Abstract:
A clip and a bioabsorbable marker are employed to mark a biopsy site. The former provides a permanent marker that is clamped onto tissue and that cannot migrate from the site over time. The latter is gradually bioabsorbed over time but the time may vary widely from weeks to months. In most embodiments, the clip and marker are integrally formed with one another at the time of manufacture. In one embodiment, the clip and marker are independently made but are joined to one another during the site-marking process. The markers are deployed by core biopsy needles of the type employing a vacuum, of the type that does not employ a vacuum, and by coaxial biopsy needles.

Description:
BACKGROUND OF INVENTION 
     1. Field of the Invention 
     This invention relates, generally, to tissue markers. More particularly, it relates to a bioabsorbable marker having an anchoring means that is not bioabsorbable and that is external to the bioabsorbable part of the marker. 
     2. Description of the Prior Art 
     Placing a marker in or near a lesion or tumor upon which a biopsy procedure has been performed enables a physician to find the lesion or tumor at a date weeks or months after the biopsy, depending upon the rate of degradation of the marker. The marker may be observed under ultrasound, it may be radiopaque, or the like. 
     In some cases, the marker material may be completely bioabsorbed by the time the physician needs to locate the lesion or tumor again. One of the ways to enable such re-finding of the lesion or tumor is to attach a metallic marker to the bioabsorbable marker so that the metallic marker may be found by X-ray or other techniques long after the marker has been bioabsorbed. 
     However, metallic markers are prone to migrate within the tissue. Thus, when they are found after the passage of an extent of time, they may have migrated from their initial position in or near the lesion or tumor, thereby destroying their functionality as a marker to accurately mark the biopsy site. 
     What is needed, then, is a bioabsorbable marker having a metallic part that does not migrate after the bioabsorbable material of the marker has been absorbed by a patient&#39;s body. 
     However, in view of the prior art considered as a whole at the time the present invention was made, it was not obvious to those of ordinary skill in the pertinent art how the identified need could be fulfilled. 
     SUMMARY OF INVENTION 
     The long-standing but heretofore unfulfilled need for a bioabsorbable marker having a metallic part that does not migrate after the bioabsorbable material of the marker has been absorbed by a patient&#39;s body is now met by a new, useful, and nonobvious invention. 
     In a first embodiment of the novel tissue marker means, a biologically absorbable marker has a trailing end and a leading end. A metal wire of straight configuration has a trailing end embedded within the leading end of the biologically absorbable marker and a leading end of the metal wire is disposed in leading relation to the leading end of the biologically absorbable marker. 
     A delivery catheter has an anvil means fixedly secured within a lumen of the delivery catheter at a leading end of the delivery catheter. The anvil has a cavity formed therein that causes bending of the straight wire into a hook shape when the straight wire is driven in a trailing-to-leading direction into the cavity. 
     Without restriction to the particular apparatus of the first embodiment, the method of the first embodiment includes the steps of fixedly securing a trailing end of a straight wire into a leading end of a tissue marker means, providing a delivery catheter having a side port and means for communicating a vacuum to a lumen of the delivery catheter, fixedly securing an anvil means within the lumen of the delivery catheter at a leading end of the delivery catheter in leading relation to the side port, forming a blind bore having a concave bottom in the anvil, introducing the tissue marker means into the lumen of the delivery catheter from a trailing end of the delivery catheter, introducing the delivery catheter into a biopsy needle having a side port so that the respective side ports of the delivery catheter and biopsy needle are in substantial registration with one another, applying a vacuum to the biopsy needle so that tissue is pulled into the lumen of the delivery catheter, pushing the tissue marker means in a trailing-to-leading direction toward the leading end of the delivery catheter so that the free leading end of the straight wire penetrates tissue that has been pulled under vacuum into the lumen of the delivery catheter and so that the free leading end of the straight wire then enters into the blind bore and is bent into a hook shape when said leading end encounters the concave bottom of the cavity and is constrained to form a return bend as the pushing of the tissue marker means continues, and removing the biopsy needle and delivery catheter from the tissue site so that only the biologically absorbable marker and the wire remain at the site whereby the wire engaging the tissue prevents migration of the biologically absorbable marker and of the wire. 
     There is no requirement in the first embodiment, or any other embodiment, that the marker be biologically absorbable. Such feature is merely preferable but not critical. 
     Nor must the means for anchoring the marker against migration necessarily be formed of metal. Instead of metal, an injection-molded plastic member could be employed, as long as the injection-molded member is observable under ultrasound, CT scan, x-ray, MRI, or other imaging technique. Nor is the anchoring means limited to metal or plastic; any material that can be formed into a clip or hook, which can be seen under at least one imaging technique, and which is not toxic to a mammalian body can be employed in lieu of a metallic or plastic clip, hook, or other anchoring means. The anchoring means may be bioabsorbable or non-bioabsorbable. Where a bioabsorbable anchoring means is employed, it should be formed of materials enabling the amount of time required for bioabsorption to be controllable. 
     In a second embodiment of the novel apparatus for anchoring a tissue marker to a tissue site, the structure includes a tissue marker of generally cylindrical configuration. A first bore is formed in the tissue marker in coincidence with a longitudinal axis of symmetry of the tissue marker. The first bore extends from a trailing end to a leading end of the tissue marker. 
     An annular cavity is formed in a leading end of the tissue marker in concentric relation to the bore. A clip formed of metal or other suitable material has opposed jaws disposed in a normally closed configuration where respective free ends of the jaws are in close juxtaposition with one another. The clip has an annular base formed in a trailing end thereof. The annular base is received within and fixedly secured to the annular cavity. 
     A second bore is formed in the clip in coincidence with a longitudinal axis of symmetry thereof. The second bore is in axial alignment with the first bore when the annular base of the clip is received within the annular cavity of the tissue marker. 
     A plunger has a first part of generally cylindrical configuration. The first part has a diameter substantially equal to a diameter of the tissue marker so that the first part and the tissue marker are adapted to be slideably received within a delivery catheter. The plunger has a reduced diameter second part with a pointed leading end for penetrating tissue. 
     A second part of the plunger has an elongate extent sufficient to extend sequentially through the first bore formed in the tissue marker, the second bore formed in the clip, and between the opposed jaws. The pointed leading end of the second part is disposed in leading relation to a leading end of the jaws when the plunger is fully introduced into the delivery catheter. Accordingly, the second part causes the opposed jaws to diverge from one another when inserted therebetween. The opposed jaws converge toward one another under their inherent bias when the second part of the plunger is withdrawn. 
     Without limitation to the particular structure of the second embodiment, a second method for anchoring a tissue marker to a tissue site includes the steps of providing a tissue marker of generally cylindrical configuration, forming a first bore in the tissue marker in coincidence with a longitudinal axis of symmetry thereof so that the first bore extends from a trailing end to a leading end of the tissue marker, forming an annular cavity in a leading end of the tissue marker in concentric relation to the bore, providing a clip having opposed jaws disposed in a normally closed configuration where respective free ends of the jaws are in close juxtaposition with one another, forming an annular base formed in a trailing end of the clip so that the annular base is received within and fixedly secured to the annular cavity, forming a second bore in the clip in coincidence with a longitudinal axis of symmetry of the clip so that the second bore is in axial alignment with the first bore when the annular base of the clip is received within the annular cavity of the tissue marker, providing a plunger having a first part of generally cylindrical configuration, the first part having a diameter substantially equal to a diameter of the tissue marker so that the first part and the tissue marker are adapted to be slideably received within a delivery catheter, providing the plunger with a reduced diameter second part with a pointed leading end for penetrating tissue, forming the second part to have an elongate extent sufficient to extend sequentially through the first bore formed in the tissue marker, the second bore being formed in the clip, and between the opposed jaws so that said pointed leading end of the second part is disposed in leading relation to a leading end of said jaws when the plunger is fully introduced into the delivery catheter so that the second part causes the opposed jaws to diverge from one another when inserted therebetween and so that the opposed jaws converge toward one another under their inherent bias when the second part of the plunger is withdrawn. 
