EP0000949A1 - Cardiac and vascular prostheses and methods of making the same - Google Patents
Cardiac and vascular prostheses and methods of making the same Download PDFInfo
- Publication number
- EP0000949A1 EP0000949A1 EP78100752A EP78100752A EP0000949A1 EP 0000949 A1 EP0000949 A1 EP 0000949A1 EP 78100752 A EP78100752 A EP 78100752A EP 78100752 A EP78100752 A EP 78100752A EP 0000949 A1 EP0000949 A1 EP 0000949A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- prosthesis
- dacron
- surface material
- protein
- graft
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/0077—Special surfaces of prostheses, e.g. for improving ingrowth
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/14—Macromolecular materials
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/28—Materials for coating prostheses
- A61L27/34—Macromolecular materials
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/50—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
- A61L27/507—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials for artificial blood vessels
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L33/00—Antithrombogenic treatment of surgical articles, e.g. sutures, catheters, prostheses, or of articles for the manipulation or conditioning of blood; Materials for such treatment
Definitions
- This invention relates to cardiac and vascular prostheses and methods of making the same and materials therefor.
- the Dacron graft is considered to be the most successful cloth type graft. (Sawyer, P. N. et al. Vascular Graft Symposium, Current Status and Future Trends. NIH (1976)).
- vascular graft must: (i) have an appropriate porosity (10,000-20,000 ml of water/square cm/minute) Sawyer, P. N., Wu, K. T., Wesolowski, S. A. Brattain, W. and Boddy, P. J. An Aid in the Selection of Vascular Prosthesis Proc. Natl. Acad. Sci., U.S.A., 53:1965), (ii) be blood compatible, (iii) possess tensile strength and (iv) be easy to handle with respect to sewing characteristics (Sawyer, P. N. and Srinivasan, S. New Approaches in the Selections of Materials Compatible with Bluod. Artificial Heart Prog.Conf.Proc.Chapter 2,1969).
- Dacron vascular grafts have been altered, in accordance with the invention, by coating them and filling their interstitial spaces with a variety of agents, in a variety of ways, to produce grafts with superior anti- thrombogenic characteristics.
- the techniques utilized include: (1) copolymerization of proteins to the Dacron with glutaraldehyde and subsequent negative charging, (2) aluminization of the grafts,
- a prosthesis suitable for implantation in a bloody environment comprising a surface material adapted for exhibiting a regular and periodic surface charge characteristic in said bloody environment, and prostheses means supporting said surface material and adapted to perform a prosthetic function in this environment.
- the surface material may be aluminum. In accordance with another embodiment, the surface material may be albumin. In accordance with still other embodiments, the surface material may be agar or acrylamide.
- the prosthetic means is of a material normally incapable of crosslinking to said surface material.
- the surface charge is preferably equivalent to approximately one electron per thousand square Angstroms in a regular three-dimensional pattern.
- a method for preparing a prosthesis for functioning in a bloody environment with minimal thrombogenicity comprises depositing on the surface of the prostheses a material adapted for exhibiting a regular and periodic thrombosis resistant surface charge in the bloody environment.
- a synthetic material may be adapted for use as a prosthetic material which is adapted to function in a bloody environment. This may be achieved, for example, by metallizing the material at the surface thereof.
- the metallizing may take place by the vapor depositing of aluminum on the surface.
- the aluminum may be sprayed in an aerosol on the surface.
- the prosthesis may be, for example, of woven Dacron. Thereupon may be deposited a surface material in the form of albumin, combined with gelatin. The thusly coated prosthesis may, for example, thereafter be treated with glutaraldehyde.
- the material deposited on the prosthesis may be , for example, of the general category of proteins and may be applied preferably in, for example, about a 3 % solution.
- a thusly coated prosthesis may be further treated with a succinic acid compound.
- the material may be applied by immersing the prosthesis in a slurry of agar.
- the prosthesis may be immersed in a solution of acrylamide.
- the invention relates to the provision of a prosthesis having the capability of fuctioning in a bloody environment.
- the prosthesis may be of varying types but it can be for example, a vascular prosthesis consisting of a tube adapted to function as a connection for bypass or a valve functioning to operate in the cardiac environment.
- the invention is based in general on having the prosthesis exhibit a regular and periodic negative surface charge characteristic in the preferred case approximating one electron per thousand square Angstroms of surface in a regular threedimensional pattern. Under certain circumstances, the regular and periodic surface charge may be positive.
- a surface material will generally be employed to exhibit the above-noted characteristic.
- the present invention is concerned with hybrid prostheses which are prostheses consisting of a basic material forming a prosthesis so that it is capable of performing the desired function and a surface material which exhibits the aforenoted charge.
- an adaptive material may be provided to offer architectural continuity and cross-link the surface material and the supporting material by being adapted to cross-link itself respectively to each of these materials.
- the invention offers, for example, copolymerization for a form of protein deposition, metallizing, agar application in the form of a uniform coating and the application of, for example, acrylamide.
- the invention offers further selective processing of certain of the above materials by treatment with succinic acid or the like or, for example, by treatment with glutaraldehyde.
- Copolymerization (a method of protein deposition) Fraction V Albumin (purified bovine or other mammalia albumin) purchased from Sigma Corporation, St. Louis, Mo.,USA was dissolved (1, 3, 5 and 10 grams in 100 ml. of water) to produce several solutions of 1 % - 10 % with distilled and deionized water Gelatin (cutaneous), purchased from Baker Corporation * , was dissolved at room temperature in water, producing solutions ranging in concentration (1, 3, 5 and 10 grams in 100 ml of water) from 1 % - 10%.
- Fraction V Albumin purified bovine or other mammalia albumin
- a Microknit® knitted or woven vascular prosthesis possessing 18 ridge to the inch (50 interstices per inch) was cut into 10 cm. segmen (collapsed length) and cleaned in distilled and deionized water. It is then immersed in 10-20 % (preferably 20%) qlutaraldehyde (purchased from Electron Microscope Science Corporation of Fort Washington Penna., USA) with distilled and deionized water (40 ml of 50 % glutaraldehyde in 60 ml of water) and was allowed to stand for three hours.
- the graft materials were then immersed in the appropriate protein (albumin, gelatin, collagen or the like) solution until thin (1 to 2,000 microns) coats of polymerized protein surrounded the Dacron tube. They were then suspended in air at room temperature and rinsed with water at room temperature for a minimum of 2 minutes. Care was taken to rinse the lumen of the grafts with water.
- the graft-protein "hybrid" prostheses were then reintroduced into fresh (20%) glutaraldehyde (40 ml of 50 % glutaraldehyde in 60 ml of water) for 5-15 minutes. The process was repeated several times (three to ten times) until thin (1 to 2000 microns), uniformly coated grafts with their interstitial spaces filled were produced.
- grafts and varying concentrations of proteins were utilized to determine optimal reaction condition. They included 3 and 6 mm. I.D. (2-20 mm is the range), 18 and 32 ridges/inch (10-32 ridges would be the range), and 1, 3, 5 and 10 % protein solutions. It was found that the grafts possessing 18 ridges/inch (half crimp) were the optimal type of graft to modify, as they possessed the best surface configuration to provide for an even deposition of protein. The grafts having 32 ridges/inch (full crimp) had to be stretched on a glass rod of the same I.D. as the grafts in order to coat them properly.
- the protein copolymerized hybrid grafts were further modified to enhance their net negative surface charge.
- the end terminal amino acid residues were covalently coupled to succinic acid under acetylation reaction conditions (see Pat. No. 3,927,422).
- the grafts were rinsed thoroughly with distilled deionized water, and placed into a 10 % (8-10 % range) sodium bicarbonate buffer at a pH 8.5 (8.2-8.7 range) (8-10 grains in 100 ml of water).
- the grafts were allowed to equilibrate with the buffer (5-30 minutes at 17-27°C) then ground solid succinic anhydride was added in 5 mg portions (range 2-5 grams) to the buffer such that the final succinate solution concentration would be 1 M, (range: 1 to 5 molar) (2 to 8 micromoles of succinate per gram of protein).
- the reaction was sufficiently vigorous to perfuse the lumen of the grafts.
- Several aliquots range: 3 to 5) of the solid anhydride were added directly into the lumens of the grafts which were then placed into the buffer.
- the grafts were retested on a Zarb hydrostatic testing apparatus to ascertain structural integrity of copolymerization.
