FR2850008A1 - Vascular prosthesis has tube and collar for adapting to blood vessel ends of different diameters - Google Patents

Vascular prosthesis has tube and collar for adapting to blood vessel ends of different diameters Download PDF

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Publication number
FR2850008A1
FR2850008A1 FR0300500A FR0300500A FR2850008A1 FR 2850008 A1 FR2850008 A1 FR 2850008A1 FR 0300500 A FR0300500 A FR 0300500A FR 0300500 A FR0300500 A FR 0300500A FR 2850008 A1 FR2850008 A1 FR 2850008A1
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France
Prior art keywords
vascular prosthesis
collar
tube
prosthesis according
diameter
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FR0300500A
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French (fr)
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Daniel Roux
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Individual
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Individual
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Priority to FR0300500A priority Critical patent/FR2850008A1/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2412—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body with soft flexible valve members, e.g. tissue valves shaped like natural valves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2/064—Blood vessels with special features to facilitate anastomotic coupling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2002/061—Blood vessels provided with means for allowing access to secondary lumens
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2002/065—Y-shaped blood vessels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2002/821—Ostial stents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0039—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in diameter

Landscapes

  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Pulmonology (AREA)
  • Prostheses (AREA)

Abstract

The prosthesis combines a tube (1) and a collar (2) of the same biocompatible textile material that extends round the tube in a plane perpendicular to its axis and has a diameter substantially greater than that of the tube. The collar can be flat or conical in shape and trimmed by surgical scissors to adapt to the diameter of one section (3') of a blood vessel. The prosthesis combines a tube (1) and a collar (2) of the same biocompatible textile material that extends round the tube in a plane perpendicular to its axis and has a diameter substantially greater than that of the tube. The collar can be flat or conical in shape and trimmed by surgical scissors to adapt to the diameter of one section (3') of a blood vessel while the tube is attached to the end of a smaller-diameter section (3).

Description

La présente invention a pour objet une prothèse vasculaire permettant uneThe present invention relates to a vascular prosthesis allowing a

adaptation aux différences de diamètre entre les deux extrémités d'un segment de  adaptation to differences in diameter between the two ends of a segment of

vaisseau sanguin à remplacer.blood vessel to be replaced.

Elle se rapporte d'une manière générale au domaine de la chirurgie vasculaire et en particulier aux interventions visant au remplacement par une prothèse d'une partie ou de la totalité de l'aorte.  It relates generally to the field of vascular surgery and in particular to interventions aimed at replacing part or all of the aorta with a prosthesis.

Les prothèses vasculaires actuelles sont réalisées en textile synthétique à base de polyester "Dacron" tissé ou tricoté, ou en "Goretex", matériau inerte souple à base de polytétra-fluoro-éthylène, totalement compatible avec les tissus biologiques et utilisé pour la chirurgie (vaisseaux et ligaments) et pour l'esthétique.  Current vascular prostheses are made of synthetic fabric based on woven or knitted polyester "Dacron", or "Goretex", a flexible inert material based on polytetrafluoroethylene, fully compatible with biological tissues and used for surgery ( vessels and ligaments) and for aesthetics.

Leur diamètre varie de 4 mm à 40 mm et toutes les prothèses connues sont cylindriques.  Their diameter varies from 4 mm to 40 mm and all known prostheses are cylindrical.

Or, dans de nombreux cas, le diamètre du vaisseau sanguin n'est pas identique d'un point à un autre. Si cette différence de diamètre est peu sensible dans les petits diamètres, elle peut devenir importante pour des vaisseaux sanguins de grand 20 diamètre comme l'aorte par exemple.  However, in many cases, the diameter of the blood vessel is not identical from one point to another. If this difference in diameter is insignificant in small diameters, it can become significant for large diameter blood vessels such as the aorta.

Cet état de fait engendre une difficulté pour le chirurgien. Il devra choisir en effet une prothèse dont le diamètre est une moyenne entre la grande section et la petite section du vaisseau sanguin o il va l'interposer. Puis, il devra suturer en fronçant de façon à compenser la différence de diamètre. Il va s'en suivre. une perte 25 de temps un risque de fuite.  This state of affairs creates a difficulty for the surgeon. He will have to choose a prosthesis whose diameter is an average between the large section and the small section of the blood vessel where he will interpose it. Then, it will have to suture while gathering so as to compensate for the difference in diameter. It will follow. a waste of time a risk of leakage.

