US3818511A - Medical prosthesis for ducts or conduits - Google Patents

Medical prosthesis for ducts or conduits Download PDF

Info

Publication number
US3818511A
US3818511A US30764172A US3818511A US 3818511 A US3818511 A US 3818511A US 30764172 A US30764172 A US 30764172A US 3818511 A US3818511 A US 3818511A
Authority
US
Grant status
Grant
Patent type
Prior art keywords
funnel
prosthesis
cannula
invention
end
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
Application number
Inventor
E Goldberg
S Bazell
R Ostensen
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
MEDICAL PROD CORP
Original Assignee
MEDICAL PROD CORP
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Grant date

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/36Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
    • A61M1/3621Extra-corporeal blood circuits
    • A61M1/3653Interfaces between patient blood circulation and extra-corporal blood circuit
    • A61M1/3655Arterio-venous shunts, fistulae
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/36Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
    • A61M1/3621Extra-corporeal blood circuits
    • A61M1/3653Interfaces between patient blood circulation and extra-corporal blood circuit
    • A61M1/3659Cannulae pertaining to extracorporeal circulation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1139Side-to-side connections, e.g. shunt or X-connections

Abstract

Medical prosthesis for ducts or conduits and method of manufacture. An exemplary embodiment is an arteriovenous shunt having a cannula terminated in a funnel in which the interior included angle ranges from 15* - 30*. The funnel is of an implantable, resilient silicone rubber into which a woven, flexible Dacron skirt is molded to enable suturing and tissue ingrowth at the anastomotic juncture. The silicone is of a medical type which is body tissue-compatible, and has sufficient elasticity and resilience to permit compliance during pulsatile fluid flow, storage and return of fluid kinetic energy, and accommodation to various sizes of vessels, ducts, or conduits. Actual experimental use shows improved results compared to prior types of tip-type cannulae.

Description

United States Patent [191 Goldberg et al.

[ MEDICAL PROSTHESIS FOR DUCTS OR CONDUITS [75] Inventors: Edward M. Goldberg, Glencoe;

Seymour Bazell, Skokie; Ralph G. Ostensen, Morton Grove, all of I11.

[73] Assignee: Medical Products Corporation,

Skokie, Ill.

22 Filed: Nov. 17, 1972 211 Appl. N01: 307,641

[52] US. Cl 3/1, 3/DIG. 1, 128/214 R, 128/334 R, 128/348, 264/257 [51] Int. Cl..... A6lf 1/24, A6lm 5/00, A6lm 25/00 [58] Field of Search 3/1, DIG. 1; 128/214 R, 128/214 B, 348, 334 R, 334 C, l R

[56] References Cited v UNITED STATES PATENTS 3,646,616 3/1972 Keshin 3/1 3,667,069 6/1972 Blackshear et a1. 3/1 3,713,441 1/1973 Thomas 128/214 R FOREIGN PATENTS OR APPLICATIONS 1,546,118 10/1968 France 3/1 OTHER PUBLICATIONS A Large-Vessel Applique A-V Shunt For Hemodial- June 25,1974

Primary Examiner-Richard A. Gaudet Assistant Examiner-Ronald L. Frinks Attorney, Agent, or Firm-Molinare, Allegretti, Newitt & Witcoff 5 7 ABSTRACT Medical prosthesis for ducts or conduits and method of manufacture. An exemplary embodiment is an arteriovenous shunt having a cannula terminated in a funnel in which the interior included angle ranges from 15 The funnel is of an implantable, resilient silicone rubber into which a woven, flexible Dacron skirt is molded to enable suturing and tissue ingrowth at the anastomotic juncture. The silicone is of a medical type which is body tissue-compatible, and has sufficient elasticity and resilience to permit compliance during pulsatile fluid flow, storage and return of fluid kinetic energy, and accommodation to various sizes of vessels, ducts, or conduits. Actual experimental use shows improved results compared to prior types of tip-type cannulae.

9 Claims, 7 Drawing Figures 24(CLOTH SKIRT) 6 (SHANK) (PUMA/5L 7 (CONNECTOR) 2 (cA/v/vuLA) MEDICAL PROSTHESIS FOR DUCTS OR CONDUITS FIELD OF THE INVENTION This invention is directed to an improved prosthesis for access to, and transport of ducted fluids, such as the vascular, lymphatic, reproductive, regulatory (e.g. glandular) or excretory systems, and repair, extension or access to other body ducts or tubes, such as tracheal, esophagogastrointestinal systems and the like. The invention also includes methods of manufacture of the prosthetic devices. More specifically, the invention is directed to a tipless, funnel-terminated, tubular prosthesis in which the interior angle of the funnel ranges from 30, which funnel is molded of high compliance, body tissue-compatible, flexible, resilient silicone rubber, and has molded therein a Dacron skirt for tissue ingrowth at the anastomotic junctions.

BACKGROUND OF THE INVENTION There is a clear need for artificial, implantable duct prosthesis for treatment or cure of various medical conditions in animals and humans. Examples include artificial veins or arteries used in treatment of circulatory conditions. Likewise repair of, or access to the GI. tract may employ artificial ducting. All of such ducting involves the connecting (anastomosing) of the ducts to body tissue, usually the natural duct which is being replaced or repaired, or connection to the organ or organs which communicate with the natural duct. Frequently the artificial duct prosthesis is led extracorporeally for treatment of the ducted fluid and return to the body, e.g. blood for dialysis in cases of kidney failure.

