US20100049289A1 - Tissue anchor - Google Patents

Abstract

Embodiments of the invention generally relate to an anchor used to secure a position of a device or component relative to internal tissue of a patient and prevent migration of the component relative to the tissue of the patient. In one embodiment, the anchor is combined with an electrode lead that is configured for implantation in a patient. The electrode lead comprises a lead body having a proximal end and a distal end, a stimulating electrode and an anchor. The stimulating electrode is attached to the lead body at the distal end. The anchor is attached to the distal end of the lead body and comprises an anchor body and mesh attached to the anchor body.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS
• The present application claims the benefit of U.S. provisional patent application Ser. Nos. 61/096,387 filed Sep. 12, 2008 and 61/160,765 filed Mar. 17, 2009; and the present application is a continuation-in-part of U.S. application Ser. No. 12/170,582 filed Jul. 10, 2008, which in turn claims the benefit of U.S. provisional patent application Ser. No. 60/948,908, filed Jul. 10, 2007. The content of each of the above-referenced applications, is hereby incorporated by reference in its entirety.
FIELD OF THE INVENTION
• Embodiments of the present invention generally relate to an anchor that facilitates securing devices or components to internal tissue of a patient and preventing migration of the devices or components from their intended location relative to the tissue of the patient.
BACKGROUND OF THE INVENTION
• Implantable electronic stimulator devices, such as neuromuscular stimulation devices, have been disclosed for use in the treatment of various pelvic conditions, such as urinary incontinence, fecal incontinence and sexual dysfunction. Such devices generally include one or more electrodes that are coupled to a control unit by electrode leads. Electrical signals are applied to the desired pelvic tissue of the patient through the electrode leads in order to treat the condition of the patient. The electrode leads are typically secured to the tissue using an anchor in the form of a helical coil. Exemplary implantable electronic stimulator devices and uses of the devices are disclosed in U.S. Pat. Nos. 6,354,991, 6,652,449, 6,712,772 and 6,862,480, each of which is hereby incorporated by reference in its entirety.
• Urinary incontinence in women has been treated by a surgical method involving the placement of a sling to stabilize or support the bladder neck or urethra of the patient. Varieties of sling procedures are described in U.S. Pub. No. 2002-016382 A1, which is incorporated herein by reference in its entirety. One type of sling procedure is a pubovaginal sling procedure, which is a minimally invasive surgical method involving the placement (e.g. by the use of a Stamey needle or other ligature carrier) of a sling to stabilize or support the bladder neck or urethra. This procedure does not utilize bone anchors. Rather the sling is anchored in the abdominal or rectus fascia.
• U.S. Pub. No. 2007-0260288 A1, which is incorporated herein by reference in its entirety, generally describes a combination of the above devices. One or more electrodes are attached to a mechanical support, such as a sling, that supports a portion of the urethra of the patient. The electrodes are configured to contact tissue of the patient when the mechanical support is implanted in the patient. A control unit drives the electrodes to apply a current to the tissue that treats a pelvic condition of the patient.
• The above-describe devices utilize anchors to secure components of the devices, such as electrode leads and/or mechanical supports, in tissue of the patient. It is desirable, for example, that such anchors prevent relative movement between the anchor and the tissue in which the anchor in embedded, are easy to install in the tissue, avoid damaging the tissue during the implantation procedure, operate as electrical stimulators, can be temporarily moved relative to the tissue without significant restriction by the anchor during installation, can be removed without significantly damaging the tissue, and/or have other features or benefits recognized by those skilled in the art.
SUMMARY OF THE INVENTION
• Embodiments of the invention generally relate to an anchor used to secure a position of a device or component relative to internal tissue of a patient and prevent migration of the component relative to the tissue of the patient. In one embodiment, the anchor is combined with an electrode lead that is configured for implantation in a patient. The electrode lead comprises a lead body having a proximal end and a distal end, a stimulating electrode and an anchor. The stimulating electrode is attached to the lead body at the distal end. The anchor is attached to the distal end of the lead body and comprises an anchor body and mesh attached to the anchor body.
• This Summary is provided to introduce a selection of concepts in a simplified form that are further described below in the Detailed Description. This Summary is not indented to identify key features or essential features of the claimed subject matter, nor is it intended to be used as an aid in determining the scope of the claimed subject matter. The claimed subject matter is not limited to implementations that solve any or all disadvantages noted in the Background.
BRIEF DESCRIPTION OF THE DRAWINGS
• FIG. 1 is a side plan view of an exemplary electronic stimulator device, in accordance with the embodiments of the invention.
• FIG. 2 is a schematic illustration of a pelvic treatment apparatus in accordance with embodiments of the invention.
• FIGS. 3-5 are cross-sectional views of a distal end of an exemplary electrode lead that includes one or more tissue anchors in accordance with embodiments of the invention.
• FIG. 6 is an isometric view of an anchor in accordance with embodiments of the invention.
• FIG. 7 is a front cross-sectional view of an anchor in accordance with embodiments of the invention.
• FIG. 8 is a cross-sectional view of a portion of an anchor in accordance with embodiments of the invention.
• FIG. 9A is a side plan view of an anchor in accordance with embodiments of the invention.
• FIG. 9B is a cross-sectional view of the anchor ofFIG. 9A taken generally along line B-B.
• FIG. 10A is a front plan view of an anchor in accordance with embodiments of the invention.
• FIG. 10B is a cross-sectional view of the anchor ofFIG. 10A taken generally along line B-B.
• FIG. 11A is a front plan view of an anchor in accordance with embodiments of the invention.
• FIG. 11B is a cross-sectional view of the anchor ofFIG. 11A taken generally along line B-B.
• FIG. 12 is a cross-sectional view of a portion of an anchor in accordance with embodiments of the invention.
• FIG. 13 is a cross-sectional view of a portion of an anchor illustrating various embodiments of the invention.
• FIGS. 14 and 15 are isometric views of anchors in accordance with embodiments of the invention.
