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Publication numberUS3626947 A
Publication typeGrant
Publication dateDec 14, 1971
Filing dateFeb 19, 1970
Priority dateFeb 19, 1970
Publication numberUS 3626947 A, US 3626947A, US-A-3626947, US3626947 A, US3626947A
InventorsCharles Howard Sparks
Original AssigneeCharles Howard Sparks
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Method and apparatus for vein and artery reenforcement
US 3626947 A
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Description  (OCR text may contain errors)

United States Patent [45] Patented Dec.l4,l97l

[54] METHOD AND APPARATUS FOR VEIN AND ARTERY REENFORCEMENT 15 Claims, 7 Drawing Figs.

[52] US. Cl 128/334 R, 3/ l, 3/D1G. l [5 1] Int. Cl ..A61b 17/04, A6lf 1/24 [50] Field olSearch 128/1, 334 R, 334 C; 3/1, BIG. 1

[56] References Cited UNITED STATES PATENTS 3,105,492 10/1963 Jeckel l28/334R 3,254,650 6/1966 Collito. 128/334 C 3,254,651 6/1966 Collito 128/334 C OTHER REFERENCES An Experimental Method for Nonsuture Anastomosis of I the Aorta by N. Narter et al., Surgery, Gynecology, and Obstetrics, Vol. 1 19, No. 2, pages 362- 364, August 1964.

Primary ExaminerRichard A. Gaudet Assistant Examiner- Ronald L. Frinks Attorney-Lee R. Schermerhorn ABSTRACT: A novel method and apparatus are provided for applying a textile mesh reenforcing tube on a vein or artery.

The mesh tube is gathered on a spool and confined between the end flanges of the'spool. After making a severed end of the vein or artery accessible, the spool containing the mesh tube is slipped onto the blood vessel. Then the vessel is anastomosed and blood flow is established through the vessel, expanding the collapsed vessel to normal size. One end of the mesh tube is pulled off one end of the spool and secured on the vessel. By sliding the spool along the vessel, the mesh tube is pulled oi? the end of the spool and applied progressively to the vessel, the mesh being tensioned sufficiently to contract the tube to fit the vessel. The spool is split longitudinally so that the two halves may be removed from the vessel. The mesh tube subsequently becomes incorporated into the wall of the vessel, making it stronger than a normal artery. Such reenforcement is useful for strengthening an artery in situ and for strengthening a vein graft which is subject to arterial pressure.

Pmcmsnnmm SHEET 1 [IF 2 INVENTOR. CHARLES H. SPARKS 12b fliiorney PATENTED nu: 1 4 an saw v 2 or 2 INVENTOR- CHARLES H. SPARKS flitorn ey METHOD AND APPARATUS FOR VEIN AND ARTERY REENFORCEMENT BACKGROUND OF THE INVENTION This invention relates to a method and apparatus for applying a textile mesh reenforcing tube on a vein or artery.

The use of veins from the patients own body as graft replacements for diseased arteries and to bypass obstructions in certain arteries has a number of important advantages. In the first place, such autogenous grafts do not tend to be rejected by the body as are artificial grafts, heterografts and homografts. Further, there are various veins available in the body which may be removed without producing a serious circulatory deficiency in the patient. It is seldom possible to find an artery of suitable size which may be removed without injury to the patient.

Evidence is accumulating, however, that even autogenous vein grafts degenerate after a few years of exposure to arterial pressure owing to the fact that veins are relatively weaker than arteries. Such degeneration is particularly likely to occur when the vein graft lies free in the abdominal or thoracic cavity. Considering that there is normally a partial vacuum in the thoracic cavity of 2 to 3 centimeters of water, aneurysm formation in vein grafts carrying arterial pressure is more likely to occur in the chest than in any other location in the body. Thus, vein grafts used to bypass obstructions in the coronary arteries are particularly susceptible to aneurysm. In view of the increasing use of vein grafts for such arterial bypass purposes, there is a great need for a convenient and effective vein graft reenforcement. There is also need for reenforcing certain arteries in situ, as for example when an artery wall is weakened by endarterectomy.

Objects of the invention are, therefore, to provide a reenforcement for a blood vessel, to provide an improved vein graft reenforcement, to provide a reenforcing tube of synthetic textile fiber and to provide a convenient method and apparatus for applying a reenforcing mesh tube over a vein or artery.

SUMMARY OF THE INVENTION According to the present invention, a textile mesh reenforcing tube is pulled over a blood vessel while the vessel is fully expanded under arterial pressure. In order to do this, the mesh tube is gathered on a spool. After one end of the vessel has been made accessible, the spool containing the mesh tube is slipped over the collapsed vessel. Then the vessel is anastomosed and blood flow is established through the vessel.

