WO1998019631A1 - Artificial medical graft methods and apparatus - Google Patents
Artificial medical graft methods and apparatus Download PDFInfo
- Publication number
- WO1998019631A1 WO1998019631A1 PCT/US1997/020060 US9720060W WO9819631A1 WO 1998019631 A1 WO1998019631 A1 WO 1998019631A1 US 9720060 W US9720060 W US 9720060W WO 9819631 A1 WO9819631 A1 WO 9819631A1
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- WO
- WIPO (PCT)
- Prior art keywords
- graft
- radially
- enlargeable
- body tissue
- connection portion
- Prior art date
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- JAPMJSVZDUYFKL-UHFFFAOYSA-N C1C2C1CCC2 Chemical compound C1C2C1CCC2 JAPMJSVZDUYFKL-UHFFFAOYSA-N 0.000 description 1
Classifications
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- 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
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Definitions
- This invention relates to medical apparatus and procedures, and more particularly to artificial medical graft methods and apparatus.
- Tubular artificial grafts are needed in various medical procedures. For example, such grafts may be needed to replace diseased or damaged sections of natural tubular body tissue such as in the circulatory system, the urinary tract, etc. Or such grafts may be needed to make new connections in natural tubular body tissue systems such as bypass or shunt connections in the circulatory system. An artificial tubular graft may be needed as either a temporary or permanent installation.
- FIG. 1 is a simplified elevational view of an illustrative embodiment of an artificial graft and illustrative apparatus useful in installing the graft, all in accordance with this invention.
- FIG. 1 shows the graft being installed between the ends of two sections of natural body tissue tubing.
- FIG. 2 is a simplified elevational view of an illustrative embodiment of a portion of the apparatus shown in FIG. 1.
- FIG. 3 is a view similar to FIG. 1 showing the installed graft.
- FIG. 4 is a simplified end view of an illustrative embodiment of a portion of the apparatus shown in FIG. 3.
- FIG. 5 is a simplified end view of another illustrative embodiment of a portion of the apparatus shown in FIG. 3.
- FIG. 6 is an elevational view of a structure that can be used to make a particular embodiment of the apparatus portion shown in FIG. 4.
- FIG. 7 is a simplified elevational view of a subsequent condition of the FIG. 6 structure during fabrication.
- FIG. 8 is another view generally similar to
- FIG. 1 but showing another illustrative embodiment of the invention.
- FIG. 9 is a view similar to FIG. 8 showing a later stage in use of the FIG. 8 apparatus.
- artificial tubular graft 20 is being installed between the ends of two sections 10a and 10b of natural body tissue tubing in a patient.
- the purpose of graft 20 may be to replace a diseased or damaged portion of the patient's body tissue tubing that has been removed.
- Tubing 10 may be circulatory system tubing or any other body tissue tubing that is suitable for use with graft 20.
- any suitable construction can be used for the main portion of graft 20, a particularly preferred construction is shown and described in Goldsteen et al .
- this graft construction may include a tubular mesh framework 22 of nitinol covered with silicone 24 to substantially fill in the interstices in the framework. Additional details, features, and alternatives regarding this type of graft construction will be found in the above-mentioned Goldsteen et al . reference, and in Bachinski et al .
- each axial end portion of graft 20 includes a radially enlargeable connector structure 30.
- each connector structure 30 is self-expanding.
- each connector structure 30 is an elastic, annular structure which is resiliently biased to return to a radially enlarged size that is preferably at least as large as (and more preferably somewhat larger than) the body tissue tube opening to which that end portion of the graft will be attached. Initially, however, each connector structure 30 is radially compressed to a substantially smaller size as shown in FIG. 1. This allows each axial end portion of graft 20 to be easily inserted (as shown in FIG. 1) into the body tissue tubing 10 to which that end portion of the graft is to be attached.
- each connector structure 30 includes a clip portion 52 and a release portion 54 (see also FIG. 2) .
- each clip structure 50 may be made of stainless steel, with the clip portion 52 being strong enough to radially compress the associated connector structure 30.
- the release portion 54 of either clip structure 50 is pulled radially out from graft 20
- the C-shaped clip portion 52 of that clip structure comes off the associated connector structure 30.