• FIGS. 16A and 16B are isometric views of anchors in accordance with embodiments of the invention.
• FIG. 17 is an isometric view of an anchor in accordance with embodiments of the invention.
• FIG. 18 is a front plan view of an anchor in accordance with embodiments of the invention.
• FIG. 19 is a front plan view of an anchor in an expanded state.
• FIGS. 20A and 20B illustrate a temporary anchor covering in accordance with embodiments of the invention.
• FIGS. 21A and 21B are simplified top plan views of one embodiment of an anchor in opened and closed positions, respectively.
• FIGS. 22A-22C illustrate various stages of deployment of a protruding element of an anchor in accordance with embodiments of the invention.
• FIGS. 23 and 24 are simplified on-axis views of various embodiments of the anchor shown inFIGS. 22A-22C.
• FIGS. 25A and 25B are simplified side views of a hinged anchor respectively in retracted and extended positions in accordance with embodiments of the invention.
• FIGS. 26A and 26B are simplified side views of a hinged anchor respectively in retracted and extended positions in accordance with embodiments of the invention.
• FIG. 27 is a simplified side view of an electrode lead comprising a fixation component in accordance with embodiments of the invention.
• FIG. 28 is a side cross-sectional view of the electrode lead ofFIG. 27 taken generally along line28-28.
• FIG. 29 is a front cross-sectional view of a distal end of an electrode lead installed within a trocar.
• FIG. 30 is a simplified front cross-sectional view of a distal end of an electrode lead comprising a fixation component in accordance with embodiments of the invention.
• FIG. 31 is a partial side view of an installation tool in accordance with embodiments of the invention.
• FIGS. 32-34 are simplified front cross-sectional views of the distal end of an electrode lead illustrating a method of installing the electrode lead within a trocar.
• FIG. 35 is a simplified front cross-sectional view of an electrode lead installed within a trocar along with a tool in accordance with embodiments of the invention.
• FIG. 36 is a side cross-sectional view ofFIG. 35 taken generally along line36-36.
• FIGS. 37-39 illustrate method steps of deploying the distal end of the electrode lead ofFIGS. 35 and 36 within tissue of a patient, in accordance with embodiments of the invention.
• FIGS. 40-42 are simplified side views of an electrode lead installation tool in accordance with embodiments of the invention.
• FIG. 43 is a block diagram of a kit in accordance with embodiments of the invention.
DETAILED DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS
• Embodiments of the invention are directed to an anchor that facilitates securing devices or components, such as electrode leads, mechanical supports (e.g., meshes, slings), and other devices or components to internal tissue of a patient, and preventing migration of the devices or components from their intended position.
• The tissue in which the anchor of the present invention may be use includes adipose tissue, muscle tissue or any other tissue of the patient. In one embodiment, the tissue is located in the pelvic region of the patient. In some embodiments, the tissue, in which the anchor is to be embedded, is targeted for electrical stimulation or is adjacent a desired stimulation target site. Embodiments of the invention comprise the individual embodiments described below and combinations of two or more of the embodiments described below.
• Initially, exemplary devices or components with which the anchors of the present invention may be used will be discussed.FIG. 1 is a side plan view of an exemplaryelectronic stimulator device100, with which embodiments of the anchors of the present invention may be used.Device100 is configured for implantation into a pelvic region of a patient to provide muscle and/or nerve stimulation that is used to control and/or treat a pelvic condition of the patient, such as pelvic pain, urinary incontinence, fecal incontinence, erectile dysfunction or other pelvic condition that may be treated through electrical stimulation.
• In one embodiment, thedevice100 comprises acontrol unit102 and one or more electrode leads104, aproximal end106 of which is coupled to thecontrol unit102 via aconnector108. Eachelectrode lead104 comprises alead body110 and one or morestimulating electrodes112 at adistal end114 of theelectrode lead104 orlead body110. Thelead body110 insulates electrical wires connecting thecontrol unit102 to the stimulatingelectrodes112. Thelead body110 can be in the form of an insulating jacket typically comprising silicone, polyurethane or other flexible, biocompatible electrically insulating material. Additional electrode leads104 or physiological sensors may be coupled to thecontrol unit102.
• In one embodiment, thecontrol unit102 comprises circuitry for processing electrical signals received from the one or morestimulating electrodes112 or physiological sensors. Thecontrol unit102 is also configured to apply an electrical current or waveform to the tissue of the patient that is in contact with the one or morestimulating electrodes112.
• Theelectrode lead104 can be anchored to pelvic tissue of the patient (e.g., internal urinary sphincter muscle) by means of atissue anchor120, which is formed in accordance with embodiments of the invention described below. Theanchor120 operates to secure the position of thedistal end114 of theelectrode lead104 in the desired tissue of the patient. Theanchor120 can be coupled to thelead body110 or the stimulatingelectrode112 at a location that is proximate to thedistal end114 of theelectrode lead104, for example. In one embodiment, theanchor120 operates to provide electrical contact between the pelvic tissue of the patient and the one ormore stimulation electrodes112 of theelectrode lead104.
• Another device or component with which embodiments of theanchor120 may be used is apelvic treatment apparatus130, an example of which is illustrated inFIG. 2. Thepelvic treatment apparatus130 can be used to treat, for example, urinary incontinence of a patient, and generally comprises amechanical support132, which can be in the form of a mesh or other mechanical support that is installed to provide support to the neck of thebladder134 or the urethra of the patient, which are generally indicated at136. The mechanical support can be configured for implantation by any number of known surgical approaches, for example, a suprapubic approach, a transvaginal approach, a retropubic approach, and a transobturator approach.
• In one embodiment, the mechanical support is anchored to pelvic tissue of the patient using one ormore anchors120 of the present invention described below. Eachanchor120 can be attached to acable138 or directly attached to themechanical support132.