     A third embodiment of the novel apparatus for anchoring a tissue marker to a tissue site includes a marker of generally cylindrical configuration having a leading end and a trailing end. A first bore is formed in the trailing end of the marker in coincidence with a longitudinal axis of symmetry of the marker. A second bore is formed in the leading end of the marker in coincidence with a longitudinal axis of symmetry thereof. The first and second bores are in open communication with one another. The second bore has a diameter greater than a diameter of said first bore. 
     A clip has a trailing end and a leading end. The trailing end is adapted to be received within the second bore. 
     A third bore is formed in the trailing end of the clip in coincidence with a longitudinal axis of symmetry of the clip. The third bore is cross-shaped in transverse cross-section. 
     An inner plunger has a leading end with a circular transverse cross-section of predetermined extent and a pointed distal end of predetermined extent that is adapted to penetrate tissue. The pointed distal end is formed integrally with the leading end and is positioned in leading relation thereto. The inner plunger has a trailing end with a circular transverse cross-section and a middle part with a cross-shaped transverse cross-section adapted to be slidingly received within the cross-shaped third bore. The middle part is formed integrally with the leading and trailing ends of the plunger and is disposed therebetween. 
     An outer plunger has a central bore adapted to slidingly receive the trailing end of the inner plunger. The outer plunger also has a leading end adapted to abuttingly engage the trailing end of the marker. 
     A first radially outwardly extending protuberance is formed on a first jaw of the clip and a second radially outwardly extending protuberance is formed on a second jaw of the clip. The first protuberance has a first beveled trailing surface and the second protuberance has a second beveled trailing surface. The first and second opposed jaws are driven toward one another when the marker is driven in a trailing to leading direction by the outer plunger. The leading end of the marker slideably engages the first and second beveled surfaces and drives the first and second beveled surfaces toward one another. 
     The middle part of the inner plunger is positioned on a trailing side of the third bore and is rotationally misaligned with the cross-shaped third bore so that a trailing end of the middle part is disposed in abutting relation to a leading end of the third bore to prevent travel of the clip in a trailing-to-leading direction when the inner plunger is held against movement in the trailing-to-leading direction. Accordingly, the inner plunger is held against movement in the trailing-to-leading direction, thereby holding the clip against movement in the trailing-to-leading direction, and the outer plunger is displaced in a trailing-to-leading direction to drive the marker in the trailing-to-leading direction. The leading end of the marker enters into sliding engagement with the first and second beveled surfaces, driving them into converging relation with one another. The respective leading ends of the opposed jaws are driven into the tissue by continued trailing-to-leading displacement of the outer plunger. When the jaws are fully embedded within the tissue, a part of the tissue is captured between the jaws. 
     The marker when driven in a trailing-to-leading direction slideably receives the trailing end of the clip into the second bore. Longitudinal displacement of the inner plunger in the trailing-to-leading direction and rotation of the inner plunger about its longitudinal axis of symmetry until the middle part aligns with the cross-shaped cross section of the third bore, followed by retraction of the inner plunger in a leading-to-trailing direction until the inner plunger has exited the first bore leaves the clip secured to the tissue and the marker secured to the trailing end of the clip. 
     A beveled surface is formed in the leading end of the marker to facilitate sliding engagement of the first and second trailing beveled surfaces formed on the first and second jaws of the clip by the beveled surface formed in the leading end of the marker. 
     Without restriction to the particular apparatus of the third embodiment, the method steps of the third embodiment include the steps of forming a marker of generally cylindrical configuration so that it has a leading end and a trailing end, forming a first bore in the trailing end of the marker in coincidence with a longitudinal axis of symmetry of the marker, forming a second bore in the leading end of the marker in coincidence with a longitudinal axis of symmetry of the marker, forming the first and second bores so that they are in open communication with one another and so that the second bore has a diameter greater than a diameter of said first bore, providing a clip having a trailing end and a leading end, and adapting the trailing end so that it is received within the second bore formed in the leading end of the marker, forming a third bore in the trailing end of the clip marker in coincidence with a longitudinal axis of symmetry of the clip and forming the third bore so that it is cross-shaped in transverse cross-section, providing an inner plunger having a leading end with a circular transverse cross-section of predetermined extent and a pointed distal end of predetermined extent that is adapted to penetrate tissue, the pointed distal end being formed integrally with said the leading end and being positioned in leading relation thereto, providing the inner plunger with a trailing end having a circular transverse cross-section, providing the inner plunger with a middle part having a cross-shaped transverse cross-section that is adapted to be slidingly received within the cross-shaped third bore, forming an outer plunger with a central bore adapted to slidingly receive the trailing end of the inner plunger, providing the outer plunger with a leading end adapted to abuttingly engage the trailing end of the marker, forming a first radially-outwardly extending protuberance on a first jaw of the clip and forming a second radially-outwardly extending protuberance on a second jaw of the clip, forming a first beveled trailing surface on a trailing side of the first protuberance and forming a second beveled trailing surface on a trailing side of the second protuberance, driving the first and second opposed jaws toward one another by driving the marker in a trailing-to-leading direction with the outer plunger so that the leading end of the marker slideably engages the first and second beveled trailing surfaces and drives the first and second beveled trailing surfaces toward one another, the middle part of the inner plunger being positioned on a trailing side of the third bore and the middle part being rotationally misaligned with the cross-shaped third bore so that a trailing end of the middle part is disposed in abutting relation to a leading end of the third bore, the inner plunger being held against movement in a longitudinal direction, thereby holding the clip against movement in said longitudinal direction, so that when the outer plunger is displaced in a trailing-to-leading direction to drive the marker and the clip in said trailing-to-leading direction, the marker leading end enters into sliding engagement with the first and second beveled surfaces and drives them into converging relation with one another. Respective leading ends of the opposed jaws are driven into tissue by continued trailing-to-leading displacement of the outer plunger so that when the jaws are fully embedded within the tissue, a part of the tissue is captured between the jaws. Longitudinal displacement of the inner plunger in a trailing-to-leading direction and rotation of the inner plunger about its longitudinal axis of symmetry until the middle part aligns with the cross-shaped cross section of the third bore, followed by retraction of the inner plunger in a leading-to-trailing direction until the inner plunger has exited the first bore leaves the clip secured to the tissue and the marker secured to the trailing end of the clip. 
     In the fourth embodiment, an annular bevel is formed in the leading end of the marker to facilitate sliding engagement of the leading end of the marker and the first and second beveled trailing surfaces formed in the first and second jaws, respectively. 
     A fifth embodiment includes a marker having an elongate cylindrical structure. A cross-shaped bore is formed in the marker by a first slot that intersects with a second slot. The first slot has a greater radial extent than the second slot. 