- the grafts were recoated if necessary and then stored and sterilized in 10 % (range 3 - 10 %) glutaraldehyde.
- Acrylamide was prepared in accordance with the method of Davis et al. A solution which would yield 7 % (range: 5 to 8 %) gel was utilized. The graft was immersed into solution and was allowed to polymerize. The graft was removed, washed with distilled deionized water and stored in 40 % ETOH and water.
- a 20 ml solution of 28,0 g of acrylamide (Bio-Rad Labs of Richmond, Ca.) and .735 g of bis-acrylamide (Bio-Rad Labs of Richmond, Ca.) were added to a 20 ml solution containing 1 N. HC1, 48.0ml/100 ml., 36.3 g/100 ml of TRIS (Bio-Rad Inc. of ) and 0.723 ml of TEMED/100 ml.
- a segment ot graft material was added to the acrylamide solution and allowed to equilibrate for one hour (1/2-1 hours at room temperature). At that time, a 40 ml solution of ammonium persulfate, 1 mg/ml, (Bio-Rad Labs of Richmond, Ca.) was added to the acrylamide-bis-acrylamide solution in order to polymerize the solution. The solution was allowed to gel at room temperature for 1/2 hour (range: 10-40 minutes). During this time interval, the graft was removed and reintroduced into the gelling medium 10 (range: 10 to 20) times. The graft was removed after the solution began to gel but before a solidified gel could form.
- the graft was then placed into a new test tube, and the acrylamide which had coated the Dacron fibers was allowed to gel. After the acrylamide polymerized, the graft was perfused with water at room temperature for 1 hour (range: 1/2 to 1 hour).
- a 3 % agar-water mixture (Difco Labs, Detroit,Mich. USA) was made and heated to 100°C until a uniform (aggregate free) slurry was evident.
- the graft material washed three to ten times in distilled and deionized water, was immersed in the agar slurry until it was uniformly coated (100-2,000 microns). It was then kept at 4°C (range: 4-10°C) until the agar congealed.
- the graft was removed, washed and stored in 40 % ethanol-H 2 0 until used.
- Two techniques of coating a Dacron prosthesis with aluminum were utilized. They were: (1) vapor deposition and (2) hot plasma spray technique.
- Vapor deposition was accomplished in vacuum at 10 -5 Torr.
- the aluminium vapor was forced through a small opening ( .25 to 20 mm) in a heat shield and deposited on a Dagron graft in a thin, uniform coat of 1/2 to 10 microns.
- This technique proved to be the best technique for coating Dacron tubular material with aluminum as it provides a vapor which coats the graft completely with localized over concentration.
- Aluminium powder is heated to its melting points and is then sprayed by a pressurized aerosol-like container. This is repeated until a thin coating (1/2 to 10 microns) of aluminum is observed on the Dacron.
- Implantation studies were divided into chronic and short term evaluation of hybrid graft materials.
- Three and four mm hybrid grafts were sutured (implanted) into the carotid and femoral arteries of dogs for periods ranging from 1 second to 2 months. (1 second, 2 hours, 1 week, 1 month, 2 months).
- the hybrid grafts were removed from their sterile solutions and placed into a sterilized 500 ml beaker and sequential washed with 250 ml of sterile saline 20 x. The grafts were then placed into a sterile stainless steel bin containing 1.5 liters of sterile saline, until placed in a sterile field and implanted.
- the end pieces Prior to implantation, the end pieces were cut to provide an even surface for anastomosis and samples for controls, culturing and SEM studies to determine efficiency of coating and fuction.
- End-to-end anastomosis was carried out using a running Carrell suture with 4-0 cardiovascular Dacron or other material. Precise anastomosis was carried out in all cases.
- Percent patency has been determined using a semiquantative scale. This has been determined by taking the cross sectional view of a graft and dividing it into equal
- the graft-hybrid materials were analyzed using (1) scanning electron microscopy (SEM), (2) light microscopy and (3) histological staining. Patency was determined using the aforementioned semi-quantitative technique.
- the SEM's were used to detect (1) efficiency of hybridization (to determine structural flaws in the coatings) and (2) to determine visible evidence of the type of blood prostheses interfacial reactions.
- H&E Hemotoxylan and Eosin
- Elastic VG stain Van Geisen
- Table 1 Relates the type of hybridization, time of implantation and percent patency. Column 1 is the type of "coating" and subsequent negative charging. The next 4 colums are the time parameters at which they were analyzed. The numbers represent the % of patency. A check indicates that the graft is still functioning in-vivo. A - indicates that that parameter was not measured. The last column is the type of Dacron support used with that particular modification.
- FIG. l(a) shows scanning electron micrographs of a polymerized protein, namely, of an albumin Dacron hybrid graft. This series of photographs demonstrates the homo- genicity of a protein on Dacron surface.
- Fig. l(B) shows scanning electron micrographs of a protein-gelatin Dacron hybrid graft. The photographs show a homogeneous surface prior to and after exposure of the surface to blood for 1 second.
- Fig. 2(A) shows scanning electron micrographs of a gelatin-Dacron hybrid graft. These photographs reveal minor cracking of the polymerized surface at high (lOKx) magnification.
- Fig. 2(B) shows scanning electron micrographs of a gelatin-Dacron hybrid graft. Following polymerization of the hybrid, the surface was chemically treated (succinylating) to produce a net negative surface charge. These micrographs indicate that the negative surface at 1 second, 2 hours and 1 month is far less reactive than the unmodified hybrid surface.
- the unmodified surface has a dense amount of cellular protein deposition thereon, while the negatively charged surface attracts fewer cellular aggregates.
- the patency rate for the negatively charged grafts was approximately 90 % as opposed to 60 % for the unmodified surface at 2 hours.
- Fig. 3(A) shows the smooth structure of an agar coated Microknit ⁇ Dacron graft and Fig. 3(B) shows implantation results of a protein-gelatin Dacron hybrid graft.
- the SEM photographs reveal that the protein-gelatin negatively charged hybrid is less reactive at 1 second, 2 hours and 1 month than the unmodified graft. Many erythrocytes entrapped in a protein matrix can be seen in the unmodified surface while the negatively charged surface possesses few red cells and no visible platelets. Patency rates for the negatively charged grafts was approximately 90 % as opposed to 70 % for the unmodified grafts at 2 hours.
- F ig. 4 shows scanning electron micrographs of an aluminum coated Dacron hybrid graft. Following implantation, the graft was examined. Little protein deposition could be seen. A layer of cells which appear to be erythrocytes and monocytes bound to fibrinogin seem to be sparsely coating the surface. The metallic coating may be toxic to cellular elements, as the monocytes are atypical. The patency rate in all cases was 100 %.
- Fig. 5 shows scanning electron micrographs of an agar coated-Dacron hybrid. Implantation results indicate a reactive surface with cellular and protein deposition. Patentcy rates were 80 % at 1 second and 40 % at 2 hours.
- Fig. 6(A) shows an aluminum coated Dacron prosthesis exposed to blood for 1 second.
- the fibrils are virtually free of cellular elements with the exception of a very few erythrocytes and leukocytes with a few visible platelets attached as well.
- the single large cell appears to be a toxic neutrophile.
- the remainder of the photograph displays proteinated aluminum substrate.
- the cells are smaller and appear to be crenating.
- Fig. 6(B) shows further magnifications at 1 K X and these reveal a few crenating cells with a very thin layer of protein attached to the aluminized Dacron fabric. These cells are completely gone by 1 month, the fabric being joined by what appears to be a thin amorphous layer of protein. This may be proteinated aluminum.
Abstract
Description
- This invention relates to cardiac and vascular prostheses and methods of making the same and materials therefor.
- The major emphasis in early research on implants was performed within the field of orthopedics. (Bechtol, C. D., Ferguson, Jr., A. B., and Laing, P. G. Metals and Engineering in Bone and Joint Surgery. Williams and Wilkins Co., Balt.
