U.S. patent application number 10/484159 was filed with the patent office on 2004-12-09 for device for assembling blood vessels.
Invention is credited to Cinquin, Phillippe, Favier, Denis, Orgeas, Laurent, Pecher, Matthieu, Pujol, Sonia.
Application Number | 20040249399 10/484159 |
Document ID | / |
Family ID | 8865602 |
Filed Date | 2004-12-09 |
United States Patent
Application |
20040249399 |
Kind Code |
A1 |
Cinquin, Phillippe ; et
al. |
December 9, 2004 |
Device for assembling blood vessels
Abstract
The invention concerns an end piece for connecting blood
vessels, comprising an inner stent (2) designed to be inserted
inside part of the end of a vessel (1) and an outer stent (3)
arranged at the outer periphery of said end, one of the two stents
being capable of expansion/compression after it has been set in
place, thereby blocking the vessel between the two stents after
they have been installed. The invention is useful for assembling
blood vessels.
Inventors: |
Cinquin, Phillippe; (La
Tronche, FR) ; Favier, Denis; (Martin D'Uriage,
FR) ; Orgeas, Laurent; (Voiron, FR) ; Pecher,
Matthieu; (Meylan, FR) ; Pujol, Sonia;
(Grenoble, FR) |
Correspondence
Address: |
LOWRIE, LANDO & ANASTASI
RIVERFRONT OFFICE
ONE MAIN STREET, ELEVENTH FLOOR
CAMBRIDGE
MA
02142
US
|
Family ID: |
8865602 |
Appl. No.: |
10/484159 |
Filed: |
June 30, 2004 |
PCT Filed: |
July 17, 2002 |
PCT NO: |
PCT/FR02/02555 |
Current U.S.
Class: |
606/153 |
Current CPC
Class: |
A61F 2002/0894 20130101;
A61F 2/064 20130101; A61F 2/08 20130101; A61F 2/02 20130101 |
Class at
Publication: |
606/153 |
International
Class: |
A61B 017/08 |
Foreign Application Data
Date |
Code |
Application Number |
Jul 17, 2001 |
FR |
01/09526 |
Claims
1-6. Cancelled.
7. A vessel connection connector, comprising an internal cylinder
insertable inside of an end portion of a vessel, and an external
cylinder distinct from the internal cylinder arranged at an
external periphery of the end portion, wherein the internal
cylinder is capable of expanding after being put into place and the
external cylinder is non-expandable, whereby the vessel is blocked
between the internal and external cylinders after their being put
into place, the connector being capable of cooperating with a
connector equipping another vessel.
8. The connector of claim 7, wherein the external cylinder is
provided with means for attaching to the external cylinder the
connector equipping another vessel.
9. The connector of claim 7, wherein the external cylinder is
formed of two rigid half-cylinders associated with a temporary
attachment means.
10. The connector of claim 8, wherein the connector equipping
another vessel includes internal and external cylinders, and
wherein each of the external cylinders protrudes out of the end of
the vessels and comprises complementary male and female connection
means.
11. The connector of claim 7, wherein the vessel is a first vessel
that is equipped with a first male connector and the another vessel
is a second vessel that is equipped with a second female connector
having internal and external cylinders, the external cylinder of
which protrudes out of the end of the second vessel, has a diameter
greater than that of the external cylinder of the first connector
and has at least one flexible end portion, this end portion being
surrounded with two removable rigid half-cylinders, themselves
surrounded with a stent acting in compression, whereby, after
removal of the removable half-cylinders, the flexible end of the
external cylinder of the second vessel presses against the end of
the external cylinder of the first vessel.
12. The connector of claim 9, wherein the another vessel is
equipped with a connector comprising two rigid removable
half-cylinders surrounded with a stent acting in compression.
Description
[0001] The present invention relates to a device for jointing
flexible ducts. The case of the jointing of two blood vessels will
more specifically be considered herein, but, generally, each of the
vessels may be any type of duct with a non-rigid flexible wall.
[0002] The stump of a blood vessel, vein or artery, is a fragile
piece of flesh, uneasy to handle and, conventionally, it can only
be connected to another vessel by means of a sewing.
[0003] The present invention provides transforming the stump end
into an object which is easy to handle and connect by equipping
each stump with a connector connectable to a complementary
connector.
[0004] More specifically, the present invention provides a vessel
connector, comprising an internal cylinder insertable inside of a
portion of the end of a vessel, and an external cylinder arranged
at the external periphery of said end, one of the two cylinders
being capable of expanding/compressing after its putting into
place, whereby the vessel is blocked between the two cylinders
after their putting into place.
[0005] According to an embodiment of the present invention, the
internal cylinder is capable of expanding after its putting into
place and the external cylinder is non-expandable, this external
cylinder being provided with means of attachment to an external
cylinder equipping another vessel.