- This firm contact provides a fluid-tight seal between body tissue 10 and graft 20, as well as secure mechanical attachment of the graft to the tissue.
- each connector structure 30 may be initially radially compressed by a wire wrapped around the connector structure.
- the wire is unwrapped from that structure.
- removable retaining structures are possible as alternatives to clip structures 50 or the above-mentioned wire wrapping for initially radially compressing connector structures 30.
- spring-loaded clamps can be used, and such clamps can be provided with lever-type opening arms, or such clamps can be adapted for opening with a pliers- type or forceps-type instrument.
- Connector structures 30 may have any of a large number of constructions.
- each connector structure 30 may include one or more annularly compressible, serpentine-shaped, metal rings 32 (e.g., of nitinol) .
- annularly compressible, serpentine-shaped, metal rings 32 e.g., of nitinol
- the serpentine convolutions of the ring become more sharply curved and closer together
- the convolutions of the ring become somewhat straighter.
- rings 32 may be integral with framework 22, and covering 24 may continue into the vicinity of rings 32. Rings 32 may be formed to press substantially uniformly out against the inner surface of body tissue tubing 10 all the way around the circumference of the graft. Alternatively, rings 32 may be formed with circumferentially spaced "high spots” or "pressure points" 34 (see FIG. 4) which locally bear somewhat more strongly on the inner surface of body tissue tubing 10. Such localized points 34 of higher bearing pressure and therefore greater indentation of body tissue tubing 10 can help ensure that the end portion of the graft does not slip out of the body tubing after the graft has been installed.
- a metal e.g., nitinol
- covering 24 e.g., of silicone
- connector structures 30 may additionally include structures 36 (see FIG. 5) which radially penetrate the adjacent body tissue tubing 10. If such tissue-piercing structures 36 are provided, they may be substantially straight prongs or struts, curved hooks, or any other suitably shaped members. If provided, structures 36 may be sharply pointed to facilitate tissue penetration, and they may be barbed (e.g., like fishing hooks) to substantially prevent them from coming out of the tissue they have pierced.
- a particularly preferred way of producing a serpentine ring 32 with the above-described high spots 34 is to start with a short length of thin-walled metal tubing 60 as shown in FIG. 6 and cut away interdigitated portions 62 from opposite axial ends of the tube as shown in FIG. 7.
- each connector structure 130 contains a dilatation balloon 140 connected to an associated inflation device 144 by an associated tube 142. (Elements in the FIG.
- Each of tubes 142 may pass through an aperture 126 in the side wall of tubular graft 120.
- Each of apertures 126 may be provided with a purse string suture 128 or other functionally equivalent structure for use in closing the aperture when desired.
- Balloons 140 are initially uninflated so that connector structures 130 can be initially radially relatively small as shown in FIG. 8. As in the case of FIG. 1, the initially relatively small radial size of connector structures 130 facilitates their insertion in the body tissue tubing 10a and 10b to which graft 120 is to be attached.
- Each connector structure 130 may be a structure which is plastically deformable to a radially relatively large size by inflation of the associated balloon 140.
- each connector structure 130 may be a radially compressed, self- expanding structure that is releasably held in a radially compressed state by an associated frangible structure.
- FIG. 9 shows inflation of balloons 140 to radially enlarge connector structures 130, either by plastically deforming the connector structures or by releasing the connector structures from frangible or other similar restraints.
- connector structures 130 engage the surrounding body tissue 10 and form a fluid-tight seal and mechanical attachment between the body tissue and graft 120.
- Connector structures 130 may have any of the constructions and/or features described above in connection with structures 30 (e.g., with reference to FIGS. 4-7) for helping to ensure good mechanical and fluid-tight connections between body tissue 10 and graft 120.
- graft 120 After graft 120 has been installed by inflation of balloons 140 as shown in FIG. 9, balloons 140 are deflated again. Then tubes 142 and balloons 140 are withdrawn from graft 120 via apertures 126. After apertures 126 have thus been cleared, apertures 126 are closed (e.g., by tightening and securing purse string sutures 128). Except for the addition of closed apertures 126, the appearance of finished and fully installed graft 120 may be substantially as shown for graft 20 in FIG. 3.
