Bypass Grafting System and Apparatus

• US 20070129662A1
• Filed: 02/09/2007
• Published: 06/07/2007
• Est. Priority Date: 07/03/1991
• Status: Active Grant

• Current Assignee: Lifeshield Sciences LLC (Acacia Research Corporation)
• Original Assignee: Thomas Maginot
• Inventors: Maginot, Thomas
• Granted Patent: US 7,753,946 B2
• Time in Patent Office: Days
• US Class Current: 604/8
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 2017/1107 for blood vessels
• CPC Class Codes: A61F 2/06 Blood vessels
• CPC Class Codes: A61F 2/064 with special features to facilitate anastomotic coupling anastomosis of natural blood vessels A61B17/11
• CPC Class Codes: A61F 2/07 Stent-grafts
• CPC Class Codes: A61F 2/856 Single tubular stent with a side portal passage
• CPC Class Codes: A61F 2/88 the wire-like elements formed as helical or spiral coils forming a net-like or mesh-like structure A61F2/90
• CPC Class Codes: A61F 2/90 characterised by a net-like or mesh-like structure
• CPC Class Codes: A61F 2/954 for placing stents or stent-grafts in a bifurcation
• CPC Class Codes: A61F 2/958 Inflatable balloons for placing stents or stent-grafts
• CPC Class Codes: A61F 2002/065 Y-shaped blood vessels
• CPC Class Codes: A61F 2002/075 the stent being loosely attached to the graft material, e.g. by stitching
• CPC Class Codes: A61F 2002/821 Ostial stents
• CPC Class Codes: A61F 2220/0075 sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: Y10S 623/902 Method of implanting
• CPC Class Codes: Y10S 623/903 Blood vessel

Abstract

Minimally invasive techniques utilized in bypass grafting are disclosed. For instance, a method of implanting an end portion of a graft in the body of a patient during a bypass grafting procedure includes the steps of (i) advancing a medical instrument within a circulatory system of said body, (ii) guiding a distal end of said medical instrument out of said circulatory system through an opening defined in said circulatory system after said medical instrument advancing step, (iii) advancing said end portion of said graft within said medical instrument after said guiding step, and (iv) securing said end portion of said graft to a blood vessel of said circulatory system after said end portion advancing step.

Claims

1. A graft assembly, comprising:

a graft having an orifice; and

a plurality of arms extending away from said orifice of said graft.

2. The graft assembly of claim 1, wherein:

said graft defines a fluid lumen; and

each of said plurality of arms extend outwardly from said fluid lumen.

3. The graft assembly of claim 1, wherein each of said plurality of arms extends radially outwardly from said orifice.

4. The graft assembly of claim 1, wherein:

said graft includes a flange portion; and

each of said plurality of arms is positioned in contact with said flange portion.

5. The graft assembly of claim 4, wherein at least a part of each of said plurality of arms is integrally positioned within said flange portion.

6. The graft assembly of claim 1, wherein each of said plurality of arms is configured to move from a first position in relation to said graft to a second position in relation to said graft due to spring action.

7. The graft assembly of claim 1, wherein said plurality of arms are configured to inhibit advancement of said graft in a direction away from a blood vessel with said plurality of arms located adjacent to an internal sidewall of said blood vessel.

8. The graft assembly of claim 1, wherein said plurality of arms is secured to said graft.

9. A graft and delivery assembly, comprising:

a delivery sheath defining an interior space;

a graft positioned within said interior space of said delivery sheath; and

a spring assembly positioned within said interior space of said delivery sheath, said spring assembly being in a compressed state in response to said spring assembly being located within said interior space of said delivery sheath.

10. The assembly of claim 9, wherein:

said spring assembly includes a plurality of spring arms secured to said graft;

said graft defines a fluid lumen; and

said spring assembly is configured with each of said plurality of arms extending outwardly from said fluid lumen responsive to said spring assembly being located outside of said delivery sheath.

11. The graft assembly of claim 9, wherein:

said graft includes a flange portion; and

each of said plurality of spring arms is positioned in contact with said flange portion.

