Catheter-based fastener implantation apparatus and methods

Abstract

Apparatus and methods utilize an intraluminal fastener applier having a guide body with a longitudinal axis. The guide body is sized and configured for intraluminal deployment in a hollow body organ. An actuated assembly is carried by the guide body that is selectively operable to generate an implantation force to implant at least one fastener into tissue within the hollow body organ. The actuated assembly includes a driven member extending generally along the longitudinal axis, which is sized and configured to engage a selected fastener. The actuated assembly also includes a drive member coupled to the driven member to impart the implantation force to the driven element in a direction that is at an angle to the longitudinal axis of the guide body.

1 . An intraluminal fastener applier comprising a guide body having a longitudinal axis sized and configured for intraluminal deployment in a hollow body organ, and an actuated assembly carried by the guide body that is selectively operable to generate an implantation force to implant at least one fastener into tissue within the hollow body organ, the actuated assembly including a driven member extending generally along the longitudinal axis and being sized and configured to engage a selected fastener, and a drive member coupled to the driven member to impart the implantation force to the driven element in a direction that is at an angle to the longitudinal axis of the guide body.  
     
     
         2 . An intraluminal fastener applier according to  claim 1   wherein the actuated assembly includes structure that maintains the angle between the driven member and the drive member at about ninety-degrees or less.    
     
     
         3 . An intraluminal fastener applier according to  claim 1   wherein the actuated assembly includes structure that maintains a fixed angle between the driven member and the drive member.    
     
     
         4 . An intraluminal fastener applier according to  claim 3   wherein the fixed angle is about ninety-degrees or less.    
     
     
         5 . An intraluminal fastener applier according to  claim 1   wherein the actuated assembly includes a control mechanism to articulate the driven member relative to the drive member to adjust the angle.    
     
     
         6 . An intraluminal fastener applier according to  claim 5   wherein the control mechanism articulates the drive member from a first position generally aligned with the longitudinal axis and a second position articulated at the angle relative to the longitudinal axis.    
     
     
         7 . An intraluminal fastener applier according to  claim 6   wherein the control mechanism articulates the drive member in a range of positions between the first position and the second position.    
     
     
         8 . An intraluminal fastener applier according to  claim 6   wherein, in the second position, the angle is about ninety-degrees or less.    
     
     
         9 . An intraluminal fastener applier according to  claim 1   further including stabilization means associated with the guide body for applying a resolving force in a direction different than the implantation force direction to resolve at least a portion of the implantation force within the hollow body organ.    
     
     
         10 . An intraluminal fastener applier according to  claim 9   wherein the stabilizing means includes a strut assembly.    
     
     
         11 . An intraluminal fastener applier according to  claim 9   wherein the stabilizing means includes a spring-loaded arm adapted for contact with tissue.    
     
     
         12 . An intraluminal fastener applier according to  claim 9   wherein the stabilizing means includes an expandable member adapted for contact with tissue.    
     
     
         13 . An intraluminal fastener applier according to  claim 9   wherein the stabilizing means includes a tissue grasping element.    
     
     
         14 . An intraluminal fastener applier according to  claim 1   wherein the at least one fastener includes a tissue-piercing fastener having a sharpened distal tip for piercing and penetrating tissue.    
     
     
         15 . An intraluminal fastener applier according to  claim 14   wherein the tissue-piercing fastener comprises a helical fastener.    
     
     
         16 . An intraluminal fastener applier according to  claim 1   wherein the guide body includes a catheter body having a column strength that applies a resolving force in a direction different than the implantation force direction to resolve at least a portion of the implantation force within the hollow body organ.    
     
     
         17 . A method comprising 
 deploying an intraluminal fastener applier as defined in  claim 1  within a hollow body organ,    placing the driven member into contact with tissue along a side wall of the hollow body while the longitudinal axis of the guide body remains substantially aligned with a long axis of the hollow body organ, and    operating the drive member to impart the implantation force to the driven element in the direction that is at an angle to the longitudinal axis of the guide body, to thereby implant the fastener in the side wall while the guide body remains substantially aligned with the long axis of the hollow body organ.    
     
     
         18 . A method according to  claim 17   further including applying a resolving force at or near the drive member to resolve within the hollow body organ at least a portion of the implantation force.    
     
     
         19 . A method according to  claim 17   wherein the hollow body organ comprises an aorta.    
     
     
         20 . A method according to  claim 17   wherein the fastener includes a tissue-piercing fastener having a sharpened distal tip for piercing and penetrating tissue.    
     
     
         21 . A method according to  claim 20   wherein the tissue-piercing fastener comprises a helical fastener.    
     
     
         22 . A method according to  claim 17   wherein the guide body includes a catheter body having a column strength that applies a resolving force in a direction different than the implantation force direction to resolve at least a portion of the implantation force within the hollow body organ.    
     
     
         23 . A method comprising 
 advancing an intraluminal fastener applier as defined in  claim 1  to a location within a prosthesis that has been deployed at a target site along a side wall of an aorta where a diseased or damaged section exits,    placing the driven member in alignment with a desired fastening site on the prosthesis along the side wall of the aorta, wherein, due to the angle, the longitudinal axis of the guide body remains substantially aligned with a long axis of the aorta, and    anchoring the prosthesis to a side wall of the aorta by operating the drive member to impart the implantation force to the driven element in the direction that is at an angle to the longitudinal axis of the guide body, thereby implanting the fastener into tissue in a side wall of the aorta while the longitudinal axis of the guide body remains substantially aligned with a long axis of the aorta.    
     
     
         24 . A method according to  claim 23   further including applying a resolving force at or near the drive member to resolve within the aorta at least a portion of the implantation force.    
     
     
         25 . A method according to  claim 23   wherein the fastener includes a tissue-piercing fastener having a sharpened distal tip for piercing and penetrating tissue.    
     
     
         26 . A method according to  claim 25   wherein the tissue-piercing fastener comprises a helical fastener.    
     
     
         27 . A method according to  claim 23   wherein the guide body includes a catheter body having a column strength that applies a resolving force in a direction different than the implantation force direction to resolve at least a portion of the implantation force within the aorta.