While holding one end of the mesh tube on the vessel, the spool is moved along the vessel causing the mesh to be stripped from the spool and applied to the vessel under sufficient tension to contract the tube to fit the vessel. The spool is of split construction, allowing its two halves to be removed from the vessel after the mesh tube has been completely removed from the spool. The mesh tube subsequently becomes incorporated into the wall of the vessel, making it stronger than a normal artery.

Mesh tubes are applied in this manner to strengthen vein grafts which are subject to arterial pressure and to strengthen arteries in situ.

The invention will be better understood and additional objects and advantages will become apparent from the following description of the preferred embodiment of the method and apparatus illustrated in the accompanying drawings. Various changes may be made in the details of the method and construction of the apparatus and certain features may be employed without others. All such modifications within the scope of the appended claims are included in the invention.

BRIEF DESCRIPTION OF THE DRAWINGSv FIG. 1 is a view of a heart, with parts broken away, showing a completed coronary bypass embodying the invention and showing the first step in the installation of a second coronary bypass;

FIG. 2 is a fragmentary enlarged view of a portion of FIG. I;

FIG. 3 is a view showing a subsequent step in the application of the mesh tube to a vein graft;

FIG. 4 is a similar view showing a further step in the method;

FIG. 5 is an enlarged perspective view of the spool shown in FIG. 4;

FIG. 6 is a view showing the final step of the method; and

FIG. 7 is an enlarged side elevation view, with parts broken away, showing the mesh reenforcing tube.

DESCRIPTION OF THE PREFERRED EMBODIMENT The drawings illustrate the method and apparatus of the invention in connection with a coronary bypass. In FIG. 1 the heart H has coronary arteries 10 and 11 which carry blood from the aorta 12 to nourish the heart muscles. Arteries l0 and I1 lie on the outer surface of the heart where they are readily available after opening the chest. In a common form of heart disease, the upper ends of coronary arteries 10 and 11 become obstructed by deposits 13, shown in FIG. 2, which reduce the flow of blood to the heart muscles thereby rendering the muscles incapable of performing the normal pumping function of the heart and severely limiting the activities of the patient. In FIG. 1, the pulmonary artery I4 has been broken away in order to make the full length of the coronary artery 11 visible.

One way of restoring an adequate blood supply to the heart muscles is to install a bypass 15 around the obstructed portion of each coronary artery. The bypass then carries a normal flow of blood from aorta I2 to a point in the coronary artery below the obstruction 13. When vein graft is used for such a bypass, the danger exists that the vein will not be strong enough to withstand indefinitely the arterial pressure, particularly since the partial vacuum in the chest cavity produces a greater effective pressure on the bypass than in arteries elsewhere in the body.

The method and apparatus of the invention will now be described, by way of example, with reference to a bypass for the coronary artery 1 1. First, a saphenous or cephalic vein V is obtained from a lower extremity or upper extremity of the patient. These veins are of suitable size for the purpose and may be safely removed without serious detriment to the patient. The tributaries 19 are cut off and ligated, the ends are bevelled at 45 and the normal downstream end of the vein is sutured at 20 to the artery 11 in end-to-side anastomosis. As indicated by the arrow 21, the new arterial flow through the bypass must be in the same direction as the previous venous flow in order to pass freely through the valves in the vein.

A spool S carrying a textile mesh reenforcing tube T is then slipped on the free end of collapsed vein V as shown in FIGS. 1 and 2. Tube T is preferably knitted from a suitable synthetic textile fiber such as Dacron and the ends are bevelled at an angle at 45. The bevelled ends are pushed back one-eighth inch and fused with a soldering iron to prevent runs in the material and form a strengthened ring to be secured by sutures as indicated at 18 in FIG. 7. The tube is gathered on the spool and confined between a large end fiange 22 and a small end flange 23 with the bevelled ends facing away from a tactile indicium knob 24 on the large flange 22. Spool S is preferably made of a suitable plastic which is autoclavable, such as Lexan. It is unimportant which end of the spool goes on the vein first.

Broken-line circle 25 in FIG. 1 indicates the location of an opening to be made in aorta 12 for connection with the upper end of vein V. FIG. 3 shown the upper end-to-side anastomosis completed with sutures 26. With arterial flow established through bypass graft vein V, the lower end of mesh tube T is pulled off spool S over its small flange 23 and secured over the suture line 20 by sutures 30.