     A clip has opposed jaws that are disposed in parallel relation to one another when in a position of repose. The clip has a base fixedly secured to the marker. A cross-shaped bore is formed in the base of the clip by a first slot that intersects with a second slot. The first slot has a greater radial extent than the second slot. 
     The bore formed in the marker and the bore formed in the base of the clip are in axial alignment with one another. 
     First and second laterally-outwardly projecting, external wings are formed in the first and second jaws, respectively, and first and second laterally-inward projecting, internal wings are formed in the first and second jaws, respectively. The first and second external wings are diametrically opposed to one another and the first and second internal wings are also diametrically opposed to one another. The first and second external wings have a swept back configuration to facilitate their entry into tissue. 
     A plunger having a pointed leading end and a cross-shaped transverse cross section that corresponds to the respective shapes of the slots is formed in the marker. The plunger is sequentially inserted into the bore formed in the marker and the bore formed in the trailing end of the clip so that the pointed distal end of the plunger is introduced into a space between the opposed jaws. 
     The plunger has protuberances that bear against the beveled trailing surfaces formed in the internal wings and cause the opposed jaws to diverge from one another. Accordingly, retracting the plunger so that it disengages from the slots formed in the clip, followed by rotating the plunger ninety degrees to align its radially extending protuberances with the slots, and sequentially pulling the plunger out of the clip and marker enables the opposed jaws to close under an inherent bias. The jaws capture tissue therebetween when so closed. The beveled surfaces serve to engage the tissue and work in conjunction with the external wings to prevent retraction of the clip from the tissue. The first and second external wings prevent reverse migration of the clip after the clip has penetrated the tissue. 
     Without limiting the fifth embodiment to the particular structure employed, the novel method of the fifth embodiment includes the steps of providing a marker having an elongate cylindrical structure, forming a cross-shaped bore in the marker by forming a first slot that intersects with a second slot, the first slot having a greater radial extent than the second slot, providing a clip having opposed jaws that are disposed in parallel relation to one another when in a position of repose, fixedly securing a base of the clip to the marker, forming a cross-shaped bore in the base of the clip by forming a first slot that intersects with a second slot, said first slot having a greater radial extent than the second slot, positioning the bore formed in the marker and the bore formed in the base of the clip so that the bores are in axial alignment with one another, forming first and second laterally-outwardly projecting, external wings in the first and second jaws, respectively, and forming a first and second laterally-inward projecting, internal wings in the first and second jaws, respectively, positioning the first and second external wings in diametrically opposed relation to one another and positioning the first and second internal wings in diametrically opposed relation to one another, forming the first and second external wings so that they have a swept back configuration to facilitate their entry into tissue, providing a plunger having a pointed leading end and a cross-shaped transverse cross section that corresponds to the respective shapes of the slots formed in the marker, sequentially inserting the plunger into the bore formed in the marker and the bore formed in the trailing end of the clip so that the pointed distal end of the plunger is introduced into a space between the opposed jaws. The plunger protuberances bear against the beveled trailing surfaces formed in the internal wings and thereby cause the opposed jaws to diverge from one another. Retracting the plunger so that it disengages from the slots formed in the clip, followed by rotating the plunger ninety degrees to align the radially extending protuberances of the plunger with the slots, and sequentially pulling the plunger out of the clip and marker enables the opposed jaws to close under an inherent bias. The jaws capture tissue therebetween when so closed. The beveled surfaces serve to engage the tissue and work in conjunction with the external wings to prevent retraction of the clip from the tissue. Moreover, the first and second external wings prevent reverse migration of the clip after the clip has penetrated the tissue. 
     The apparatus of the sixth embodiment of this invention includes a clip having a base received within a blind cylindrical bore formed in a leading end of a marker. The base is fixedly secured within the bore. The clip includes a pair of opposed jaws that are disposed in substantially parallel relation to one another when in repose. A first pair of recesses is formed in a leading end of a main body of the clip in diametrically opposed relation to one another. A second pair of recesses is formed in the trailing end of the main body of the clip, each recess of said pair of recesses being disposed in diametrically opposed relation to the other recess. A pair of diametrically opposed raised areas is formed in the main body between the recesses. 
     The clip is ensleeved within a delivery catheter and the delivery catheter is ensleeved within a cylindrical sleeve. A pair of diametrically opposed, radially inwardly extending pins are formed in the cylindrical sleeve. A first opening is formed in the delivery catheter to accommodate a first pin and a second opening is formed in the delivery catheter in diametric opposition to the first opening to accommodate a second pin. A leading end of the delivery catheter and a leading end of the cylindrical sleeve are in substantial alignment with one another and the opposed jaws are in repose when the cylindrical sleeve is positioned in ensleeving relation to the delivery catheter and hence to the clip. 
     Advancing the plunger in a trailing-to-leading the direction causes the marker to drive the clip in the same direction and causes the opposed jaws to be driven toward one another because the pins are constrained against radial travel by the cylindrical sleeve and because the pins cannot be displaced in a radially outward direction when they are compelled to slide out of the leading recesses onto the respective raised surfaces formed in the main body. The respective distal free ends of the jaws firmly grasp tissue therebetween, permanently anchoring the clip to the tissue. 
     Continued advancement of the plunger enables the pins to slide from the respective raised surfaces into engagement with the trailing recessed surfaces, thereby releasing pressure form the pins and enabling withdrawal of the delivery catheter and cylindrical sleeve. 
     Without limitation to the structure of the sixth embodiment, the sixth novel method includes the steps of forming a blind cylindrical bore in a leading end of a cylindrical marker, providing a clip having a base received within the blind cylindrical bore, providing the clip with a pair of opposed jaws that are disposed in substantially parallel relation to one another when in repose, forming a first pair of recesses in a main body of the clip in diametrically opposed relation to one another, forming a second pair of recesses in the trailing end of the main body of the clip in diametrically opposed relation to one another, thereby forming a pair of diametrically opposed raised areas in said main body between the leading and trailing recesses, forming a pair of diametrically opposed, radially inwardly extending pins in a cylindrical sleeve that ensleeves a delivery catheter that ensleeves said clip, forming a first opening in said delivery catheter to accommodate a first pin and forming a second opening formed in the delivery catheter in diametric opposition to the first opening to accommodate a second pin, positioning a leading end of the delivery catheter and a leading end of the cylindrical sleeve in substantial alignment with one another so that advancing a plunger introduced into a trailing end of a lumen of said delivery catheter in a trailing-to-leading direction causes the marker to drive the clip in the same direction and causes the opposed jaws to be driven toward one another because the pins are constrained against radial travel by the cylindrical sleeve and because the pins cannot be displaced in a radially outward direction when they are compelled to slide out of the leading recesses onto the raised surfaces formed in said main body. The respective distal free ends of the jaws firmly grasp tissue therebetween, permanently anchoring the clip to the tissue. Continued advancement of the plunger displaces the clip until the pins in the cylindrical sleeve enter into registration with the recesses formed in the trailing end of the main body of the clip, thereby releasing pressure from the pins and enabling leading-to-trailing retraction of the delivery catheter and cylindrical sleeve. 
     In a seventh embodiment, a core biopsy needle is employed but no vacuum is required to pull tissue into the lumen of the delivery catheter. In the apparatus of the seventh embodiment, a core biopsy needle has a side port near a leading end thereof and a delivery catheter has a side port near a leading end thereof. The delivery catheter is slideably disposed within a lumen of the core biopsy needle. The side port of the delivery catheter is in substantial juxtaposition with the side port of the core biopsy needle. 
