Intraluminal vein holder

Abstract

A device for use in the preparation of a vein for arterial grafting. A tubular core, closed at one end and open at the other end to couple with a source of pressurized fluid, rests removably adjacent each end on a frame. The core wall is perforated in an area intermediate the ends of the core and the outer surface of the core wall is smooth.

Description

This invention relates to the preparation of a vein for arterial grafting.

In peripheral arterial or in aortocoronary bypass surgery it is the practice to implant the great saphenous vein taken from the leg. To prepare the vein for grafting it is distended, leads are identified and repaired, and the ends of the vein are cleared of adventitia. Two persons are required to perform this work, which is costly and cumbersome and often damages the vein.

It is an object of the invention to provide a simple device to hold a vein during its preparation for arterial grafting.

In its broadest aspect the invention consists of a device for use in the preparation of a vein for artificial grafting, comprising a tubular core closed at one end to define a chamber and open at the other end to define an inlet to the chamber, the wall of the core being perforated in an area between its ends, and frame means to receive the core removably and to hold it adjacent its ends. The frame means may comprise a base and two spaced, upstanding brackets which receive the core transversely to rest on the brackets. Also, the wall may carry a connector at its open end to couple the core to a pressurized fluid source such as a resevoir located above the core. Preferably the core is pliable for threading into the vein in situ.

An example embodiment of the invention is shown in the accompanying drawings in which:

FIG. 1 is a perspective view of an intraluminal vein holder; and

FIG. 2 is a longitudinal cross-sectional view of one end of the core of FIG. 1.

The embodiment shown in the drawings consists of an elongated, tubular core 10 having a wall 11 defining a passage or chamber 12 which is perforated in the area of its midsection by a plurality of apertures 13. One end 14 of core 10 is sealed by a plug 16 (FIG. 2) while the other end 18 of the core carries a tubular connector 20 which has a nipple 22 at one end for coupling with a flexible tube and a pair of spaced, coaxial locating rings 24. The outer surface of wall 11 is smooth.

Core 10 removably rests in a frame 30 which has a flat base plate 32 and a pair of spaced, upright supporting brackets 34, one bracket being located at each end of the base and the brackets being spaced apart slightly less than the length of the core. An aperture 35 adjacent the top edge of one bracket 34 loosely receives end 14 of core 10 and a U-shaped notch or recess 36 at the top edge of the other bracket 34 loosely receives tubular connector 20 between locating rings 24.

In the operation of the device a vein 40 removed from the body for grafting is slipped onto core 10, i.e. core 10 is threaded proximally (i.e. in the direction of normal blood flow) through the vein intraluminally, and gathered adjacent connector 20. Core 10 is placed transversely in aperture 35 and notch 36 of frame 30, spacer rings 24 serving to locate connector 20 in notch 36. One end 42 of vein 30 is then sealed on core 10 between apertures 13 and end 14 of the core while the other end 43 of the vein is sealed on the core adjacent connector 20. Each vein end 42 and 43 is sealed by encircling it with an umbilical tape 44 and weighting the tape with a clamp 46.

Core 10 is connected with a reservoir 50 of liquid 52 by a flexible tube 54 which fits onto nipple 22 of connector 20. Reservoir 50 is adjustable vertically to create a column of liquid 52 approximating the level of normal arterial blood pressure. Liquid 52 passes out of core 10 through apertures 13 and distends vein 40 in that area. Any leaks in vein 40 are located by the escape of pressurized liquid 52 and they are repaired in the usual manner. The whole length of vein 40 is distended, tested and repaired in this manner by sequentially drawing gathered sections of the vein over the area of apertures 12. Also, the ends of vein 40 are readily accessible to be cleaned in preparation for suturing. To remove prepared vein 40 for implantation, core 10 is lifted from frame 30, and the vein is slipped off the core.

Core 10 is preferably about 12 inches to 14 inches long with an outer diameter less than 4 millimetres. Vein grafts should be greater than 4 mm in diameter; thus a test for a potential vein graft is its accommodation of core 10 of about that diameter. Core 10 may be constructed of any suitable form retaining material such as SILASTIC (a trade mark) which provides a smooth surface and a pliability sufficient to enable the core to be threaded into the vein in situ in order that the vein may be located more easily for cutting.

It will be appreciated that the device of the present invention allows a single person to scrutinize a severed vein and prepare it for implantation. Also, the relationship of the container of liquid used to distend the veing allows it to be adjusted to simulate normal blood pressure and prevent undue stress being applied against the vein wall.

Liquid 52 is preferable to gas for use as a fluid because its escape from the wall of vein 40 is visually identifiable. Tapes 44 and clamps 46 of the example embodiment may be replaced by the hands of the operator who would hold one end of vein 40 on core 10 and distend the vein as described, the undistended end portion of the vein acting as its own seal.

Claims

I claim:

1. A device for use in the preparation of a severed length of vein for arterial grafting, comprising:

an elongated core having a tubular wall closed at one end to define a chamber and open at the other end to define an inlet to the chamber, the wall being perforated in an area intermediate the ends thereof, the outer surface of the wall being smooth, the core being receivable proximally in the vein intraluminally whereby the vein extends along the core in each direction beyond the perforated area of the wall; and

frame means constructed and arranged to receive the core removably and to hold the core adjacent the ends of the wall.

2. A device as claimed in claim 1 in which the frame means comprises a base and two spaced, upstanding brackets shaped to receive the core transversely to rest thereon.

3. A device as claimed in claim 2 in which one bracket has an aperture adjacent the upper end thereof to receive axially the closed end of the wall of the core and the other bracket is notched at the upper end thereof to receive transversely the wall of the core adjacent said other end.

4. A device as claimed in claim 2 in which the base comprises a flat plate and the core rests on the brackets parallel to the plate.

5. A device as claimed in claim 1 in which the wall carries a connector at the open end thereof, the connector having means to couple to pressurized fluid source thereto.

6. A device as claimed in claim 5 in which the connector is tubular coaxial with the wall of the core, the connector carrying a pair of spaced circumferential rings, at least one bracket being notched at the upper end thereof to receive the connector therein between the rings.

7. A device as claimed in claim 1 in which the core is pliable.