Chapter 1, 1-18 (1959); Scales, J. T. Arthroplasty of the Hip Using Foreign Materials: A History, Paper 13, A Symposium, Institute of Mechanical Engineers, Vol. 181 Part 3J. 63-84, (1967); Weisman. S. Metals for Implantation in the Human Body. Ann. N.Y. Acad. Sci. 146, 80-95, (1968)). The most significant addition to implant surgery in the last twenty years has been the development of prostheses for vascular and cardiac reconstruction (Wesolowski, S.A., Martinez, A., and McMahone, J. D. The Use of Artificial Materials in Surgery, "Current Problems in Surgery." Year Book Medical Publishers, Inc., Chicago (1966). A major problem involved in the use of prosthetic alloplastic materials has been severe occlusive thrombogenicity (Hufnagel, C. A. The Use of Rigid and Flexible Plastic Prostheses for Arterial Replacement, Surgery, 37:165, (1955) ). The search for acceptable materials and designs for vascular prostheses was of great importance because of a number of problems which were encountered with the use of polymeric and metal prostheses, autologous, homologous and heterologous bypass grafts in man. (Johnson, W. D. Auer, J. E. and Tector, A. T., Late Changes in Coronary Vein Grafts, Am. Jour. of Cardiol. 26: 640, (1970) and Artegraft Conference, Johnson and Johnson, Toronto, Ontario, Canada, June 23, (1973)). - Following the development of open heart surgery, an enormous effort was made in the field of prosthetic heart valves. The first successful development in this area was made by Goodman, Berg and Stuckey (Wesolowski, C. A. eL al. The Use of Artificial Materials in Surgery, "Current Problems in Surgery" Year Book Medical Publishers, Inc., Chicago (1966). They produced the first completely thromboresistant prosthetic heart valve. This valve was later improved by Dr. Albert Star and Edwards Laboratories (Edwards, W. S. and Smith, L. Aortial Valve Replacement with a Sub Coronary Ball Valve. Sur. Forum 9:309 (1958); Starr, A. Mitral Valve Replacement with a Ball Valve Prosthesis. British Heart Journal, 33 Supp. 47 (1971). A number of valves were further developed by several corporations. These included the Bjork-Shiley valve which is the most successful of the prosthetic heart valves available today. More recently, glutaraldehyde tanned porcine collagen prosthetic heart valves developed by the Hancock Laboratory (Sauvage, L. R. Wesolowski, A. S., Sawyer, P. N. et al. Prosthetic Valve Replacement Ann. of the N. Y. Academy of Sci. 146:289 (1968)) have proven useful. They are resistant to intravascular thrombosis and have maintained their tensile strength following several years of implantation in man. Thus, a host of glutaraldehyde tanned collagen valvular prostheses have proven useful in man with respect to long term function and resistance to thrombosis.
- Early attempts to replace blood vessels in man involved the use of rigid tubes of gold, silver, aluminum, magnesium, as well as the later development of polyethylene and polymethyl acrylic tubes (Szilagayi, D. E. Long Term Evaluation of Plastic Arterial Substitutes: An Experimental Study, Surg. 55:165 (1964); Woodward, S. C. Biological End Points for Compatibility, Plastics in Surgical Implants ASTM-STP 386, A Symposium on Surg. Implants, Indianapolis, Indiana (1964); Sawyer, P. N.,Wu, K. T., Wesolowski, A. S., Brattain, W. H. and Boddy, P. J. Long Term Patency of Solid Wall Vascular Prostheses, Arch. Surg. 91:735, (1965). In the majority of cases, these prostheses did not function satisfactorily. A major breakthrough came in 1952 when Voorhees and Blakemore described their experiments with a cloth prosthesis of Vinyon. (Voorhees, A. B., Jr., Jaretski, 111, A. and Blakemore, A. H. Use of tubes constructed from Vinyon-"N" Cloth in bridging Arterial Defects. Ann. Surg. 135; 332 (1952)). This material was easy to handle, preclottable and resistant to thrombosis following implantation, although tensile strength, in situ, was lost with the passage of time. Preclotting the graft with the patient's blood produced a compound prosthesis, whereby, the lumen was covered by a fibrous neo-intima and the adventitia was enclosed by a fibrous capsule, which resulted in a well tolerated graft. Presently, the Dacron graft is considered to be the most successful cloth type graft. (Sawyer, P. N. et al. Vascular Graft Symposium, Current Status and Future Trends. NIH (1976)).
- Early attempts at vessel substitution with materials of biological origin were carried out using arteries from cadavers (Wesolowski, S. A. and Sauvage, L. R. Hetero- logus Aortic Hetergrafts with Special Reference to Recipient Site, Ethylene Oxide Freeze Dry Preparation and Specied of Origin, Ann. Surg. 145:187 (195 ). On the whole, these homografts functioned well for a period of time, but were soon replaced by fibrous tissue and calcium salts. This resulted in an inelastic structure, susceptible to thrombus, fracture, and aneurysm formation (Sauvage, L. R. and Wesolowski, A. S. Healing and Fate of Arterial Grafts, Surg. 38:1090 (1955)).
- Following failure of the homografts, autografts from a patient's veins (saphenous) were used. Currently, the implantation statistics show that the saphenous vein is superior to synthetic implants (Sawyer, P. N. et al, Vascular Graft Symposium;Sauvage, L. R. and Wesolowski, A. S. Healing and Fate of Arterial Grafts, supra, and Vladamer, C. and Edwards, J. E. Pathological Changes in Aortocoronary Arterial Saphenous Vein Grafts. Circulation 44:719 (1971)). When the saphenous vein is not available, i.e., the question arises as to which implant should be used. Experience has shown that a vascular graft must: (i) have an appropriate porosity (10,000-20,000 ml of water/square cm/minute) Sawyer, P. N., Wu, K. T., Wesolowski, S. A. Brattain, W. and Boddy, P. J. An Aid in the Selection of Vascular Prosthesis Proc. Natl. Acad. Sci., U.S.A., 53:1965), (ii) be blood compatible, (iii) possess tensile strength and (iv) be easy to handle with respect to sewing characteristics (Sawyer, P. N. and Srinivasan, S. New Approaches in the Selections of Materials Compatible with Bluod. Artificial Heart Prog.
Conf.Proc.Chapter 2,1969). - In an effort to overcome the problems of porosity, junctional thrombosis, and small diameter compliance exhibited by most implants in the periphery, I have conducted research on copolymeric collagen remnants from bovine carotid and brachial arteries. The collagen remains intact following enzymatic digestion (ficin) and is then glutaraldehyde tanned and negatively charged.
- When implanted, these grafts reveal a striking tendency to remain thromboresistant and maintain their tensile strength as opposed to other commerically available collagen grafts that possess a limited degree of patency with early loss of tensile strength. My copolymeric grafts have remained patent in the femoral-popliteal, carotid and coronary positions (Vascular Graft Symposium, supra).
- As to why these types of grafts perform so well, conclusive answers are not yet available. Scanning electron microscopic studies indicate that when the grafts fail, they become occluded by an atypical thrombus. It is therefore obvious that the success of this type of graft depends upon (i) the surface modification characteristics of the collagen (ii) blood interfacial reactions' occurring, (iii) structural aspects of the collagen surface.
- I have heretofore developed a negatively charged, glutaraldehyde tanned collagen copolymeric vascular bypass graft This new graft appears to be superior to other commerically available bypass heterografts based upon life analysis tables. The processes used to chemically modify the collagen are uniquely versatile.
- I am now working with second and third generation grafts and have produced Dacron* hybrid grafts of several types. The application of this graft is aimed at specific clinical problems where the saphenous vein or conventional heterografts would be considered unsatisfactory. The hybrid graft can also be applied to the total artificial heart and bypass pump chambers and Dacron skirt of heart valves providing a more satisfactory blood compatible surface.
- Dacron vascular grafts have been altered, in accordance with the invention, by coating them and filling their interstitial spaces with a variety of agents, in a variety of ways, to produce grafts with superior anti- thrombogenic characteristics.
- The techniques utilized include: (1) copolymerization of proteins to the Dacron with glutaraldehyde and subsequent negative charging, (2) aluminization of the grafts,
- *Registered Trademark for a Polyester of terephthalic acid and ethylene glycol manufactured by DuPont de Nemours & Co., Inc., Wilmington, Delaware, U.S.A.
- (3) the deposit of substances which may accept from a bloody environment materials which are compatible with the environment.
- It is an object of the invention to provide an improved prosthesis material for making an improved prosthesis and method for making the same.
- It is another object of the invention to provide for improved prosthesis characteristics in a blood environment.
- To achieve the above and other objects of the invention there is provided a prosthesis suitable for implantation in a bloody environment, said prosthesis comprising a surface material adapted for exhibiting a regular and periodic surface charge characteristic in said bloody environment, and prostheses means supporting said surface material and adapted to perform a prosthetic function in this environment.