• In one embodiment, thepelvic treatment apparatus130 includes one or morestimulating electrodes140 that are attached to themechanical support132 or extend from themechanical support132 on electrode leads (not shown), such as those described above with reference toFIG. 1. Acontrol unit142, located inside or outside of the patient's body, drives theelectrodes140 to apply a current to a pelvic site and treat, for example, stress incontinence, urge incontinence, urge frequency, erectile dysfunction, or other pelvic dysfunctions.
• FIGS. 3-5 are cross-sectional views of thedistal end114 of anelectrode lead104 that includes one or more anchors orfixation components120 in accordance with embodiments of the invention. WhileFIGS. 3-5 specifically illustrate theanchor120 in use with theelectrode lead104, it is understood that embodiments of theanchor120 include its use with other devices and components, such as the mechanical support described above.
• Eachanchor120 generally comprises one or moreprotruding elements150 that are attached to ananchor body152. It is understood that although exemplary illustrations of theanchors120 described below comprise multipleprotruding elements150, it is understood that embodiments of theanchor120 include anchors having a singleprotruding element150 and anchors having different types of protrudingelements150 in accordance with the embodiments described herein.
• Multiple embodiments of theanchor120 that are generally independent of the type of protrudingelement150 that is employed will initially be discussed with reference toFIGS. 3-5. Embodiments of theanchor body152 include the lead body110 (FIG. 3), the stimulating electrode112 (FIG. 4), a mechanical support or sling132 (FIG. 2), a cable138 (FIG. 2), and a separate component154 (FIG. 5) that can be attached to thelead body110 or other component. These embodiments of theanchor body152 are generally included in each reference to theanchor body152.
• In one embodiment, theanchor body152 and theprotruding elements150 can be formed of a wide variety of biocompatible implant materials. Suitable materials for an implant include polymerics, and plastics such as polypropylene, polyethylene, nylon, polyester, biocompatible metals or other suitable biocompatible material. In one embodiment, the protrudingelements150 of the stimulatingelectrode112 are formed of a metallic conductive material, such as that of the stimulatingelectrode112.
• In one embodiment, the protrudingelements150 are integral with theanchor body152, such as thelead body110 or the stimulatingelectrode112, as respectively illustrated inFIGS. 3 and 4. Thus, the protrudingelements150 are either formed along with the formation of theanchor body152 or are subsequently fused to theanchor body152 through a welding or other conventional process. In one embodiment, when the protruding elements are integral with the stimulatingelectrode112, the stimulating signals generated by thecontrol unit102 are discharged into the tissue through the electrically conductiveprotruding elements150.
• In one embodiment, the protrudingelements150 are non-integral to theanchor body152. That is, the protrudingelements152 are attached to theanchor body152 using an adhesive, a mechanical fastener or other suitable means.
• As mentioned above, one embodiment of theanchor body152 comprises acomponent154 that is used to attach the anchor to the desiredelectrode body110, stimulatingelectrode112,mechanical support132 or other component. In one embodiment, thecomponent154 comprises a hub or sleeve as shown inFIG. 5, to which one or more of theprotruding elements150 are attached. Thecomponent154 can be attached to the lead body110 (FIG. 5) to the stimulatingelectrode112, themechanical support132, or other component. The protrudingelements150 can be attached to thecomponent154 or formed integral therewith.
• In one embodiment, thecomponent154 comprises a cylindrical hub having abore156 having a diameter that is slightly larger than the external diameter the component to which it is attached and concentric thereto, an example of which is thelead body110 shown inFIG. 5. Thecylindrical hub154 is fixedly attached to a desired portion of thelead body110 or the stimulatingelectrode112 using a biocompatible adhesive or other suitable means. In one embodiment, thebore156 of thecylindrical hub154 is approximately the same or smaller than the external diameter of thelead body110 or other component to which it is attached, such that thebore156 of thecylindrical hub154 compresses theexterior surface158 of thelead body110 with sufficient force to maintain the relative positions of thecylindrical hub154 and thelead body110 during, and subsequent to, implantation of theelectrode lead104 in the patient.
• In one embodiment, theanchor body152 comprises aspiral tube160, from which the one or moreprotruding elements150 extend, as shown inFIG. 6. In one embodiment, thespiral tube160 wraps around thelead body110, the stimulatingelectrode112, or other component, represented in phantom lines, and is fixed thereto using a biocompatible adhesive or through frictional resistance between theinterior surface162 of thespiral tube160 and theexterior surface164 of the lead body or stimulating electrode. As mentioned above, theanchor body152 can be formed by the stimulatingelectrode112. Thus, it is understood that, in a related embodiment, the stimulatingelectrode112 is formed like theanchor body152 withspiral tube160.
• The following discussion of the location and orientation of theprotruding elements150 in accordance with embodiments of the invention applies to the embodiments described above and is generally independent of the type ofanchor body152, to which theprotruding elements150 are attached. In one embodiment, at least some of theprotruding elements150 are displaced from each other along the longitudinal axis of theanchor body152, as illustrated inFIGS. 3-5. In another embodiment, at least some of theprotruding elements150 are not displaced from each other along thelongitudinal axis170. Rather, some of theprotruding elements150 are aligned with aplane172 that extends perpendicular to thelongitudinal axis170.
• In one embodiment, the protrudingelements150 are angularly aligned such that at least some of theprotruding elements150 are positioned in the same radial plane, such asprotruding elements150A and150B that are aligned with theradial plane174A, which extends through thelongitudinal axis170, as shown inFIG. 7.
• In one embodiment, the protrudingelements150 are angularly displaced from each other by anangle176, as shown inFIG. 7. Theangle176 can be selected based on the type of protrudingelement150 being used, the number ofprotruding elements150, the type of tissue in which theprotruding elements150 are to be embedded and other factors.Exemplary angles176 include angles that result in the equal angular displacement of theprotruding elements150 that are in thesame plane172 that is perpendicular to thelongitudinal axis170, such as 90 degrees for the exemplary embodiment illustrated inFIG. 7. In one embodiment, theangles176 between the protruding elements are non-uniform. This may be useful when there is a side of thelead body110 that will be in close proximity to tissue that you do not wish to contact with aprotruding element150, for example.