- Grafts 20/120 are preferably made up in a range of sizes (e.g., lengths and diameters) so that they are available for various patient applications. Grafts 20/120 may also be made in a variety of shapes, and these various shapes may also be made in a range of sizes. For example, grafts 20/120 may be made in curved shapes, Y shapes, T shapes, etc. In the case of shapes with more than two ports (e.g., Y or T shapes with three ports) , each port is provided with a connector structure 30/130 for attachment of that port to body tissue of the patient. References to "tubular grafts" herein include such graft structures with more than two ports. References herein to "ends" or “end portions" of grafts refer to the port regions of grafts, regardless of the shape or number of ports of the graft.
- connector structures 30/130 can differ from the number employed in the embodiments shown herein.
- Other possible constructions or features of connector structures 30/130 are shown in Bachinski et al. U.S. patent application No. 08/839,199, filed April 23, 1997, which is hereby incorporated by reference herein in its entirety.
- structures other than balloons 140 may be used for radially enlarging connector structures 130.
- a radially enlargeable mechanical structure somewhat like a reversely operating pair of pliers or a reversely operating forceps may be used inside each connector structure 130 to radially enlarge the connector structure.
- illustrative grafts 20/120 are shown connecting ends of body tissue tubing 10, it will be understood that the grafts of this invention are equally useful in making connections to body tissue tubing through apertures (e.g., incisions) in the side walls of body tissue tubing.
Abstract
Description
Claims
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AU51664/98A AU5166498A (en) | 1996-11-07 | 1997-11-05 | Artificial medical graft methods and apparatus |
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US08/745,618 | 1996-11-07 | ||
US08/745,618 US5976178A (en) | 1996-11-07 | 1996-11-07 | Medical grafting methods |
US08/844,979 US5941908A (en) | 1997-04-23 | 1997-04-23 | Artificial medical graft with a releasable retainer |
US08/844,979 | 1997-04-23 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO1998019631A1 true WO1998019631A1 (en) | 1998-05-14 |
Family
ID=27114492
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US1997/020060 WO1998019631A1 (en) | 1996-11-07 | 1997-11-05 | Artificial medical graft methods and apparatus |
Country Status (2)
Country | Link |
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AU (1) | AU5166498A (en) |
WO (1) | WO1998019631A1 (en) |
Cited By (22)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5989276A (en) * | 1996-11-08 | 1999-11-23 | Advanced Bypass Technologies, Inc. | Percutaneous bypass graft and securing system |
WO2000027310A2 (en) * | 1998-11-06 | 2000-05-18 | St. Jude Medical Cardiovascular Group, Inc. | Medical graft connector component and methods of making and installing same |
WO2000045737A1 (en) * | 1999-02-05 | 2000-08-10 | Pietro Quaretti | Urethral, biliary or esophagal tubular endoprosthesis |
US6110188A (en) * | 1998-03-09 | 2000-08-29 | Corvascular, Inc. | Anastomosis method |
WO2000053104A1 (en) * | 1999-03-09 | 2000-09-14 | St. Jude Medical Cardiovascular Group, Inc. | Medical grafting methods and apparatus |
US6149681A (en) * | 1996-09-20 | 2000-11-21 | Converge Medical, Inc. | Radially expanding prostheses and systems for their deployment |
WO2001000108A1 (en) * | 1999-06-25 | 2001-01-04 | Contini, Emilio | Device for connecting an implant with a body channel |
US6241741B1 (en) | 1998-03-09 | 2001-06-05 | Corvascular Surgical Systems, Inc. | Anastomosis device and method |
