U.S. patent number 3,688,317 [Application Number 05/066,710] was granted by the patent office on 1972-09-05 for vascular prosthetic.
This patent grant is currently assigned to Sutures Inc., Coventry, CT. Invention is credited to Leonard D. Kurtz.
United States Patent |
3,688,317 |
|
September 5, 1972 |
VASCULAR PROSTHETIC
Abstract
A vascular prosthetic comprising a multilayered tubular fabric
contains an anticoagulant on an inner layer to reduce the
likelihood of clot formation. An outer layer does not contain an
anticoagulant and may contain an anticoagulant inhibitor or
antagonist to permit clot formation adjacent the outer layer to
thus prevent exsanguination.
Inventors: |
Leonard D. Kurtz (Woodmere,
NY) |
Assignee: |
Sutures Inc., Coventry, CT
(N/A)
|
Family
ID: |
22071207 |
Appl.
No.: |
05/066,710 |
Filed: |
August 25, 1970 |
Current U.S.
Class: |
623/1.43 |
Current CPC
Class: |
A61L
27/54 (20130101); A61F 2/06 (20130101); A61L
33/0011 (20130101); A61L 27/14 (20130101); A61L
2300/208 (20130101); A61L 2300/404 (20130101); A61L
2300/236 (20130101); A61L 2300/42 (20130101); A61L
2300/432 (20130101); A61L 2300/61 (20130101) |
Current International
Class: |
A61F
2/06 (20060101); A61L 27/54 (20060101); A61L
27/00 (20060101); A61L 27/14 (20060101); A61L
33/00 (20060101); A61f 001/24 () |
Field of
Search: |
;3/1,DIG.1
;128/334R |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Richard A. Gaudet
Assistant Examiner: Ronald L. Frinks
Attorney, Agent or Firm: Larson, Taylor and Hinds
Claims
What is claimed is:
1. A vascular prosthetic comprising a porous, multilayered tubular
fabric comprising a first tubular fabric layer containing an
anticoagulant and a second tubular fabric layer surrounding said
first fabric layer, said second layer being free of anticoagulant
and containing an inhibitor for said anticoagulant.
2. A vascular prosthetic according to claim 1 wherein said
anticoagulant comprises heparin.
3. A vascular prosthetic according to claim 2 wherein said
inhibitor comprises a heparin inhibitor.
4. A vascular prosthetic according to claim 3 wherein said heparin
inhibitor is selected from the group consisting of epsilon amino
caprioc acid, protamine, protamine zinc, acridine blue, polybrene
and toludine blue.
5. A vascular prosthetic according to claim 3 wherein said heparin
inhibitor comprises a basic salt capable of reacting with heparin
to form an insoluble salt with heparin.
6. A vascular prosthetic according to claim 5 wherein said basic
salt comprises a quaternary ammonium salt germicide.
Description
The present invention relates to prosthetic devices, vascular
implants and the like for surgical use in the repair and
replacement of vessels and tracts in human and animal bodies.
In the practice of vascular surgery, such defects in he vascular
system as aneurysms or occlusions are corrected by the technique of
suture anastomosis, by which the area or segment of pathology is
excised or resected, and replaced by a prosthetic device, or graft,
which is implanted, or sutured in. The vascular prosthetic grafts
are employed in various sizes and in all parts of the vascular
system, and comprise straight or variously branched tubes of
flexible, porous construction or fabrication from fibers or strands
run together or interlaced in an interstitial or mesh
structure.
The vascular prosthetic grafts here concerned desirably are
non-toxic and non-allergenic; non-deteriorating upon implantation
for prolonged periods; and capable of deforming without collapsing
and twisting without kinking. Desirably also the porosity of the
grafts on implantation is low enough to permit the implantation
without pre-cloting.
The body heals by fibrosis; that is, the organism's reaction to the
implantation of the foreign body is to attempt to completely
encapsulate the graft with fibrous or scar tissue, forming both an
outer layer or capsule of fibrous tissue and an inner capsule of
fibrous tissue within the lumen of the graft. The healing process
is initiated withing hours of implantation by the deposit of a thin
fibrous layer or mat on the inside of the graft in contact with the
blood stream. The fibrous mat then organized more slowly, within a
period of days to weeks, into a layer of mature scar tissue. The
origin of the fibroblasts forming the inner layer or capsule is
considered to be migration or growth from the outer capsule through
the mesh or interstices of the graft. The fibrous inner layer,
then, is dependent for its blood supply and integrity on
interstitial tissue ingrowth, and a principal factor limiting the
biological fate of the graft is the case with which the fibrous
tissue may grow through the implant wall.
It has been proposed to heparinize the prosthetic to reduce the
likelihood of clot formation within the lumen of the graft. The use
of an anticoagulant, however, inhibits the formation of clots not
only in the graft lumen but throughout the implant itself as well
which may result in exsanguination. This adverse result may be
minimized by reducing porosity, but this has the adverse effect of
interfering with the normal healing process as described above.
Alternatively, a reduced amount of heparin may be utilized but this
results in increased likelihood of clot formation in the graft
lumen. Furthermore, in both of these cases, the anticoagulant
affects clotting to substantially the same extend throughout the
implant.
It is an object of the present invention to provide a vascular
prosthetic which includes an anticoagulant but which is free from
the disadvantages mentioned above.