     A ramp member is disposed at a leading end of the delivery catheter and includes an arcuate curved surface formed in a trailing end thereof. 
     A marker is disposed in a lumen of the delivery catheter. An attachment means has a trailing end secured to the marker and a leading end disposed in leading relation thereto. A barb means for engaging tissue is formed in the leading end of the attachment means. 
     A plunger is disposed in the lumen of the delivery catheter in trailing relation to the marker. The plunger is adapted to push the marker into the ramp member so that the attachment means is pushed through the delivery catheter side port and the core biopsy needle side port so that the barb means formed in the leading end of the attachment means is embedded within tissue that surrounds the core biopsy needle. 
     The marker is secured to the tissue when it has been pushed from the delivery catheter and the barb maintains the marker against migration in the absence of a vacuum means for pulling tissue into the core biopsy needle or the delivery catheter. 
     An important object of this invention is to provide a marker and a clip adapted to non-releasably engage tissue where the marker and clip are formed integrally with one another. 
     Another object is to provide a marker and clip that are not formed integrally with one another but which become conjoined to one another at the time of a tissue site is marked. 
     Another object is to provide a marker having a clip or other attachment means of the type that may be delivered to a tissue site by a core biopsy needle of the type that employs a vacuum, a core biopsy needle of the type that does not employ a vacuum, and by a coaxial biopsy needle. 
     Additional objects include the provision of multiple methods for using the several structural embodiments of the invention. 
     These and other important objects, advantages, and features of the invention will become clear as this description proceeds. 
     The invention accordingly comprises the features of construction, combination of elements, and arrangement of parts that will be exemplified in the description set forth hereinafter and the scope of the invention will be indicated in the claims. 
    
    
     
       BRIEF DESCRIPTION OF DRAWINGS 
       For a fuller understanding of the nature and objects of the invention, reference should be made to the following detailed description, taken in connection with the accompanying drawings, in which: 
         FIG. 1  is a sectional side elevational view of a commercially available needle; 
         FIG. 1A  is an end view of the needle depicted in  FIG. 1 ; 
         FIG. 2  is a sectional side elevational view of a delivery catheter having a novel anvil received within the leading end of the lumen of said delivery catheter; 
         FIG. 3  is a sectional side elevational view depicting the delivery catheter and anvil of  FIG. 2  positioned within the lumen of the needle of  FIG. 1 ; 
         FIG. 4  is a sectional side elevational view depicting the novel marker and a plunger positioned within the lumen of said delivery catheter; 
         FIG. 5  is a view like that of  FIG. 4 , depicting the novel marker and plunger when the plunger has been advanced relative to its  FIG. 4  position; 
         FIG. 6  is a view like that of  FIG. 5 , depicting the novel marker and plunger when the plunger has been advanced relative to its  FIG. 5  position; 
         FIG. 7  depicts the parts depicted in  FIG. 6  after the novel marker has been removed from the needle; 
         FIG. 8  is the first view of a seven step animation depicting the installation of a second embodiment of the novel marker in a tissue or lesion; 
         FIG. 9  is the second view of said seven step animation; 
         FIG. 10  is the third view of said seven step animation; 
         FIG. 11  is the fourth view of said seven step animation; 
         FIG. 12  is the fifth view of said seven step animation; 
         FIG. 13  is the sixth view of said seven step animation; 
         FIG. 14  is the seventh view of said seven step animation; 
         FIG. 15  is a side elevational view of a plunger that forms a part of the third embodiment; 
         FIG. 16  is a side elevational view of the marker and clip of the third embodiment; 
         FIG. 16A  is a rear perspective view of the clip of the third embodiment; 
         FIG. 17  is a side elevational view depicting the plunger of  FIG. 15  slideably inserted within a bore formed in the marker of  FIG. 16  and extending into the clip of  FIG. 16 ; 
         FIG. 18  is a side elevational view like that of  FIG. 17 , depicting the plunger when fully advanced; 
         FIG. 19  is a side elevational view of a fourth embodiment of the bioabsorbable marker and clip; 
         FIG. 20  is a perspective view of a fifth embodiment; 
         FIG. 21  is a top plan view of the parts depicted in  FIG. 19 ; 
         FIG. 22  is a side elevational view of the clip of the fifth embodiment; 
         FIG. 23  is a side elevational view of the fifth embodiment when a plunger having a cross-shaped profile is used to open the clip; 
         FIG. 24  is a side elevational view depicting the marker and clip after the plunger is retracted, rotated ninety degrees, and withdrawn from the marker and clip assembly; 
         FIG. 25  is a side elevational view depicting the marker and clip assembly of a fifth embodiment when the plunger is fully withdrawn and with the clip attached to tissue; 
         FIG. 26A  depicts the clip of the fifth embodiment in its normally closed position; 
         FIG. 26B  depicts the clip of  FIG. 25  when in its open position; 
         FIG. 27  depicts the marker and clip assembly of the fifth embodiment when the jaws of the clip member are opened by insertion of a plunger having a cross-shaped cross-section; 
         FIG. 28  depicts the parts of  FIG. 27  when the plunger is rotated ninety degrees (90°) preparatory to being pulled out of the marker/clip assembly; 
         FIG. 29  depicts the marker/clip when the clip is locked onto a piece of tissue; 
         FIG. 30  is a perspective view of a sixth embodiment of the invention; 
         FIG. 31  is a side elevational view of the sixth embodiment; 
         FIG. 32A  is a perspective view of the clip of the sixth embodiment; 
         FIG. 32B  is a side elevational view of said sixth embodiment clip; 
         FIG. 33  is a perspective view of the locking cylinder of the sixth embodiment; 
         FIG. 34  is an end elevational view of the  FIG. 33  locking cylinder; 
         FIG. 35  is a longitudinal sectional view taken along line  35 — 35  in  FIG. 31 ; 
         FIG. 36  is a longitudinal sectional view like that of  FIG. 35  but when a plunger has driven the clip from its position of repose; 
         FIG. 37  is a side elevational view of a core biopsy needle of the type that does not employ a vacuum; 
         FIG. 38  is a longitudinal sectional view of a delivery catheter equipped with a ramp member, said delivery catheter being disposed within the lumen of the core biopsy needle of  FIG. 37 ; 
         FIG. 39  is a longitudinal sectional view depicting a plunger advancing a marker in a lumen of said delivery catheter; 
         FIG. 40  is a view like that of  FIG. 39 , showing deployment of the attachment means and the marker secured thereto upon further advance of said plunger; 
         FIG. 41A  is a side elevational view depicting a marker and a particular type of attachment means; 
         FIG. 41B  is a side elevational view depicting a marker and a particular type of attachment means; 
         FIG. 41C  is a side elevational view depicting a particular type of attachment means; 
         FIG. 41D  is a side elevational view depicting a particular type of attachment means; 
         FIG. 42A  depicts a marker having a particular type of attachment means when in its folded, undeployed configuration; 
         FIG. 42B  depicts a marker having a particular type of attachment means when in its unfolded, deployed configuration; 
         FIG. 43A  depicts a marker having a particular type of attachment means when in its folded, undeployed configuration; 
         FIG. 43B  depicts a marker having a particular type of attachment means when in its unfolded, deployed configuration; 
         FIG. 44A  depicts a marker having a particular type of attachment means when in its folded, undeployed configuration; 
         FIG. 44B  depicts a marker having a particular type of attachment means when in its unfolded, deployed configuration; 
         FIG. 45A  depicts a marker having a particular type of attachment means when in its folded, undeployed configuration; 
         FIG. 45B  is an end view of the marker and attachment means depicted in  FIG. 45A ; 
         FIG. 45C  depicts a marker having a particular type of attachment means when in its unfolded, deployed configuration; 
         FIG. 45D  is an end view of the marker and attachment means depicted in  FIG. 45C ; 
         FIG. 46  is a side elevational view of a marker having a particular type of attachment means; 
         FIG. 47  is a side elevational view of a marker having a particular type of attachment means; and 
         FIG. 48  is a side elevational view of a coaxial biopsy needle having a plunger for pushing a marker from a lumen of said coaxial biopsy needle so that an attachment means secured to said marker engages tissue external to said coaxial biopsy needle and anchors said marker against migration. 
