|Publication number||US3837345 A|
|Publication date||Sep 24, 1974|
|Filing date||Aug 31, 1973|
|Priority date||Aug 31, 1973|
|Publication number||US 3837345 A, US 3837345A, US-A-3837345, US3837345 A, US3837345A|
|Original Assignee||A Matar|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (6), Referenced by (158), Classifications (11) |
|External Links: USPTO, USPTO Assignment, Espacenet|
Venous valve snipper
US 3837345 A
A cylindrical catheter-type instrument has a tubular member slidable lengthwise relative to a distal head member. The instrument may be inserted in the distal end of a vein in closed position causing it to pass through the venous valves in the direction of normal blood flow. When the instrument is partially withdrawn in open position the venous valve leaflets protrude into a gap between the tubular and head members and become impaled on spikes in the head member. Then the tubular member is closed on the head member causing an annular cutting blade on the tubular member to snip off the valve leaflets. Opening and closing of the head and tubular members is accomplished by a scissors-type handle connected to the two parts.
1Jnited States Patent 1 1 Matar VENOUS VALVE SNIIPER Adel F. Matar, 4226 SW. Downsview Ct., Portland, Oreg. 97205 221' Filed: Aug. 31, 1973 1211 Appl. No.: 393,653
1451 Sept. 24, 1974 Primary Examiner-Channing L. Pace Attorney, Agent, or FirmLee R. Schermerhorn [5 7] ABSTRACT A cylindrical catheter-type instrument has a tubular member slidable lengthwise relative to a distal head member. The instrument may be inserted in the distal end of a vein in closed position causing it to pass through the venous valves in the direction of normal blood flow. When the instrument is partially withdrawn in open position the venous valve leaflets protrude into a gap between the tubular and head members and become impaled on spikes in the head member. Then the tubular member is closed on the head member causing an annular cutting blade on the tubu lar member to snip off the valve leaflets. Opening and closing of the head and tubular members is accomplished by a scissors-type handle connected to the two parts.
1,160,573 1/1964 Germanym 67,204 6/1969 E Germany 128/2 B 7 Clam, 5 Drawmg F'gures 1 l l a VENOUS VALVE SNIPPER BACKGROUND OF THE INVENTION This invention relates to an instrument for removing the venous valves from veins.
In utilizing vein grafts to bypass blocked arteries, the standard procedure is to reverse the vein in order to avoid obstruction to the blood flow by the valves in the vein. However, in reversing the vein the arterial flow through the graft then proceeds from the narrow end to the wider end. This produces undesirable flow characteristics including turbulence which is believed to be one of the causes of development of intimal hyperplastia reported after such operations.
By excising the valves it is possible to place the vein with the wider end toward the inflow anastomosis and the narrower end toward the outflow anastomosis. This achieves better flow characteristics and reduces the possibility of stasis in the vein graft which sometimes predisposes to thrombosis. It is also often desirable to remove the venous valves while the vein remains in situ, obviating the necessity to dissect'the vein out. This reduces the operative time significantly in appropriate situations.
Objects of the invention are, therefore, to provide an instrument for excising venous valves safely and without damage to the vein wall, to provide an instrument for this purpose which can be used after the vein is dissected out or while the vein still remains in situ, and to provide an instrument of the type described having a disposable part which does not have to be cleaned and sterilized after use.
SUMMARY OF THE INVENTION The present instrument consists of a disposable part and a permanent or re-usable part. The utilization of a disposable part insures good functioning of the instrument every time it is used. The disposable part comprises a flexible tubular portion having an annular cutting blade which may be closed and opened toward and away from a rounded metal head. The permanent part comprises a scissors-type handle which may be detachably connected with the disposable part to accomplish the cutting action.
The instrument is introduced in closed position into the distal end of a vein in the direction of blood flow and is therefore easily maneuvered past all of the venous valves. The instrument is then placed in the open position, leaving a gap between the head and the cutting blade on the tubular portion. By partially withdrawing the instrument in open position, sharp spikes in the head portion spear and impale the venous valve leaflets which protrude into the gap. Closing of the tubular portion and blade against the head cleanly excises the valvev leaflets without damaging the vein wall.