• In another embodiment, at least some of theprotruding elements150 that are longitudinally displaced from each other are angularly staggered such that they do not lie in the same radial plane that is in line with the longitudinal axis. For instance, one or moreprotruding elements150A and150B may be positioned in theradial plane174A while one or more other protrudingelements150C and150D, which are longitudinally displaced from the protrudingelements150A and150B, are positioned in theradial plane174B that is angularly displaced from theradial plane174A by theangle178, as illustrated inFIG. 7.
• In one embodiment, the one or moreprotruding elements150 have aproximal end180 that is attached to theanchor body152 and adistal end182 that is displaced from theanchor body152 and is configured to embed in the tissue of the patient. In one embodiment, thedistal end182 of the protrudingelement150 is angled toward aproximal side184 of theanchor120 corresponding to theproximal end106 of theelectrode lead104, as illustrated by protrudingelement150A ofFIG. 8. In accordance with another embodiment, thedistal end182 of the protrudingelement150 is angled toward thedistal side186 of theanchor120 corresponding to thedistal end114 of theelectrode lead104, as illustrated by protrudingelement150B inFIG. 8. In accordance with another embodiment, theanchor120 includes a combination of protrudingelements150 having distal ends182 that are angled toward theproximal side184 and thedistal side186 of theanchor120, as shown inFIG. 8.
• Additional embodiments of theanchor120 include various combinations of the above-described embodiments and one or more of the embodiments of theprotruding elements150 described below. In one embodiment, the protrudingelements150 extend radially from theanchor body152 and operate to secure the position of theelectrode lead104 relative to the tissue in which it is embedded. The radially extending protruding element orelements150 of theanchor120 resist movement of theelectrode lead104 in the longitudinal direction defined by thelongitudinal axis170 of theelectrode lead104 relative to the tissue in which theelectrode lead104 is embedded. Embodiments of theprotruding elements150 can also operate to inhibit or prevent theelectrode lead104 from twisting relative to the tissue in which it is embedded.
• In one embodiment, the protrudingelement150 is flexible and can be compressed radially toward theanchor body152. This compressibility of the protruding element orelements150 allows theanchor120 to be received within an introducer for deployment into the desired tissue of the patient. Additionally, this flexibility can provide a stress relief from forces that drive movement of theanchor120 relative to the tissue in which theanchor120 is embedded and can avoid or reduce the likelihood of tearing the tissue. Further, the flexibility of the protrudingelement150 can drive the stimulating electrode back to its intended position relative to the tissue in response to small movements of the stimulatingelectrode112.
• One embodiment of the protrudingelement150 comprises atine190, exemplary illustrations of which are shown inFIGS. 3-8. Thetine190 is preferably flexible, but can also be formed to be rigid. In one embodiment, the tine90 is bowed slightly as shown inFIG. 8.
• One embodiment of the protrudingelement150 comprises a disk192 that extends radially from theanchor body152, as illustrated in the side plan view ofFIG. 9A and the cross-sectional view ofFIG. 9B taken generally along line B-B ofFIG. 9A. In one embodiment, the one or more disks192 are flexible and hold theelectrode lead104 in the tissue of the patient like plunger seal. The diameter and thickness of the disks192 can be selected to provide the desired fixation performance.
• In another embodiment of the protruding element orelements150, theanchor120 comprise an umbrella-shapedcup194, as illustrated in the front plan view ofFIG. 10A and the cross-sectional view ofFIG. 10B, which is taken generally along line B-B ofFIG. 10A. In another embodiment, the protrudingelement150 comprises a cone-shapedcup196, as illustrated in the front plan view ofFIG. 11A and the side-cross sectional view ofFIG. 11B, which is generally taken along line B-B ofFIG. 11A. Thecups194 and196 can be reinforced byribs198, which limit the amount thecups194 or196 flex in response to movement relative to the tissue in which they are embedded. The reinforcingribs198 can be formed integrally with thecups194 or196, extend between an exterior surface200 and the anchor body152 (FIG. 10B), or extend between aninterior surface202 and the anchor body152 (FIG. 11B).
• In one embodiment, theanchor120 includes one or moreprotruding elements150 in the form ofbarbs204, as illustrated in the cross-sectional view of a portion of theanchor120 provided inFIG. 12. Thebarbs204 are generally smaller than thetines190 and are preferably disposed about the surface of theanchor body152 in greater numbers than thetines190. The reduced gripping power that thebarbs204 have as a result of the shorter depth to which they extend into the tissue of the patient is preferably offset by greater numbers ofbarbs204.
• Another embodiment of the protruding element orelements150 comprise shapedbumps206 orridges208, as illustrated in the side-cross sectional view ofFIG. 13. Thebumps206 generally provide a surface texture to theanchor body152 that can increase the slip resistance between theanchor120 and the tissue, in which theanchor120 is embedded. Theridges208 can be shaped similarly to thecups194 and196 but are generally smaller and do not extend as far radially from theanchor body152. In one embodiment, thebumps206 and theridges208 are annular and, thus, extend around the circumference of theanchor body152.
• FIG. 14 is an isometric view of ananchor120 in accordance with another embodiment of the invention, in which theprotruding elements150 are in the form of bristles or brush-like protrusions210. Thebristles210 can be similar to those typically found in test tube or bottle brushes. Embodiments of theprotruding elements210 include orienting the bristles such that they are substantially perpendicular to thelongitudinal axis170, or angling the protrudingelements210 toward theproximal side184, and/or thedistal side186 of theanchor120.
• FIG. 15 is an isometric view of ananchor120 in accordance with another embodiment of the invention, in which theprotruding elements150 are in the form offiber loops212 that are disposed about the exterior surface of theanchor body152. The tissue, in which theanchor120 is embedded, grows around and through the fibrous loops to secure theanchor120 to the tissue. In one embodiment, thefibrous loops212 are similar to Velcro® or DuoLock® like material, or are of a hook and loop design.