     
    
    
     DETAILED DESCRIPTION 
     Referring to the longitudinal sectional view of  FIG. 1 , it will there be seen that the reference numeral  10  denotes a prior art needle sold under the trademark Mammotone® core biopsy needle. This invention has utility in connection with all core biopsy needles, of which the Mammotone® core biopsy needle is merely an example. 
     However, some core biopsy needles do not employ a vacuum as does the Mammotone® core biopsy needle. As will be disclosed later in this disclosure, this invention also has utility in connection with such vacuumless core biopsy needles. 
     Moreover, this invention also has utility in connection with coaxial biopsy needles, as disclosed in greater detail near the end of this disclosure. Coaxial biopsy needles do not employ a vacuum to pull tissue into a lumen thereof. 
     Core biopsy needle  10  is of the vacuum type as aforesaid and has a solid, pointed leading end  12 . A side-opening port  14  is formed in cylindrical sidewall  16  of the needle in slightly trailing relation to said leading end  12 . 
     As best understood when comparing  FIGS. 1 and 1A , a vacuum lumen  18  is formed along the extent of needle  12  and a plurality of openings, collectively denoted  20 , are formed in vacuum lumen  18  near its leading end in diametrically opposed relation to sideport  14 . 
     Cavity  21  is formed in solid leading end  12 , in leading relation to sideport  14 . 
       FIG. 2  depicts a novel delivery catheter  22  having side port  24  formed in cylindrical sidewall  26 . A plurality of openings, collectively denoted  28 , are formed in sidewall  26  in diametrically opposed relation to sideport  24 . 
     Anvil  30  is fixedly secured to the leading end of delivery catheter  22  as depicted, and includes cavity  32  formed therein. Anvil  30  is made of a hard material, preferably metal. Cavity  32  is a blind bore formed in the center of anvil  30 ; it has a gently rounded concave bottom. 
       FIG. 3  depicts delivery catheter  22  of  FIG. 2  when slidingly disposed within core biopsy needle  10  of  FIG. 1 . Sideports  14  and  24  are in substantial juxtaposition with one another, as are openings  20  and  28 , and anvil  30  is fully received within cavity  21 . A vacuum has been applied to vacuum lumen  18  and the alignment of openings  20  and  28  has caused part of a lesion, tumor, cyst, or other form of tissue  33  to be pulled into sideports  14  and  24  so that it is positioned within the hollow interior of delivery catheter  22 . 
       FIG. 4  depicts a bioabsorbable marker  34  disposed within the hollow interior of delivery catheter  22 . The trailing end of marker  34  is denoted  34   a  and its leading end is denoted  34   b . It should be understood that this invention also relates to markers that are not bioabsorbable. A trailing end  35  of straight member  36  of metallic construction is embedded within leading end  34   b  of marker  34  as depicted. As drawn, pointed leading end  38  of straight member  36  has penetrated into tissue  33  because plunger  39  has been introduced into the open trailing end of delivery catheter  22  and displaced in a trailing-to-leading direction, denoted by single-headed directional arrow  41 , so that it abuts trailing end  34   a  of marker  34  and drives it forward. 
     Plunger  39  has been further advanced in the direction of arrow  41  in  FIG. 5 , straight member  36  has advanced deeper into tissue  33 , and tissue  33  has been confined into a relatively small space at the leading end of sideports  14 ,  24 . 
     In  FIG. 6 , plunger  39  has been advanced still further in the direction of arrow  41  and straight member  36  has pierced tissue  33 . Pointed leading end  38  of straight member  36  has been shoved into cavity  32  and bent back as depicted by its rounded concave bottom to form a hook. 
     The vacuum in vacuum lumen  18  is then turned off so that tissue  33  may be withdrawn from sideports  14  and  24  as depicted in  FIG. 7 . Bioabsorbable marker  34  exits through sideports  14  and  24  with lesion  33  because it is now hooked to said lesion as depicted. 
     A second embodiment is depicted in  FIGS. 8–14 . Core biopsy needle  10  and delivery catheter  22  are also used in this embodiment, but said parts are not depicted to simplify the drawings. 
     Metallic straight member  36  of the first embodiment is replaced in this second embodiment by clip  40  that is permanently bonded by suitable means to bioabsorbable marker  34 . Specifically, clip  40  has an annular base  42  that is received within an annular cavity  44  formed in leading end  34   b  of marker  34 . A central bore  46  is formed in marker  34  in coincidence with its longitudinal axis of symmetry and a similar bore  48  is formed in annular base  42  of clip  40  so that bores  46  and  48  are in axial alignment with one another when the trailing end of clip  40  is secured to the leading end  34   b  of marker  34 . 
     Clip  40  is preferably of metallic construction but may also be made of other materials as mentioned above. 
     The  FIG. 8  configuration of clip  40  is its in repose, normally closed configuration where opposed jaws  50 ,  52  are disposed in converging relation to one another. 
     As depicted in  FIG. 9 , plunger  54  has an elongate extension  56  formed at its leading end that terminates at a sharp distal end  58 . The leading end of the main body of plunger  54  is denoted  55 . Said leading end  55  is adapted to bear against trailing end  34   a  of marker  34 . Elongate extension  56  is introduced sequentially through central bore  46  and central bore  48  until said distal end  58  is positioned between jaws  50  and  52  of clip  40 . 
     Jaws  50 ,  52  assume their fully open position when plunger  54  and hence elongate extension  56  are fully advanced as depicted in  FIG. 10 . Note that sharp point  58  now extends beyond the respective leading ends of jaws  50 ,  52  and is poised to penetrate tissue  33 . Leading end  55  of plunger  54  abuts trailing end  34   a  of marker  34  when plunger extension  56  is fully inserted between jaws  50 ,  52 . 
       FIG. 11  depicts the initial penetration of tissue  33  by clip  40  and  FIG. 12  depicts clip  40  when fully seated within said tissue  33 . 
     Partial retraction of plunger  54  and hence of plunger extension  56  is depicted in  FIG. 13 . Clip  40  is formed of a flexible and resilient metal so that normally closed jaws  50 ,  52  converge toward one another under their inherent bias when plunger extension  56  is withdrawn from between said jaws as shown. A part of tissue  33  is captured between said jaws when the jaws converge, thereby anchoring clip  40  to said tissue. 