Then more of the mesh tube T is pulled off the spool and applied to the vein V by moving the spool upward along the vein. During this movement a portion of tube T is grasped on the vein with one hand while the other hand moves the spool and creates a drag on the gathered portion of the tube remaining on the spool to tension the tube leaving the spool as shown in FIG. 3. The spool and fingers cooperate in this manipulation as in pulling on a stocking. Longitudinal tension on tube T as it is withdrawn from the spool causes the tube to contract circumferentially to fit the vein while the vein is carrying arterial flow. The spool serves as a support tube for the gathering mesh tube and functions as the thumbs inserted in a gathered stocking to tension the stocking as it is drawn out between thumb and fingers.

As the spool is moved along the vein, the indicium knob 24 provides means to avoid rotation of the spool so that the tube T will not be twisted as it is applied to the vein and so that the bevel on the upper end of the tube will be properly oriented to conform to the surface of the aorta 12 as the upper end of the tube is withdrawn from the spool. In the manipulation shown in FIG. 3, the surgeon feels the knob 24 between the thumb and forefinger of his left hand without giving conscious attention to it.

Spool S is split longitudinally in two halves 35 and 36, as shown in FIG. 5. The two halves are normally held together by four pins 37 in part 35 which have a frictional fit in holes 38 in part 36. When mesh tube T has been withdrawn from the spool, the two halves are separated and the spool removed from vein V as shown in FIG. 4. Then the upper end of tube T is secured over the suture line 26 by sutures 40 as shown in FIG. 6. This completes the bypass for artery 11 corresponding to bypass on artery 10. In the course of time the mesh tube T becomes incorporated into the wall of vein V, making the vein even stronger than a normal artery and preventing the development of aneurysms in the graft.

When mesh tube T is stretched on the vein, the length of a given tube varies inversely with the diameter of the distended vein. With a known length and diameter of vein, a tube T is selected which will assume that length, or a little greater length, at that diameter. Any excess length is included in the sutures 40 or distributed back along the vein.

The invention is not limited to a coronary artery bypass nor is it limited to end-to-side anastomoses as described herein. The present method and apparatus are equally well adapted for vein graft replacement of a diseased section of artery involving end-to-end anastomosis. The invention may be utilized to advantage in various parts of the body. It is also useful in reenforcing an artery in situ as, for example, when an artery has been weakened by endarterectomy. In these various appli cations the mesh tube T may have square cut instead of bevelled ends when desired.

Having now described my invention and in what manner the same may be used, what I claim as new and desire to protect by Letters Patent is:

l. The method of applying a textile mesh reenforcing tube to a blood vessel comprising gathering said mesh tube on a supporting tube, inserting an end of said blood vessel through said supporting tube, pulling one end of said mesh tube off one end of said supporting tube and holding said one end of said mesh tube in stationary position on said blood vessel, moving said supporting tube along said blood vessel and causing the rest of said gathered mesh tube to be pulled off said one end of said supporting tube and transferred to said blood vessel, and then removing said supporting tube from the blood vessel.

2. The method of claim 1 including the step as establishing blood flow through said blood vessel before said mesh tube is transferred from said supporting blood vessel.

3. The method of claim 1 including the step of applying a frictional drag to said gathered mesh tube on said supporting tube as said mesh tube is pulled off the supporting tube causing the mesh tube to be tensioned and contracted in diameter as it leaves the supporting tube.

4. The method of claim I wherein said supporting tube is removed from said blood vessel by separating two halves of said supporting tube along a longitudinal joint line.

5. The method of claim 1 including the step of anchoring the ends of said mesh tube by sutures.

6. The method of claim 1 wherein said blood vessel is an artery in situ.

7. The method of claim 1 wherein said blood vessel is a vein graft.

8. The method of applying a textile mesh reenforcing tube to a vein graft comprising gathering said mesh tube on a supporting tube, anastomosing one end of said vein, inserting the opposite end of said vein through said supporting tube, anastomosing said opposite end of said vein and establishing blood flow through the vein, pulling one end of said mesh tube off one end of said supporting tube and holding said one end of said mesh tube in stationary position on said vein, moving said supporting tube along said vein and causing the rest of said gathered mesh tube to be pulled off said one end of said supporting tube and transferred to said vein while applying a frictional drag to said gathered mesh tube on said supporting tube to cause said mesh tube to be tensioned and contracted to fit said vein, and then removing said supporting tube from the vein. 7

9. The method of claim 8 including the step of anchoring the ends of said mesh tube over said anastomoses by sutures.

10. A unit for applying a textile mesh reenforcing tube to a blood vessel comprising a supporting tube having an axial hole adapted to receive said blood vessel, and means holding a textile mesh reenforcing tube gathered on said supporting tube.