Then the insrument is withdrawn to the next valve and the above manipulations repeated. When the instrument is finally withdrawn from the vein, it contains all the excised valve leaflets impaled on the spikes in the head portion. The vein is then capable of conveying a flow of blood in the reverse direction, i.e., from the wider end to the narrower end.
The invention will be better understood and additional objects and advantages will become apparent from the following description of the preferred embodiment illustrated on the accompanying drawing. Various changes may be made, however, in the details of construction and arrangement of parts and certain features may be used without others. All such modifications 'within the scope of the appended claims are included in the invention.
BRIEF DESCRIPTION OF THE DRAWING FIG. 1 is an elevation view with parts broken away and parts in section, showing an instrument embodying the invention in open position;
FIG. 2 is an enlarged longitudinal sectional view of a portion of FIG. 1;
FIG. 3 is a view on the line 3-3 in FIG. 2;
FIG. 4 is a longitudinal sectional view of a vein, showing how the instrument is introduced into the vein; and
FIG. 5 is a view similar to FIG. 3, showing the operation of the instrument.
I DESCRIPTION OF THE PREFERRED EMBODIMENT The instrument comprises a flexible catheter tube A of suitable plastic material such as Teflon, a highly polished and rounded metal head B and a manipulating handle C. A metal collar or cap is fixedly mounted on the proximal end of tube A and a sharpened annular metal cutting blade 11 is fixedly mounted on the distal end of the tube. The tube contains a lumen or bore 12.
The proximal end of head B is cylindrical and its wall section is notched or recessed at 13 forming an anvil to guide and receive the sharpened cutting edge of blade 11. A transverse wall 14 in the head B has a central threaded opening to receive the threaded distal end 15 of a flexible metal core rod or wire which is slidable longitudinally in the lumen 12. The proximal end 21 of the core rod is also threaded.
Four spikes or prongs 22 having sharpened ends are mounted on a nut or collar 23 which is fixedly secured to the rod 20. Spikes 22 extend divergently in a proximal direction slightly beyond the end 13 of head B, the sharpened ends of the spikes being within the diameter of blade 11 so that the blade will reciprocate freely past the ends of the spikes without interference.
Handle C has a forceps or scissors action comprising a pair of levers and 31 pivotally connected together at 32. Lever 31 has a link 33 pivotally connected therewith at 34. A circular clamp 35 is pivotally connected at 36 with link 33. Clamp 35 may be tightened on collar 10 by means of clamp screw 37.
Lever 30 contains a smooth bore at 38 to slidably receive the rod 20. Proximal end 21 of rod 20 is threaded through a cylindrical nut 40. Nut 40 has a peripheral groove 41 which receives projections 42 on a retainer 43 mounted on handle lever 30.
Thus, the handle C is adapted to reciprocate tube A and blade 11 relative to head B. Nut 40 provides means for adjustment of head B relative to tube A and handle C. Tube A and core rod 20 may be made to different lengths as desired and tube A and head B may be made in different diameters, the outside diameter of collar 10 being uniform in all cases to fit the clamp 35 which is a part of the handle C. Tube A and head B with its core rod 20 and spikes 22 are preferably made as disposable parts while handle C is a re-usable or permanent part.
FIGS. 4 and 5 illustrate the operation of the instrument. With tube A and head B closed together, these parts are introduced from the distal end of the vein V in the direction of venous blood flow and passed through the valve leaflets L as shown in FIG. 4. Depending on the length of the vein, the instrument may have to pass through a number of such valves. When head B has passed through all the valves in the vein segment which is being treated, the instrument is then placed in opened position as shown in FIG. 2, leaving a gap between cutter blade 11 and head B.
When the instrument is slightly withdrawn in the open position, the valve leaflets L enter the gap between cutter blade 11 and head B and become impaled on spikes 22 as shown in FIG. 5. This will impose a resistance to further withdrawal of the instrument which will be felt by the operator. The instrument is then closed, causing cutter blade 11 to move against the anvil l3 and excise the valve leaflets. The cutting action leaves the valve leaflets impaled on the spikes in the head with the spikes protruding through the upstream sides of the leaflets.