All such artificial duct prostheses pose serious medical problems at their anastomotic juncture within the body, for example juncture necrosis, chronic infection, leakage, thrombosis, stricture and the like. This invention is directed to an improved juncture prosthesis or duct terminus. The discussion which follows will be with reference to an arteriovenous shunt by way of example, but it is to be understood that the funnel prostheses of this invention may be applied to any artificial implantable duct, or to a natural duct that is being anastomosed to a natural or artificial duct, organ or tissue, as the case may be.

In the United States, approximately 50,000 persons each year suffer some degree of renal (kidney) failure. Of this number, fully percent, or 10,000 patients, can be helped by dialyzing the blood to remove the accumulated urea and other metabolic byproducts.

Kolff introduced direct dialysis of arterial blood, thereby employing arteriostatic pressure to assist in the dialysis. Quinten and Scribner developed an arteriovenous shunt system employing a tipped cannula sutured at 90 to an artery, tunneled subcutaneously, exited through the skin, and connected externally to a similar cannula which analogously was sutured to a vein. When hemodialysis was required, the shunt was disconnected externally and the arterial line was connected to the dialysis machine. The return line from the machine was connected to the venous cannula.

Such Quinten-Scribem shunts are often disfiguring and ineffective, complicated by frequency infections and thrombosis. The tips of the Scriber shunts are very inefficient, with significant turbulence, and low flow rates, which contribute to the thrombosis. The cannula tip is attached to the blood vessel by sutures, and causes juncture necrosis and strictures.

Results of using tip-type cannulae were reported by Baillod et al. at the 1969 meeting of the European Dialysis and Transplant Association, reported at Proc. Europ. Dialysis Transplant Assn., 6:65, 1969. 60 patients treated for more than one year exhibited arterial cannula survival of 13.5 months, during which an average of two and one half cannulae were required. Their venous cannulae survived an average of 8 /2 months, with four cannulae required per patient.

Problems with shunts led Brescia and Cimino to the innovation of the internal arteriovenous fistula which remains post-surgically subcutaneous. In this procedure, the side of an artery is sutured to the side of a vein to form a classical, side-by-side, h-shaped shunt. When dialysis is desired the shunt loop is punctured with hypodermic needles attached to the inlet and return lines of the dialysis machine.

However, the Brescia-Cimino internal A-V fistula is not without its serious problems. The use of the fistula requires training and skill in venipuncture, which frequently mitigates against home dialysis by the patient or other unskilled persons. After repeated punctures with large bore needles, hematomas, scarring, induration and false aneurysms-develop.

There is,therefore, a great need for improved juncture prostheses for ducts and conduits of all types, both internal and external shunts to provide for vascular access, and access to the lymphatic system, reproductive system, regulatory system, excretory system. G. I. system and the like or to other organs or implanted prostheses to or from which fluid (gas or liquid) transmittal is desired. The ducts should be readily established and perform continuously as long as needed. They must allow adequate fluid (e.g., blood) flow, be nonthrombogenic and free of infection. They should be easily declottable, and should be large enough to provide adequate fluid volume exit or input.

THE INVENTION OBJECTS It is among the objects of this invention to provide an improved duct juncture prosthesis which overcomes the above-described problems of the prior art tips and achieves the goals set forth for improved medical ducts, e.g., A-V shunts and the like.

It is another object to provide a juncture prosthesis for ducts which has fluid dynamics advantages, and presents improved survival expectancy.

It is another object to provide a funnel juncture prosthesis for ducts which may be used internally or externally, and which may be used for access to any body organ or tissue from any other, or from the exterior, and for transport of any fluid (gas or liquid) which is input, withdrawn, administered or monitored.

It is another object of this invention to provide a funnel juncture for a shunt prosthesis which exhibits low incidence of late failure, thrombosis, provides smooth transition from body organ, duct or tissue to the prosthesis, is simple to declot, has excellent flow rates, an absence of major clinical complications, and exhibits long survival.

Still other objects will be evident from the following summary and detailed description.

SUMMARY Our juncture prosthesis employs a tipless" cannula having a dacron-skirted silicone rubber funnel at an end for transmitting fluids across an anastomotic site. We have discovered that best hemodynamic and medical properties are obtained when the included angle of the funnel ranges from about 30, whether the funneledorifice is anastomosed end-to-end or at an acute angle to a body duct, organ or tissue. The flexibility, resilience and compliance of the silicone rubber is selected to permit sufficient elasticity to be responsive to natural pulsatile flow, and to store and return fluid kinetic energy. The funnel is also sufficiently elastic to be self-compensating within small angles, thus permitting anastomosis to vessels or ducts of varying size. The Dacron skirt permits tissue ingrowth with a pseudoendothelium and a fibrous adventitia which prevents buildup of fibrin at the anastomotic juncture. The juncture funnel prostheses of this invention are applicable to internal A.V. fistulae, arterialized vein shunts, external shunts, or to any situation where fluid (gas or liquid) is to be transferred to or from any body duct, organ or tissue to another, or to or from the exterior. Improved results are demonstrated by the prostheses of this invention.

BRIEF DESCRIPTION OF THE DRAWINGS The following detailed description makes reference to the FIGURES in which:

FIG. 1 illustrates in sectional view the funnel assembly for a cannula prosthesis in accordance with this invention;

FIG. 2 illustrates in sectional view a molding apparatus employed in the method of manufacture of the prostheses of this invention;

FIG. 3 shows in perspective a funnel assembly in accordance with this invention particularly useful for end-to-end anastomosis;

FIG. 4 shows in perspective a funnel assembly in accordance with this invention for acute angle anastomosis;

FIG. 5 shows an exemplary prosthesis of this invention in use; and

FIGS. 6a and 6b compare flow with the funnel prosthesis of this invention to prior art tipped" cannulae.

