使环或线圈旋转成与护套的轴线垂直或横向的平面。 在护套的近端处的机械锁允许控制构件被选择性地受到平移的约束,从而将护套直径锁定在适当的位置。
    • 50. 发明申请
    • Methods, materials and apparatus for deterring or preventing endoleaks following endovascular graft implantation
    • 用于阻止或防止血管内移植物植入后的内漏的方法,材料和装置
    • US20050004660A1
    • 2005-01-06
    • US10726135
    • 2003-12-01
    • Robert RosenbluthBrian CoxJay Lenker
    • Robert RosenbluthBrian CoxJay Lenker
    • A61B17/00A61B17/12A61F2/06A61F2/82A61L27/00A61L29/00
    • A61B17/12022A61B17/12118A61B17/12145A61B17/1215A61B17/12163A61B17/12186A61B17/1219A61B17/12195A61B2017/1205A61F2/07A61F2002/077
    • Methods and apparatus for treating or preventing endoleaks after an endovascular graft (e.g., a stent, tubular graft, stent-graft, coated stent, covered stent, intravascular flow modifier or other endovascular implant that affects, limits or prevents blood flow into a vascular defect such as an aneurysm, arterio-venous fistula, arterio-venous malformation, vessel wall perforation, etc.) has been implanted in the vasculature of a human or veterinary patient. An expansile polymeric material, such as a swellable polymer (e.g., a hydrogel), a flexible or elastomeric polymer foam (e.g. silicone, polyurethane, etc.) or a carrier member (e.g, a coil, filament, wire, etc) that carries a quantity of such expansile polymer is delivered into a perigraft space (i.e., space between the endovascular graft and the surrounding blood vessel wall) such that the polymeric material expands in situ to substantially fill the perigraft space or a portion thereof. The expansile polymeric material is delivered into he perigraft space through a catheter and/or cannula that is placed prior to, during or after the implantation of the endovascular graft. The invention includes an injector apparatus that is useable to deliver the expansile polymeric material through the wall of a previously implanted graft. After delivery into the perigraft space, the expanded polymeric material expands so as to fill all or an intended portion of the perigraft space in a manner that substantially prevents additional blood from leaking or flowing into such perigraft space. One type of blood-absorbing, porous, expansile polymeric material useable in this invention is a super-expansile hydrogel.
    • 用于治疗或预防血管内移植物(例如,支架,管状移植物,支架移植物,涂层支架,覆膜支架,血管内流动改性剂或影响,限制或防止血液流入血管缺损的其他血管内植入物)中的内漏的方法和装置 例如动脉瘤,动静脉瘘,动静脉畸形,血管壁穿孔等)已被植入人或兽医患者的脉管系统中。 膨胀聚合物材料,例如可溶胀聚合物(例如,水凝胶),柔性或弹性聚合物泡沫(例如硅树脂,聚氨酯等)或载体(例如,线圈,长丝,电线等),其携带 一定数量的这种膨胀聚合物被输送到一个过端口空间(即,血管内移植物和周围的血管壁之间的空间),使得聚合物材料在现场扩张,以基本上填充周围移植物空间或其一部分。 通过在血管内移植物植入之前,期间或之后放置的导管和/或插管,将可膨胀的聚合物材料输送到他的围手术处。 本发明包括一种可用于通过先前植入的移植物的壁递送可膨胀聚合材料的注射器装置。 在递送到周边区域之后,膨胀的聚合物材料膨胀,以便充分填充所述全部或预期部分的过孔面积,以便基本上防止额外的血液泄漏或流入这种周边空间。 可用于本发明的一种类型的吸收,多孔,可膨胀的聚合物材料是超膨胀水凝胶。