Le dispositif selon la présente invention a pour objectif de remédier à cet état de choses. Il permet en effet au chirurgien, lorsqu'il y a un segment de vaisseau sanguin à remplacer avec une différence de diamètre d'amont et d'aval, de gagner du 30 temps de façon sensible, tout en réalisant des sutures parfaitement étanches aux deux extrémités de l'implant.  The device according to the present invention aims to remedy this state of affairs. It allows the surgeon, when there is a segment of blood vessel to be replaced with a difference in diameter upstream and downstream, to save time appreciably, while making sutures perfectly sealed to both ends of the implant.

Il est constitué d'un tube prothétique équipé à la périphérie de l'une de ses extrémités d'une collerette de même nature que la prothèse et d'un diamètre relativement important par rapport à celui du tube prothétique, de manière à obtenir une prothèse dont l'une des extrémités a un diamètre parfaitement adaptable à celui du 5 vaisseau sanguin, la collerette pouvant être retaillée par le chirurgien comme il le désire.  It consists of a prosthetic tube fitted at the periphery of one of its ends with a collar of the same nature as the prosthesis and of a relatively large diameter compared to that of the prosthetic tube, so as to obtain a prosthesis one end of which has a diameter which is perfectly adaptable to that of the blood vessel, the collar being able to be cut by the surgeon as desired.

Sur les dessins annexés, donnés à titre d'exemples non limitatifs de formes de réalisation conformes à la présente demande: la figure 1 représente en perspective une prothèse vasculaire selon l'invention avant implantation, la figure 2 montre la même prothèse après mise en place, les figures 3 à 6 illustrent l'utilisation de la prothèse vasculaire sur une aorte, La figure 7 représente une prothèse vasculaire de remplacement de la partie abdominale de l'aorte et les figures 8 et 9 montrent une prothèse d'aorte descendante associée à une valvule cardiaque, respectivement avant et après assemblage de la prothèse et de la valvule.  In the appended drawings, given by way of nonlimiting examples of embodiments in accordance with the present application: FIG. 1 represents in perspective a vascular prosthesis according to the invention before implantation, FIG. 2 shows the same prosthesis after placement , Figures 3 to 6 illustrate the use of the vascular prosthesis on an aorta, Figure 7 shows a vascular prosthesis to replace the abdominal part of the aorta and Figures 8 and 9 show a descending aorta prosthesis associated with a heart valve, respectively before and after assembly of the prosthesis and the valve.

Le dispositif, figures 1 à 9, est formé d'un tube prothétique 1 comportant à l'une de ses extrémités, ou près de cette extrémité, une collerette 2 s'étendant autour de la périphérie du tube prothétique dans un plan sensiblement perpendiculaire à l'axe de celui-ci.  The device, FIGS. 1 to 9, is formed of a prosthetic tube 1 comprising at one of its ends, or near this end, a flange 2 extending around the periphery of the prosthetic tube in a plane substantially perpendicular to the axis of it.

Le tube prothétique 1, réalisé en matériau biocompatible tel que "Dacron" ou "Goretex", est du type standard actuellement utilisé dans le remplacement de segments de vaisseaux sanguins 3, 3'.  The prosthetic tube 1, made of biocompatible material such as "Dacron" or "Goretex", is of the standard type currently used in the replacement of segments of blood vessels 3, 3 '.

La collerette 2 est un élément plan ou conique, du même matériau que le tube prothétique 1, de forme circulaire ou semi-circulaire et comportant une ouverture dont le bord est joint de façon parfaitement étanche à la paroi du tube.  The collar 2 is a flat or conical element, of the same material as the prosthetic tube 1, of circular or semi-circular shape and comprising an opening whose edge is joined in a perfectly sealed manner to the wall of the tube.

Le diamètre de la collerette 2 sera nettement plus important que celui du tube prothétique 1 de façon à pouvoir faire face à tous les cas pouvant se présenter.  The diameter of the collar 2 will be significantly larger than that of the prosthetic tube 1 so as to be able to cope with any case that may arise.

par exemple pour une prothèse aortique d'un diamètre de 4 cm supérieur à celui de la prothèse.  for example for an aortic prosthesis with a diameter of 4 cm greater than that of the prosthesis.

Ainsi lorsqu'il y a un segment de vaisseau sanguin 3, 3' à remplacer avec une différence de diamètre d'amont et d'aval, le chirurgien choisit le diamètre de la prothèse égal au petit diamètre du vaisseau. Il réalise alors la suture bout à bout de façon parfaitement congruente puisque les diamètres du vaisseau et de la prothèse sont identiques.  Thus when there is a segment of blood vessel 3, 3 'to be replaced with a difference in diameter upstream and downstream, the surgeon chooses the diameter of the prosthesis equal to the small diameter of the vessel. He then performs the suture end to end in a perfectly congruent manner since the diameters of the vessel and of the prosthesis are identical.