- In accordance with one embodiment of the invention, the surface material may be aluminum. In accordance with another embodiment, the surface material may be albumin. In accordance with still other embodiments, the surface material may be agar or acrylamide.
- In accordance with one aspect of the invention, the prosthetic means is of a material normally incapable of crosslinking to said surface material. In this case, there is provided an adaptive material to cross-link to the material of said prosthetic means and to said surface material to provide architectural continuity therebetween while preserving said surface charge characteristics.
- In accordance with the invention and the preferred embodiment thereof, the surface charge is preferably equivalent to approximately one electron per thousand square Angstroms in a regular three-dimensional pattern.
- According to the invention, there is provided a method for preparing a prosthesis for functioning in a bloody environment with minimal thrombogenicity. This method comprises depositing on the surface of the prostheses a material adapted for exhibiting a regular and periodic thrombosis resistant surface charge in the bloody environment. Thus, for example, a synthetic material may be adapted for use as a prosthetic material which is adapted to function in a bloody environment. This may be achieved, for example, by metallizing the material at the surface thereof.
- According to one embodiment of the invention, the metallizing may take place by the vapor depositing of aluminum on the surface.
- According to another embodiment, the aluminum may be sprayed in an aerosol on the surface.
- The prosthesis may be, for example, of woven Dacron. Thereupon may be deposited a surface material in the form of albumin, combined with gelatin. The thusly coated prosthesis may, for example, thereafter be treated with glutaraldehyde. The material deposited on the prosthesis may be , for example, of the general category of proteins and may be applied preferably in, for example, about a 3 % solution.
- According to the further feature of the invention, a thusly coated prosthesis may be further treated with a succinic acid compound.
- According to still further aspects of the invention, the material may be applied by immersing the prosthesis in a slurry of agar. As an alternative, the prosthesis may be immersed in a solution of acrylamide.
- The above and further objects and features of the invention will be found in the detailed description thereof as follows hereinafter.
-
- Figure l(A) is a scanning electron microphotograph group of a polarized protein;
- Figure l(B) is a collection of scanning electron micrographs of a protein-gelatin Dacron hybrid graft;
- Figure 2(A) shows scanning electron micrographs of a gelatin-Dacron hybrid graft;
- Figure 2 (B) is a group of scanning electron micrographs of a gelatin-Dacron hybrid graft;
- Figure 3(A) shows the structure of an agar coated graft;
- Figure 3(B) shows the implantation results of a protein-gelatin Dacron hybrid graft;
- Figure 4 is a group of scanning electron micrographs of an aluminum coated Dacron hybrid graft;
- Figure 5 shows scanning electron micrographs of an agar coated Dacron hybrid graft;
- Figure 6(A) shows an aluminum coated Dacron prosthesis exposed to blood for one second; and
- Figure 6(B) shows further magnification of the prosthesis illustrated in Fig. 6(A).
- As has been stated hereinabove, the invention relates to the provision of a prosthesis having the capability of fuctioning in a bloody environment. The prosthesis may be of varying types but it can be for example, a vascular prosthesis consisting of a tube adapted to function as a connection for bypass or a valve functioning to operate in the cardiac environment.
- The invention is based in general on having the prosthesis exhibit a regular and periodic negative surface charge characteristic in the preferred case approximating one electron per thousand square Angstroms of surface in a regular threedimensional pattern. Under certain circumstances, the regular and periodic surface charge may be positive.
- A surface material will generally be employed to exhibit the above-noted characteristic. For this reason, the present invention is concerned with hybrid prostheses which are prostheses consisting of a basic material forming a prosthesis so that it is capable of performing the desired function and a surface material which exhibits the aforenoted charge.
- In case the basic material is incapable of crosslinking with the surface material, an adaptive material may be provided to offer architectural continuity and cross-link the surface material and the supporting material by being adapted to cross-link itself respectively to each of these materials.
- The invention offers, for example, copolymerization for a form of protein deposition, metallizing, agar application in the form of a uniform coating and the application of, for example, acrylamide. The invention offers further selective processing of certain of the above materials by treatment with succinic acid or the like or, for example, by treatment with glutaraldehyde.
- The following are details of materials and methods which may be employed in accordance with the above: Copolymerization (a method of protein deposition) Fraction V Albumin (purified bovine or other mammalia albumin) purchased from Sigma Corporation, St. Louis, Mo.,USA was dissolved (1, 3, 5 and 10 grams in 100 ml. of water) to produce several solutions of 1 % - 10 % with distilled and deionized water Gelatin (cutaneous), purchased from Baker Corporation*, was dissolved at room temperature in water, producing solutions ranging in concentration (1, 3, 5 and 10 grams in 100 ml of water) from 1 % - 10%.
- A Microknit® knitted or woven vascular prosthesis (Go- laski Labs. Inc. of Philadelphia, Penna.USA) possessing 18 ridge to the inch (50 interstices per inch) was cut into 10 cm. segmen (collapsed length) and cleaned in distilled and deionized water. It is then immersed in 10-20 % (preferably 20%) qlutaraldehyde (purchased from Electron Microscope Science Corporation of Fort Washington Penna., USA) with distilled and deionized water (40 ml of 50 % glutaraldehyde in 60 ml of water) and was allowed to stand for three hours.
- The graft materials were then immersed in the appropriate protein (albumin, gelatin, collagen or the like) solution until thin (1 to 2,000 microns) coats of polymerized protein surrounded the Dacron tube. They were then suspended in air at room temperature and rinsed with water at room temperature for a minimum of 2 minutes. Care was taken to rinse the lumen of the grafts with water. The graft-protein "hybrid" prostheses were then reintroduced into fresh (20%) glutaraldehyde (40 ml of 50 % glutaraldehyde in 60 ml of water) for 5-15 minutes. The process was repeated several times (three to ten times) until thin (1 to 2000 microns), uniformly coated grafts with their interstitial spaces filled were produced.
- * J. T. Baker Chemical Co., Phillipsburgh, New Jersey,USA.
- Several types of grafts and varying concentrations of proteins were utilized to determine optimal reaction condition. They included 3 and 6 mm. I.D. (2-20 mm is the range), 18 and 32 ridges/inch (10-32 ridges would be the range), and 1, 3, 5 and 10 % protein solutions. It was found that the grafts possessing 18 ridges/inch (half crimp) were the optimal type of graft to modify, as they possessed the best surface configuration to provide for an even deposition of protein. The grafts having 32 ridges/inch (full crimp) had to be stretched on a glass rod of the same I.D. as the grafts in order to coat them properly. This prevented intra lumen coating and produced cracking when the rod was removed and the grafts regained their original shape. It was further found that a 3 % solution of protein provided the most effective coating both in optimizing time to coat and in thickness. One percent took a much longer time period to coat (greater than 1 hour). A 10 % coating was achieved within 30 seconds but was very thick and did not permit obtaining the amount of flexibility required. In the aforegoing, the range of depth of the crimps is about 1 to 2 mm and the wall thickness of the grafts is about 1/2 to 1 mm. Using the techniques described above (i.e., 3 % protein solutions and half crimped grafts) it was possible to coat both 3 mm and 6 mm I.D. grafts without difficulty.
- The protein copolymerized hybrid grafts were further modified to enhance their net negative surface charge.
- The end terminal amino acid residues were covalently coupled to succinic acid under acetylation reaction conditions (see Pat. No. 3,927,422). The grafts were rinsed thoroughly with distilled deionized water, and placed into a 10 % (8-10 % range) sodium bicarbonate buffer at a pH 8.5 (8.2-8.7 range) (8-10 grains in 100 ml of water). The grafts were allowed to equilibrate with the buffer (5-30 minutes at 17-27°C) then ground solid succinic anhydride was added in 5 mg portions (range 2-5 grams) to the buffer such that the final succinate solution concentration would be 1 M, (range: 1 to 5 molar) (2 to 8 micromoles of succinate per gram of protein). The reaction was sufficiently vigorous to perfuse the lumen of the grafts. Several aliquots (range: 3 to 5) of the solid anhydride were added directly into the lumens of the grafts which were then placed into the buffer. At the conclusion of the reaction (i.e., cessation of effervescence), the grafts were retested on a Zarb hydrostatic testing apparatus to ascertain structural integrity of copolymerization. The grafts were recoated if necessary and then stored and sterilized in 10 % (range 3 - 10 %) glutaraldehyde.
- Acrylamide was prepared in accordance with the method of Davis et al. A solution which would yield 7 % (range: 5 to 8 %) gel was utilized. The graft was immersed into solution and was allowed to polymerize. The graft was removed, washed with distilled deionized water and stored in 40 % ETOH and water.