DETAILED DESCRIPTION Referring to FIGS. 1, 3 and 4, the prosthesis of this invention comprises a funnel assembly I mounted on a cannula tube 2. The funnel assembly in turn includes a cloth skirt 3, typically a sterile polyester (Dacron) cloth, for example, one about 0.007 inch thick, embedded in the walls of the funnel mouth portion 4 as at 5. The Dacron cloth may be flat or formed into a conical shape. Shank portion 6 connects the funnel mouth portion 4 with connector portion 7, into which is seated a cannula 2. The cannula 2 may be secured into connector portion 7 with cannula tip 8 abutting against shoulder 9 in a manner to provide a smooth interior passage at 10. We prefer to use a silicone cement 11 to join the tube 2 to the funnel assembly. The funnel walls may be tapered so that the mouth edge 4 is thinner and more flexible than the shank end portion 6. This flexibility permits a range of fit for various sized ducts or blood vessels, and compensates for pulsatile fluid flow by storage and return of kinetic energy.

Critical to our invention is the fact that the included angle 6, defined as the angle lying between the inner surfaces l2, 12' of the funnel mouth, is in the range of about 15 30. This provides a smooth transition of flow of fluids, e.g., blood, lymph, urine, oxygen or the like in either direction through the tipless cannula prosthesis, and improves system survival. In addition, the entrance energy loss using our prosthesis is tenfold less than a constant diameter orifice anastomosed end-toend to a duct. In such constant diameter juncture, the entrance loss is 0.5 (V /2g), where V is flow velocity and g is gravity. In our tipless funnel juncture prosthesis, the entrance loss is one tenth, that is, 0.05 (V /2g) for the same flow velocity.

In addition to the end-to-end anastomosis, we have found that the same type of funnel transition provided for by our tipless funnel cannulae is beneficial when anastomosing vessels end-to-end to ducts or cannulae. As seen in FIG. 6a in the prior art techniques employing tip-type cannulae 28, there is almost always a stric ture or sudden reduction 29 of the internal diameter of the vessel which is anastomosed to the body vessel or duct 30. This abrupt narrowing of the diameter results in frictional energy losses and boundary layer separation 31 contributing to hemolysis and the formation of thrombi whether the flow is converging or diverging. In addition, there is a pressure drop with up to 50 percent velocity head loss, occasioned by the use of such tiptype cannula. In contrast, as seen in FIG. 6b, end-toend anastomosis using the tipless funnel-type cannula l of this invention for either converging or diverging flow affords a smooth translation and flow 32, improves system survival, promotes more effective declotting, helps eliminate the buildup of fibrin at the junction of the cannula and vessel, and generally exhibits an absence of major clinical complications. We have been able to observe cannula survival of over two years, using the cannula of this invention.

The funnel juncture prosthesis, anastomosed to the arterial limb ofa fistula or any afferent flow duct, is the converging channel with a short graduated contraction of diameter. The converging channel or nozzle" refers to a channel system in which the velocity of the fluid is increased and the pressure is reduced. The fluid is accelerated in the converging channel and some pressure head is converted into velocity head. In general, this conversion is a stable process and can be made with few losses.

The prosthesis anastomosed to the venous limb of the fistula or any efferent flow duct is the diverging channel with a short gradual enlargement of diameter. The diverging channel or diffuser refers to a channel in which the velocity of fluid is decreased and the pressure is increased. The flow involves a conversion of velocity head to pressure head. As the fluid moves down stream, a greater boundary layer forms and grows in thickness. The fluid may not fill the channel completely, but separates by breaking away from the walls. This results in eddy formation and dissipation of energy by turbulent mixing. Flow in a diverging channel is more troublesome than flow in a converging nozzle and can be an unstable inefficient process.

In evaluating the efficiency of a diverging channel, it is necessary to consider the velocity variations across the channel. The diverging channel efficiency can be considered as a function of the total included angle of divergence (0). Theta represents a particular expansion ratio or ratio of final area to initial area. The efficiency is high (75 90 percent) in the region between 0 and 30. Beyond about 30, the efficiency decreases with an increase in the included angle.

We further have improved the system by the provision of flexibility and compliance so that in pulsatile flow, the juncture expands upon systoly storing kinetic energy, and delivers the energy to the fluid on diastoly.