Par contre pour le grand diamètre, il va suturer la collerette si son diamètre est adapté sinon, il peut la retailler au ciseau de façon à lui donner un diamètre exactement adapté à celui du vaisseau sanguin 3, 3' (figure 2). Le chirurgien va ainsi gagner du temps et la suture sera plus facile et étanche.  On the other hand, for the large diameter, it will suture the collar if its diameter is suitable otherwise, it can resize it with a chisel so as to give it a diameter exactly adapted to that of the blood vessel 3, 3 '(FIG. 2). The surgeon will thus save time and the suture will be easier and watertight.

Ce dispositif permet de s'adapter aisément à la forme du vaisseau; en 15 effet, s'il n'est pas parfaitement cylindrique comme cela est souvent le cas, la collerette sera découpée à la forme de la section du vaisseau.  This device makes it easy to adapt to the shape of the vessel; in fact, if it is not perfectly cylindrical as is often the case, the collar will be cut to the shape of the section of the vessel.

La prothèse vasculaire selon l'invention est particulièrement adaptée dans le cas d'interventions sur l'aorte 4 et permet d'intervenir dans des conditions très 20 satisfaisantes pour traiter des situations particulières telles que celles faisant l'objet des  The vascular prosthesis according to the invention is particularly suitable in the case of interventions on the aorta 4 and makes it possible to intervene under very satisfactory conditions to treat particular situations such as those subject to

exemples suivants:following examples:

- Dissection aortique, la prothèse comportant avantageusement un conduit de perfusion 5 permettant la connexion rapide avec la circulation extracorporelle (cf brevet N0 FR 01 12 642 déposé par l'auteur de la présente 25 demande). Les figures 3 et 4 montrent respectivement la partie ascendante d'une aorte 4 (côté coeur 6) sectionnée avant pose de la prothèse et après mise en place de cette dernière.  - Aortic dissection, the prosthesis advantageously comprising a perfusion conduit 5 allowing rapid connection with the extracorporeal circulation (cf. patent N0 FR 01 12 642 filed by the author of the present application). FIGS. 3 and 4 respectively show the ascending part of an aorta 4 (heart side 6) sectioned before fitting the prosthesis and after putting it in place.

- Anévrysme de l'aorte thoracique 7: la prothèse comporte non seulement un conduit de perfusion 5 mais également des branches 8 permettant une 30 connexion avec les dérivations 9 constituant le tronc artériel brachiocéphalique, la carotide gauche et la sous clavière gauche. (figure 5).  - Aneurysm of the thoracic aorta 7: the prosthesis comprises not only a perfusion duct 5 but also branches 8 allowing a connection with the leads 9 constituting the brachiocephalic arterial trunk, the left carotid and the left subclavian. (figure 5).

L'invention permet une opération en deux temps. Premier temps remplacement de la crosse aortique 10; Deuxième temps: remplacement de l'aorte thoracique 7 descendante (figure 6).  The invention allows an operation in two stages. First time replacement of the aortic arch 10; Second step: replacement of the descending thoracic aorta 7 (Figure 6).

- Anévrysme de l'aorte abdominale 11: quand l'anévrysme intéresse l'aorte abdominale et les artères iliaques, le chirurgien utilise une prothèse bifurquée ici, l'invention pourra être adaptée à la prothèse bifurquée 12 de façon à effectuer sa fixation sur l'aorte abdominale (Figure 7).  - Aneurysm of the abdominal aorta 11: when the aneurysm involves the abdominal aorta and the iliac arteries, the surgeon uses a bifurcated prosthesis here, the invention can be adapted to the bifurcated prosthesis 12 so as to effect its fixation on the abdominal aorta (Figure 7).

Lorsqu'une fuite de la valvule cardiaque aortique est associée à une aorte ascendante pathologique (anévrisme), il faut changer la valvule et remplacer l'aorte ascendante par une prothèse vasculaire.  When a leak of the aortic heart valve is associated with a pathological ascending aorta (aneurysm), the valve should be changed and the ascending aorta replaced by a vascular prosthesis.

Il existe des valves mécaniques suturées sur des prothèses 10 vasculaires. Par contre ce dispositif n'existe pas pour les valvules biologiques 13 (à base de tissus de porc ou de veau). En effet, les valvules biologiques sont conservées dans un produit liquide appelé glutamaldehyde qui altérerait la prothèse vasculaire, c'est pourquoi il n'existe pas de tube valvulé avec une bioprothèse.  There are mechanical valves sutured on vascular prostheses. On the other hand, this device does not exist for biological valves 13 (based on pork or calf tissue). Indeed, the biological valves are kept in a liquid product called glutamaldehyde which would alter the vascular prosthesis, this is why there is no valve tube with a bioprosthesis.

