Cedars-sinai Medical Center

Alexander Popov

Peter A Barath

A method and devices are provided for performing end-to-side anastomoses between the severed end of a first hollow organ and the side-wall of a second hollow organ utilizing transluminal approach with endoscopic assistance, wherein the first and second hollow organs can be secured utilizing a biocompatible glue, clips or by suturing. In an alternative embodiment, the method utilizes a modified cutter catheter which is introduced into the first hollow organ in combination with a receiver catheter which is introduced into the second hollow organ. The distal end of the receiver catheter includes a receiver cavity and a selectively activatable magnetic material. The magnetic material is selected so that it will interact with a magnetically susceptible material disposed in the distal end of the modified cutter catheter when the modified cutter catheter is disposed in proximity to the proposed site for anastomosis whereby the severed end of the first hollow organ is matingly engaged with the sidewall of the second hollow organ. Thereafter, the severed end of the first hollow organ can be attached in sealing engagement with the side-wall utilizing clips, a biocompatible glue, or other suitable methods. The cutter is then activated to remove a portion of the side-wall of the second hollow organ, thereby creating an opening within the region of securement and establishing the anastomosis. In the preferred embodiment, the portion of the sidewall of the second hollow organ is engaged in the receiver cavity by the attractive force between the magnetically susceptible material and the magnetic material. The magnetically susceptible material is then released from the modified cutter catheter and withdrawn along with the portion of the sidewall removed by the cutter when the receiver catheter is withdrawn from the second hollow organ. These methods and devices find particular utility in coronary bypass surgery, including, in particular, where the first hollow organ is the left internal mammary artery (LIMA) and the second hollow organ is the left anterior descending coronary artery (LAD).

Method and devices for performing vascular anastomosis

A method and devices are provided for performing end-to-side anastomoses between the severed end of a first hollow organ and the side-wall of a second hollow organ utilizing transluminal approach with endoscopic assistance. In particular, the method utilizes a catheter, having a selectively operable cutter, which is introduced into the first hollow organ until the distal end of the catheter is substantially adjacent to the severed end of the first hollow organ. The severed end of the first hollow organ is positioned in proximity to the site for anastomoses on the side wall of the second hollow organ and the severed end is secured in sealing engagement with the side-wall, thereby defining a region of securement on the side wall of the second hollow organ. The severed end of the first hollow organ is preferably secured to the side wall of the second hollow organ by activating a corkscrew element in the catheter to penetrate the side-wall of the second hollow organ and hold the severed end of the first hollow organ in mating engagement with the side-wall of the second hollow organ. A plurality of clips can be applied to the seam between the first hollow organ and the second hollow organ. Alternatively, the first and second hollow organs can be secured by suturing. The cutter is then activated to remove a portion of the side-wall of the second hollow organ, thereby creating an opening within the region of securement and establishing the anastomosis.

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Los Angeles, CA, United States of America

Alexander Popov