- More particularly, a 20 ml solution of 28,0 g of acrylamide (Bio-Rad Labs of Richmond, Ca.) and .735 g of bis-acrylamide (Bio-Rad Labs of Richmond, Ca.) were added to a 20 ml solution containing 1 N. HC1, 48.0ml/100 ml., 36.3 g/100 ml of TRIS (Bio-Rad Inc. of ) and 0.723 ml of TEMED/100 ml.
- A segment ot graft material was added to the acrylamide solution and allowed to equilibrate for one hour (1/2-1 hours at room temperature). At that time, a 40 ml solution of ammonium persulfate, 1 mg/ml, (Bio-Rad Labs of Richmond, Ca.) was added to the acrylamide-bis-acrylamide solution in order to polymerize the solution. The solution was allowed to gel at room temperature for 1/2 hour (range: 10-40 minutes). During this time interval, the graft was removed and reintroduced into the gelling medium 10 (range: 10 to 20) times. The graft was removed after the solution began to gel but before a solidified gel could form. The graft was then placed into a new test tube, and the acrylamide which had coated the Dacron fibers was allowed to gel. After the acrylamide polymerized, the graft was perfused with water at room temperature for 1 hour (range: 1/2 to 1 hour).
- A 3 % agar-water mixture (Difco Labs, Detroit,Mich. USA) was made and heated to 100°C until a uniform (aggregate free) slurry was evident. The graft material, washed three to ten times in distilled and deionized water, was immersed in the agar slurry until it was uniformly coated (100-2,000 microns). It was then kept at 4°C (range: 4-10°C) until the agar congealed. The graft was removed, washed and stored in 40 % ethanol-H20 until used.
- All hybrid grafts underwent hydrostatic testing using a Zarb hydraulic pressure tester. The criterion used was the ability to withstand 30 mm (range 20-50) of Hg pressure without showing evidence of air leaks through the graft pores.
- If a graft failed because of leaks during the test procedure, it was recoated by the process described above until there was no evidence of leakage. The hybrid grafts were stored in 10 % glutaraldehyde until used.
- Two techniques of coating a Dacron prosthesis with aluminum were utilized. They were: (1) vapor deposition and (2) hot plasma spray technique.
- Vapor deposition was accomplished in vacuum at 10-5 Torr. The aluminium vapor was forced through a small opening ( .25 to 20 mm) in a heat shield and deposited on a Dagron graft in a thin, uniform coat of 1/2 to 10 microns.
- This technique proved to be the best technique for coating Dacron tubular material with aluminum as it provides a vapor which coats the graft completely with localized over concentration.
- Aluminium powder is heated to its melting points and is then sprayed by a pressurized aerosol-like container. This is repeated until a thin coating (1/2 to 10 microns) of aluminum is observed on the Dacron.
- Implantation studies were divided into chronic and short term evaluation of hybrid graft materials.
- Three and four mm hybrid grafts were sutured (implanted) into the carotid and femoral arteries of dogs for periods ranging from 1 second to 2 months. (1 second, 2 hours, 1 week, 1 month, 2 months).
- Six mm hybrid grafts were implanted into the abdominal aorta of dogs for time periods ranging from 1 month to 1 year (1 month, 6 months, 9 months, 1 year).
- The hybrid grafts were removed from their sterile solutions and placed into a sterilized 500 ml beaker and sequential washed with 250 ml of sterile saline 20 x. The grafts were then placed into a sterile stainless steel bin containing 1.5 liters of sterile saline, until placed in a sterile field and implanted.
- Prior to implantation, the end pieces were cut to provide an even surface for anastomosis and samples for controls, culturing and SEM studies to determine efficiency of coating and fuction.
- End-to-end anastomosis was carried out using a running Carrell suture with 4-0 cardiovascular Dacron or other material. Precise anastomosis was carried out in all cases.
- Percent patency has been determined using a semiquantative scale. This has been determined by taking the cross sectional view of a graft and dividing it into equal
- concentric circles of 1/4 D from the wall of the vessel. Thus, it is now possible to quantify the amount of thrombus formed by measuring the depth of the thrombus then relating it to the total cross sectional area. The numbers generated by this technique are expressed in terms of percentage of'the entire vessel.
- The graft-hybrid materials were analyzed using (1) scanning electron microscopy (SEM), (2) light microscopy and (3) histological staining. Patency was determined using the aforementioned semi-quantitative technique.
- SEM's were performed on the grafts before implantation and after removal using a Phillip's scanning electron microscope at 200x, 10Kx and 20Kx magnifications. With these magnifications, it is possible to resolve and differentiate platelets, erythrocytes, and leukocytes, and white blood cells and to visualize protein (including fibrin) deposition.
- The SEM's were used to detect (1) efficiency of hybridization (to determine structural flaws in the coatings) and (2) to determine visible evidence of the type of blood prostheses interfacial reactions.
- Graft sections were evaluated by the use of several standard histological stains including Hemotoxylan and Eosin (H&E) Van Geisen (Elastic VG stain), PTAH and Trichrome. Each stain specifically detects the type of material adhering to the graft or removal from the animal by the colors which are produced when the staining solution is in contact with the biologic material. H&E is used to visualize cellular entities and to demonstrate if an inflamatory response has occurred and if polynucleated cells or lymphocytes are present. EVG stain is used to illustrate fibroblastic invasion and to dye the collagen present. For instance, Trichrome stains collagen blue. PTAH stain is used to demonstrate the presence of fibrin.
- The following table illustrates the patency levels of the various hybrid grafts.
-
- Table 1: Relates the type of hybridization, time of implantation and percent patency.
Column 1 is the type of "coating" and subsequent negative charging. The next 4 colums are the time parameters at which they were analyzed. The numbers represent the % of patency. A check indicates that the graft is still functioning in-vivo. A - indicates that that parameter was not measured. The last column is the type of Dacron support used with that particular modification. - The following figures are SEM studies of the following hybrid grafts before and after implantation, negative charged and unmodified, of (i) Albumin (A) coated grafts, (ii) Gelatin (G) coated grafts, (iii) a 50/50 mixture of albumin and gelatin a concentration of 3 % each (AG), (iv) acrylamide coated graft (ACD), (v) agar-agar coated grafts (AGR), and CVD aluminum coated grafts (Al). Fig. l(a) shows scanning electron micrographs of a polymerized protein, namely, of an albumin Dacron hybrid graft. This series of photographs demonstrates the homo- genicity of a protein on Dacron surface.
- Fig. l(B) shows scanning electron micrographs of a protein-gelatin Dacron hybrid graft. The photographs show a homogeneous surface prior to and after exposure of the surface to blood for 1 second.
- Fig. 2(A) shows scanning electron micrographs of a gelatin-Dacron hybrid graft. These photographs reveal minor cracking of the polymerized surface at high (lOKx) magnification.
- Fig. 2(B) shows scanning electron micrographs of a gelatin-Dacron hybrid graft. Following polymerization of the hybrid, the surface was chemically treated (succinylating) to produce a net negative surface charge. These micrographs indicate that the negative surface at 1 second, 2 hours and 1 month is far less reactive than the unmodified hybrid surface. The unmodified surface has a dense amount of cellular protein deposition thereon, while the negatively charged surface attracts fewer cellular aggregates. The patency rate for the negatively charged grafts was approximately 90 % as opposed to 60 % for the unmodified surface at 2 hours.
- Fig. 3(A) shows the smooth structure of an agar coated Microknit― Dacron graft and Fig. 3(B) shows implantation results of a protein-gelatin Dacron hybrid graft. The SEM photographs reveal that the protein-gelatin negatively charged hybrid is less reactive at 1 second, 2 hours and 1 month than the unmodified graft. Many erythrocytes entrapped in a protein matrix can be seen in the unmodified surface while the negatively charged surface possesses few red cells and no visible platelets. Patency rates for the negatively charged grafts was approximately 90 % as opposed to 70 % for the unmodified grafts at 2 hours.
- Fig. 4 shows scanning electron micrographs of an aluminum coated Dacron hybrid graft. Following implantation, the graft was examined. Little protein deposition could be seen. A layer of cells which appear to be erythrocytes and monocytes bound to fibrinogin seem to be sparsely coating the surface. The metallic coating may be toxic to cellular elements, as the monocytes are atypical. The patency rate in all cases was 100 %.