• FIGS. 16A and 16B are isometric views ofanchors120, in which theprotruding elements150 comprises a spiralingthread214. Thethread214 operates like a screw that can be screwed into the tissue of the patient by rotating theanchor120 in the appropriate direction. In one embodiment, thethread214 extends radially from theanchor body152 at anangle216 that is approximately perpendicular to thelongitudinal axis170 of theanchor body152, as shown inFIG. 16A. In accordance with another embodiment, thethread214 extends from theanchor body152 at anacute angle218 relative to thelongitudinal axis170. In one embodiment, thethreads214 are formed of a rigid plastic or other biocompatible material. In another embodiment, thethreads214 are formed of a flexible material that allows thethreads214 to flex with motion of the tissue.
• FIG. 17 is an isometric view of ananchor120 in accordance with another embodiment of the invention, in which the protrudingelement150 is in the form of amesh sleeve220. Themesh sleeve220 preferably extends around the circumference of theanchor body152 and can be concentric thereto. The size of the openings or pores of themesh sleeve220 are preferably sufficient to allow tissue in-growth and fixation within the surrounding tissue. The mesh can be made from polypropylene, for example.
• In accordance with another embodiment, a mesh material222 is integrally formed with theanchor body152, as illustrated inFIG. 18.
• In one embodiment of theanchor120, theanchor body152 comprises an expandable stent likemesh224 that is formed of a flexible material or plastic, as shown in the side plan view ofFIG. 19, in which the expandable stent likemesh224 is shown in an expanded state. During the implantation of theanchor120 in the patient, the expandable stent likemesh224 is placed in a compact state, similar to that illustrated inFIG. 18. Once theanchor120 is in the desired position within the tissue of the patient, the expandable stent likemesh224 can be expanded in accordance with conventional techniques into the tissue of the patient. The expansion of thestent224 provides immediate resistance to movement of theanchor120 relative to the tissue. Over time, the tissue of the patient is allowed to grow within the pores of the mesh material, which further secures theanchor120 to the tissue of the patient.
• In accordance with another embodiment of the invention, the protrudingelements150 of theanchor120 are either partially or completely covered by a material that allows for the temporary repositioning of theanchor120 relative to the tissue of the patient. This is particularly useful where the protruding elements are not compatible with an introducer or are relatively inflexible.
• In one embodiment, the protrudingelements150 of theanchor120 are wrapped in asheath226, as shown in the side cross-sectional view ofFIG. 20A. Thesheath226 prevents the protrudingelements150 from gripping the tissue of the patient as theanchor120 is moved in either the forward or rearward direction along thelongitudinal axis170 of theanchor body152. In one embodiment, the sheath operates to compress theprotruding elements150 toward theanchor body152, which reduces the cross-sectional area of theanchor120 and allows for easier insertion and repositioning of theanchor120 within the tissue of the patient.
• In one embodiment, thesheath226 can be removed after theanchor120 or stimulatingelectrode112 is placed in the desired position. In one embodiment, thesheath226 includes a longitudinal slit that simplifies its removal. In another embodiment, a wire or other component is used to pull out thesheath226 or generate a longitudinal slit insheath226 after the implantation of theelectrode anchor body152. After the sheath is removed or absorbed by the patient, the protruding elements spring open to an expanded position and embed into the tissue of the patient.
• In another embodiment, thesheath226 is formed of a material that is absorbable by the patient. Once theanchor body120 or the stimulatingelectrode112 is place in the desired position within the patient, thesheath226 is absorbed by the body and theprotruding elements150 are allowed to become embedded within tissue of the patient.
• In accordance with another embodiment, anabsorbable material228 is positioned at least about the protrudingelements150 to prevent theprotruding elements150 from snagging the tissue of the patient. Thematerial228 allows theanchor120 to be moved in either direction along thelongitudinal axis170 within the tissue of the patient. After theanchor120 is placed in the desired position within the tissue of the patient, the absorbable material gets absorbed by the patient over time and the protruding elements become embedded in the tissue of the patient.
• Theanchor120 illustrated in the top plan views ofFIGS. 21A and 21B comprises a pair of protrudingelements150 that can be placed in an expandedposition230, which is illustrated inFIG. 21A, and a closed or clampingposition232, which is illustrated inFIG. 21B. Initially, theanchor120 is driven into thetissue234 of the patient while in the expandedposition230. Once inserted into the tissue as desired, the protrudingelements150 of theanchor120 are brought together to theclamping position232 and the tissue is pinched between theprotruding elements150. When in the clamping position, the protrudingelements150 grip thetissue234 and secure theanchor120 to thetissue234. In one embodiment, one or morestimulating electrodes112 are located at thedistal end182 of at least one of theprotruding elements150 and are configured to apply electrical stimulation to thetissue234 that is generated by thecontrol unit102 described above.
• FIGS. 22A-C illustrate ananchor120 in accordance with another embodiment of the invention, in which the protruding element orelements150 comprise afine wire240 that extends out of alumen242 that is formed in theanchor body152. In one embodiment, thewire240 is initially in a retracted position, shown inFIG. 22A, in which thewire240 is either slightly extended out of the lumen242 (as shown) or fully retracted within thelumen242. This arrangement allows theanchor120 to be fed into the tissue of the patient. Once theanchor120 is in the desired position within the tissue of the patient, thewire240 can be extended out of thelumen242 and into the tissue, as illustrated inFIG. 22B. In one embodiment, thewire240 coils as it is fed into the tissue of the patient, as illustrated inFIG. 22C. In one embodiment, thewire240 is formed of a memory shaped material, such as nickel titanium (i.e., NITINOL), that forces thewire240 to follow a coil trajectory through the surrounding tissue of the patient as it is extended from thelumen242. Embodiments of theanchor120 include one ormore wires240. Thewires240 can be angularly displaced about the surface of theanchor body120, as illustrated in the on-axis view ofFIG. 23. In one embodiment, thewires240 are configured to coil around theanchor body152, as illustrated in the on-axis view ofFIG. 24.