BRIEF SUMMARY OF THE PRESENT INVENTION of the Present Invention
The foregoing and other objects are achieved according to the
present invention by providing a vascular prosthetic comprising a
porous, multilayered tubular fabric comprising a first tubular
fabric layer containing an anticoagulant and a second tubular
fabric layer surrounding said first fabric layer, said second layer
being free of anticoagulant.
DESCRIPTION OF PREFERRED EMBODIMENTS
There follows a detailed description of a preferred embodiment of
the invention, together with accompanying drawings. However, it is
to be understood that the detailed description and accompanying
drawings are provided solely for the purpose of illustrating a
preferred embodiment and that the invention is capable of numerous
modifications and variations apparent to those skilled in the art
without departing from the spirit and scope of the invention.
The drawing is a perspective view, partially cut away, of a
vascular prosthetic according to the present invention.
With reference to the drawings, a vascular prosthetic according to
the present invention comprises a porous, multilayered tubular
fabric 1 comprising a first tubular fabric layer 2 and a second
tubular fabric layer surrounding the first tubular fabric layer. A
portion of second layer 3 is cut away in the drawing to reveal
first layer 2. The multilayered prosthetic is conveniently made by
inserting one vascular prosthetic within another and stitching the
two together. One or both of the prosthetics may be crimped and
each is of conventional construction such as woven or knitted. The
composite prosthetic may be in the form shown in U.S. Pat. No.
3,105,492, herein incorporated by reference. The graft may be
fabricated from fibers of synthetic resins useful in prosthetics
such as polyesters such as polyethylene terephthalate, polyamides
such as nylon 66, acrylics and modacrylics such as Orlon, and
polyhalogenated hydrocarbons such as Teflon, or from mixtures of
these fibers with one another or with animal derivative fibers such
as disclosed in U.S. Pat. No. 3,316,557, herein incorporated by
reference. Thus, each layer of the prosthetic, as well as the
composite prosthetic, is conventional in configuration, the
porosity, size and other structural features being selected as
desired for a given use according to known considerations.
In accordance with the present invention, a first fabric layer of
the implant is provided with an anticoagulant and a second fabric
layer of the implant surrounds the first. The anticoagulant is
preferably heparin and is provided in the first layer by
impregnation of the fibers making up the layer or by impregnation
of the layer prior to assembling the composite prosthetic. In a
preferred embodiment, a tubular fabric prosthetic of crimped woven
Dacron is immersed into a 5 percent aqueous solution of sodium
heparin for a few minutes and the thus-impregnated implant is dried
providing about 0.5 percent by weight of heparin in the
prosthetic.
The impregnated prosthetic is then inserted inside a second tubular
prosthetic fabric having an inside diameter slightly larger than
the outside diameter of the impregnated prosthetic. The second
prosthetic is preferably woven more loosely than the first.
An implant constructed in the foregoing manner is utilized in
surgery in the usual manner. The presence of heparin anticoagulant
in the inner layer minimizes the risk of clotting within the
implant. The outer layer, however, is free of anticoagulant and
permits the formation of clots outside the inner layer thus
minimizing the likelihood of exsanguination due to the presence of
heparin in the prosthetic.
The inhibiting effect of the outer layer on the anticoagulant can
be enhanced according to the invention in several ways. First, the
second layer may be relatively large in thickness relative to the
first layer thus providing greater capacity to absorb the
anticoagulant. Alternatively, the second layer may comprise a
material which inhibits the effect of the anticoagulant. The
inhibitor may be the fabric material itself or a material added
thereto such as an anticoagulant antagonist or inhibitor.
Heparin anticoagulant is an organic acid which will react with a
base. The fabric may comprise a basic material, such as silk or
other protenaceous fiber, which will chemically combine with
heparin thus effectively inhibiting the effect of heparin on
clotting in the second fabric layer.
Where a material is added to the second fabric layer as an
inhibiting agent, that material may simply react chemically with
the anticoagulant to form a reaction product having no effect on
clotting. For example, the second fabric may be coated or
impregnated with a basic salt, such as a quaternary ammonium
germicide, for example benzethonium chloride, which will react
chemically with heparin to form a highly insoluble material having
very little anticoagulating effect. Alternatively, the second
fabric may be coated or impregnated with a heparin antagonist such
as a protamine or protamine zinc or with an antifibrinolytic agent
such as epsilon amino caproic acid. Other heparin inhibitors which
may be provided in the second fabric include Acridine Blue,
Polybrene, and Toluidine Blue.
The amount of anticoagulant is, in general, less than that which
would give the normal dosage of anticoagulant if released.
Preferably, the amount of anticoagulant is not more than one-tenth
that amount. Thus, the conventional dosage of heparin anticoagulant
is about 50 mg i.v. Therefore, the maximum amount of heparin
anticoagulant in a prosthetic would generally be about 50 mgm.,
preferably about 5 mgm. Where a heparin antagonist or inhibitor is
utilized in the second fabric layer, the amount thereof will, in
general, be at least an amount sufficient to inhibit a substantial
amount of the anticoagulant in the first layer. For example, where
anticoagulant inhibition is achieved by chemical reaction, the
amount of inhibitor is at least sufficient to react with a
substantial amount, preferably a major proportion of the
anticoagulant present in the prosthetic. The maximum amount of the
inhibitor is preferably about five times the amount theoretically
needed to inhibit all of the anticoagulant, and more preferably,
about twice that amount.
While the preferred prosthetic has two layers as shown, additional
fabric layers may be added. However, at least the inner layer will
be heparinized in accordance with the invention and at least one
outer layer, preferably the outermost layer, will be free of
heparin according to the present invention.
* * * * *