Surgery – Instruments – Surgical mesh – connector – clip – clamp or band
Reexamination Certificate
1998-03-09
2001-06-05
Jackson, Gary (Department: 3731)
Surgery
Instruments
Surgical mesh, connector, clip, clamp or band
Reexamination Certificate
active
06241741
ABSTRACT:
FIELD OF THE INVENTION
The present invention relates generally to devices and methods for performing a vascular anastomosis and, more particularly, to a device for coupling the end of a vessel, such as a coronary bypass graft, to the side wall of a vessel, such as a coronary artery.
BACKGROUND OF THE INVENTION
A manifestation of coronary artery disease is the build-up of plaque on the inner walls of the coronary arteries, which causes narrowing or complete closure of these arteries, resulting in insufficient blood flow. Surgery to alleviate this problem often involves creating an anastomosis between a blood vessel and a graft vessel to restore a blood flow path to essential tissues.
Current methods available for creating an anastomosis include hand suturing the vessels together. Suturing the anastomosis is time-consuming and often does not provide a leak-free seal. Furthermore, suturing requires the heart to be isolated from the systemic circulation, and the heart must typically be stopped for an extended period of time, so that the anastomosis site on the heart is blood-free and still during the suturing of the anastomosis. Thus, it is desirable to reduce the difficulty of creating the vascular anastomosis and provide a rapid method for making a reliable anastomosis between a graft vessel and artery.
One method available for expediting anastomosis procedures is through the use of anastomosis fittings for joining blood vessels together. These fittings, however, require multiple components which make installation of the fitting difficult and time consuming. Moreover, these fittings expose foreign material of the fittings to the blood flow path within the arteries, which increases the risks of hemolysis and thrombosis.
Another method currently available involves the use of stapling devices. These instruments are not easily adaptable for use in vascular anastomosis. It is often difficult to manipulate these devices through the vessels without inadvertently piercing a side wall of the vessel. In addition to being difficult to operate, these devices often do not provide a reliable leak-free seal.
SUMMARY OF THE INVENTION
The present invention involves improvements to devices and methods for performing vascular anastomoses. The invention facilitates positioning one vessel in the fluid path of another vessel to enhance the fluid flow juncture therebetween. In one aspect of the invention, the two vessels are sealingly secured to one another without the need for sutures.
A method of the present invention is for coupling a first vessel and a second vessel in an anastomosis and generally includes providing a fastener attached to the first vessel, inserting at least a portion of the fastener into an opening formed in a side wall of the second vessel with an end portion of the fastener extending generally longitudinally within the second vessel, and radially expanding at least a portion of the fastener to sealingly secure the first vessel to an inner wall of the second vessel.
According to one aspect of the present invention, the fastener comprises a tubular member at least a portion thereof being radially expandable. The tubular member is preformed with a bend along its central longitudinal axis so that a portion of the tubular member extends out of the side wall of the second vessel while an end portion of the tubular member extends out from the side wall of the second vessel while an end portion of the tubular member extends generally coaxially with the second vessel when the device in inserted in the second vessel. The tubular member is sufficiently rigid to substantially retain the tubular member in its preformed configuration after the tubular member is radially expanded.
In another aspect of the present invention, the first vessel is attached to the tubular member and the tubular member is transformable between a compressed state in which the member has a diameter smaller than the diameter of the second vessel to permit the fastener to move longitudinally within the second vessel, and an expanded state in which at least a portion of the fastener has a diameter at least equal to the diameter of the second vessel to sealingly engage the first vessel with the second vessel.
In yet another aspect of the present invention, the device comprises a tubular member having two expandable end portions and a central portion having a cylindrical member formed of a substantially nonporous material. The cylindrical member has an opening formed in a side wall thereof.
The above is a brief description of some deficiencies in the prior art and advantages of the present invention. Other features, advantages, and embodiments of the invention will be apparent to those skilled in the art from the following description, accompanying drawings and claims.
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Duhaylongsod Francis G.
French Fritz
Corvascular Surgical Systems, Inc.
Jackson Gary
Morrison & Foerster / LLP
Trinh Vikki
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