US-12616479-B2 - Aggressive featured clips with improved tissue retention

Abstract

A system for treating tissue includes a capsule including a channel extending therethrough; first and second clip arms each extending from a proximal end to a distal end, the proximal ends being received within the channel of a capsule to be moved between an open tissue receiving configuration; and a closed tissue clipping configuration. The first clip arm includes a first tissue retention feature at a distal portion thereof configured to pierce through a target tissue when in the tissue clipping configuration and subsequently release the target tissue when the clip arms are moved to an at least partially open configuration. The second clip arm includes a second tissue retention feature at a distal portion thereof configured to pierce and retain the target tissue thereon when in both the closed tissue clipping configuration and the open tissue receiving configuration.

Inventors

• Shawn Ryan
• Irina Pyataeva

Assignees

• BOSTON SCIENTIFIC SCIMED, INC.

Dates

Publication Date

20260505

Application Date

20240930

Claims (20)

1. 1 . An apparatus for treating tissue, comprising: a first clip configured to be releasably coupled to a distal end of an insertion section, the first clip including first and second clip arms movable between an open configuration in which distal ends of the first and second clip arms are drawn apart to receive target tissue therebetween and a closed configuration in which the distal ends of the first and second clip arms are drawn together to clip tissue received therebetween, the first clip arm including a first tissue engaging feature and the second clip arm including a second tissue engaging feature, the first tissue engaging feature being proximal of the distal end of the first clip arm, one of the first tissue engaging feature and the second tissue engaging feature being configured to pierce target tissue as the first clip is closed over the target tissue and to remain embedded in the pierced target tissue when the first and second clip arms are moved to the open configuration after having been closed over the target tissue.
2. 2 . The apparatus of claim 1 , wherein the insertion section includes a control wire extending through the insertion section, the control wire being configured to be releasably coupled to the first clip and the control wire being further configured to be releasably coupled to a second clip after the first clip has been deployed therefrom.
3. 3 . The apparatus of claim 1 , further comprising: a capsule extending from a proximal end releasably coupled to the distal end of the insertion section to a distal end, the capsule defining a channel sized and shaped to slidably receive therein proximal ends of the first and second clip arms.
4. 4 . The apparatus of claim 1 , wherein the second tissue engaging feature is configured to release previously engaged tissue when the first and second clip arms are moved to the open configuration.
5. 5 . The apparatus of claim 4 , wherein the first clip arm includes a third tissue engaging feature proximal of the first tissue engaging feature.
6. 6 . The apparatus of claim 1 , wherein the first tissue engaging feature is configured to engage and retain a first tissue edge on the first clip arm while the second clip arm engages and drags a second tissue edge toward the first tissue edge.
7. 7 . The apparatus of claim 1 , wherein the first tissue engaging feature extends from the first clip arm at a 90 degree angle relative to a longitudinal axis of the first clip arm.
8. 8 . The apparatus of claim 1 , wherein the first and second tissue engaging features are offset from one another longitudinally when the first and second clip arms are in the closed configuration.
9. 9 . The apparatus of claim 1 , wherein the first tissue engaging feature includes a spike and the second tissue engaging feature includes a hook.
10. 10 . The apparatus of claim 1 , wherein the second tissue engaging feature includes a plurality of barbs.
11. 11 . The apparatus of claim 10 , wherein a first one of the barbs extends at a 90 degree angle relative to a longitudinal axis of the second clip arm.
12. 12 . A clipping device configured to be releasably coupled to a distal end of an insertion section, comprising: a first clip arm having a first tissue retaining feature; and a second clip arm having a second tissue retaining feature, the first retaining feature being proximal of a distal end of the first clip arm, one of the first and second tissue retaining features being configured such that, when the clipping device is opened, the one of the first and second tissue retaining features remains embedded in the pierced target tissue while the other one of the first and second tissue retaining features releases the target tissue.
13. 13 . The device of claim 12 , further comprising: a capsule extending from a proximal end releasably coupled to the distal end of the insertion section to a distal end, the capsule defining a channel sized and shaped to slidably receive therein proximal ends of the first and second clip arms.
14. 14 . The device of claim 12 , wherein the first clip arm includes a third tissue retaining feature proximal of the first tissue retaining feature.
15. 15 . The device of claim 12 , wherein the first tissue retaining feature is configured to engage and retain a first tissue edge on the first clip arm while the second clip arm engages and drags a second tissue edge toward the first tissue edge.
16. 16 . The device of claim 12 , wherein the first tissue retaining feature extends from the first clip arm at a 90 degree angle relative to a longitudinal axis of the first clip arm.
17. 17 . The device of claim 12 , wherein the first and second tissue retaining features are offset from one another longitudinally when the clipping device is closed.
18. 18 . The device of claim 12 , wherein the first tissue retaining feature includes a spike and the second tissue retaining feature includes a hook.
19. 19 . The device of claim 12 , wherein the second tissue retaining feature includes a plurality of barbs, at least one of the barbs extending at a 90 degree angle relative to a longitudinal axis of the second clip arm.
20. 20 . An apparatus for treating tissue, comprising: an applicator extending from a proximal end to a distal end; a first clip configured to be releasably coupled to the applicator, the first clip including a first clip arm having a first tissue retaining feature and a second clip arm having a second tissue retaining feature, at least one of the first and second tissue retaining features being proximal of a distal end of its respective clip arm, and the first and second tissue retaining features being configured to pierce target tissue as the first clip is closed over the target tissue, such that, when the first clip is opened, one of the first and second tissue retaining features remains embedded in the pierced target tissue while the other one of the first and second tissue retaining features releases the target tissue; and a second clip configured to be releasably coupled to the applicator after the first clip is deployed from the applicator, the second clip including a third clip arm having a third tissue retaining feature and a fourth clip arm having a fourth tissue retaining feature, at least one of the third and fourth tissue retaining features being proximal of a distal end of its respective clip arm, and the third and fourth tissue retaining features being configured to pierce the target tissue as the second clip is closed over the target tissue, such that, when the second clip is opened, one of the third and fourth tissue retaining features remains embedded in the pierced target tissue while the other one of the third and fourth tissue retaining features releases the target tissue.