11. A unit as defined in claim 10, said means comprising radial flanges on the opposite ends of said support tube confining said gathered mesh tube between said flanges.

12. A unit as defined in claim 10, said support tube being split longitudinally in two halves, and means holding said tow halves together. frictional spool, a small radial flange on the other end of said spool, and a protruding 13. A unit as defined in claim 10 including a tactile indicium on one side of said support tube.

14. A unit for applying a textile mesh reenforcing tube to a blood vessel comprising a spool split longitudinally in two halves, holes in one of said halves receiving pins in the other half in a frictional fit to hold the two halves together, a large radial flange on one end of said spool, a small radial flange on the other end of said spool, and a protruding indicium on said large flange on one of said halves.

15. A unit defined in claim 14 including a textile mesh reenforcing tube gathered on said spool between said end fingers.

zgfi UNlTED STATES rATsNT OFFICE fiER'llFlCAlE 6F CORRECHON Patent NO- Dated Dec b 1h, Inventor) CHARLES HOWARD SPARKS I It is certified that error appears in the above-identified patent, and that said Letters Patent are hereby corrected as shown below:

Column 2, line 31, "when vein graft" should read when a vein graft Column h, line 3, "0s" should read of- Column h, line 1 5, "tow' should read two Column L1, lines b6 and m, delete "frictional spool, a small radial flange on the other end of said spool, and a protruding".

Column b, line 58, "fingers" should read flanges Signed and sealed this 2nd day of May 1972.

(SEAL) Attest:

EDWARD MQFLETCHER, JR0 ROBERT GOTTSGHALK Attesting Officer Commissioner of Patents