• Another embodiment of theanchor120 of the present invention comprises one or moreprotruding elements150 that are configured to have a retracted position, in which thedistal end182 of the protrudingelement150 is located in close proximity to theanchor body152, and an extended position, in which thedistal end182 is displaced radially from theanchor body152.FIGS. 25A and 25B are side plan views of an embodiment of aprotruding element150 respectively in a retractedposition244 and anextended position246. When in the retractedposition244, thedistal end182 of the protrudingelement150 lies in close proximity to theexterior surface248 of theanchor body152. In one embodiment, the protrudingelement150 is flexible and is configured to bend at aportion250 that is adjacent to theproximal end180. A protrudingelement150 can move to this retractedposition244 automatically in response to the feeding of theanchor120 through the tissue of the patient or by placing theanchor120 in a tube of an introducer, for example.
• Once theanchor120 is positioned as desired in the tissue of the patient, theanchor body152 can be pulled toward theproximal side184. During this movement of theanchor body120, thedistal end182 of the protrudingelement150 snags a portion of the tissue of the patient and the protrudingelement150 is driven to theextended position246 shown inFIG. 25B. With only a slight movement of theanchor body152 toward theproximal side184, the protrudingelement150 can reach the fullyextended position246. In one embodiment, astop member252 is positioned to limit the distance that thedistal end182 of the protrudingelement150 can move toward thedistal side186. Thus, thestop member252 defines the fullyextended position246 for theprotruding element150.
• FIGS. 26A and 26B respectively illustrate another embodiment of aprotruding element150 having a retractedposition244 and anextended position246. In accordance with one embodiment, the protrudingelement150 is coupled to theanchor body152 by ahinge254. The protrudingelement150 is allowed to pivot about thehinge254 between the retractedposition244 shown inFIG. 26A and theextended position246 shown inFIG. 26B. As with the embodiment of the protrudingelement150 described above with regard toFIGS. 25A and 25B, the protrudingelement150 shown inFIGS. 26A and 26B moves from the retractedposition244 to theextended position246 in response to movement of theanchor body152 toward theproximal side184 or during the slight withdrawal of theanchor120 from the tissue of the patient.
• FIG. 27 illustrates a simplified side view of adistal end114 of anelectrode lead104 having alead body110 that includes ananchor257, in accordance with embodiments of the invention, that is implanted intissue258 of the patient.FIG. 28 provides a cross-sectional view of theanchor257 taken generally along line28-28 ofFIG. 27 and illustrates the implantation of thedistal end114 of the electrode adjacent a structure259 of the patient.
• As discussed above, one embodiment of theelectrode lead104 comprises one ormore electrodes112, each located at adistal end114 of thelead body110. Theelectrodes112 may be separated by an insulatingelement267, which may comprise thelead body110.
• One embodiment of theanchor257 comprises ananchor body152 in accordance with the embodiments described above, such as the lead body110 (FIG. 27), and a section ofmesh260 attached to theanchor body152. In one embodiment, theanchor257 is located at thedistal end114 of theelectrode lead104. Thebio-compatible mesh260 is preferably an open matrix mesh, such as a mesh constructed of polypropylene monofilament. In one embodiment, themesh260 comprises one or more mesh sections or wings, such aswings261 and262.
• In one embodiment, themesh260 has a compact state and an expanded state. In general, at least a portion of themesh260 is displaced a greater distance from theanchor body152 when in the expanded state than when in the compact state. Theanchor257 is generally in a form suitable for implantation in thetissue258 when themesh260 is in the compact state and performs its anchoring function in thetissue258 when themesh260 is in the expanded state, such as described above with regard toFIG. 19.
• In one embodiment, themesh260 has a shape memory that drives the mesh to a preset expanded, quiescent shape, in which at least a portion of themesh260 extends away from theanchor body152 and into the surroundingtissue258. As used herein, the “quiescent shape” of themesh260 is one in which the mesh will naturally return to after being deformed, such as when compressed into a compact state.
• In one embodiment, the expanded state of themesh wings261 and262 is one in which thewings261 and262 are displaced from each other, such as illustratedFIG. 28. Thus, one embodiment of themesh260 has a shape memory that encourages separation of the one or more wings, such aswings261 and262, within thetissue258.
• In one embodiment, theanchor257 is configured to deliver electrical signals from the control unit to thetissue258. In one embodiment, themesh260 comprises the one ormore electrodes112 that are used to deliver electrical signals to thetissue258. In one embodiment, one or more conductive fibers264 (FIG. 27) are attached to themesh260 and conduct electrical signals from one or more of theelectrodes112 of the lead body (FIG. 27), or thecontrol unit102, into thetissue258. In one embodiment, theconductive fivers264 are electrically insulated from thetissue258 and conduct the electrical signals to one or more electrically conductive nodes orelectrodes266 that are attached to themesh260 and deliver the electrical signals to thetissue258.
• A portion of themesh260 is attached to thedistal end114 of theelectrode lead104 at alocation268. Exemplary means for attaching themesh260 to theelectrode lead104 include sutures, glue, anchors, or other suitable bio-compatible methods. In one embodiment, theattachment location268 comprises a central portion of themesh260. As a result, one embodiment of theanchor257 comprises at least two wings ofmesh261 and262 that extend from the distal end of theelectrode lead104 at theconnection location268.
• FIG. 29 is a simplified cross-sectional view of thedistal end114 of theelectrode lead104 having theanchor257 installed in adelivery trocar270 that is used to implant theelectrode lead104 in the desiredtissue258 of the patient. In one embodiment, themesh260 of theanchor257 is placed in the compact state (e.g., rolled up) and installed in thetrocar270. When theanchor257 is deployed from thetrocar270 into thetissue258, themesh260 expands toward the expanded state or its expanded quiescent shape. Tissue ingrowth secures themesh260 to thetissue258 to anchor the location of thedistal end114 of theelectrode lead104.
• When themesh260 comprises thewings261 and262, thewings261 and262 compressed into the compact state, as shown inFIG. 29. In one embodiment, themesh wings261 and262 extend from theconnection point268 away from thedistal end114 of theelectrode lead104. Upon deployment of thedistal end114 of theelectrode lead104 in the desiredtissue258 of the patient, themesh sections261 and262 move toward the preset expanded quiescent shape and into thetissue258, as shown inFIG. 28. Ingrowth of thetissue258 into themesh260 operates to anchor themesh260 to thetissue258, thereby anchoring thedistal end114 of theelectrode lead104 in the desired position.