- Fig. 5 shows scanning electron micrographs of an agar coated-Dacron hybrid. Implantation results indicate a reactive surface with cellular and protein deposition. Patentcy rates were 80 % at 1 second and 40 % at 2 hours.
- Fig. 6(A) shows an aluminum coated Dacron prosthesis exposed to blood for 1 second. The fibrils are virtually free of cellular elements with the exception of a very few erythrocytes and leukocytes with a few visible platelets attached as well. At 10K X magnification, the single large cell appears to be a toxic neutrophile. The remainder of the photograph displays proteinated aluminum substrate. At 2 hours, the cells are smaller and appear to be crenating.
- Fig. 6(B) shows further magnifications at 1 K X and these reveal a few crenating cells with a very thin layer of protein attached to the aluminized Dacron fabric. These cells are completely gone by 1 month, the fabric being joined by what appears to be a thin amorphous layer of protein. This may be proteinated aluminum.
- Histological evaluation was carried out in parallel to the SEM studies. In all cases, there was no evidence of (1) polynucleated cells or lymphocytes or, (ii) inflamatory response. All grafts had fibroblastic invasion. Type A presents the most explicit example. In all cases, protein coating was firmly attached to the Dacron. Coating of each strand of Dacron was also established.
-
- There will now be obvious to those skilled in the art many modifications and variations of the methods and materials set forth hereinabove. These modifications and variations will not depart from the scope of the invention if defined by the following claims.
Claims (20)
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US827952 | 1977-08-26 | ||
US05/827,952 US4167045A (en) | 1977-08-26 | 1977-08-26 | Cardiac and vascular prostheses |
Publications (2)
Publication Number | Publication Date |
---|---|
EP0000949A1 true EP0000949A1 (en) | 1979-03-07 |
EP0000949B1 EP0000949B1 (en) | 1983-05-18 |
Family
ID=25250568
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP78100752A Expired EP0000949B1 (en) | 1977-08-26 | 1978-08-25 | Cardiac and vascular prostheses and methods of making the same |
Country Status (5)
Country | Link |
---|---|
US (1) | US4167045A (en) |
EP (1) | EP0000949B1 (en) |
JP (1) | JPS5463588A (en) |
CA (1) | CA1122353A (en) |
DE (1) | DE2862259D1 (en) |
Cited By (14)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0124659A1 (en) * | 1983-04-13 | 1984-11-14 | Koken Co. Ltd. | Medical material |
FR2572654A1 (en) * | 1984-11-08 | 1986-05-09 | Mitsubishi Monsanto Chem | FLEXIBLE POLY (VINYL CHLORIDE) MEDICAL EQUIPMENT COMPRISING A CROSSLINKED GELATIN COATING, AND METHOD FOR MANUFACTURING SUCH MATERIAL |
EP0183365A2 (en) * | 1984-11-30 | 1986-06-04 | Vascutek Limited | Vascular graft |
GB2203342A (en) * | 1987-04-07 | 1988-10-19 | Julian Garth Ellis | Radio-opaque tracer for surgical implants |
US4842575A (en) * | 1984-01-30 | 1989-06-27 | Meadox Medicals, Inc. | Method for forming impregnated synthetic vascular grafts |
US5073171A (en) * | 1989-01-12 | 1991-12-17 | Eaton John W | Biocompatible materials comprising albumin-binding dyes |
US5108424A (en) * | 1984-01-30 | 1992-04-28 | Meadox Medicals, Inc. | Collagen-impregnated dacron graft |
EP0311305B1 (en) * | 1987-10-02 | 1992-09-09 | Koken Company Limited | Artificial blood vessel |
US5197977A (en) * | 1984-01-30 | 1993-03-30 | Meadox Medicals, Inc. | Drug delivery collagen-impregnated synthetic vascular graft |
EP0542880A1 (en) * | 1990-07-27 | 1993-05-26 | The Trustees of Columbia University in the City of New York | Tissue bonding and sealing composition and method of using the same |
WO1996040302A1 (en) * | 1995-06-07 | 1996-12-19 | W.L. Gore & Associates, Inc. | Bioabsorbable space filling soft tissue prosthesis |
US5716660A (en) * | 1994-08-12 | 1998-02-10 | Meadox Medicals, Inc. | Tubular polytetrafluoroethylene implantable prostheses |
US5851230A (en) * | 1994-08-12 | 1998-12-22 | Meadox Medicals, Inc. | Vascular graft with a heparin-containing collagen sealant |
EP1267749B2 (en) † | 2000-03-20 | 2017-07-26 | Vactronix Scientific, Inc. | Endoluminal implantable devices and method of making same |
Families Citing this family (37)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4530974A (en) * | 1981-03-19 | 1985-07-23 | Board Of Regents, The University Of Texas System | Nonthrombogenic articles having enhanced albumin affinity |
SE446372B (en) * | 1983-02-03 | 1986-09-08 | Medinvent Sa | BLOODKERL PROTES FOR USE AS SHUNT BETWEEN BLOODKERL |
US4562596A (en) * | 1984-04-25 | 1986-01-07 | Elliot Kornberg | Aortic graft, device and method for performing an intraluminal abdominal aortic aneurysm repair |
JPS60227763A (en) * | 1984-04-27 | 1985-11-13 | 筏 義人 | Anti-thrombotic medical material |
US5037377A (en) * | 1984-11-28 | 1991-08-06 | Medtronic, Inc. | Means for improving biocompatibility of implants, particularly of vascular grafts |
US4629458A (en) * | 1985-02-26 | 1986-12-16 | Cordis Corporation | Reinforcing structure for cardiovascular graft |
DE3608158A1 (en) * | 1986-03-12 | 1987-09-17 | Braun Melsungen Ag | VESSELED PROSTHESIS IMPREGNATED WITH CROSSLINED GELATINE AND METHOD FOR THE PRODUCTION THEREOF |
US4911713A (en) * | 1986-03-26 | 1990-03-27 | Sauvage Lester R | Method of making vascular prosthesis by perfusion |
CH670759A5 (en) * | 1986-06-02 | 1989-07-14 | Sulzer Ag | |
US5447966A (en) * | 1988-07-19 | 1995-09-05 | United States Surgical Corporation | Treating bioabsorbable surgical articles by coating with glycerine, polalkyleneoxide block copolymer and gelatin |
US5464438A (en) * | 1988-10-05 | 1995-11-07 | Menaker; Gerald J. | Gold coating means for limiting thromboses in implantable grafts |
US5207706A (en) * | 1988-10-05 | 1993-05-04 | Menaker M D Gerald | Method and means for gold-coating implantable intravascular devices |
JPH02277886A (en) * | 1989-04-17 | 1990-11-14 | Shigesaburo Mizushima | Method for processing synthetic fiber and vegetable fiber with fibroin protein |
JP2799596B2 (en) * | 1989-08-10 | 1998-09-17 | 株式会社ジェイ・エム・エス | Bioimplant device and method for producing the same |
US5118524A (en) * | 1990-09-14 | 1992-06-02 | The Toronto Hospital | Vascular biomaterial |
GB9026687D0 (en) * | 1990-12-07 | 1991-01-23 | Vascutek Ltd | Process for providing a low-energy surface on a polymer |
US5120833A (en) * | 1991-03-15 | 1992-06-09 | Alexander Kaplan | Method of producing grafts |
US5500013A (en) * | 1991-10-04 | 1996-03-19 | Scimed Life Systems, Inc. | Biodegradable drug delivery vascular stent |
US5584875A (en) * | 1991-12-20 | 1996-12-17 | C. R. Bard, Inc. | Method for making vascular grafts |
US5272074A (en) * | 1992-04-23 | 1993-12-21 | Mcmaster University | Fibrin coated polymer surfaces |
US5681575A (en) | 1992-05-19 | 1997-10-28 | Westaim Technologies Inc. | Anti-microbial coating for medical devices |
GEP20002074B (en) * | 1992-05-19 | 2000-05-10 | Westaim Tech Inc Ca | Modified Material and Method for its Production |
CN1052915C (en) * | 1995-11-27 | 2000-05-31 | 中国医学科学院生物医学工程研究所 | Medical carrier of protein coat for carrying gene and its prodn. method |
US6193749B1 (en) * | 1996-02-05 | 2001-02-27 | St. Jude Medical, Inc. | Calcification-resistant biomaterials |
US6302909B1 (en) | 1996-07-31 | 2001-10-16 | St. Jude Medical, Inc. | Calcification-resistant biomaterials |
US5851229A (en) * | 1996-09-13 | 1998-12-22 | Meadox Medicals, Inc. | Bioresorbable sealants for porous vascular grafts |