       FIG. 14  depicts full retraction of plunger  54 . Bioabsorbable marker  34  remains fixedly secured to clip  40  and clip  40  remains clamped onto tissue  33 . Accordingly, even after marker  34  has been bioabsorbed, if it is made of bioabsorbable materials, clip  40  will continue to permanently mark the site and said clip will not migrate therefrom. 
     A third embodiment is depicted in  FIGS. 15–22 . This embodiment is the only embodiment where the marker and the metal hook are manufactured separately and do not combine with one another until a site is marked. This embodiment is also the only embodiment having two plungers, hereinafter referred to as the inner and outer plungers. 
     As depicted in  FIG. 15 , inner plunger  60  has a trailing section  62  of a first diameter, a leading section  66  of the same diameter as said trailing section, a middle section  64  having an enlarged diameter relative to trailing section  62  and leading section  66 , and a tapered leading section  67  that terminates in sharp point  68 . Annular step  63  is formed where section  62  meets section  64 , and annular step  65  is formed at the juncture of sections  64  and  66 . 
     Outer plunger  60   a  is of cylindrical configuration and has a central bore  61  that accommodates trailing section  62  of inner plunger  60 . Accordingly, inner plunger  62  is concentrically disposed with respect to outer plunger  60   a  as indicated in the transverse cross sectional view of  FIG. 15A . The transverse cross section of inner plunger  62  is circular as depicted in  FIG. 15B , the transverse cross section of middle section  64  is cross-shaped as depicted in  FIG. 15C , and the transverse cross section of leading section  66  of inner plunger  62  is circular as depicted in  FIG. 15D . 
       FIG. 16  depicts the structure of bioabsorbable marker  34  and clip  40  of this embodiment, and  FIG. 16A  depicts the proximal or trailing end of clip  40 . A cross shaped bore  74  is formed by the intersection of elongate slot  78  and truncate slot  80 . The terms “elongate” and “truncate” indicate that slot  78  has a greater radial extent than does slot  80 . The transverse cross section of middle part  64  ( FIG. 15C ) matches said cross shaped bore  74 . Specifically, middle part  64  has a radially long protrusion  64   a  and a radially short protrusion  64   b , said protrusions extending along the longitudinal extent of said part. Thus, if radially long and short protrusions  64   a ,  64   b  are rotationally aligned with radially long and short slots  78 ,  80  of bore  74 , respectively, then middle part  64  may slideably enter into the hollow interior of the trailing end of clip  40 . Plunger parts  62  and  64  are circular in cross section as aforesaid and enter into the hollow interior of clip  40  regardless of the rotational orientation of inner plunger  60 . 
     In this embodiment, cylindrical cavity  70  is formed in leading end  34   b  of cylindrical marker  34  as indicated in  FIG. 16 . Bore  72  is formed in trailing end  34   a  of marker  34 , in coincidence with its longitudinal axis of symmetry. Long and short slots  78 ,  80  formed in clip  40  collectively form cross-shaped bore  74  as aforesaid and bores  72 ,  74  are in axial alignment with one another when trailing end  42  of clip  40  is slideably received within cylindrical cavity  70 . 
     Significantly, marker  34  and clip  40  are independently manufactured and form separate and distinct parts that are unconnected to one another. Clip  40  is positioned so that its trailing end is slideably received within cavity  70  of marker  34  as aforesaid. As will become clear as this disclosure proceeds, said two parts effectively become a single part when the site-marking process has been concluded. 
       FIG. 16  also depicts beveled surfaces  50   b ,  52   b  formed on the trailing side of protrusions  50   a ,  52   a , respectively, formed in each jaw  50 ,  52  of clip  40 . The function of beveled annular surfaces  50   b ,  52   b  will become clear as this description proceeds. 
     Notches  43  formed in each jaw of clip allow the respective distal or leading tips  50   c ,  52   c  of each jaw to converge toward one another as will also become clear as this description proceeds. 
     The manner in which the parts depicted in  FIGS. 15 ,  16 , and  16 A work with one another is best understood in connection with  FIGS. 17–22 . In  FIG. 17 , inner plunger  60  is sequentially introduced through bore  61  formed in outer plunger  60   a , bore  72  formed in marker  34 , and bore  74  formed in the trailing end of clip  40  until cross-shaped middle section  64  of inner plunger  60  is received within cross-shaped bore  74  of clip  40 . This introduction is accomplished while middle section  64  is held in rotational alignment with slots  78  and  80  formed in the trailing end of clip  40 . 
     Next, inner plunger  60  is pushed forward (in the direction of single-headed directional arrow  59 ) so that middle section  64  is positioned in distal relation to notches  43 ,  43  as depicted in  FIG. 18 . Cross-shaped bore  74  does not extend to the part of clip  40  that is distal of said notches  43 ,  43 . More particularly, the space denoted  74   a  is the space between jaws  50 ,  52  of clip  40  and as such is not a bore. Nor does cross-shaped bore  74  extend from the trailing end of clip  40  to said notches; it extends about half of said length. The area marked  74   a  in  FIG. 18  has a circular cross section. Thus it should be understood that cross-shaped bore  74  extends from the trailing end of clip  40  to a point about mid-way between said trailing end and notches  43 ,  43 . 
     Inner plunger  60  is rotated ninety degrees (90°) about its longitudinal axis of symmetry after it has attained its  FIG. 18  position. Such rotation causes the radially long and radially short protrusions formed in middle section  64  of inner plunger  60  to misalign with long and short slots  78 ,  80 , respectively. 
     Inner plunger  62  is then withdrawn in a direction opposite to that of directional arrow  59  until it reaches its  FIG. 19  position. When in said  FIG. 19  position, the misalignment of the radially long and radially short protrusions formed in middle section  64  with long and short slots  78 ,  80 , respectively, prevents further retraction of said inner plunger  62 . Specifically, annular shoulder  63  at the trailing end of middle section  64  abuts bore  74  in misalignment therewith. Accordingly, with middle section  64  in its  FIG. 19  position, and with inner plunger  60  held against movement by a physician, advancing outer plunger  60   a  and hence marker  34  in the direction indicated by directional arrow  59  causes marker  34  to advance in the direction indicated by directional arrow  59 , thereby driving the trailing end of clip  40  deeper into cavity  70  of marker  34 , as indicated in  FIG. 20 . 
     As outer plunger  60   a  and marker  34  are pushed in the direction of directional arrow  59 , clip  40  begins to penetrate tissue  33  as also depicted in  FIG. 20 . Note that in  FIG. 20 , leading end  34   b  of marker  34  is about to make contact with ramps  50   b ,  52   b  of protuberances  50   a ,  52   a , respectively, formed in jaws  50 ,  52  of clip  40 . 
     Further forward travel of outer plunger  60   a , as depicted in  FIG. 21 , thus drives leading end  34   b  of marker  34  into sliding engagement with said ramps  50   b ,  52   b . Notches  43 ,  43  create a weakness in jaws  50 ,  52  so that said jaws converge toward one another as depicted in  FIG. 21  as said leading end of marker  34  rides over said ramped surfaces  50   b ,  52   b . When the jaws converge, they capture a quantity of tissue  33  between them as depicted in said  FIG. 21 . Clip  40  is not made of a resilient material in this embodiment so that when said jaws close onto said tissue, they remain in clamping engagement with said tissue even when marker  34  is bioabsorbed. 