Turning now to FIG. 2, this figure illustrates the method of construction of the funnel assembly of our invention. Mold 13 comprises a skirt holder plate 16 and body-forming plate 17. In manufacture, a core, ring or washer of Dacron cloth, a medical grade such as US. Catheter& Instrument Corp. No. 6103, is centered over the central aperture 19 in the body-forming plate 17. The Dacron cloth may be of any type which has sufficiently large mesh to permit complete inpregnation of the silicone rubber around the fibers. Thereafter, the skirt holder plate 16 is placed thereover to securely retain the Dacron skirt in position during molding. The skirt holder is shown as flat, but may be conical. Centering pins l8, 18 are inserted to secure the mold parts together, and the mold is then positioned on the bottom plate of the molding press. Centering pins 18 and 18 extend into recesses 20, 20 in the bottom plate of the press for proper centering of the shoulder-forming projection 21 in the mold aperture. A tubular slug of vinyl type silicone rubber molding compound, such as a Dow-Corning *Silastic" brand rubber MDX-445l2, is dropped into the mold aperture 19, and top press plate 14 is lowered into position to compression-mold the silicone rubber, for ten minutes at 260F. In the alternative, 21 fluorosilicone may be used; this type silicone rubber exhibits lesser clotting characteristics under dynamic flow conditions. The mold pin 22 projecting from the top press plate 14 forces the gum-like silicone rubber into the mold cavity. Optionally, the amount of the silicone rubber slug may be chosen so that there may be very small excess of the silicone rubber which extrudes into the cloth skirt beyond the outward edge of the funnel mount portion 4. This is best illustrated in FIG. 1 as zone 23. The extrusion of this silicone provides a zone for anchoring the sutures when anastomising the funnel mouth to the body vessel or duct. The funnel mouth walls 12, 12 are thus free of turbulence-causing sutures, yet there is a sufficient feather edge of silastic-impregnated Dacron to provide for proper suture anchorage while at the same time sealing against fluid loss. The outer edge of the Dacron skirt 24 is open mesh which providesfor tissue ingrowth. The excess skirt may be trimmed as desired to fit any given duct size. For a tipless funnel juncture prosthesis of 0.125 inch ID. and a funnel mouth opening of 0.250 inches, we employ approximately 0.1 gram of a silicone rubber slug for the molding.

After the compressionmolding for ten minutes at 260F., the funnel assembly part is extracted from the mold and inspected. Thereafter, the molded funnel assembly part is post-cured for four hours at 350F. All flashing is trimmed from the part, and after final inspection and washing, it is ready for assembly on a cannula tube. In assembling the cannula tube, a clean, transversely cut end of a cannula is painted on its exterior surface with a medical grade silicone rubber adhesive, such as Dow-Corning medical grade Silastic brand adhesive Type A, and inserted into the connector portion of the funnel assembly. Excess may build up and form a smooth transition shoulder, as 11, seen in FIG. 1. The final tipless funnel cannula prosthesis is best seen in FIGS. 3 and 4. FIG. 3 illustrates a prosthesis either for end-to-end anastomosis with a body vessel, duct, tissue or organ, or for end-to-side anastomosis. FIG. 4 shows a tipless funnel cannula prosthesis having an oval or eliptical-shaped funnel mouth which is oriented at an angle to the longitudinal axis of the shank and connector portions. This oblique funnel is particularly adapted for acute angle end-to-side anastomosis to body vessels, ducts, tissues or organs.

The method of employing the tipless funnel cannula of this invention may be seen with reference to FIG. 5. This description is in reference to providing vascular access to an arterialized vein although it should be understood that vascular access is merely exemplary of the more general use of the cannula of this invention. FIG. 5 shows the use, in a 2-step procedure, of our tipless funnel cannula where external access is required.

A suitably dilated arterialized vein 33 is selected for cannulation. This vessel is severed transversely at 34 and each end 35, 36 directly anastomosed to a tipless, funnel-shaped skirted cannula 37, 38 of this invention. The cannulae may be buried in subcutaneous tunnels 39 with open cell silicone rubber cuffs for fixation and seal. The exterior loop 40 of the cannula tube 2 may be adapted to come apart at collar 25 for attachment of the outlet segment 26 and inlet segment 27 to the inlet tube 41 and outlet tube 42 of the dialyzer 43.

Optionally, a direct fistula can be created by directly anastomising a cannula terminated at each end with a funnel prosthesis of this invention and utilizing a vein graft for juncture to the small artery. First, one end of a vein graft is anastomosed to an artery and the other end anastomised to the mouth of the funnel prosthesisterminated cannula. A vein is then selected for return flow to the heart and the distal branch of this vein anastomised to the funnel prosthesis at the other end of the cannula.

It is also possible to make a vein-to-vein shunt, as in a porto-canal shunt to reduce portal hypertension. In the same manner an artery-to-artery shunt can be performed (artery bypass). As above, for access to small vessels, we use a vein graft anastomosed to a funnel mouth, and for large vessels, we can directly anastomose our funnel juncture prosthesis thereto.

Fourteen or our new external fistula systems using tipless, funnel-skirted prostheses of this invention have been created for external circulatory access useful in chronic hemodialysis. The treatment periods range from 2 to 34 months. In all 14 patients flow exceeded 300 ml/min. Taken as a whole 13 of 14 systems have survived to date, representing an experience of 213 months with a mean survival of 15.2 months. The 14 arterial prostheses had a mean survival of 15.0 months; the 13 venous prostheses had a mean survival of [2.4 months. All arterial and venous prosthesis replacements have not been included in the above analysis. Expression of data in this manner, however, is unsatisfactory. Any series, with a number of patients having a short period of observation will, when calculated in this manner, result in spuriously low survival times. Thus, the survival times will actually be greater than the number of months calculated in the above manner.

If survival data are computed only from patients observed for more than 12 months, (including all failures even under 12 months), the recalculated mean survival times are as follows: for an arterial prosthesis 19.3 months, and for a venous prosthesis 15 months. This compares to 13.5 months (arterial) and 8.5 months (venous) for tipped cannulae of the prior art.

A more meaningful representation of circulatory access survival data would be to express it in terms of estimated survival curves calculated by standard life table techniques described by Merrell and Shulman Determination of Prognosis of Chronic Disease Illustrated by Systemic Lupus Erythematosus, .1. Chronic Dis. 1, (1955). The logarithm of the percent surviving is plotted against the duration in months. These curves are of course provisional since the numbers are small. They show the expected survival of an arterial prosthesis is 80 percent, and for the venous prosthesis about 50 percent under these circumstances.