Description

PRIORITY CLAIM The present application is a Continuation of U.S. patent application Ser. No. 18/467,557 filed on Sep. 14, 2023, now U.S. Pat. No. 12,127,745; which is a Continuation of U.S. patent application Ser. No. 17/305,373 filed on Jul. 6, 2021, now U.S. Pat. No. 11,793,525; which is a Continuation of U.S. patent application Ser. No. 16/564,822 filed on Sep. 9, 2019, now U.S. Pat. No. 11,083,465; which claims priority to U.S. Provisional Patent Application Ser. No. 62/735,728 filed on Sep. 24, 2018. The disclosures of the above application(s)/patent(s) are incorporated herewith by reference. FIELD The present disclosure relates to compression clips, and more specifically, to compression clips delivered to a target site through an endoscope to cause hemostasis of blood vessels along the gastrointestinal tract. BACKGROUND Pathologies of the gastrointestinal (GI) system, the biliary tree, the vascular system, and other body lumens and hollow organs are often treated through endoscopic procedures, many of which require hemostasis to control bleeding. Hemostasis clips grasp tissue surrounding a wound and hold edges of the wound together temporarily to allow natural healing processes to permanently close the wound. Specialized endoscopic clipping devices are used to deliver the clips at desired locations within the body after which the clip delivery device is withdrawn, leaving the clip within the body. In addition to providing hemostasis, endoscopic clipping devices may also be used to provide, for example, endoscopic marking and closure of luminal perforations, e.g., from endoscopic procedures involving access to internal tissue by passing a device through a wall of a natural body lumen. The opening width of the clips usually determine a maximum size of a defect that it can potentially close. To close a defect larger than a maximum clip opening width, several sophisticated closure techniques have been developed that often require the additional use of snares, “8 rings”, or other devices. As an alternative to these advanced and technically challenging methods, a novel technique for defect closure uses a technique known colloquially “hold and drag” that makes it possible to close sizable defects using only conventional clips. This technique simplifies the closure of large defects and reduces the time required for the procedure. However, the biggest challenge in using this technique is the high risk of tissue slipping out if a clip is reopened. As a result, it is not uncommon that many attempts are required for the successful closure of defects when applying this technique. SUMMARY The present disclosure relates to a system for treating tissue comprising a capsule extending longitudinally from a proximal end to a distal end and including a channel extending therethrough and first and second clip arms each extending from a proximal end to a distal end, the proximal ends being received within a channel of a capsule to be moved between an open tissue receiving configuration, in which distal ends of the clip arms are separated from one another, and a closed tissue clipping configuration, in which distal ends of the clip arms are moved toward one another, wherein the first clip arm includes a first tissue retention feature at a distal portion thereof configured to pierce through a target tissue when in the tissue clipping configuration and subsequently release the target tissue when the clip arms are moved to an at least partially open configuration and the second clip arm includes a second tissue retention feature at a distal portion thereof configured to pierce and retain the target tissue thereon when in both the closed tissue clipping configuration and the open tissue receiving configuration. In an embodiment, the first tissue retention feature includes a single spike at a distal tip of the first arm and the second tissue retention feature includes two spikes at a distal tip of the second arm. In an embodiment, the spikes extend from the distal tips of the first and second arms at a 90 degrees angle relative to the longitudinal axis of the clip arms. In an embodiment, when the clip arms are in the closed configuration, spikes on opposing clip arms are configured to be staggered. In an embodiment, the first tissue retention feature includes at least one spike at a distal tip of the first arm and the second retention feature is a hook extending from the distal tip of the second arm. In an embodiment, the second tissue retention feature includes a plurality of barbs extending from an interior surface of the second clip arm. In an embodiment, the barbs extend at a 90 degrees angle relative to a longitudinal axis of the second clip arm. The present disclosure also relates to a reloadable clip device comprising an applicator including a catheter and a control member extending therethrough, the control member extending from a proximal end to a distal end and being longitudinally movable relative to the applicator, a