La prothèse vasculaire selon l'invention permet de réaliser un tube valvulé au moment de l'opération par le chirurgien.  The vascular prosthesis according to the invention makes it possible to produce a valve valve at the time of the operation by the surgeon.

Il faut une prothèse vasculaire dont le diamètre du tube prothétique 1 soit légèrement supérieur à celui de la valvule biologique (à titre indicatif, il faut une prothèse vasculaire de 26 mm de diamètre pour une valvule de 23 mm de diamètre.) 20 Ainsi le tube prothétique 1 se coiffe sur la valvule biologique 13 et la collerette 2 vient s'appliquer sur le coussin de suture 14 de la valvule constitué d'un anneau en "dacron" (figures 8 et 9).  A vascular prosthesis is required, the diameter of the prosthetic tube 1 being slightly greater than that of the biological valve (as a guide, a vascular prosthesis 26 mm in diameter is required for a valve 23 mm in diameter). Thus the tube prosthetic 1 is capped on the biological valve 13 and the flange 2 is applied to the suture cushion 14 of the valve consisting of a "dacron" ring (Figures 8 and 9).

Il ne reste plus au chirurgien qu'à suturer cet ensemble. Il y aura donc un conditionnement séparé de la valvule et de la 25 prothèse à collerette, un assemblage au moment de l'opération.  It only remains for the surgeon to suture this set. There will therefore be separate packaging of the valve and of the flange prosthesis, an assembly at the time of the operation.

La collerette pourra mesurer par exemple 1 cm de large. Après assemblage du tube et de la valvule 13, la suture sur le coeur 6 est effectuée de façon à ce que la collerette 2 de la prothèse vasculaire et le coussin de suture 14 de la valvule biologique 13 soient solidarisés lorsque les fils sont noués. 30 D'une manière générale, le dispositif selon l'invention peut être mis en place sur toute prothèse vasculaire de façon à ce que le chirurgien l'utilise si besoin est sinon, ne l'utilise pas. En effet, ce dispositif ne gène en rien l'utilisation de la prothèse de façon conventionnelle.  The collar can measure for example 1 cm wide. After assembly of the tube and the valve 13, the suture on the heart 6 is carried out so that the collar 2 of the vascular prosthesis and the suture cushion 14 of the biological valve 13 are secured when the threads are tied. In general, the device according to the invention can be placed on any vascular prosthesis so that the surgeon uses it if need be otherwise, does not use it. Indeed, this device does not interfere with the use of the prosthesis in a conventional manner.

Le positionnement des divers éléments constitutifs donne à l'objet de l'invention un maximum d'effets utiles qui n'avaient pas été, à ce jour, obtenus par des dispositifs similaires.  The positioning of the various constituent elements gives the object of the invention a maximum of useful effects which had not, to date, been obtained by similar devices.

Claims (1)