It is to be understood that various modifications within the scope of this invention can be made by one of ordinary skill in the art without departing from the spirit thereof. We therefore wish our invention to be defined by the scope of the appended claims as broadly as the prior will permit, and in view of this specification if need be.

We claim:

1. A medical prosthesis for providing vascular access to an arterialized vein which comprises:

a. a cannula;

b. a funnel assembly secured to an end of said cannula, said funnel assembly comprising: i. a connector portion connected to said cannula;

ii. a funnel portion with walls having an included interior angle ranging from about 15 to 30, said walls tapering to a smaller thickness at the mouth 8 of the funnel;

c. said funnel assembly being a tissue compatible, silicone rubber with sufficient flexibility and compliance so that in pulsatile flow, the funnel walls expand upon systole and deliver energy during diastole;

d. a flexible fabric skirt embedded in the walls of said funnel portion and extending outward from the edges of the funnel mouth a distance sufficient to provide for tissue growth therein and to connect the prosthesis through the skirt to a vein or artery.

2. A prosthesis as in claim 1 wherein a plane defined by the distal edge of said funnel mouth portion is ori ented at an angle to the longitudinal axis of said connector portion to provide an elliptical funnel mouth.

3. A prosthesis as in claim 1 wherein a plane defined by the distal edge of said funnel mouth is oriented at substantially a angle to the longitudinal axis of said connector portion.

4. A prosthesis as in claim 1 where a portion of said fabric adjacent said funnel mouth is impregnated with silicone rubber to provide suture anchorage for anastomosis.

5. A prosthesis as in claim 1 wherein said connector portion comprises a collar having an inner diameter suitable for fitting over said cannula and a shoulder to abut the end of said cannula,

6. A prosthesis as in claim 1 wherein said cannula is a body tissue compatible tube.

7. A prosthesis as in claim 6 wherein each end of said cannula has a funnel assembly secured thereto.

8. A prosthesis as in claim 6 wherein said cannula is silicone rubber.

9. A prosthesis as in claim 1 wherein said silicone rubber is a fluorosilicone rubber.

Claims (9)

1. A medical prosthesIs for providing vascular access to an arterialized vein which comprises: a. a cannula; b. a funnel assembly secured to an end of said cannula, said funnel assembly comprising; i. a connector portion connected to said cannula; ii. a funnel portion with walls having an included interior angle ranging from about 15* to 30, said walls tapering to a smaller thickness at the mouth of the funnel; c. said funnel assembly being a tissue compatible, silicone rubber with sufficient flexibility and compliance so that in pulsatile flow, the funnel walls expand upon systole and deliver energy during diastole; d. a flexible fabric skirt embedded in the walls of said funnel portion and extending outward from the edges of the funnel mouth a distance sufficient to provide for tissue growth therein and to connect the prosthesis through the skirt to a vein or artery.
2. A prosthesis as in claim 1 wherein a plane defined by the distal edge of said funnel mouth portion is oriented at an angle to the longitudinal axis of said connector portion to provide an elliptical funnel mouth.
3. A prosthesis as in claim 1 wherein a plane defined by the distal edge of said funnel mouth is oriented at substantially a 90* angle to the longitudinal axis of said connector portion.
4. A prosthesis as in claim 1 where a portion of said fabric adjacent said funnel mouth is impregnated with silicone rubber to provide suture anchorage for anastomosis.
5. A prosthesis as in claim 1 wherein said connector portion comprises a collar having an inner diameter suitable for fitting over said cannula and a shoulder to abut the end of said cannula.
6. A prosthesis as in claim 1 wherein said cannula is a body tissue compatible tube.
7. A prosthesis as in claim 6 wherein each end of said cannula has a funnel assembly secured thereto.
8. A prosthesis as in claim 6 wherein said cannula is silicone rubber.
9. A prosthesis as in claim 1 wherein said silicone rubber is a fluorosilicone rubber.
US3818511A 1972-11-17 1972-11-17 Medical prosthesis for ducts or conduits Expired - Lifetime US3818511A (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
US3818511A US3818511A (en) 1972-11-17 1972-11-17 Medical prosthesis for ducts or conduits

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
US3818511A US3818511A (en) 1972-11-17 1972-11-17 Medical prosthesis for ducts or conduits

Publications (1)

Publication Number Publication Date
US3818511A true US3818511A (en) 1974-06-25

Family

ID=23190595

Family Applications (1)

Application Number Title Priority Date Filing Date
US3818511A Expired - Lifetime US3818511A (en) 1972-11-17 1972-11-17 Medical prosthesis for ducts or conduits

Country Status (1)

Country Link
US (1) US3818511A (en)