When the first pair of valve leaflets has been excised as described, it will then be possible to withdraw the instrument further. Then the instrument is re-opened and the procedure is repeated at the next valve. After all the valves have been excised, the instrument is withdrawn from the distal end of the vein with all the excised valve leaflets speared on the spikes 22 and contained in the hollow head B. Free flow of blood is then possible in the vein in the reverse direction, i.e., from the wider to the narrower end. The vein may then be used as an artery in situ or as a transplant.
Flexible tube A follows the path of a vein in situ in the manner of a catheter. When the vein is dissected out of the body for use as a transplant graft, the tube A may be a rigid tube.
The present type of instrument may also be used to excise any valves, webs or strictures in any tubular structure in the body, such as the urethra, esophagus or the bile ducts.
Having now described my invention and in what manner the same may be used, what I claim as new and desire to protect by Letters Patent is:
l. A venous valve snipper catheter instrument comprising a tubular member having a distal end and a proximal end, an annular cutting blade on said distal end, a rounded head mounted on a core rod extending through said tubular member, means for sliding said tubular member on said core rod to reciprocate said cutting blade toward and away from said head, said blade having an open position leaving a gap between the blade and head to receive the valve leaflets in a vein when the instrument is inserted and manipulated in the vein, and spikes in said head extending in a proximal direction beyond the head and partially across said gap when the blade is in said open position to impale said valve leaflets by manipulation of the instrument in the vein, said valve leaflets being excised by closing said cutting blade against said head.
2. An instrument as defined in claim 1, said head being hollow to contain said excised valveleaflets on said spikes.
3. An instrument as defined in claim 1, said tubular member and core rod being flexible.
4. An instrument as defined in claim 1, said spikes being mounted on said core rod.
5. An instrument as defined in claim 1 including a rigid collar on said proximal end of said tubular memher.
6. An instrument as defined in claim 5, said means for sliding said tubular member on said core rod comprising a handle having a pair of pivotal levers, means for detachably connecting one of said levers with said rigid collar, and means for detachably connecting the other lever with said core rod.
7. An instrument as defined in claim 1, said tubular member and core rod being flexible, a rigid collar on said proximal end of said tubular member, said means for sliding said tubular member on said core rod comprising a handle having a pair of pivotal levers, a clamp on one of said levers for clamping said rigid collar, and a nut on the other lever having threaded engagement with said core rod.
|Cited Patent||Filing date||Publication date||Applicant||Title|
|US769829 *||May 4, 1904||Sep 13, 1904||Irvine K Mott||Surgical instrument.|
|US1167014 *||Jun 25, 1915||Jan 4, 1916||William R O'brien||Veterinary surgical instrument.|
|US2505358 *||Apr 20, 1949||Apr 25, 1950||Sklar Mfg Co Inc J||Double-cutting biopsy bistoury|
|DD67204A *|| ||Title not available|
|DE1160573B *||Sep 8, 1961||Jan 2, 1964||Dr Med Paul Ludwig||Probeexcisionsinstrument|