WO2002060348A2 (en) * | 2001-02-01 | 2002-08-08 | Zuehlke Helmut | Combination of a vascular prosthesis and retaining element |
US6432127B1 (en) | 1996-10-11 | 2002-08-13 | Transvascular, Inc. | Devices for forming and/or maintaining connections between adjacent anatomical conduits |
US6554764B1 (en) | 2000-11-13 | 2003-04-29 | Cardica, Inc. | Graft vessel preparation device and methods for using the same |
US6712836B1 (en) | 1999-05-13 | 2004-03-30 | St. Jude Medical Atg, Inc. | Apparatus and methods for closing septal defects and occluding blood flow |
FR2845590A1 (en) * | 2002-10-10 | 2004-04-16 | Jean Francois Garbe | Device for interconnecting a tubular prosthesis and a vessel in a person's body to form an anastomosis, has sleeve at end of prosthesis with pins that pierce prosthesis and tubular vessel inserted in its end to interconnect them |
EP1973497A2 (en) * | 2006-01-20 | 2008-10-01 | Gore Enterprise Holdings, Inc. | Device for rapid repair of body conduits |
WO2008138529A1 (en) * | 2007-05-11 | 2008-11-20 | Nicola Rubenstein | Device for connecting two blood vessels |
US7691128B2 (en) | 2002-05-06 | 2010-04-06 | St. Jude Medical, Cardiology Division, Inc. | PFO closure devices and related methods of use |
US8114102B2 (en) | 2003-06-16 | 2012-02-14 | St. Jude Medical Atg, Inc. | Temporary hemostatic plug apparatus and method of use |
US20120277774A1 (en) * | 2009-11-13 | 2012-11-01 | The Brigham And Women's Hospital, Inc. | Method and Apparatus for Vascular Anastomosis |
US8574264B2 (en) | 2003-04-11 | 2013-11-05 | St. Jude Medical, Cardiology Division, Inc. | Method for retrieving a closure device |
EP2416733B1 (en) * | 2009-04-07 | 2014-12-17 | Cook Medical Technologies LLC | Introducer assembly and implantable medical device |
US9078630B2 (en) | 2001-06-01 | 2015-07-14 | St. Jude Medical, Cardiology Division, Inc. | Closure devices, related delivery methods and tools, and related methods of use |
WO2020073972A1 (en) * | 2018-10-12 | 2020-04-16 | 大连科万维医疗科技有限公司 | Suture-free integrated branched film-covered stent blood vessel |
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WO1996022745A1 (en) * | 1995-01-23 | 1996-08-01 | Schneider (Usa) Inc. | Percutaneous stent-graft and method for delivery thereof |
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1997
- 1997-11-05 AU AU51664/98A patent/AU5166498A/en not_active Abandoned
- 1997-11-05 WO PCT/US1997/020060 patent/WO1998019631A1/en active Application Filing
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GB2269104A (en) * | 1992-04-09 | 1994-02-02 | Taha Roudan Lazim | Vascular graft apparatus |
WO1996014808A1 (en) * | 1994-11-09 | 1996-05-23 | Endotex Interventional Systems, Inc. | Delivery catheter and graft for aneurysm repair |
WO1996022745A1 (en) * | 1995-01-23 | 1996-08-01 | Schneider (Usa) Inc. | Percutaneous stent-graft and method for delivery thereof |
Cited By (34)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6149681A (en) * | 1996-09-20 | 2000-11-21 | Converge Medical, Inc. | Radially expanding prostheses and systems for their deployment |
US6432127B1 (en) | 1996-10-11 | 2002-08-13 | Transvascular, Inc. | Devices for forming and/or maintaining connections between adjacent anatomical conduits |
US5989276A (en) * | 1996-11-08 | 1999-11-23 | Advanced Bypass Technologies, Inc. | Percutaneous bypass graft and securing system |
US6110188A (en) * | 1998-03-09 | 2000-08-29 | Corvascular, Inc. | Anastomosis method |
US6241741B1 (en) | 1998-03-09 | 2001-06-05 | Corvascular Surgical Systems, Inc. | Anastomosis device and method |
WO2000027310A2 (en) * | 1998-11-06 | 2000-05-18 | St. Jude Medical Cardiovascular Group, Inc. | Medical graft connector component and methods of making and installing same |