• In one embodiment, themesh260 is deployed in thetissue258 such that it has a desired orientation relative to the structure259 of the patient. As a result, the expansion of themesh260 can be directed to a side of theelectrode lead104 such that it expands away from the structure259 or toward the structure259. For instance, when the structure259 is in the form of the urethra of the patient, thedistal end114 of theelectrode lead104 can be oriented relative to the urethra259 such that themesh260 is located on a side of theelectrode lead104 that is away from the urethra259. This prevents fibrosis around themesh260 from interfering with the communication of electrical stimulation signals from theelectrode lead104 to the structure259.
• In one embodiment, theanchor257 is initially provided in a sterilized and sealed package, in which themesh260, such asmesh sections261 and262, have a quiescent shape in which they lie substantially flat, as illustrated in the simplified cross-sectional view ofFIG. 30.FIG. 31 is a simplified side view of aninstallation tool276 in accordance with embodiments of the invention that is used to prepare theanchor257 for installation within atrocar270. Thetool276 comprises a forkedend278 that includesprongs280 and282 that extend substantially parallel to thelongitudinal axis284 of thetool276. Agap286 between theprongs280 and282 is configured to receive a distal end288 of themesh260, as illustrated in the simplified cross-sectional view ofFIG. 32.
• Theanchor257 is prepared for installation within atrocar270 by placing the end288 of themesh260 through thegap286 and rotating thetool276, such as in the direction indicated byarrow290, to roll up themesh260, as illustrated in simplified front cross-sectional views ofFIGS. 32 and 33. Once themesh260 has been rolled up into a compact state, thedistal end114 of theelectrode lead104 and theanchor257 can be installed in atrocar270, as illustrated in the simplified cross-sectional view ofFIG. 34. Theend278 of thetool276 is disengaged from themesh260 either prior to or after the insertion of thedistal end114 within thetrocar270. When thedistal end114 of theelectrode lead104 is deployed into the desiredtissue258 of the patient using thetrocar270, themesh260 expands toward its expanded quiescent shape within thetissue258, as discussed above.
• FIGS. 35 and 36 respectively are front and side cross-sectional views of adistal end114 of theelectrode lead104 comprising theanchor257 installed within atrocar270, in accordance with embodiments of the invention. Atool292 is installed in thetrocar270 to aid in the deployment of themesh wings261 and262.
• In one embodiment, thetool292 operates to separate themesh wings261 and262 and prevent their entanglement within thetrocar270.
• In one embodiment, thetool292 is configured to cause or assist in the expansion of themesh wings261 and262 into thetissue258 after deployment of thedistal end114 into thetissue258. In one embodiment, once thedistal end114 of theelectrode lead104 held in thetrocar270 is located at the desired position within thetissue258 of the patient, thetrocar270 is partially retracted, as illustrated in the side cross-sectional view ofFIG. 37. In one embodiment, the cross-sectional width of theend284 of thetool292 is expanded, which drives themesh wings261 and262 away from each other within thetissue258, as illustrated inFIG. 38. Thedistal end294 of thetool292 can then be withdrawn into thetrocar270 and removed from the patient through thetrocar270 to complete the implantation of thedistal end114 of theelectrode lead104 within thetissue258 of the patient, as illustrated in the cross-sectional view ofFIG. 39. In one embodiment, the cross-sectional width of theend294 of thetool292 is reduced prior to its withdrawal from the patient.
• In one embodiment, thetool292 comprises a scissor-like mechanism that expands the effective width of thedistal end294.
• FIGS. 40-42 are simplified side views of atool292 in accordance with embodiments of the invention. In one embodiment, thetool292 comprises first and secondelongated components296 and298 that are respectively coupled to athird component300 throughhinges302 and304. Theinitial width306 of thetool292 allows thetool292 to be received within thetrocar270, as shown inFIGS. 35 and 36. Following the retraction of the trocar270 (FIG. 37),component296 is moved relative to component298, such as, for example, in the direction indicated byarrow308. The displacement of thehinge304 from thehinge302 in the widthwise direction causes thecomponent300 to pivot about thehinge302 relative to the component298 in the direction indicated byarrow310 to an expanded position, as shown inFIG. 41. Thewidth312 of thedistal end294 of thetool292 in the expanded position is significantly greater than thewidth306. This expansion of the width of thedistal end294 drives the expansion of themesh wings261 and262, as illustrated inFIG. 38.
• After themesh wings261 and262 have been expanded through the expansion of the width of thedistal end294 of thetool292, thecomponent296 can be further moved relative to the component298 in a direction indicated byarrow308 to place thedistal end294 in a compacted state (FIG. 42), in which thetool292 may either be received again within thetrocar270, or otherwise removed from the patient, while leaving thedistal end114 of theelectrode lead104 in the desired location within thetissue258 of the patient.
• Additional embodiments of the invention are directed to kits that include one or more of the embodiments described above.FIG. 43 illustrates akit320 in accordance with embodiments of the invention. In one embodiment, the kit includes apackage322 containing components including one or more electrode leads104 in accordance with one or more of the embodiments described above. In one embodiment, thekit320 includes thecontrol unit102. In one embodiment, the kit includesinstructions326 for installing the one or more electrode leads104 in the patient. In one embodiment, theinstructions324 include instructions for installing thecontrol unit102.
• In one embodiment, the one or more electrode leads104 in thekit320 include ananchor326 in accordance with one or more of the embodiments described above, such asanchor120 or257. In accordance with one embodiment, thedistal end114 of the one or more electrode leads are provided pre-installed in atrocar270. In accordance with one embodiment, one or more tools, such asinstallation tool278 ordeployment tool292, are provided in thekit320. Embodiments of theinstructions324 include instructions for implanting thedistal end114 of theelectrode lead104 withintissue258 of the patient using thetrocar270,tool278 and/ortool292. Such instructions include instructions describing one or more of the method steps discussed above with reference toFIGS. 32-42.
• Although the present invention has been described with reference to preferred embodiments, workers skilled in the art will recognize that changes may be made in form and detail without departing from the spirit and scope of the invention.