12. The graft assembly of claim 11, wherein each of said plurality of spring arms is integrally positioned within said flange portion.

13. The graft assembly of claim 11, wherein said delivery sheath is a laparoscope.

14. The graft assembly of claim 10, in which the spring assembly includes a plurality of spring arms that extend radially outwardly from said orifice when said spring assembly is advanced to a location outside of said delivery sheath.

15. The graft assembly of claim 14, wherein each of said plurality of spring arms is configured to move from a first position in relation to said graft to a second position in relation to said graft due to spring action.

16. A graft assembly, comprising:

a blood flow conduit having an orifice at an end of the conduit; and

a plurality of struts each extending outwardly from said orifice.

17. The graft assembly of claim 16, wherein:

said graft includes a flange portion at said end; and

each of said plurality of struts is positioned in contact with said flange portion.

18. The graft assembly of claim 17, wherein each of said plurality of struts is integrally positioned within said flange portion.

19. The graft assembly of claim 16, wherein each of said plurality of struts extends radially outwardly from said orifice.

20. The graft assembly of claim 16, wherein each of said plurality of struts is configured to move from a first position in relation to said blood flow conduit to a second position in relation to said blood flow conduit due to spring action.

21. The graft assembly of claim 16, wherein each of said plurality of struts is configured to move from a first position in relation to said blood flow conduit to a second position in relation to said blood flow conduit in response to said plurality of struts being advanced out of a delivery device.

22. The graft assembly of claim 20, wherein each of said plurality of struts extends radially outwardly from said orifice of said graft with each of said plurality of struts positioned in said second position in relation to said graft.

23. The graft assembly of claim 16, wherein said plurality of struts are configured to inhibit advancement of said blood flow conduit in a direction away from a blood vessel with said plurality of struts located adjacent to an internal sidewall of said blood vessel.

24. A medical assembly, comprising:

a delivery device having a passageway extending therethrough; and

a graft assembly including (i) a graft positioned within said passageway of said delivery device, and (ii) a plurality of struts secured to said graft.

25. The medical assembly of claim 24, wherein:

each of said plurality of struts includes (i) an inner end located adjacent to an orifice of said graft, and (ii) an outer end which is spaced apart from said orifice of said graft.

26. The assembly of claim 24, wherein said graft is a synthetic graft.

27. The graft assembly of claim 24, wherein said delivery device is a laparoscope.

28. The graft assembly of claim 24, wherein:

said graft includes a flange portion; and

each of said plurality of struts is positioned in contact with said flange portion.

29. The graft assembly of claim 28, wherein each of said plurality of struts is integrally positioned within said flange portion.

30. The graft assembly of claim 24, wherein each of said plurality of struts is configured to move from a first position in relation to said graft to a second position in relation to said graft due to spring action.

31. The graft assembly of claim 24, wherein each of said plurality of struts is configured to move from a first position in relation to said graft to a second position in relation to said graft due to spring action in response to removal of said plurality of struts from said passageway of said delivery device.

32. The graft assembly of claim 24, wherein said plurality of struts is configured to inhibit advancement of said graft in a direction away from a blood vessel due to physical interaction between said plurality of struts and said blood vessel with said plurality of arms located adjacent to an internal sidewall of said blood vessel.

33. A graft assembly, comprising:

a graft having a fluid lumen; and

a plurality of braces extending outwardly from an end of said graft.

34. The graft assembly of claim 33, wherein:

said graft includes an orifice at said end; and

each of said plurality of braces extends outwardly from said orifice.

35. The graft assembly of claim 34, wherein each of said plurality of braces extends radially outwardly from said orifice.

36. The graft assembly of claim 33, wherein:

said graft includes a flange portion; and

each of said plurality of braces is positioned in contact with said flange portion.

38. The graft assembly of claim 33, wherein each of said plurality of braces is maintained resiliently outwardly extending in a direction transverse to said fluid lumen.