WO2000027310A3 (en) * | 1998-11-06 | 2000-07-27 | St Jude Medical Cardiovascular | Medical graft connector component and methods of making and installing same |
WO2000045737A1 (en) * | 1999-02-05 | 2000-08-10 | Pietro Quaretti | Urethral, biliary or esophagal tubular endoprosthesis |
WO2000053104A1 (en) * | 1999-03-09 | 2000-09-14 | St. Jude Medical Cardiovascular Group, Inc. | Medical grafting methods and apparatus |
US6712836B1 (en) | 1999-05-13 | 2004-03-30 | St. Jude Medical Atg, Inc. | Apparatus and methods for closing septal defects and occluding blood flow |
WO2001001884A3 (en) * | 1999-06-25 | 2001-03-22 | Contini Emilio | Vessel aperture closure prosthesis |
WO2001000108A1 (en) * | 1999-06-25 | 2001-01-04 | Contini, Emilio | Device for connecting an implant with a body channel |
US6554764B1 (en) | 2000-11-13 | 2003-04-29 | Cardica, Inc. | Graft vessel preparation device and methods for using the same |
US6786862B2 (en) | 2000-11-13 | 2004-09-07 | Cardica, Inc. | Graft vessel preparation device and methods for using the same |
WO2002060348A2 (en) * | 2001-02-01 | 2002-08-08 | Zuehlke Helmut | Combination of a vascular prosthesis and retaining element |
WO2002060348A3 (en) * | 2001-02-01 | 2002-12-27 | Helmut Zuehlke | Combination of a vascular prosthesis and retaining element |
US9078630B2 (en) | 2001-06-01 | 2015-07-14 | St. Jude Medical, Cardiology Division, Inc. | Closure devices, related delivery methods and tools, and related methods of use |
US7691128B2 (en) | 2002-05-06 | 2010-04-06 | St. Jude Medical, Cardiology Division, Inc. | PFO closure devices and related methods of use |
WO2004032800A1 (en) | 2002-10-10 | 2004-04-22 | Garbe Jean-Francois | Device for connection between a corporeal duct and a prosthesis |
FR2845590A1 (en) * | 2002-10-10 | 2004-04-16 | Jean Francois Garbe | Device for interconnecting a tubular prosthesis and a vessel in a person's body to form an anastomosis, has sleeve at end of prosthesis with pins that pierce prosthesis and tubular vessel inserted in its end to interconnect them |
US7828834B2 (en) | 2002-10-10 | 2010-11-09 | Protomed | Device for connection between a corporeal duct and a prosthesis |
US8574264B2 (en) | 2003-04-11 | 2013-11-05 | St. Jude Medical, Cardiology Division, Inc. | Method for retrieving a closure device |
US8114102B2 (en) | 2003-06-16 | 2012-02-14 | St. Jude Medical Atg, Inc. | Temporary hemostatic plug apparatus and method of use |
EP1973497A4 (en) * | 2006-01-20 | 2011-03-02 | Gore Enterprise Holdings Inc | Device for rapid repair of body conduits |
EP1973497A2 (en) * | 2006-01-20 | 2008-10-01 | Gore Enterprise Holdings, Inc. | Device for rapid repair of body conduits |
US9375215B2 (en) | 2006-01-20 | 2016-06-28 | W. L. Gore & Associates, Inc. | Device for rapid repair of body conduits |
US9381018B2 (en) | 2006-01-20 | 2016-07-05 | W. L. Gore & Associates, Inc. | Device for rapid repair of body conduits |
US10357352B2 (en) | 2006-01-20 | 2019-07-23 | W. L. Gore & Associates, Inc. | Device for rapid repair of body conduits |
US8388634B2 (en) | 2007-05-11 | 2013-03-05 | Nicola Osypka Rubenstein | Device for connecting two blood vessels |
WO2008138529A1 (en) * | 2007-05-11 | 2008-11-20 | Nicola Rubenstein | Device for connecting two blood vessels |
EP2416733B1 (en) * | 2009-04-07 | 2014-12-17 | Cook Medical Technologies LLC | Introducer assembly and implantable medical device |
US9724220B2 (en) | 2009-04-07 | 2017-08-08 | Cook Medical Technologies Llc | Introducer assembly and implantable medical device |
US20120277774A1 (en) * | 2009-11-13 | 2012-11-01 | The Brigham And Women's Hospital, Inc. | Method and Apparatus for Vascular Anastomosis |
WO2020073972A1 (en) * | 2018-10-12 | 2020-04-16 | 大连科万维医疗科技有限公司 | Suture-free integrated branched film-covered stent blood vessel |
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