US5895419A (en) | 1996-09-30 | 1999-04-20 | St. Jude Medical, Inc. | Coated prosthetic cardiac device |
US6254635B1 (en) | 1998-02-02 | 2001-07-03 | St. Jude Medical, Inc. | Calcification-resistant medical articles |
JP2003522002A (en) * | 2000-02-09 | 2003-07-22 | サジタリアス、エイイー、リミテッド | Non-thrombotic implantable device |
US6719987B2 (en) | 2000-04-17 | 2004-04-13 | Nucryst Pharmaceuticals Corp. | Antimicrobial bioabsorbable materials |
JP2003126125A (en) * | 2001-10-24 | 2003-05-07 | Katsuko Sakai | Artificial blood vessel and method of preparing it |
US7740656B2 (en) * | 2003-11-17 | 2010-06-22 | Medtronic, Inc. | Implantable heart valve prosthetic devices having intrinsically conductive polymers |
US7658975B2 (en) * | 2003-12-12 | 2010-02-09 | Intel Corporation | Sealing porous dielectric materials |
US7329531B2 (en) * | 2003-12-12 | 2008-02-12 | Scimed Life Systems, Inc. | Blood-tight implantable textile material and method of making |
JP2008528162A (en) * | 2004-01-29 | 2008-07-31 | スマート インプラント パブリック リミティド カンパニー | Prosthesis and method for producing the prosthesis |
EP2247264A4 (en) * | 2008-02-29 | 2011-08-31 | Florida Int Univ Board Trustees | Catheter deliverable artificial multi-leaflet heart valve prosthesis and intravascular delivery system for a catheter deliverable heart valve prosthesis |
DE102009037134A1 (en) | 2009-07-31 | 2011-02-03 | Aesculap Ag | Tubular implant for replacement of natural blood vessels |
Citations (16)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3096560A (en) * | 1958-11-21 | 1963-07-09 | William J Liebig | Process for synthetic vascular implants |
GB1008193A (en) * | 1961-03-01 | 1965-10-27 | Ethicon Inc | Improvements in or relating to surgical implants |
US3276448A (en) * | 1962-12-14 | 1966-10-04 | Ethicon Inc | Collagen coated fabric prosthesis |
GB1064850A (en) * | 1962-12-20 | 1967-04-12 | Ethicon Inc | Tubular body and process of making it |
GB1097787A (en) * | 1966-09-22 | 1968-01-03 | Ethicon Inc | Surgical prosthesis |
DE1494939A1 (en) * | 1963-06-11 | 1969-06-04 | Buddecke Dr Eckhart | Implant material and process for its manufacture |
US3512183A (en) * | 1967-06-08 | 1970-05-19 | Us Health Education & Welfare | Bioelectric polyurethane and use of same in internal prostheses |
FR2029155A5 (en) * | 1969-01-15 | 1970-10-16 | Mo Med I | Prosthetic vessels of high biological - permeability |
US3563925A (en) * | 1967-12-20 | 1971-02-16 | Ceskoslovenska Akademie Ved | Composition containing interlocked foams of partly tanned collagen and cross-linked glycol methacrylate polymer |
US3609768A (en) * | 1969-06-16 | 1971-10-05 | Becton Dickinson Co | Anticoagulant material having charged electrostatic surfaces suitable for use in prosthetic devices |
US3744062A (en) * | 1971-10-08 | 1973-07-10 | V Parsonnet | Heart valve construction having a collagen cover encapsulation thereon |
US3914802A (en) * | 1974-05-23 | 1975-10-28 | Ebert Michael | Non-thrombogenic prosthetic material |
US3927422A (en) * | 1973-12-12 | 1975-12-23 | Philip Nicholas Sawyer | Prosthesis and method for making same |
US4038702A (en) * | 1973-09-21 | 1977-08-02 | Philip Nicholas Sawyer | Electrochemical and chemical methods for production of non-thrombogenic metal heart valves |
CH593676A5 (en) * | 1975-12-16 | 1977-12-15 | Intermedicat Gmbh | Sealing of blood vessel implants of velour-coated fabric - by impregnating with organic colloidal solns. and drying |
US4082507A (en) * | 1976-05-10 | 1978-04-04 | Sawyer Philip Nicholas | Prosthesis and method for making the same |
Family Cites Families (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3557795A (en) * | 1968-06-19 | 1971-01-26 | Weck & Co Inc Edward | Suture provided with wound healing coating |
FR2110622A5 (en) * | 1970-10-23 | 1972-06-02 | Commissariat Energie Atomique | |
US3765414A (en) * | 1972-03-10 | 1973-10-16 | Hydro Med Sciences Inc | Drug release system |
AT336173B (en) * | 1973-05-29 | 1977-04-25 | Fuhr Jurgen Dr Med | METHOD FOR PRODUCING ARTIFICIAL ORGANS, ORGAN PARTS, ORGAN SECTIONS ORGANIC SECTIONS ORGANIC INTO THE HUMAN BODY. |
-
1977
- 1977-08-26 US US05/827,952 patent/US4167045A/en not_active Expired - Lifetime
-
1978
- 1978-08-22 CA CA309,853A patent/CA1122353A/en not_active Expired
- 1978-08-25 EP EP78100752A patent/EP0000949B1/en not_active Expired
- 1978-08-25 DE DE7878100752T patent/DE2862259D1/en not_active Expired
- 1978-08-26 JP JP10339278A patent/JPS5463588A/en active Granted
Patent Citations (16)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3096560A (en) * | 1958-11-21 | 1963-07-09 | William J Liebig | Process for synthetic vascular implants |
GB1008193A (en) * | 1961-03-01 | 1965-10-27 | Ethicon Inc | Improvements in or relating to surgical implants |
US3276448A (en) * | 1962-12-14 | 1966-10-04 | Ethicon Inc | Collagen coated fabric prosthesis |
GB1064850A (en) * | 1962-12-20 | 1967-04-12 | Ethicon Inc | Tubular body and process of making it |
DE1494939A1 (en) * | 1963-06-11 | 1969-06-04 | Buddecke Dr Eckhart | Implant material and process for its manufacture |
GB1097787A (en) * | 1966-09-22 | 1968-01-03 | Ethicon Inc | Surgical prosthesis |
US3512183A (en) * | 1967-06-08 | 1970-05-19 | Us Health Education & Welfare | Bioelectric polyurethane and use of same in internal prostheses |
US3563925A (en) * | 1967-12-20 | 1971-02-16 | Ceskoslovenska Akademie Ved | Composition containing interlocked foams of partly tanned collagen and cross-linked glycol methacrylate polymer |
FR2029155A5 (en) * | 1969-01-15 | 1970-10-16 | Mo Med I | Prosthetic vessels of high biological - permeability |
US3609768A (en) * | 1969-06-16 | 1971-10-05 | Becton Dickinson Co | Anticoagulant material having charged electrostatic surfaces suitable for use in prosthetic devices |
US3744062A (en) * | 1971-10-08 | 1973-07-10 | V Parsonnet | Heart valve construction having a collagen cover encapsulation thereon |
US4038702A (en) * | 1973-09-21 | 1977-08-02 | Philip Nicholas Sawyer | Electrochemical and chemical methods for production of non-thrombogenic metal heart valves |
US3927422A (en) * | 1973-12-12 | 1975-12-23 | Philip Nicholas Sawyer | Prosthesis and method for making same |
US3914802A (en) * | 1974-05-23 | 1975-10-28 | Ebert Michael | Non-thrombogenic prosthetic material |
CH593676A5 (en) * | 1975-12-16 | 1977-12-15 | Intermedicat Gmbh | Sealing of blood vessel implants of velour-coated fabric - by impregnating with organic colloidal solns. and drying |
US4082507A (en) * | 1976-05-10 | 1978-04-04 | Sawyer Philip Nicholas | Prosthesis and method for making the same |
Non-Patent Citations (1)
Title |
---|
MEDICAL PROGRESS TECHNOLOGY, vol. 5, nr. 2 (1977) Springer Verlag, Berlin. S.D. BRUCK: "Biological Evaluation of Biomaterials for Cardiovascular Applications: Some Current Results", pages 51-56, (Invited paper presented at the Workshop on Biomaterials, 11th International Conference on Medical and Biological Engineering, Ottawa, Canada, Aug. 2-6, 1976) * |
Cited By (18)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0124659A1 (en) * | 1983-04-13 | 1984-11-14 | Koken Co. Ltd. | Medical material |
US4842575A (en) * | 1984-01-30 | 1989-06-27 | Meadox Medicals, Inc. | Method for forming impregnated synthetic vascular grafts |
US5197977A (en) * | 1984-01-30 | 1993-03-30 | Meadox Medicals, Inc. | Drug delivery collagen-impregnated synthetic vascular graft |
US5108424A (en) * | 1984-01-30 | 1992-04-28 | Meadox Medicals, Inc. | Collagen-impregnated dacron graft |