Patent Citations
Cited PatentFiling datePublication dateApplicantTitle
US3105492 *Oct 1, 1958Oct 1, 1963Us Catheter & Instr CorpSynthetic blood vessel grafts
US3254650 *Mar 19, 1962Jun 7, 1966Michael B CollitoSurgical anastomosis methods and devices
US3254651 *Sep 12, 1962Jun 7, 1966Babies HospitalSurgical anastomosis methods and devices
Non-Patent Citations
Reference
1 *An Experimental Method for Nonsuture Anastomosis of the Aorta by N. Narter et al., Surgery, Gynecology, and Obstetrics, Vol. 119, No. 2, pages 362 364, August 1964.
Referenced by
Citing PatentFiling datePublication dateApplicantTitle
US3842441 *Mar 21, 1973Oct 22, 1974Kaiser AA temporary implant and method for tendon surgery
US4441215 *Feb 23, 1983Apr 10, 1984Kaster Robert LVascular graft
US4546499 *Dec 13, 1982Oct 15, 1985Possis Medical, Inc.Method of supplying blood to blood receiving vessels
US4562597 *Apr 29, 1983Jan 7, 1986Possis Medical, Inc.Method of supplying blood to blood receiving vessels
US4601718 *Jul 13, 1984Jul 22, 1986Possis Medical, Inc.Vascular graft and blood supply method
US4787391 *Aug 11, 1987Nov 29, 1988Elefteriades John AAnastomotic marking device and related method
US5178634 *Sep 24, 1991Jan 12, 1993Wilson Ramos MartinezAortic valved tubes for human implants
US5425757 *May 21, 1993Jun 20, 1995Tiefenbrun; JonathanAortic surgical procedure
US5584876 *Apr 29, 1994Dec 17, 1996W. L. Gore & Associates, Inc.Cell excluding sheath for vascular grafts
US5591179 *Apr 19, 1995Jan 7, 1997Applied Medical Resources CorporationAnastomosis suturing device and method
US5628788 *Nov 7, 1995May 13, 1997Corvita CorporationSelf-expanding endoluminal stent-graft
US5645581 *Nov 29, 1994Jul 8, 1997Zurbruegg; Heinz RobertFor replacing a human or animal blood vessel
US5700269 *Nov 13, 1995Dec 23, 1997Corvita CorporationEndoluminal prosthesis deployment device for use with prostheses of variable length and having retraction ability
US5741333 *Apr 3, 1996Apr 21, 1998Corvita CorporationSelf-expanding stent for a medical device to be introduced into a cavity of a body
US5755659 *Mar 11, 1997May 26, 1998Zurbruegg; Heinz RobertMethod of making a vascular prosthesis
US5843171 *Jan 24, 1997Dec 1, 1998W. L. Gore & Associates, Inc.Method of insitu bypass to hold open venous valves
US5849037 *Apr 3, 1996Dec 15, 1998Corvita CorporationSelf-expanding stent for a medical device to be introduced into a cavity of a body, and method for its preparation
US5968091 *Nov 26, 1997Oct 19, 1999Corvita Corp.Stents and stent grafts having enhanced hoop strength and methods of making the same
US5989287 *May 6, 1998Nov 23, 1999Av Healing LlcVascular graft assemblies and methods for implanting same
US6071306 *Oct 30, 1997Jun 6, 2000University Of BristolExternally stented vein segment and its use in an arteriovenous bypass grafting procedure
US6123725 *Jul 11, 1997Sep 26, 2000A-Med Systems, Inc.Single port cardiac support apparatus
US6237460 *Apr 30, 1998May 29, 2001Corvita CorporationMethod for preparation of a self-expanding stent for a medical device to be introduced into a cavity of a body
US6371981Nov 2, 1999Apr 16, 2002Av Healing LlcVascular graft assemblies and methods for implanting same
US6436135Oct 24, 1974Aug 20, 2002David GoldfarbProsthetic vascular graft
US6532964Jan 13, 1999Mar 18, 2003A-Med Systems, Inc.Pulmonary and circulatory blood flow support devices and methods for heart surgery procedures
US6858001Sep 25, 2000Feb 22, 2005A-Med Systems, Inc.Single port cardiac support apparatus
US6935344Jan 11, 2000Aug 30, 2005A-Med Systems, Inc.Methods and systems for providing right and/or left heart support during cardiac surgery
US6976996Oct 14, 1997Dec 20, 2005A-Med Systems, Inc.Transport pump and organ stabilization apparatus including related methods
US7033383 *Apr 13, 2004Apr 25, 2006Cardiothoracic Systems, Inc.Endoscopic bypass grafting method utilizing an inguinal approach
US7182727Feb 11, 2005Feb 27, 2007A—Med Systems Inc.Single port cardiac support apparatus
US7278430Mar 1, 2002Oct 9, 2007Arvik Enterprises, LlcBlood vessel occlusion device
US7363927Aug 25, 2003Apr 29, 2008Arvik Enterprises, LlcRemovable blood vessel occlusion device
US7381179May 24, 2005Jun 3, 2008A-Med Systems, Inc.Pulmonary and circulatory blood flow support devices and methods for heart surgery procedures
US7708769Mar 13, 1997May 4, 2010United States Surgical CorporationGraft attachment assembly
US7753946Feb 9, 2007Jul 13, 2010Boston Scientific Scimed, Inc.Bypass grafting system and apparatus
US7998188May 4, 2007Aug 16, 2011Kips Bay Medical, Inc.Compliant blood vessel graft
US8172746Feb 19, 2009May 8, 2012Kips Bay Medical, Inc.Compliant venous graft
US8246673Jul 31, 2009Aug 21, 2012Exstent LimitedExternal support for a blood vessel
US8252039Jun 10, 2009Aug 28, 2012Golesworthy Taliesin JohnAortic root dissection treatment
US8353814 *Oct 9, 2008Jan 15, 2013Kips Bay Medical, Inc.Apparatus and method for mounting an external scaffold to a vascular graft
US8382814Aug 15, 2011Feb 26, 2013Kips Bay Medical, Inc.Compliant blood vessel graft
US8734503Nov 24, 2009May 27, 2014Vascular Graft Solutions Ltd.External stent
US8747451Jan 21, 2013Jun 10, 2014Kips Bay Medical, Inc.Graft apparatus
US20100160718 *Oct 9, 2008Jun 24, 2010Villafana Manuel AApparatus and Method for Mounting an External Scaffold to a Vascular Graft
DE3390385C2 *Dec 8, 1983Jul 7, 1994Possis Medical IncGefäßimplantate
EP0269254A1 *Oct 26, 1987Jun 1, 1988Ethicon Inc.Improvements in synthetic vascular grafts
EP0730849A2 *Mar 11, 1996Sep 11, 1996University Of BristolArteriovenous bypass grafting
WO1982001647A1 *Oct 30, 1981May 27, 1982Robert L KasterVascular graft
WO1984002266A1 *Dec 8, 1983Jun 21, 1984Possis Medical IncVascular graft and blood supply method
WO1996003084A1 *Jul 25, 1995Feb 8, 1996Univ AkronDevice and method for restoration of connective tissue
WO2012143925A1Apr 17, 2012Oct 26, 2012Vascular Graft Solutions LtdDevices and methods for deploying implantable sleeves over blood vessels
Classifications
U.S. Classification623/1.15, 606/155
International ClassificationA61F2/06
Cooperative ClassificationA61F2/064, A61F2/06
European ClassificationA61F2/06C, A61F2/06