Claims (20)

1. An electrode lead configured for implantation in a patient comprising

a lead body having proximal and distal ends;

an electrode formed of an electrically conductive material and attached to the distal end of the lead body; and

an anchor attached to the distal end of the lead body, the anchor comprising an anchor body and mesh attached to the anchor body.

2. The electrode lead ofclaim 1, wherein the mesh comprises compact and an expanded states, wherein at least a portion of the mesh is displaced a greater distance from the anchor body when in the expanded state than when in the compact state.

3. The electrode lead ofclaim 2, wherein:

the mesh comprises first and second wings of mesh; and

the mesh wings are each biased to move from the compact state to the expanded state.

4. The electrode lead ofclaim 2, wherein the anchor comprises an expandable stent like mesh.

5. The electrode lead ofclaim 1, wherein the mesh comprises first and second wings.

6. The electrode lead ofclaim 5, wherein the first and second wings each have a quiescent shape in which they are extended away from the anchor body.

7. The electrode lead ofclaim 1, further comprising one or more conductive fibers attached to the mesh.

8. The electrode lead ofclaim 7, wherein the electrode is attached to the mesh and the one or more conductive fibers.

9. The electrode lead ofclaim 8, wherein:

the mesh comprises first and second wings; and

the first and second wings each have a quiescent shape in which they are extended away from the anchor body.

10. The electrode lead ofclaim 1, wherein the anchor body is selected from the group consisting of the lead body, the electrode, a component coupled to the lead body, and a component coupled to the stimulating electrode.

11. An assembly comprising:

an electrode lead comprising:

a lead body having proximal and distal ends;

an electrode formed of an electrically conductive material and attached to the distal end of the lead body; and

an anchor attached to the distal end of the lead body, the anchor comprising an anchor body and mesh attached to the anchor body; and

a trocar;

wherein the distal end of the lead body, the electrode and the anchor are installed within the trocar.

12. The assembly ofclaim 11, wherein the mesh is rolled upon itself.

13. The assembly ofclaim 11, wherein the mesh comprises first and second wings.

14. The assembly ofclaim 13, wherein the first and second wings each have a quiescent shape in which they are extended away from the anchor body.

15. The assembly ofclaim 11, wherein:

the electrode is attached to the mesh; and

the electrode lead further comprises one or more conductive fibers attached to the mesh and configured to deliver electrical signals to the electrode.

16. The assembly ofclaim 11, further comprising a tool having an expandable distal end positioned within the trocar adjacent the mesh.

17. A kit comprising:

a package; and

an electrode lead contained in the package, the electrode lead comprising:

a lead body having proximal and distal ends;

an electrode formed of an electrically conductive material and attached to the distal end of the lead body; and

an anchor attached to the distal end of the lead body, the anchor comprising an anchor body and mesh attached to the anchor body.

18. The kit ofclaim 17, further comprising:

a trocar contained in the package, wherein the distal end of the lead body is within the trocar; and

a tool having an expandable distal end positioned within the trocar adjacent the mesh.

19. The kit ofclaim 18, further comprising instructions for implanting the electrode lead in tissue of a patient using the trocar and the tool.

20. The kit ofclaim 17, further comprising an implantable control unit configured to deliver electrical signals to the electrode.

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