REVENDICATIONS 1 . Prothèse vasculaire permettant une adaptation aux différences de diamètre entre les deux extrémités d'un segment de vaisseau sanguin à remplacer, destinée en particulier aux interventions visant au remplacement par une prothèse d'une partie ou de la totalité de l'aorte, caractérisé par la combinaison d'un tube prothétique (1) et d'une 10 collerette (2) du même matériau s'étendant autour de la périphérie du dit tube prothétique dans un plan sensiblement perpendiculaire à l'axe de celui-ci, la collerette étant d'un diamètre relativement important par rapport à celui du tube prothétique (1) et comportant une ouverture dont le bord est joint de façon parfaitement étanche à la paroi du tube, à l'une des extrémités de celui-ci ou près de cette extrémité, de façon à 15 obtenir une prothèse vasculaire dont l'une des extrémités a un diamètre parfaitement adaptable à celui du vaisseau sanguin (3, 3'), la collerette pouvant être retaillée aux ciseaux par le chirurgien. 2 . Prothèse vasculaire selon la revendication 1, se caractérisant par 20 le fait que la collerette (2) est un élément plan. 3'. Prothèse vasculaire selon la revendication 1, se caractérisant par le fait que la collerette (2) est un élément conique. 40. Prothèse vasculaire selon l'une quelconque des revendications précédentes, se caractérisant par le fait que la collerette (2) est de forme semi-circulaire. 5C Prothèse vasculaire selon l'une quelconque des revendications 30 précédentes, se caractérisant par le fait que le tube prothétique (1) et la collerette (2) sont réalisés en matériau biocompatible tel que textile synthétique à base de polyester "Dacron" tissé ou tricoté, ou en matériau inerte souple à base de polytétra-fluoro-éthylène ("Goretex"). 6 . Prothèse vasculaire selon l'une quelconque des revendications précédentes, se caractérisant par le fait qu'elle est destinée aux interventions de dissection aortique et qu'elle comporte un conduit de perfusion (5) permettant la connexion rapide avec la circulation extracorporelle. 70. Prothèse vasculaire selon la revendication 6, se caractérisant par le fait qu'elle comporte des branches (8) permettant une connexion avec les dérivations (9) constituant le tronc artériel brachio-céphalique, la carotide gauche et la sous clavière gauche. 8 . Prothèse vasculaire selon l'une quelconque des revendications 1 à 5, se caractérisant par le fait qu'une de ses extrémités est bifurquée de façon à pouvoir l'utiliser pour relier l'aorte abdominale (11) aux artères iliaques. 1 5 9 . Prothèse vasculaire selon l'une quelconque des revendications 1 à 5, se caractérisant par le fait qu'elle est associée à une valvule biologique (13) et agencée de manière à permettre d'effectuer en une seule opération le changement de la valvule cardiaque et le remplacement de l'aorte ascendante par une prothèse vasculaire.CLAIMS 1. Vascular prosthesis allowing adaptation to the differences in diameter between the two ends of a segment of blood vessel to be replaced, intended in particular for interventions aimed at replacing a part or all of the aorta with a prosthesis, characterized by combination of a prosthetic tube (1) and a flange (2) of the same material extending around the periphery of said prosthetic tube in a plane substantially perpendicular to the axis thereof, the flange being d 'a relatively large diameter compared to that of the prosthetic tube (1) and comprising an opening whose edge is joined in a perfectly sealed manner to the wall of the tube, at one end thereof or near this end, so as to obtain a vascular prosthesis, one end of which has a diameter which is perfectly adaptable to that of the blood vessel (3, 3 ′), the collar being capable of being resized with scissors by the th surgeon. 2. Vascular prosthesis according to claim 1, characterized in that the flange (2) is a planar element. 3 '. Vascular prosthesis according to claim 1, characterized in that the collar (2) is a conical element. 40. Vascular prosthesis according to any one of the preceding claims, characterized in that the collar (2) is of semi-circular shape. 5C Vascular prosthesis according to any one of the preceding claims, characterized in that the prosthetic tube (1) and the collar (2) are made of biocompatible material such as woven or knitted polyester-based synthetic textile. , or in flexible inert material based on polytetrafluoroethylene ("Goretex"). 6. Vascular prosthesis according to any one of the preceding claims, characterized in that it is intended for aortic dissection interventions and that it comprises an infusion conduit (5) allowing rapid connection with the extracorporeal circulation. 70. Vascular prosthesis according to claim 6, characterized in that it comprises branches (8) allowing a connection with the leads (9) constituting the arterial brachiocephalic trunk, the left carotid artery and the left subclavian. 8. Vascular prosthesis according to any one of claims 1 to 5, characterized in that one of its ends is bifurcated so that it can be used to connect the abdominal aorta (11) to the iliac arteries. 1 5 9. Vascular prosthesis according to any one of claims 1 to 5, characterized in that it is associated with a biological valve (13) and arranged so as to allow the change of the heart valve to be carried out in a single operation and replacement of the ascending aorta with a vascular prosthesis. 1 0 . Prothèse vasculaire selon la revendication 9, se caractérisant par le fait que le diamètre du tube prothétique (1) est légèrement supérieur à celui de la valvule biologique (13) et qu'elle est agencée pour coiffer ladite valvule de façon à ce que la collerette (2) vient s'appliquer sur le coussin de suture (14) de la valvule pour 25 permettre de suturer l'ensemble sur le coeur (6) en assurant la solidarisation de ladite collerette et du dit coussin de suture lorsque les fils sont noués.  1 0. Vascular prosthesis according to claim 9, characterized in that the diameter of the prosthetic tube (1) is slightly greater than that of the biological valve (13) and that it is arranged to cap said valve so that the flange (2) is applied to the suture cushion (14) of the valve to allow the assembly to be sutured on the heart (6) while securing said collar and said suture cushion when the threads are tied .
FR0300500A 2003-01-17 2003-01-17 Vascular prosthesis has tube and collar for adapting to blood vessel ends of different diameters Withdrawn FR2850008A1 (en)

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