[0006] According to an embodiment of the present invention, the
external cylinder is formed of two half-cylinders associated with a
temporary attachment means.
[0007] The present invention also aims at a device for jointing
vessels respectively equipped with a connector, in which each of
the external cylinders comprises complementary male and female
connection means.
[0008] According to an embodiment of the present invention, the
first vessel is equipped with a male connector and the second
vessel is equipped with a female connector, the external cylinder
of which has a diameter greater than that of the external cylinder
of the first connector and at least the end portion of which is
flexible, this end portion being surrounded with two removable
half-cylinders, themselves surrounded with a stent acting in
compression.
[0009] According to an embodiment of the present invention, the
vessel jointing device uses a connector in which the internal
cylinder penetrates into two opposite vessels and the external
cylinder surrounds the external periphery of the two vessels.
[0010] The foregoing objects, features, and advantages of the
present invention will be discussed in detail in the following
non-limiting description of specific embodiments in connection with
the accompanying drawings, among which:
[0011] FIG. 1 shows an end of a blood vessel equipped with a
connector according to an embodiment of the present invention;
[0012] FIGS. 2A-2D illustrate a placing mode of the connector of
FIG. 1;
[0013] FIGS. 3A and 3B illustrate an example of application of the
present invention to a blood vessel jointing operation;
[0014] FIGS. 4 to 7 illustrate various alternatives of devices
according to the present invention; and
[0015] FIG. 8 illustrates another embodiment of the present
invention.
[0016] In the present invention, "stent" will be used to designate
a hollow cylindrical object with full or open-worked walls made of
a material capable of having at an initial state a first dimension
(first internal and external diameters) and at a final state a
second dimension (second internal and external diameters). It may
be a cylinder, the internal and external diameters of which tend to
increase or to decrease, or a cylinder, the internal diameter of
which tends to decrease, or a cylinder, the external diameter of
which tends to increase. In the case of a cylinder, the external
diameter of which tends to increase, the stent will be likely to
exert an expansion effort on the medium arranged at its external
periphery. In the second case, the stent will be likely to exert a
compressive effort on the medium located at its internal
periphery.
[0017] Such stents may use various physical phenomena. It may for
example be shape-memory materials, devices of pneumatic type, or
osmotic effect devices. In this last case, the stent will be formed
of a cylinder with a double wall, containing an osmotic material so
that the pressure between the two walls increases when the stent is
plunged into a liquid, one or the other of the two walls being
likely to deform.
[0018] FIG. 1 is a perspective view of a blood vessel 1 provided
with a connector according to the present invention. The connector
comprises a stent 2 arranged inside of the vessel and a
non-expandable cylinder 3 arranged outside of the vessel. The stent
is such that, once placed inside of the vessel, it tends to
increase its diameter so that vessel 1 is stuck between stent 2 and
cylinder 3. Hereafter, cylinder 3 intended to be used as a support
will be called the "anvil". It is preferably not a cylinder made of
a rigid material, but a cylinder made of a non-extensible flexible
material, for example, a biocompatible metal, fabric, or plastic
cylinder.
Example of the Putting into Place of a Connector
[0019] FIGS. 2A to 2D illustrate successive steps of the putting
into place of the connector of FIG. 1 at the end of a blood vessel
1 by means of an introducing device 5. The introducer has the shape
of a cylinder of small diameter. It may be introduced through a
percutaneous orifice. The introducer end located outside of the
patient will be called the "proximal end" and the introducer end
located inside of the field of operation will be called the "distal
end". The introducer is comprised of a core 6 and of a sheath 7
mobile in translation with respect to each other. An element such
as a stent 2 may be housed in the distal portion of the sheath.
[0020] By exerting translational and rotational motions on the
proximal end, the operator can control the orientation and the
position of the distal end. Such motions enable introducing the
distal end a few millimeters into the vessel. This operation may
require for the stump to be held by clips (introduced by another
percutaneous orifice).
[0021] The stent then remains to be released. The stent introducers
enable this functionality by means of devices located at the
proximal end. This phase is critical, because the stent may slide
with respect to the stump. A partially reversible introducing
device will preferably be chosen. Such a device enables having the
stent return into its protective sheath, provided that the stent
has not completely come out of it (typically, the stent must be
"spread out" over less than a set percentage, for example, 80%, of
its length). It should be noted that the used stent tends to have a
greater diameter than the vessel (due to this difference in
diameters, the stent will be able to press the vessel wall against
the anvil's). Now, at this stage (FIG. 2B), the anvil has not been
placed yet. There would be a risk of injuring the vessel if the
stent was too spread out. It will thus only be spread out by a
length that enables it to take a diameter equivalent to that of the
artery (this is performed under visual control, an endoscope being
installed in the operation field). It should be noted that when the
stent is not too spread out, it is possible to have it undergo
translation motions along the stump axis. This is only possible in
the direction that would lead to the stent extraction, given the
conical character of the stent when its spreading out is
incomplete. This will ease the correct positioning of the stent. It
should also be noted that if the operator considers that the stent
is mispositioned, it is always possible to bring it back into the
introducer sheath and repeat the operation. At this step of the
operation, the stump has become immovably attached to the proximal
end. The clip holding the stump is thus no longer necessary.