Cited By (111)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3882862A (en) * 1974-01-11 1975-05-13 Olga Berend Arteriovenous shunt
US4217664A (en) * 1979-02-02 1980-08-19 Faso Joseph M Prosthesis and method for creating a stoma
US4318401A (en) * 1980-04-24 1982-03-09 President And Fellows Of Harvard College Percutaneous vascular access portal and catheter
US4405305A (en) * 1980-10-27 1983-09-20 University Of Utah Research Foundation Subcutaneous peritoneal injection catheter
US4557724A (en) * 1981-02-17 1985-12-10 University Of Utah Research Foundation Apparatus and methods for minimizing cellular adhesion on peritoneal injection catheters
US4559033A (en) * 1980-10-27 1985-12-17 University Of Utah Research Foundation Apparatus and methods for minimizing peritoneal injection catheter obstruction
US4693704A (en) * 1982-10-12 1987-09-15 Sumitomo Bakelite Company Limited Cervical canal catheter
US4719916A (en) * 1983-10-03 1988-01-19 Biagio Ravo Intraintestinal bypass tube
US4854316A (en) * 1986-10-03 1989-08-08 Davis Emsley A Apparatus and method for repairing and preventing para-stomal hernias
US4905693A (en) * 1983-10-03 1990-03-06 Biagio Ravo Surgical method for using an intraintestinal bypass graft
WO1991019522A1 (en) * 1990-06-14 1991-12-26 Baxter International Inc. Needle assembly for reduced coagulation
US5084064A (en) * 1989-06-15 1992-01-28 Abiomed Cardiovascular, Inc. Surgical cuff
US5234006A (en) * 1991-01-18 1993-08-10 Eaton Alexander M Adjustable sutures and method of using the same
US5236446A (en) * 1988-03-02 1993-08-17 Dumon Jean Francois Tubular endoprosthesis for anatomical conduits
US5389088A (en) * 1991-11-14 1995-02-14 Hageman; Marinus J. Grommet
US5413597A (en) * 1990-12-29 1995-05-09 Krajicek; Milan Three-layer vascular prostheses
US5425761A (en) * 1990-11-21 1995-06-20 Lundgren; Dan Implant with a through passage
US5425739A (en) * 1989-03-09 1995-06-20 Avatar Design And Development, Inc. Anastomosis stent and stent selection system
US5456712A (en) * 1991-07-03 1995-10-10 Maginot; Thomas J. Graft and stent assembly
US5480434A (en) * 1993-07-13 1996-01-02 The University Of Miami Method and device for connecting biological duct to a prosthesis
US5667486A (en) * 1993-04-27 1997-09-16 Ams Medinvent, S.A. Prostatic stent
US5676696A (en) * 1995-02-24 1997-10-14 Intervascular, Inc. Modular bifurcated intraluminal grafts and methods for delivering and assembling same
US5693088A (en) * 1993-11-08 1997-12-02 Lazarus; Harrison M. Intraluminal vascular graft
WO1998044869A1 (en) * 1997-04-05 1998-10-15 The Queen's University Of Belfast Haemodynamic control device
WO1998050093A1 (en) * 1997-05-02 1998-11-12 United States Surgical Corporation Trocar seal system
US5911757A (en) * 1991-05-16 1999-06-15 Seare, Jr.; William J. Methods and apparatus for transcutaneous access
US5922019A (en) * 1995-11-27 1999-07-13 Schneider (Europe) A.G. Conical stent
US5989287A (en) * 1998-05-06 1999-11-23 Av Healing Llc Vascular graft assemblies and methods for implanting same
US6022312A (en) * 1995-05-05 2000-02-08 Chaussy; Christian Endosphincter, set for releasable closure of the urethra and method for introduction of an endosphincter into the urethra
US6086553A (en) * 1999-07-01 2000-07-11 Akbik; Mohamad J. Arteriovenous shunt
US6261255B1 (en) * 1998-11-06 2001-07-17 Ronald Jay Mullis Apparatus for vascular access for chronic hemodialysis
US6338724B1 (en) * 1999-03-29 2002-01-15 Christos D. Dossa Arterio-venous interconnection
US6355020B1 (en) * 1995-07-07 2002-03-12 Gerald G. Bousquet Transcutaneous access device
US6395019B2 (en) 1998-02-09 2002-05-28 Trivascular, Inc. Endovascular graft
WO2002054987A2 (en) * 2000-12-21 2002-07-18 Sulzer Carbomedics Inc. Prosthetic graft device with ventricular apex attachment apparatus
US6582409B1 (en) * 1997-02-07 2003-06-24 Graftcath, Inc. Hemodialysis and vascular access systems
US6585762B1 (en) 2000-08-10 2003-07-01 Paul Stanish Arteriovenous grafts and methods of implanting the same
US6589278B1 (en) 1997-05-17 2003-07-08 Impra, Inc. Vascular prosthesis
US20030236567A1 (en) * 2002-06-25 2003-12-25 Scimed Life Systems, Inc. Implantable prosthesis with displaceabe skirt
US20040073282A1 (en) * 2001-08-06 2004-04-15 Paul Stanish Distally-narrowed vascular grafts and methods of using same for making artery-to-vein and artery-to-artery connections
US20040098086A1 (en) * 1994-02-09 2004-05-20 George Goicoechea Bifurcated endoluminal prosthesis
US20040106942A1 (en) * 2002-12-02 2004-06-03 Applied Medical Resources Corporation Universal access seal
US6746480B2 (en) * 1998-12-08 2004-06-08 Bard Peripheral Vascular, Inc. Flanged graft for end-to-side anastomosis
US6821295B1 (en) * 2000-06-26 2004-11-23 Thoratec Corporation Flared coronary artery bypass grafts
US20050125071A1 (en) * 2002-03-11 2005-06-09 Oded Nahleili Polymeric stent useful for the treatment of the salivary gland ducts and method for using the same
US20050137614A1 (en) * 2003-10-08 2005-06-23 Porter Christopher H. System and method for connecting implanted conduits
US20060030935A1 (en) * 1996-02-28 2006-02-09 Bard Peripheral Vascular, Inc. Flanged graft for end-to-side anastomosis
US20060064159A1 (en) * 2003-10-08 2006-03-23 Porter Christopher H Device and method for vascular access
US20060161173A1 (en) * 1991-07-03 2006-07-20 Maginot Thomas J Endoscopic bypass grafting method utilizing an inguinal approach
US20060225747A1 (en) * 1991-07-03 2006-10-12 Maginot Thomas J Vessel grafting method
US7147661B2 (en) 2001-12-20 2006-12-12 Boston Scientific Santa Rosa Corp. Radially expandable stent
US7147660B2 (en) 2001-12-20 2006-12-12 Boston Scientific Santa Rosa Corp. Advanced endovascular graft
US20070005128A1 (en) * 2005-07-01 2007-01-04 C. R. Bard, Inc. Flanged graft with trim lines
WO2007011689A2 (en) * 2005-07-15 2007-01-25 The Brigham And Women's Hospital, Inc. Sterile access conduit
US20070100425A1 (en) * 2000-05-30 2007-05-03 Jacques Sequin Noncylindrical stent deployment system for treating vascular bifurcations
US20070167901A1 (en) * 2005-11-17 2007-07-19 Herrig Judson A Self-sealing residual compressive stress graft for dialysis