39. The graft assembly of claim 33, wherein each of said plurality of braces is configured to move from a first position in relation to said graft to a second position in relation to said graft due to spring action.

40. The graft assembly of claim 35, wherein said plurality of braces is configured to inhibit advancement of said graft away from a blood vessel with said plurality of braces located adjacent to an internal sidewall of said blood vessel.

41. A graft assembly configured to be positioned in relation to an arteriotomy defined in a blood vessel, comprising:

a graft having an orifice configured to align with an arteriotomy so that blood exiting an arteriotomy transfers to said graft through said orifice; and

a plurality of arms extending away from said orifice of said graft, each of said plurality of arms being configured to lie adjacent a sidewall of said blood vessel with said orifice of said graft aligned with said arteriotomy.

42. The graft assembly of claim 41, wherein each of said plurality of arms extends radially outwardly from said orifice of said graft.

43. The graft assembly of claim 41, wherein:

said graft includes a flange portion; and

each of said plurality of arms is positioned in contact with said flange portion.

44. The graft assembly of claim 43, wherein each of said plurality of arms is integrally positioned within said flange portion.

45. The graft assembly of claim 41, wherein:

said graft has a fluid lumen; and

each of said plurality of arms extends in a direction transverse to said fluid lumen.

46. The graft assembly of claim 41, wherein each of said plurality of arms is configured to move from a first position in relation to said graft to a second position in relation to said graft due to spring action.

47. The graft assembly of claim 41, wherein each of said plurality of arms is configured to move from a first position in relation to said graft to a second position in relation to said graft in response to said plurality of arms being advanced out of an internal space of a delivery device.

48. The graft assembly of claim 41, wherein said plurality of arms are configured to inhibit advancement of said graft in a direction away from a blood vessel due to physical interaction between said plurality of arms and said blood vessel with said plurality of arms located adjacent to an internal sidewall of said blood vessel.

49. A graft and delivery assembly, comprising:

a graft having an orifice configured to align with an arteriotomy defined in a blood vessel so that blood exiting said arteriotomy transfers to said graft through said orifice;

a plurality of support members extending away from said orifice of said graft, each of said plurality of support members being configured to lie adjacent a sidewall of said blood vessel with said orifice aligned with said arteriotomy; and

a delivery device configured to receive said graft within an interior space thereof.

37. The graft assembly of claim 49, wherein at least a part of each of said plurality of braces is integrally positioned within said flange portion.

50. The graft assembly of claim 49, wherein each of said plurality of support members is configured to move from a first position in relation to said graft to a second position in relation to said graft in response to said plurality of support members being disposed out of said delivery device.

51. The graft assembly of claim 50, wherein each of said plurality of support members extends radially outwardly from said orifice of said graft with each of said plurality of support members positioned in said second position in relation to said graft.

52. The graft assembly of claim 49, wherein:

said graft includes a flange portion, and

each of said plurality of support members is positioned in contact with said flange portion.

53. The graft assembly of claim 52, wherein each of said plurality of support members is integrally positioned within said flange portion.

54. The graft assembly of claim 49, wherein said delivery device is a laparoscope.

55. The graft assembly of claim 49, wherein each of said plurality of support members is configured to move from a first position in relation to said graft to a second position in relation to said graft due to spring action.

56. The graft assembly of claim 49, wherein each of said plurality of support members is configured to move from a first position in relation to said graft to a second position in relation to said graft due to spring action in response to removal of said plurality of support members from said internal space of said delivery device.

57. The graft assembly of claim 49, wherein said delivery device is further configured to receive said plurality of support members within said interior space of said delivery device.

58. The graft assembly of claim 49, wherein said plurality of support members is configured to inhibit advancement of said graft away from said blood vessel due to physical interaction between said plurality of support members and said blood vessel with said plurality of support members located adjacent to an internal sidewall of said blood vessel.

59. A graft and delivery system, comprising:

a delivery device having a passageway defined therein; and

a graft located within the passageway of the delivery device.