|GB1069398A *|| ||Title not available|
|Citing Patent||Filing date||Publication date||Applicant||Title|
|US4018228 *||Feb 24, 1975||Apr 19, 1977||Goosen Carl C||Surgical punch apparatus|
|US4493321 *||May 25, 1982||Jan 15, 1985||Leather Robert P||Venous valve cutter for the incision of valve leaflets in situ|
|US4655217 *||Oct 11, 1985||Apr 7, 1987||Reed Matt H||Method and apparatus for disabling vein valves in-situ|
|US4681106 *||Sep 22, 1986||Jul 21, 1987||Intravascular Surgical Instruments, Inc.||Catheter based surgical methods and apparatus therefor|
|US4718420 *||Mar 6, 1986||Jan 12, 1988||Lemp Michael A||Method and apparatus for trephining corneal tissue in preparation for keratoplasty|
|US4739760 *||Jun 6, 1986||Apr 26, 1988||Thomas J. Fogarty||Vein valve cutter apparatus|
|US4768508 *||Oct 19, 1987||Sep 6, 1988||Thomas J. Fogarty||Vein valve cutting method|
|US4785809 *||Apr 23, 1986||Nov 22, 1988||Weinrib Harry P||Arteriotomical device|
|US4842579 *||Jul 29, 1988||Jun 27, 1989||Surgical Systems & Instruments, Inc.||Atherectomy device|
|US4919146 *||Oct 25, 1988||Apr 24, 1990||Medrad, Inc.||Biopsy device|
|US4952215 *||Feb 29, 1988||Aug 28, 1990||Boisurge, Inc.||Valvulotome with leaflet disruption heads and fluid supply|
|US5026383 *||Jun 14, 1989||Jun 25, 1991||Nobles Anthony A||Apparatus for in-situ cutting of valves within veins and method therefor|
|US5061240 *||Apr 2, 1990||Oct 29, 1991||George Cherian||Balloon tip catheter for venous valve ablation|
|US5069679 *||Feb 16, 1989||Dec 3, 1991||Taheri Syde A||Method and apparatus for removing venous valves|
|US5092872 *||Jul 28, 1989||Mar 3, 1992||Jacob Segalowitz||Valvulotome catheter|
|US5129913 *||Oct 4, 1990||Jul 14, 1992||Norbert Ruppert||Surgical punch apparatus|
|US5139506 *||Mar 22, 1991||Aug 18, 1992||Pilling Co.||Valvulotome|
|US5152773 *||Sep 7, 1989||Oct 6, 1992||Falah Redha||Medical instrument|
|US5171255 *||Oct 11, 1991||Dec 15, 1992||Everest Medical Corporation||Biopsy device|
|US5192294 *||Jun 6, 1991||Mar 9, 1993||Blake Joseph W Iii||Disposable vascular punch|
|US5250065 *||Sep 14, 1992||Oct 5, 1993||Mectra Labs, Inc.||Disposable lavage tip assembly|
|US5271385 *||Feb 28, 1992||Dec 21, 1993||United States Surgical Corporation||Abdominal cavity organ retractor|
|US5282813 *||Apr 10, 1992||Feb 1, 1994||Falah Redha||Surgical apparatus for removal of deposits from vessels|
|US5284478 *||Jun 8, 1992||Feb 8, 1994||Nobles Anthony A||Detachable tip optical valvulotome|
|US5304189 *||Apr 9, 1992||Apr 19, 1994||Lafeber Company||Venous valve cutter for in situ incision of venous valve leaflets|
|US5320635 *||Nov 17, 1992||Jun 14, 1994||Smith & Nephew Dyonics, Inc.||Surgical device with surgical element removably connected to drive element|
|US5352232 *||Sep 10, 1993||Oct 4, 1994||Endovascular, Inc.||Method for using detachable tip valvulotome|
|US5368035 *||Sep 17, 1992||Nov 29, 1994||Boston Scientific Corporation||Ultrasound imaging guidewire|
|US5368606 *||Jul 2, 1992||Nov 29, 1994||Marlow Surgical Technologies, Inc.||Endoscopic instrument system|
|US5372138 *||Dec 9, 1992||Dec 13, 1994||Boston Scientific Corporation||Acousting imaging catheters and the like|
|US5372601 *||Mar 30, 1993||Dec 13, 1994||Lary; Banning G.||Longitudinal reciprocating incisor|
|US5409013 *||Feb 4, 1992||Apr 25, 1995||Mectra Labs, Inc.||Tissue removal assembly|
|US5421338 *||Jun 3, 1994||Jun 6, 1995||Boston Scientific Corporation||Acoustic imaging catheter and the like|