US7252680B2 (en) 2001-04-18 2007-08-07 Alveolus, Inc. Removable essentially cylindrical implants
WO2008014752A1 (en) * 2006-08-02 2008-02-07 Michael Heise Tubular vascular transplant
US20080039878A1 (en) * 2006-07-06 2008-02-14 Williams Michael S Systems and methods for restoring function of diseased bowel
US20080195125A1 (en) * 2007-02-12 2008-08-14 Hoffman Grant T Device for heart bypass surgery and anastomosis
US20090005802A1 (en) * 2007-06-29 2009-01-01 Applied Medical Technology, Inc. Molded and undivided medical penetrating device
US20090012521A1 (en) * 2007-07-06 2009-01-08 Howmedica Osteonics Corp. Augmentation delivery device
US20090036817A1 (en) * 2007-08-02 2009-02-05 Bio Connect Systems Implantable flow connector
US20090062717A1 (en) * 2006-03-02 2009-03-05 Laufer Michael D Gastrointestinal implant and methods for use
US7527644B2 (en) 2002-11-05 2009-05-05 Alveolus Inc. Stent with geometry determinated functionality and method of making the same
US20090143759A1 (en) * 2007-11-30 2009-06-04 Jacques Van Dam Methods, Devices, Kits and Systems for Defunctionalizing the Cystic Duct
US7547321B2 (en) 2001-07-26 2009-06-16 Alveolus Inc. Removable stent and method of using the same
US7637942B2 (en) 2002-11-05 2009-12-29 Merit Medical Systems, Inc. Coated stent with geometry determinated functionality and method of making the same
US20100069819A1 (en) * 2003-10-17 2010-03-18 Laufer Michael D Minimally invasive gastrointestinal bypass
US20100130995A1 (en) * 2008-11-26 2010-05-27 Phraxis Inc. Anastomotic connector
US7731654B2 (en) 2005-05-13 2010-06-08 Merit Medical Systems, Inc. Delivery device with viewing window and associated method
US20100191167A1 (en) * 2006-03-02 2010-07-29 Lytn Gastrointestinal implant and methods for use
US7803178B2 (en) 2004-01-30 2010-09-28 Trivascular, Inc. Inflatable porous implants and methods for drug delivery
US20100256776A1 (en) * 2005-01-19 2010-10-07 Gi Dynamics, Inc. Eversion Resistant Sleeves
US20100280598A1 (en) * 2007-12-27 2010-11-04 C.R. Bard, Inc. Vascular graft prosthesis having a reinforced margin for enhanced anastomosis
US20100312164A1 (en) * 2008-01-28 2010-12-09 Peter Forsell Implantable drainage device
US20100312163A1 (en) * 2008-01-28 2010-12-09 Peter Forsell Implantable fluid movement device
US7875068B2 (en) 2002-11-05 2011-01-25 Merit Medical Systems, Inc. Removable biliary stent
US7887579B2 (en) 2004-09-29 2011-02-15 Merit Medical Systems, Inc. Active stent
US20110054381A1 (en) * 2009-05-29 2011-03-03 Jacques Van Dam Biliary shunts, delivery systems, and methods of using the same
US7959671B2 (en) 2002-11-05 2011-06-14 Merit Medical Systems, Inc. Differential covering and coating methods
US20110184329A1 (en) * 2010-01-22 2011-07-28 Valentin Kramer Composite Arterial-Venous Shunt System
US8066755B2 (en) 2007-09-26 2011-11-29 Trivascular, Inc. System and method of pivoted stent deployment
US8079973B2 (en) 2008-03-05 2011-12-20 Hemosphere Inc. Vascular access system
US8083789B2 (en) 2007-11-16 2011-12-27 Trivascular, Inc. Securement assembly and method for expandable endovascular device
WO2012018917A1 (en) * 2010-08-03 2012-02-09 World Heart Corporation Conformal cannula device and related methods
US20120116315A1 (en) * 2010-11-08 2012-05-10 Klepac Steven R Vascular access port and catheter
US8226701B2 (en) 2007-09-26 2012-07-24 Trivascular, Inc. Stent and delivery system for deployment thereof
US8231667B2 (en) 2002-11-08 2012-07-31 Jacques Séguin Endoprosthesis for vascular bifurcation
WO2012122220A1 (en) * 2011-03-08 2012-09-13 W.L. Gore & Associates, Inc. Medical device for use with a stoma
US8282591B2 (en) 2004-03-29 2012-10-09 Iftikhar Khan Hybrid arteriovenous shunt
US20120259157A9 (en) * 2010-09-07 2012-10-11 Spence Paul A Cannula Systems and Methods
US8328861B2 (en) 2007-11-16 2012-12-11 Trivascular, Inc. Delivery system and method for bifurcated graft
US8382664B2 (en) 2007-06-29 2013-02-26 Applied Medical Technology, Inc. Molded and undivided medical penetrating device
US20130282103A1 (en) * 2012-04-23 2013-10-24 The Charlotte-Mecklenburg Hospital Authority D/B/A Carolinas Healthcare System Hybrid graft for therapy of aortic pathology and associated method
US8663309B2 (en) 2007-09-26 2014-03-04 Trivascular, Inc. Asymmetric stent apparatus and method
US8728143B2 (en) 1996-06-06 2014-05-20 Biosensors International Group, Ltd. Endoprosthesis deployment system for treating vascular bifurcations
WO2015023460A1 (en) * 2013-08-13 2015-02-19 Cryolife, Inc. Systems and methods for a fluid carrying conduit of a vascular access system
US8992595B2 (en) 2012-04-04 2015-03-31 Trivascular, Inc. Durable stent graft with tapered struts and stable delivery methods and devices
US9101501B2 (en) 1996-06-06 2015-08-11 Biosensors International Group, Ltd. Bifurcation stent and method of positioning in a body lumen
RU2561864C2 (en) * 2010-06-25 2015-09-10 Антонио САМБУССЕТИ Prosthesis of orthotopic artificial urinary bladder
US9278172B2 (en) 2011-09-06 2016-03-08 Cryolife, Inc. Vascular access system with connector
US9282967B2 (en) 2007-08-02 2016-03-15 Bioconnect Systems, Inc. Implantable flow connector
US9308311B2 (en) 2011-06-15 2016-04-12 Phraxis, Inc. Arterial venous spool anchor
EP2432423B1 (en) * 2009-05-21 2016-09-21 Massimiliano Gessaroli Improved vascular prosthesis and relevant method for realising thereof
US9498363B2 (en) 2012-04-06 2016-11-22 Trivascular, Inc. Delivery catheter for endovascular device
RU2605146C2 (en) * 2011-03-11 2016-12-20 Антонио САМБУССЕТИ Hemisphere for bladder expansion in patients with low compliance
US9585991B2 (en) 2012-10-16 2017-03-07 Heartware, Inc. Devices, systems, and methods for facilitating flow from the heart to a blood pump
US9814869B1 (en) 1999-06-15 2017-11-14 C.R. Bard, Inc. Graft-catheter vascular access system
US9913661B2 (en) 2014-08-04 2018-03-13 Cook Medical Technologies Llc Medical devices having a releasable tubular member and methods of using the same
US9974563B2 (en) 2014-05-28 2018-05-22 Cook Medical Technologies Llc Medical devices having a releasable member and methods of using the same