FR2572654A1 (en) * | 1984-11-08 | 1986-05-09 | Mitsubishi Monsanto Chem | FLEXIBLE POLY (VINYL CHLORIDE) MEDICAL EQUIPMENT COMPRISING A CROSSLINKED GELATIN COATING, AND METHOD FOR MANUFACTURING SUCH MATERIAL |
EP0183365B1 (en) * | 1984-11-30 | 1992-12-30 | Vascutek Limited | Vascular graft |
EP0183365A2 (en) * | 1984-11-30 | 1986-06-04 | Vascutek Limited | Vascular graft |
GB2203342A (en) * | 1987-04-07 | 1988-10-19 | Julian Garth Ellis | Radio-opaque tracer for surgical implants |
GB2203342B (en) * | 1987-04-07 | 1991-12-11 | Julian Garth Ellis | Radio-opaque tracer for surgical implants |
EP0311305B1 (en) * | 1987-10-02 | 1992-09-09 | Koken Company Limited | Artificial blood vessel |
US5073171A (en) * | 1989-01-12 | 1991-12-17 | Eaton John W | Biocompatible materials comprising albumin-binding dyes |
EP0542880A1 (en) * | 1990-07-27 | 1993-05-26 | The Trustees of Columbia University in the City of New York | Tissue bonding and sealing composition and method of using the same |
EP0542880A4 (en) * | 1990-07-27 | 1993-07-28 | Lawrence Samuel Bass | Tissue bonding and sealing composition and method of using the same |
US5716660A (en) * | 1994-08-12 | 1998-02-10 | Meadox Medicals, Inc. | Tubular polytetrafluoroethylene implantable prostheses |
US5851230A (en) * | 1994-08-12 | 1998-12-22 | Meadox Medicals, Inc. | Vascular graft with a heparin-containing collagen sealant |
US6162247A (en) * | 1994-08-12 | 2000-12-19 | Meadox Medicals, Inc. | Vascular graft impregnated with a heparin-containing collagen sealant |
WO1996040302A1 (en) * | 1995-06-07 | 1996-12-19 | W.L. Gore & Associates, Inc. | Bioabsorbable space filling soft tissue prosthesis |
EP1267749B2 (en) † | 2000-03-20 | 2017-07-26 | Vactronix Scientific, Inc. | Endoluminal implantable devices and method of making same |
Also Published As
Publication number | Publication date |
---|---|
JPH0137154B2 (en) | 1989-08-04 |
JPS5463588A (en) | 1979-05-22 |
CA1122353A (en) | 1982-04-27 |
US4167045A (en) | 1979-09-11 |
EP0000949B1 (en) | 1983-05-18 |
DE2862259D1 (en) | 1983-07-07 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US4167045A (en) | Cardiac and vascular prostheses | |
Chandy et al. | Use of plasma glow for surface-engineering biomolecules to enhance bloodcompatibility of Dacron and PTFE vascular prosthesis | |
Guidoin et al. | Albumin coating of a knitted polyester arterial prosthesis: an alternative to preclotting | |
Turner et al. | Preliminary in vivo biocompatibility studies on perfluorosulphonic acid polymer membranes for biosensor applications | |
Guidoin et al. | In vitro and in vivo characterization of an impervious polyester arterial prosthesis: The Gelseal Triaxial® graft | |
Guidoin et al. | Collagen coatings as biological sealants for textile arterial prostheses | |
CN1039352A (en) | Tissue graft composition and preparation method thereof | |
JP2003531685A (en) | Decellularized vascular prosthesis | |
JPH05269198A (en) | Combined artificial vessel | |
AU6452398A (en) | Methods for actively binding heparin to biological and non- biological bioprosthetic material | |
Nojiri et al. | Nonthrombogenic polymer vascular prosthesis | |
Ahlswede et al. | Microvascular endothelial cell sodding of 1-mm expanded polytetrafluoroethylene vascular grafts. | |
Huang et al. | Cellular reaction to the Vascugraft® polyesterurethane vascular prosthesis: in vivo studies in rats | |
Fujimoto et al. | Porous polyurethane tubes as vascular graft | |
Lyman et al. | Biomedical materials in surgery | |
Wesolow | The healing of arterial prostheses-the state of the art | |
Wesolowski et al. | Considerations in the development of small artery prostheses | |
Uretzky et al. | Long-term evaluation of a new selectively biodegradable vascular graft coated with polyethylene oxide-polylactic acid for right ventricular conduit: an experimental study | |
Sigot‐Luizard et al. | Cytocompatibility of albuminated polyester fabrics | |
Galletti et al. | Long-term patency of regenerated neoaortic wall following the implant of a fully biodegradable polyurethane prosthesis: experimental lipid diet model in pigs | |
Brais et al. | Tissue acceptance of materials implanted within the circulatory system | |
JP3687995B2 (en) | Artificial blood vessel and manufacturing method thereof | |
Sharp et al. | Thromboresistance of pyrolytic carbon grafts | |
JPS6346169A (en) | Antithrombogenic material | |
Nojiri et al. | Improved patency of HEMA/styrene block copolymer-coated small vessel prosthesis without neointima formation |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
PUAI | Public reference made under article 153(3) epc to a published international application that has entered the european phase |
Free format text: ORIGINAL CODE: 0009012 |
|
AK | Designated contracting states |
Designated state(s): BE CH DE FR GB LU NL SE |
|
17P | Request for examination filed | ||
GRAA | (expected) grant |
Free format text: ORIGINAL CODE: 0009210 |
|
AK | Designated contracting states |
Designated state(s): BE CH DE FR GB LU NL SE |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: NL Effective date: 19830518 Ref country code: BE Effective date: 19830518 |
|
REF | Corresponds to: |
Ref document number: 2862259 Country of ref document: DE Date of ref document: 19830707 |
|
ET | Fr: translation filed | ||
NLV1 | Nl: lapsed or annulled due to failure to fulfill the requirements of art. 29p and 29m of the patents act | ||
PLBE | No opposition filed within time limit |
Free format text: ORIGINAL CODE: 0009261 |
|
STAA | Information on the status of an ep patent application or granted ep patent |
Free format text: STATUS: NO OPPOSITION FILED WITHIN TIME LIMIT |
|
26N | No opposition filed | ||
PGFP | Annual fee paid to national office [announced via postgrant information from national office to epo] |
Ref country code: DE Payment date: 19930104 Year of fee payment: 15 |
|
PGFP | Annual fee paid to national office [announced via postgrant information from national office to epo] |
Ref country code: CH Payment date: 19930105 Year of fee payment: 15 |
|
PGFP | Annual fee paid to national office [announced via postgrant information from national office to epo] |
Ref country code: SE Payment date: 19930108 Year of fee payment: 15 Ref country code: GB Payment date: 19930108 Year of fee payment: 15 |
|
PGFP | Annual fee paid to national office [announced via postgrant information from national office to epo] |
Ref country code: FR Payment date: 19930121 Year of fee payment: 15 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: GB Effective date: 19930825 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: SE Effective date: 19930826 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: CH Effective date: 19930831 |
|
GBPC | Gb: european patent ceased through non-payment of renewal fee |
Effective date: 19930825 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: FR Effective date: 19940429 |
|
REG | Reference to a national code |
Ref country code: CH Ref legal event code: PL |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: DE Effective date: 19940503 |
|
REG | Reference to a national code |
Ref country code: FR Ref legal event code: ST |
|
EUG | Se: european patent has lapsed |
Ref document number: 78100752.1 Effective date: 19940310 |
|
PGFP | Annual fee paid to national office [announced via postgrant information from national office to epo] |
Ref country code: LU Payment date: 19960401 Year of fee payment: 19 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: LU Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES Effective date: 19970825 |