|US5505210 *||May 11, 1993||Apr 9, 1996||Mectra Labs, Inc.||Lavage with tissue cutting cannula|
|US5522824 *||Jan 24, 1994||Jun 4, 1996||Applied Medical Resources Corporation||Valvulotome and method for making and using same|
|US5524630 *||May 17, 1995||Jun 11, 1996||Crowley; Robert J.||Acoustic imaging catheter and the like|
|US5527327 *||Oct 25, 1994||Jun 18, 1996||Intramed Laboratories, Inc.||Valvulotome|
|US5527332 *||Nov 2, 1994||Jun 18, 1996||Mectra Labs, Inc.||Tissue cutter for surgery|
|US5546948 *||Nov 28, 1994||Aug 20, 1996||Boston Scientific Corporation||Ultrasound imaging guidewire|
|US5549615 *||Aug 25, 1994||Aug 27, 1996||Vascomed Institut Fur Kathetertechnologie Gmbh||Method and apparatus for extracting pacemaker electrodes embedded in the heart|
|US5571137 *||Aug 17, 1994||Nov 5, 1996||Marlow Surgical Technologies, Inc.||Endoscopic instrument system and method|
|US5601580 *||Apr 9, 1993||Feb 11, 1997||Uresil Corporation||Venous valve cutter|
|US5609598 *||Dec 30, 1994||Mar 11, 1997||Vnus Medical Technologies, Inc.||Method and apparatus for minimally invasive treatment of chronic venous insufficiency|
|US5658301 *||Apr 26, 1995||Aug 19, 1997||Vascutech, Inc.||Self-centering valvulotome|
|US5658302 *||Jun 7, 1995||Aug 19, 1997||Baxter International Inc.||Method and device for endoluminal disruption of venous valves|
|US5685320 *||May 3, 1995||Nov 11, 1997||Zimmon; David S.||Lateral biopsy device|
|US5715825 *||Jun 10, 1996||Feb 10, 1998||Boston Scientific Corporation||Acoustic imaging catheter and the like|
|US5725543 *||Mar 9, 1994||Mar 10, 1998||Redha; Falah||Medical instrument for atherectomy|
|US5749882 *||Oct 18, 1995||May 12, 1998||Applied Medical Resources Corporation||Apparatus for disrupting vein valves|
|US5755731 *||Dec 19, 1995||May 26, 1998||Smith & Nephew Dyonics, Inc.||Curved surgical instrument with segmented inner member|
|US5797907 *||Dec 15, 1995||Aug 25, 1998||Mectra Labs, Inc.||Electrocautery cutter|
|US5810847 *||Mar 6, 1997||Sep 22, 1998||Vnus Medical Technologies, Inc.||Method and apparatus for minimally invasive treatment of chronic venous insufficiency|
|US5820629 *||Aug 13, 1996||Oct 13, 1998||Medtronic, Inc.||Intimal lining transition device and endarterectomy method|
|US5843102 *||Oct 18, 1994||Dec 1, 1998||Medtronic, Inc.||Instrument for loosening and cutting through the intima of a blood vessel, and a method therefor|
|US5846241 *||Dec 18, 1996||Dec 8, 1998||Johns Hopkins University||Bipolar electrocautery valvulotome|
|US5868768 *||Apr 4, 1997||Feb 9, 1999||Baxter International Inc.||Method and device for endoluminal disruption of venous valves|
|US5902313 *||Dec 29, 1997||May 11, 1999||Redha; Falah||Medical instrument for atherectomy|
|US5910153 *||Dec 4, 1997||Jun 8, 1999||Aesculap Ag & Co. Kg||Surgical punch|
|US5913866 *||Feb 27, 1998||Jun 22, 1999||Cardiothoracic Systems, Inc.||Devices and methods for harvesting vascular conduits|
|US6027514 *||Dec 17, 1997||Feb 22, 2000||Fox Hollow Technologies, Inc.||Apparatus and method for removing occluding material from body lumens|
|US6165127 *||Sep 26, 1997||Dec 26, 2000||Boston Scientific Corporation||Acoustic imaging catheter and the like|
|US6193672||Aug 25, 1998||Feb 27, 2001||Mectra Labs, Inc.||Lavage|
|US6299622||Aug 19, 1999||Oct 9, 2001||Fox Hollow Technologies, Inc.||Atherectomy catheter with aligned imager|
|US6328749||Oct 9, 1998||Dec 11, 2001||Vascular Architects, Inc.||Remote endarterectomy ring stripper|