[0022] At the step illustrated in FIG. 2C, cylindrical anvil 3 is
introduced from the proximal end. It is a hollow cylinder that can
slide as far as the stump. A clip enables putting it in the right
place. The stent release can then be complete by maneuvering the
proximal end of the introducer. The stent releases all its
centripetal radial compression force, thus pressing the vessel wall
against the anvil (FIG. 2D).
Example of Fastening of Two Connectors
[0023] As illustrated in FIG. 3A, two stumps to be fastened 1 and
11 are provided with male and female connectors comprising stents 2
and 12 and anvils 3 and 13. Female anvil 3 preferably has an end
portion of reduced diameter. Male anvil 13 comprises an end portion
made of a flexible, but non-extensible material. Further, at least
the end portion of anvil 13 is surrounded with two rigid
half-cylinders 14a, 14b, each of which is equipped at one end with
a catch (small gripping excrescence) 15a, 15b and with a stent 16
having a tendency to contracting (decreasing its diameter).
Half-cylinders 14a, 14b are maintained in placed against each other
under the effect of the pressure exerted by stent 16.
[0024] Two clips introduced into the operation field enable
handling the two stumps equipped with connectors. As illustrated in
FIG. 3B, the end of anvil 3 can thus be introduced into the end of
anvil 13. Clips are also used to successively grip catches 15a and
15b and remove rigid semi-cylinders 14a and 14b. The jointing is
thus performed and maintained under the effect of the pressure
exerted by stent 16.
Alternatives
[0025] According to an alternative, illustrated in FIG. 4,
cylinders 3 and 13 forming an anvil are provided at their ends with
fast connection male and female devices 18a and 18b. Such devices,
such as, for example, threads, or "clipsing" devices, are very
current to quickly connect pipes, in particular for those used in
the medical field.
[0026] According to another alternative of the present invention,
instead of specializing two specific male and female connectors at
the end of two stumps to be connected, two male or two female
connectors and one complementary intermediary connection part may
be used. When more than two vessels are desired to be connected,
for example to perform an end-to-side anastomosis, an intermediary
T-shaped part to which are connected stumps equipped with
connectors as described hereabove may be used.
[0027] FIGS. 5 and 6 illustrate another embodiment of the present
invention in which a single stent 22 is inserted into the two ends
of two vessels 1 and 11 and these two ends are altogether
surrounded at their external periphery with a non-extensible
cylinder 23. FIG. 5 shows the device while stent 22 is in its
initial position, before expanding, and FIG. 6 shows the device
while the stent is in expanded position. In this embodiment, the
stent is preferably of pneumatically- or osmotically-inflatable
type.
[0028] FIG. 7 shows another alternative of the present invention in
which a single stent 22 is inserted into the two ends of the two
assembled vessels 1 and 11 and two cylinders forming an anvil 25
and 26 are arranged at the external periphery of the vessel
ends.
[0029] FIG. 8 shows another embodiment of the present invention in
which a first vessel 1 is associated with a male connector while a
second vessel 11 is associated with a female connector. The male
connector comprises an internal stent 2 and an external stent
forming an anvil. In the embodiment, the external cylinder is
formed of two half-cylinders 31a and 31b respectively associated
with grip catches 32a and 32b. Half-cylinders 31a and 31b are
assembled in any selected fashion, for example, by a wire or net 33
that maintains them in place and enables them to temporarily be
used as an anvil. The female connector is bell-mouthed and
comprises two external half-cylinders 35a and 35b, respectively
associated with gripping catches 36a and 36b. The blood vessel is
everted and pressed against the bell mouth of the connector to
which it is temporarily attached by clips, wires, or the like. The
assembly is surrounded with a cylindrical stent 37, the internal
diameter of which tends to decrease. The assembly of the male and
female connectors is performed by inserting the male connector into
the female connector, by cutting wire or net 33, and by
successively removing half-cylinders 32a, 32b, then half-cylinders
36a and 36b after having detached them from vessel 11. Then, the
connection is ensured by the two stents 2 and 37 operating
antagonistically, stent 2 exerting an expansion force and stent 37
a compression force.
[0030] The external cylinder, forming an anvil, may also be
provided in the various embodiments to be a longitudinally split
cylinder, the two opposite portions of the split being attachable
to each other after being put into place, for example by fast
connection.
* * * * *