Methods and devices for forming vascular anastomoses

• US 6,517,558 B2
• Filed: 02/01/2001
• Issued: 02/11/2003
• Est. Priority Date: 01/15/1999
• Status: Expired due to Fees

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Ventrica, Inc. (Medtronic Plc)
• Inventors: Buch, Wally S., Gittings, Darin C., Rapacki, Alan R.
• Primary Examiner(s): Chaudhuri, Olik
• Assistant Examiner(s): Trinh, (Vikki) Hoa B.
• Application Number:
  US09/776,230
• Publication Number:
  US 20010004699A1
• Time in Patent Office: 740 Days
• Field of Search: 606/151, 606/153, 606/154, 606/108
• US Class Current: 606/153
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 2017/00252 for by-pass connections, i.e. connections from heart chamber to blood vessel or from blood vessel to blood vessel
• CPC Class Codes: A61B 2017/1107 for blood vessels
• CPC Class Codes: A61B 2017/1135 End-to-side connections, e.g. T- or Y-connections Y-shaped blood vessel prostheses A61F2002/065
• 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 2/86 Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
• CPC Class Codes: A61F 2/91 made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes

Abstract

Methods and devices for forming an anastomosis utilize a graft vessel secured to a vessel coupling that is fixed to a target vessel without using suture. The vessel coupling may be collapsed for introduction into the target vessel and then expanded to engage the vessel wall. The vessel coupling may be a stent attached to a graft vessel to form a stent-graft assembly. The anastomosis may be carried out to place the graft and target vessels in fluid communication while preserving native proximal flow through the target vessel, which may be a coronary artery. As a result, blood flowing through the coronary artery from the aorta is not blocked by the vessel coupling and thus is free to move past the site of the anastomosis.

Claims

1. A method for forming an anastomosis between a first vessel and a second vessel, the method comprising steps of:

providing a vessel coupling having a main leg, a first leg and a second leg, the main leg having a proximal opening and a distal opening, the first and second legs being movable from a collapsed position to an expanded position, the;

first and second legs extending distally from the distal opening of the main leg when in the collapsed position, the first and second legs extending radially from the main leg when in the expanded position so that the first and second legs and the main body together form a generally T-shaped connector;

attaching a first vessel to the main leg of the vessel coupling;

forming an opening in a second vessel having a lumen;

introducing the first and second legs into the second vessel through the opening, the first and second legs moving to the expanded position within the second vessel so that the first and second legs form the T-shaped connector thereby coupling the first and second vessels together.

2. The method of claim 1, wherein the providing step is carried out with the first and second legs being radially expandable.

3. The method of claim 1, wherein the providing step is carried out with the main leg being radially expandable.

4. The method of claim 1, wherein the providing step is carried out with the first and second legs forming rings.

5. method of claim 1, wherein the providing step is carried out with the main leg of the vessel coupling having a conduit;

that is placed at least partially into the lumen of the first vessel.

6. The method of claim 5, wherein the providing step is carried out with the expandable conduit being a stent.

7. The method of claim 1, wherein the providing step is carried out with the first vessel comprising a combination of autologous tissue and synthetic graft material adapted to be anastomosed to a coronary artery.

8. The method of claim 1, wherein the attaching step is carried out with the vessel coupling being coupled to the first vessel so as to overlap a portion of the first vessel, and the introducing step is carried out to force the overlapped portion of the first vessel against the second vessel.

9. The method of claim 1, wherein the providing step is carried out with the first vessel being a saphenous vein graft having a, first end attached to the vessel coupling and a second end anastomosed to the patient'"'"'s aorta to complete a coronary bypass procedure.

10. The method of claim 1, further comprising the step of providing a sheath over the vessel coupling and at least a portion of the first vessel.

11. The method of claim 1, wherein the providing step is carried out with the first vessel having an autologous graft coupled to a graft formed of ePTFE, and the second vessel is a coronary artery.