|US6364840||Sep 27, 2000||Apr 2, 2002||Boston Scientific Corporation||Acoustic imaging catheter and the like|
|US6447525||Aug 19, 1999||Sep 10, 2002||Fox Hollow Technologies, Inc.||Apparatus and methods for removing material from a body lumen|
|US6500189 *||May 1, 2000||Dec 31, 2002||Karl Storz Gmbh & Co. Kg||Medical instrument for dissecting tissue|
|US6551334 *||Dec 14, 2000||Apr 22, 2003||Integrated Vascular Interventional Technologies, Lc||Externally directed anastomosis systems and externally positioned anastomosis fenestra cutting apparatus|
|US6572553||Jan 4, 2002||Jun 3, 2003||Scimed Life Systems, Inc.||Medical imaging device|
|US6585655||May 31, 2002||Jul 1, 2003||Scimed Life Systems, Inc.||Medical imaging device|
|US6623496||Aug 14, 2001||Sep 23, 2003||Fox Hollow Technologies, Inc.||Atherectomy catheter with aligned imager|
|US6626921||Oct 31, 2001||Sep 30, 2003||Integrated Vascular Interventional Technologies, L.C.||Externally positioned anvil apparatus for cutting anastomosis|
|US6638233||Aug 19, 1999||Oct 28, 2003||Fox Hollow Technologies, Inc.||Apparatus and methods for material capture and removal|
|US6695859||Mar 31, 2000||Feb 24, 2004||Coalescent Surgical, Inc.||Apparatus and methods for anastomosis|
|US6726704||Mar 20, 2000||Apr 27, 2004||By-Pass, Inc.||Advanced closure device|
|US6743244||Oct 31, 2001||Jun 1, 2004||Integrated Vascular Interventional Technologies, L.C.||Soft anvil apparatus for cutting anastomosis fenestra|
|US6915804 *||Dec 3, 2002||Jul 12, 2005||University Of Florida||Tracheotomy surgical device|
|US6979338||Mar 20, 2000||Dec 27, 2005||By-Pass Inc.||Low profile anastomosis connector|
|US7022131||May 30, 1999||Apr 4, 2006||By-Pass Inc.||Methods and devices for vascular surgery|
|US7037271||May 27, 2003||May 2, 2006||Boston Scientific Corporation||Medical imaging device|
|US7063711||Dec 8, 1999||Jun 20, 2006||By-Pass, Inc.||Vascular surgery|
|US7131981||Aug 13, 2003||Nov 7, 2006||Angiodynamics, Inc.||Device and method for converting a balloon catheter into a cutting balloon catheter|
|US7160311||Dec 14, 2000||Jan 9, 2007||Integrated Vascular Interventional Technologies, L.C. (Ivit Lc)||Locking compression plate anastomosis apparatus|
|US7258694||Jun 7, 2004||Aug 21, 2007||Origin Medsystems, Inc.||Medical punch and surgical procedure|
|US7396358||Dec 2, 2005||Jul 8, 2008||Angiodynamics, Inc.||Device and method for converting a balloon catheter into a cutting balloon catheter|
|US7547313||May 16, 2003||Jun 16, 2009||Medtronic, Inc.||Tissue connector apparatus and methods|
|US7578829||Oct 6, 2003||Aug 25, 2009||St. Jude Medical Atg, Inc.||Medical grafting methods and apparatus|
|US7699790||Jul 21, 2004||Apr 20, 2010||Ev3, Inc.||Debulking catheters and methods|
|US7708749||Dec 14, 2004||May 4, 2010||Fox Hollow Technologies, Inc.||Debulking catheters and methods|
|US7713279||Apr 22, 2003||May 11, 2010||Fox Hollow Technologies, Inc.||Method and devices for cutting tissue|
|US7717930 *||Feb 28, 2005||May 18, 2010||Cook Incorporated||Valvulotome with a cutting edge|
|US7722643||Jul 29, 2002||May 25, 2010||Medtronic, Inc.||Tissue connector apparatus and methods|
|US7744611||Nov 19, 2003||Jun 29, 2010||Medtronic, Inc.||Minimally invasive valve repair procedure and apparatus|
|US7758599||Nov 22, 2005||Jul 20, 2010||Fox Hollow Technologies, Inc.||Atherectomy catheter with aligned imager|
|US7763040||Feb 10, 2003||Jul 27, 2010||Medtronic, Inc.||Tissue connector apparatus and methods|