60. The system of claim 59, wherein the delivery device includes a tubular shape.

61. The system of claim 59, wherein:

the graft has a first end, a second end, and a body;

the first end of the graft is located at a first position in the passageway;

the second end of the graft is located at a second position in the passageway; and

the body of the graft is interposed between the first position and the second position in the passageway.

62. The system of claim 59, wherein:

the passageway includes a distal opening and a proximal opening; and

the graft extends within the passageway between the distal opening and the proximal opening.

63. The system of claim 59, wherein the delivery device is a laparoscope.

64. The system of claim 59, wherein an end of the graft is located within the passageway adjacent to a distal end of the delivery device.

65. A blood flow conduit and delivery system, comprising:

a delivery device having an interior space defined therein; and

a blood flow conduit located within the interior space of the delivery device.

66. The system of claim 65, wherein the delivery device is configured in a tubular shape.

67. The system of claim 65, wherein:

the blood flow conduit has a first end, a second end, and a body;

the first end of the blood flow conduit is located at a first position in the interior space;

the second end of the blood flow conduit is located at a second position spaced from the first position in the interior space; and

the body of the blood flow conduit is interposed between the first position and the second position in the interior space.

68. The system of claim 65, wherein:

the delivery device includes a distal opening and a proximal opening; and

the interior space extends between the distal opening and the proximal opening.

69. The system of claim 65, wherein the delivery device is a laparoscope.

70. The system of claim 65, wherein an end of the blood flow conduit located within the interior space is disposed adjacent to a distal end of the delivery device.

71. A graft and delivery system, comprising:

a delivery device; and

a graft including its full length disposed within the delivery device.

72. The system of claim 71, wherein the delivery device includes a tubular shape.

73. The system of claim 71, wherein:

the graft has a first end, a second end, and a body;

the first end of the graft is located at a first position in the delivery device;

the second end of the graft is located at a second position spaced from the first position in the delivery device; and

the body of the graft is interposed between the first position and the second position in the delivery device.

74. The system of claim 71, wherein:

the delivery device includes a distal opening and a proximal opening; and

a passage extends between the distal opening and the proximal opening.

75. The system of claim 71, wherein the delivery device is a laparoscope.

76. The system of claim 71, wherein an end of the graft is disposed within the delivery service adjacent to a distal end of the delivery device.

77. A graft and delivery system, comprising:

a delivery sheath having a passageway defined therein; and

a graft located within the passageway of the delivery sheath.

78. The system of claim 77, wherein the delivery sheath is configured in a tubular shape.

79. The system of claim 77, wherein:

the graft has a first end, a second end, and a body;

the first end of the graft is located at a first position in the passageway;

the second end of the graft is located at a second position spaced from the first position in the passageway; and

the body of the graft is interposed between the first position and the second position in the passageway.

80. The system of claim 77, wherein:

the delivery sheath includes a distal opening and a proximal opening; and

the passageway extends between the distal opening and the proximal opening.

81. The system of claim 77, wherein the delivery sheath is a laparoscope.

82. The system of claim 77, wherein an end of the graft is disposed within the passageway adjacent to a distal end of the delivery sheath.

83. A blood flow conduit and a delivery system, comprising:

a medical instrument having an interior space, defined therein; and

a blood flow conduit located within the interior space of the medical instrument.

84. The system of claim 83, wherein the medical instrument includes a tubular shape.

85. The system of claim 83, wherein:

the blood flow conduit has a first end, a second end, and a body;

the first end of the blood flow conduit is located at a first position in the interior space;

the second end of the blood flow conduit is located at a second position spaced from the first position in the interior space; and

the body of the blood flow conduit is interposed between the first position and the second position in the interior space.

86. The system of claim 83, wherein:

the medical instrument includes a distal opening and a proximal opening; and

the interior space extends between the distal opening and the proximal opening.

87. The system of claim 83, wherein the medical instrument is a laparoscope.

88. The system of claim 83, wherein an end of the blood flow conduit located within the interior space is disposed adjacent to a distal end of the medical instrument.