       FIG. 22  depicts the final position of marker  34  and metal clamp  40  when outer plunger  60   a  has driven marker  34  and hence clip  40  fully into tissue  33 . 
       FIG. 22  also depicts the assembly after inner plunger  60  and outer plunger  60   a  have been withdrawn. Such withdrawal is accomplished by advancing inner plunger  60   a  short distance in the direction of directional arrow  59  ( FIG. 21 ) so that annular trailing shoulder  63  of middle part  64  is positioned forwardly of bore  74 . Inner plunger  60  is then rotated ninety degrees (90°) about its longitudinal axis a second time until the radial protuberances formed in said middle part  64  align with long and short slots  78 ,  80  so that said inner plunger  60  may be withdrawn in a direction opposite to the direction indicated by directional arrow  59 . 
     After bioabsorbable marker  34  has been bioabsorbed over a period of days, weeks, or months, depending upon its composition, clip remains secure to tissue  33 . Clip  40  will not migrate with respect to said tissue because its jaws  50 ,  52  permanently anchor it to said tissue. 
     A fourth embodiment is depicted in  FIG. 23 . Beveled annular surface  34   c  is formed in leading end  34   b  of marker  34  and is in open communication with blind bore  70 . Jaws  50 ,  52  of clip  40  have beveled trailing surfaces  40   a ,  40   a  and beveled leading surfaces  40   b ,  40   b  formed therein. In this way, when outer plunger  60   a  is advanced in a trailing-to-leading direction, denoted by directional arrow  59 , beveled annular surface  34   c  bears against beveled surfaces  40   a ,  40   a , causing jaws  50 ,  52  of clip  40  to converge toward one another and to pinch tissue  33 , not shown, therebetween. 
     In all other aspects, the fourth embodiment of the invention works in the same way as the structure of the third embodiment. 
     A fifth embodiment is depicted in  FIGS. 24–29 . Bioabsorbable marker  34  has an elongate cylindrical structure in this embodiment. Cross-shaped bore  74   a  is formed in marker  34  by an elongate slot  78  that intersects with a truncate slot  80 , just as in the third embodiment in connection with the trailing end of clip  40  of that embodiment. The plunger of the delivery catheter, not depicted in  FIG. 24 , is slideably received within said slots when this fifth embodiment is in use. 
     Clip  40  of this embodiment includes opposed jaws  50 ,  52  that are disposed in parallel relation to one another when in their position of repose. 
     As best understood in connection with  FIG. 25 , clip  40  has a base  40   a  that is fixedly secured to bioabsorbable marker  34 . Bore  74   a  formed in marker  34  has a cross-shaped cross-section because it is formed by the intersection of slots  78  and  80  as aforesaid. Bore  74 , formed in base  40   a  of clip  40  and in the trailing end of said clip as depicted, also has a cross-shaped cross section for the same reason. Bores  74  and  74   a  are in axial alignment with one another. 
     Clip  40  has a pair of laterally-outwardly projecting, external wings  82 ,  84  formed therein and a pair of laterally-inward projecting, internal wings  86 ,  88  formed therein. External wings  82 ,  84  are diametrically opposed to one another as are internal wings  86 ,  88 . Said external wings prevent reverse migration of clip  40  during deployment. They are swept back to facilitate their entry into tissue, and such swept back configuration acts as a detent means to prevent retraction thereof from tissue. 
     The closed configuration of clip  40  is depicted in  FIG. 26A  and its open configuration is depicted in  FIG. 26B . Plunger  94 , depicted in  FIG. 27 , having pointed leading end  96 , has a cross-shaped transverse cross section that corresponds to the respective shapes of slots  78 ,  80  which collectively form bore  74   a  in marker  34 . In other words, plunger  94  has a first pair of diametrically opposed, radially extending ribs that correspond to and are slideably received within elongate slots  78  and a second pair of diametrically opposed, radially extending ribs that correspond to and are slideably received within truncate slots  80 . The first pair of ribs extends radially outwardly a greater extent than does the second pair of ribs. 
     Plunger  94  is inserted into marker bore  74   a  and into bore  74  of clip  40 . Pointed end  96  is thereby introduced into the space between opposed jaws  50 ,  52 . As plunger  94  is further advanced, the first pair of ribs bears against beveled surfaces  90 ,  92  that are formed in the trailing edges of internal wings  86 ,  88 , respectively, causing jaws  50 ,  52  to diverge from one another in the manner depicted in  FIGS. 26B and 27 . 
     As indicated in  FIG. 28 , plunger  94  is then retracted and rotated ninety degrees (90°) and pulled out of the marker  34 /clip  40  assembly. This ninety degree (90°) rotation aligns the radially extending ribs formed in plunger  94  with slots  78 ,  80  formed in clip  40  so that no resistance is presented to the retraction. 
     In  FIG. 29 , jaws  50 ,  52  have returned to their position of repose where they are in substantial parallelism to one another because plunger  94  has been fully withdrawn, allowing said jaws to re-converge under their inherent bias. Beveled surfaces  90 ,  92  now serve to engage tissue  33  and work in conjunction with external wings  82 ,  84  to prevent retraction of said clip  40  from said tissue  33 . 
     A sixth embodiment is depicted in perspective view in  FIG. 30 . It is delivered to the biopsy site by delivery catheter  100 . As best understood in connection with  FIG. 31  and  FIG. 35  which is a longitudinal sectional view taken from  FIG. 31 , base  42  of clip  40  is received within blind cylindrical bore  102  formed in the leading end of bioabsorbable marker  34  and said base  42  is fixedly secured within said bore.  FIGS. 30 ,  31 ,  32 A,  32 B and  35  depict opposed jaws  50 ,  52  in their position of repose. 
     As best depicted in  FIGS. 32A and 32B , a first pair of recesses  104 ,  106  are formed in a leading end of a main body of clip  40  of this embodiment in diametrically opposed relation to one another. Both recesses have a leading edge in open communication with beveled surfaces  104   a ,  106   a , respectively. A second pair of recesses  108 ,  110  are formed in the trailing end of the main body of clip  40  of this embodiment in diametrically opposed relation to one another. A pair of diametrically opposed raised areas  105 ,  107  ( FIG. 32B ) are thus provided between the recesses. 
     Cylindrical sleeve  112 , depicted in perspective view in  FIGS. 30 ,  33  and in end view in  FIG. 34 , has a pair of diametrically opposed, radially inwardly extending pins  114 ,  116  formed therein. As depicted in  FIG. 30 , a first opening  114   a  is formed in delivery catheter  100  to accommodate pin  114  and a second opening  116 , diametrically opposed to opening  114   a , is formed in delivery catheter  100  to accommodate pin  116 . 
     When sleeve  112  is positioned in ensleeving relation to clip  40  as depicted in  FIGS. 30 and 31 , the leading end of delivery catheter  100  and the leading end of cylindrical sleeve  112  are in substantial alignment with one another and opposed jaws  50 ,  52  are in repose. 
     As depicted in  FIG. 36 , when plunger  118  is positioned in the lumen of delivery catheter  100  and is advanced in a trailing-to-leading direction as indicated by single-headed directional arrow  120 , marker  34  drives clip  40  in the same direction and jaws  50 ,  52  are driven toward one another because pins  114 ,  116  are constrained against radial travel by cylindrical sleeve  112 . Since pins  114 ,  116  cannot be displaced in a radially outward direction when they are compelled to slide out of recesses  104 ,  106 , onto the raised surfaces formed in the main body, jaws  50 ,  52  must converge toward one another. The pivot point about which said jaws converge is denoted  119 . Accordingly, the respective distal free ends of said jaws firmly grasp tissue therebetween, permanently anchoring clip  40  to said tissue. As in the earlier embodiments, this ensures that clip will remain attached to the tissue long after marker  34  has been bioabsorbed. Moreover, clip  40  will not migrate over time. 