|US7771444||Dec 19, 2001||Aug 10, 2010||Fox Hollow Technologies, Inc.||Methods and devices for removing material from a body lumen|
|US7794413||Sep 21, 2005||Sep 14, 2010||Ev3, Inc.||Libraries and data structures of materials removed by debulking catheters|
|US7850705||Mar 19, 2007||Dec 14, 2010||St. Jude Medical Atg, Inc.||Medical grafting connectors and fasteners|
|US7879047||Dec 10, 2003||Feb 1, 2011||Medtronic, Inc.||Surgical connection apparatus and methods|
|US7887556||Nov 4, 2002||Feb 15, 2011||Fox Hollow Technologies, Inc.||Debulking catheters and methods|
|US7892255||Aug 28, 2003||Feb 22, 2011||Medtronic, Inc.||Tissue connector apparatus and methods|
|US7896892||Apr 3, 2003||Mar 1, 2011||Medtronic, Inc.||Multiple bias surgical fastener|
|US7901417||Oct 29, 2007||Mar 8, 2011||Vital Access Corporation||Systems for forming an anastomosis with an anvil and an apparatus having at least one guide|
|US7914544||Dec 7, 2004||Mar 29, 2011||Medtronic, Inc.||Minimally invasive valve repair procedure and apparatus|
|US7922734||Oct 29, 2007||Apr 12, 2011||Vital Access Corporation||Methods for forming an anastomosis with a vessel having everted tissue|
|US7927784||Jan 10, 2006||Apr 19, 2011||Ev3||Vascular lumen debulking catheters and methods|
|US7938840||Nov 18, 2003||May 10, 2011||Medtronic, Inc.||Apparatus and methods for anastomosis|
|US7963973||Sep 2, 2005||Jun 21, 2011||Medtronic, Inc.||Multiple loop tissue connector apparatus and methods|
|US7976556||Dec 21, 2006||Jul 12, 2011||Medtronic, Inc.||Anastomosis apparatus and methods|
|US7981126||Dec 14, 2000||Jul 19, 2011||Vital Access Corporation||Locking compression plate anastomosis apparatus|
|US7989207||Feb 17, 2006||Aug 2, 2011||Tyco Healthcare Group Lp||Testing lumenectomy samples for markers of non-vascular diseases|
|US8029519||Sep 14, 2006||Oct 4, 2011||Medtronic, Inc.||Eversion apparatus and methods|
|US8034064||Mar 15, 2006||Oct 11, 2011||Vital Access Corporation||Methods for forming an anastomosis opening in a side of a blood vessel|
|US8052704||Nov 2, 2007||Nov 8, 2011||Foxhollow Technologies, Inc.||High capacity debulking catheter with distal driven cutting wheel|
|US8105345||Jan 10, 2003||Jan 31, 2012||Medtronic, Inc.||Anastomosis apparatus and methods|
|US8109949||Oct 29, 2007||Feb 7, 2012||Vital Access Corporation||Systems for forming an anastomosis|
|US8118822||Apr 5, 2001||Feb 21, 2012||Medtronic, Inc.||Bridge clip tissue connector apparatus and methods|
|US8133245 *||Feb 15, 2008||Mar 13, 2012||Tyco Healthcare Group Lp||Surgical apparatus with annular penetrator|
|US8177836||Mar 10, 2009||May 15, 2012||Medtronic, Inc.||Apparatus and methods for minimally invasive valve repair|
|US8192452||May 14, 2010||Jun 5, 2012||Tyco Healthcare Group Lp||Easily cleaned atherectomy catheters and methods of use|
|US8211124||Feb 5, 2007||Jul 3, 2012||Medtronic, Inc.||Sealing clip, delivery systems, and methods|
|US8211131||Apr 5, 2011||Jul 3, 2012||Medtronic, Inc.||Apparatus and methods for anastomosis|
|US8216265 *||Sep 19, 2008||Jul 10, 2012||Karl Storz Gmbh & Co. Kg||Medical instrument for punching out tissue|
|US8226674||Apr 9, 2010||Jul 24, 2012||Tyco Healthcare Group Lp||Debulking catheters and methods|
|US8246640||May 18, 2006||Aug 21, 2012||Tyco Healthcare Group Lp||Methods and devices for cutting tissue at a vascular location|
|US8298251||Feb 27, 2008||Oct 30, 2012||Medtronic, Inc.||Anastomosis apparatus and methods|
|US8328797 *||Nov 21, 2005||Dec 11, 2012||C. R. Bard, Inc.||Blood vessel transecting and anastomosis|
|US8328829||Nov 2, 2007||Dec 11, 2012||Covidien Lp||High capacity debulking catheter with razor edge cutting window|
|US8353092||Feb 7, 2011||Jan 15, 2013||Medtronic, Inc.||Multiple bias surgical fastener|
|US8353921||Aug 4, 2010||Jan 15, 2013||Medtronic, Inc||Tissue connector apparatus and methods|
|US8382784||Sep 17, 2007||Feb 26, 2013||St. Jude Medical Atg, Inc.||Vessel cutting devices|
|US8394114||Sep 26, 2003||Mar 12, 2013||Medtronic, Inc.||Surgical connection apparatus and methods|
|US8398663||May 17, 2010||Mar 19, 2013||Cook Medical Technologies Llc||Valvulotome device and method|
|US8414604||Oct 13, 2009||Apr 9, 2013||Covidien Lp||Devices and methods for manipulating a catheter shaft|
|US8469979||Sep 22, 2011||Jun 25, 2013||Covidien Lp||High capacity debulking catheter with distal driven cutting wheel|
|US8491614||Jun 22, 2011||Jul 23, 2013||Lemaitre Vascular, Inc.||Over-the-wire valvulotomes|
|US8496677||Dec 2, 2010||Jul 30, 2013||Covidien Lp||Methods and devices for cutting tissue|
|US8518060||Apr 9, 2009||Aug 27, 2013||Medtronic, Inc.||Medical clip with radial tines, system and method of using same|
|US8529583||Mar 31, 2000||Sep 10, 2013||Medtronic, Inc.||Surgical clip removal apparatus|
|US8574249||May 1, 2012||Nov 5, 2013||Covidien Lp||Easily cleaned atherectomy catheters and methods of use|
|US8579927||Jan 13, 2012||Nov 12, 2013||Lemaitre Vascular, Inc.||Systems and methods for remote endarterectomy|
|US8597315||Jul 1, 2010||Dec 3, 2013||Covidien Lp||Atherectomy catheter with first and second imaging devices|
|DE3717926A1 *||May 27, 1987||Dec 8, 1988||Leibinger Medizintech||Venous valve incision device|
|DE19650204C2 *||Dec 4, 1996||Sep 21, 2000||Aesculap Ag & Co Kg||Chirurgische Stanze|
|DE102007046397A1 *||Sep 21, 2007||Apr 2, 2009||Karl Storz Gmbh & Co. Kg||Medizinisches Instrument zum Ausstanzen von Gewebe|
|EP0248761A1 *||May 26, 1987||Dec 9, 1987||FOGARTY, Thomas J.||Vein valve cutter|
|EP0321132A2 *||Dec 5, 1988||Jun 21, 1989||BAXTER INTERNATIONAL INC. (a Delaware corporation)||Optical valvulotome|
|EP0449663A2 *||Mar 28, 1991||Oct 2, 1991||United States Surgical Corporation||Abdominal cavity organ retractor|
|EP0517252A1 *||Jun 5, 1992||Dec 9, 1992||Blake, Joseph Walter III||Disposable vascular punch|
|EP0855879A1 *||Oct 17, 1996||Aug 5, 1998||Applied Medical Resources Corporation||Apparatus and method for disrupting vein valves|
|WO1983004174A1 *||May 23, 1983||Dec 8, 1983||Robert Paul Leather||A venous valve cutter for the incision of valve leaflets in situ|
|WO1990002523A1 *||Sep 7, 1989||Mar 22, 1990||Issa Hashim||Surgical instrument for atherectomy|
|WO1991001689A1 *||Jul 27, 1990||Feb 21, 1991||Jacob Segalowitz||Valvulotome catheter|
|WO1995028888A1 *||Nov 1, 1994||Nov 2, 1995||Gore & Ass||A valvulotome|
|WO1996033662A1 *||Dec 27, 1995||Oct 31, 1996||Vascutech Inc||Self-centering valvulotome|
|WO1999030624A1 *||Dec 16, 1998||Jun 24, 1999||Fox Hollow Technologies||Apparatus and methods for removing occluding material from body lumens|
|WO2002047532A2 *||Nov 4, 2001||Jun 20, 2002||By Pass Inc||Method and apparatus for forming apertures in blood vessels|
|WO2011010296A1 *||Jul 23, 2010||Jan 27, 2011||London Equitable Limited In Its Capacity As Trustee Of The Think Tank Trust||A device for treating valvular malformations in peripheral venous vessels, such as internal jugular veins and kit therefor|