     Further displacement of plunger  118  in the same direction causes pins  114 ,  116  to enter into registration with trailing recesses  108 ,  110 , thereby releasing the pins and enabling withdrawal of delivery catheter  100  and cylindrical sleeve  112 . The opposed jaws of the clip are not resilient so they remain in their closed configuration when the pressure on said pins is released. 
     As mentioned above, this invention is not limited to core biopsy needles that employ a vacuum. It has utility not only with coaxial needles, which do not employ a vacuum, but also with core biopsy needles where no vacuum is employed. 
     When a vacuum is applied to a core biopsy needle of the vacuum type, there is a possibility of taking in loose tissue not in the vicinity of the biopsy tract. Taking in such unwanted loose tissue may cause the marker to slide away from the biopsy site with the loose tissue. For example, where a breast is under compression, the marker may slide away when the breast compression is removed at the end of the procedure. Therefore, it is important to be able to attach the tissue marker directly into the biopsy site tract in the absence of a vacuum. 
     A seventh embodiment of the invention is depicted in  FIG. 37 . A core biopsy needle  120  of the type that does not employ a vacuum is positioned within a biopsy tract having biopsy tract wall  122 . The invention is not limited to this particular example, it being understood that the tract could be formed by means other than a biopsy needle.  FIG. 38  adds delivery catheter  124  having a ramp member  126  positioned at its distal end. Note that delivery catheter ramp  126  has an arcuate surface  127  formed therein on the proximal side thereof. 
     As depicted in  FIG. 39 , marker  34  having wire  36  or other suitable attachment means secured to a leading end thereof is pushed in a trailing-to-leading direction by plunger or pusher  39  in the direction indicated by single-headed directional arrow  41 . Attachment means  36 , which may be formed of metallic or non-metallic materials as long as such materials may be seen by at least one imaging technique, encounters arcuate surface  127  of ramp member  126  and is displaced toward port  14  formed in core biopsy needle  120 . 
     As indicated in  FIG. 40 , further advancement of pusher  39  drives attachment means  36  out of biopsy tract  122  and into tissue  33 . In the example of  FIGS. 39 and 40 , attachment means  36  ends in a loop as illustrated. Note that a free end of loop  36 , denoted  36   a , engages tissue  33  in an anchoring manner so that neither attachment means  36  nor marker  34  will migrate from the point where said attachment means  36  enters into tissue  33 . 
     There are numerous ways for attaching marker  34  and attachment means  36  to one another. In  FIG. 41A , a loop is formed in both ends of clip  36 . Exposed leading end  36   a  engages tissue when marker  34  is deployed and embedded trailing end  36   b  engages the material from which marker  34  is formed, thereby preventing clip  36  from pulling ou of said marker  34 . 
     In  FIG. 41B , bore  34   a  is formed in marker  34 . The diameter of bore  34   a  tapers downwardly in a trailing-to-leading direction so that loop  36   b  formed in the trailing end of clip  36  is retained within said bore. In  FIG. 41C , free end  36   a  of clip  36  is brazed as at  36   c  to cover the sharp cutting edge of said free end  36   a . In  FIG. 41D , said free end of clip  36  is formed into an arrowhead  36   d . The trailing edges of the arrowhead serve as barbs that engage tissue. 
     Attachment means or clip  36  need not extend from the leading end of marker  34  is in the above-described embodiments. It may also extend from a midpoint of marker  34  as depicted in  FIGS. 42A and 42B . In  FIG. 42A , clip  36  is bent into a closed position. It may be held in such closed position by the interior sidewalls of a coaxial biopsy needle. Clip  36  may be formed of a resilient material such as nitinol so that when a pusher pushes it from the lumen of the coaxial biopsy needle, clip  36  returns to its original unbent shape as depicted in  FIG. 42B . Its free end is then able to engage tissue and prevent migration of marker  34 . 
     A similar flexible and resilient clip  36  is attached to marker  34  mid-length thereof in the embodiment of  FIGS. 43A and 43B . Clip  36  in this embodiment includes a barb at its distal free end for engaging tissue. 
     As depicted in  FIGS. 44A and 44B , there may be two or more flexible and resilient clips attached to marker  34 , mid-length thereof.  FIG. 44A  depicts a pair of diametrically opposed clips  36 ,  36  when in their folded position, held down by the interior sidewalls of a coaxial biopsy needle, and  FIG. 44B  depicts said attachment means after their exit from said biopsy needle. There could be more than two of said clips  36  secured to marker  34 . The depicted mid-length positioning thereof is not critical. 
     Instead of embedding one end of clip  36  within marker  34 , a pair of flexible and resilient clips  36  could be secured to a ring  35  that tightly encircles marker  34 . Clips  36  are depicted in their folded down, undeployed configuration in the side view of FIG.  45 A and in the end view of  FIG. 45B  and in their deployed, tissue-engaging configuration in the side view of  FIG. 45C  and in the end view of  FIG. 45D . 
     Yet another alternative embodiment is depicted in  FIG. 46 . Clip  36  is eccentrically mounted as depicted to the leading end of marker  34 , near a peripheral edge of said marker  34 . A barb is formed in the distal free end of clip  36  as illustrated. By placing the barbed clip away from the center of the leading end of marker  34 , it is believed that clip  36  may better engage tissue. Also, the use of a minimal amount of metal or other suitable material for clip  36  is desirable in some applications. 
       FIG. 47  depicts an embodiment having two barbed clips  36  at the leading end of marker  34 , in diametrically opposed relation to one another, where said barbed clips are attached to said marker  34  near its outermost periphery as in the embodiment of  FIG. 46 . The central barbed clip of the first embodiment is also provided as still another attachment means. Note that, in this embodiment, central barbed clip  36  has a greater longitudinal extent than the peripherally mounted barbed clips  36 ,  36 . 
       FIG. 48  depicts marker  34  of  FIG. 47  being pushed into tissue  33  from a coaxial biopsy needle  130  by a plunger  39  that is pushed in a leading-to-trailing direction as indicated by arrow  41 . Any marker of this invention may be pushed from the lumen of a coaxial needle by a plunger, not just the marker of said  FIG. 47 . A coaxial needle has particular utility when the marker has flexible and resilient attachment means that deploy upon exiting the lumen of a coaxial needle. 
     Although numerous embodiments have been depicted and described, many more examples could be given because many more embodiments become obvious in view of the disclosures made herein. All of such additional embodiments that flow naturally from the embodiments shown and described herein are within the scope of this invention. 
     It will thus be seen that the objects set forth above, and those made apparent from the foregoing description, are efficiently attained. Since certain changes may be made in the above construction without departing from the scope of the invention, it is intended that all matters contained in the foregoing description or shown in the accompanying drawings shall be interpreted as illustrative and not in a limiting sense. 
     It is also to be understood that the following claims are intended to cover all of the generic and specific features of the invention herein described, and all statements of the scope of the invention that, as a matter of language, might be said to fall therebetween.