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR1546118A (en) * 1966-11-29 1968-11-15 Chirana Zd Y Zdravotnicke Tech prosthesis gastrostomy
US3646616A (en) * 1969-07-23 1972-03-07 Jesse G Keshin Prosthesis for implanting around a body duct such as the urethra and method of treating urinary incontinence
US3667069A (en) * 1970-03-27 1972-06-06 Univ Minnesota Jet pump cardiac replacement and assist device and method of at least partially replacing a disabled right heart
US3713441A (en) * 1970-10-22 1973-01-30 Battelle Development Corp Method of using an artery vein shunt applique

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR1546118A (en) * 1966-11-29 1968-11-15 Chirana Zd Y Zdravotnicke Tech prosthesis gastrostomy
US3646616A (en) * 1969-07-23 1972-03-07 Jesse G Keshin Prosthesis for implanting around a body duct such as the urethra and method of treating urinary incontinence
US3667069A (en) * 1970-03-27 1972-06-06 Univ Minnesota Jet pump cardiac replacement and assist device and method of at least partially replacing a disabled right heart
US3713441A (en) * 1970-10-22 1973-01-30 Battelle Development Corp Method of using an artery vein shunt applique

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
A Large Vessel Applique A V Shunt For Hemodialysis by G. I. Thomas, Transactions Amer. Soc. Artif. Internal Organs, Vol. 15, 1969, pages 288 292. *

Cited By (202)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3882862A (en) * 1974-01-11 1975-05-13 Olga Berend Arteriovenous shunt
US4217664A (en) * 1979-02-02 1980-08-19 Faso Joseph M Prosthesis and method for creating a stoma
US4318401A (en) * 1980-04-24 1982-03-09 President And Fellows Of Harvard College Percutaneous vascular access portal and catheter
US4405305A (en) * 1980-10-27 1983-09-20 University Of Utah Research Foundation Subcutaneous peritoneal injection catheter
US4559033A (en) * 1980-10-27 1985-12-17 University Of Utah Research Foundation Apparatus and methods for minimizing peritoneal injection catheter obstruction
US4557724A (en) * 1981-02-17 1985-12-10 University Of Utah Research Foundation Apparatus and methods for minimizing cellular adhesion on peritoneal injection catheters
US4693704A (en) * 1982-10-12 1987-09-15 Sumitomo Bakelite Company Limited Cervical canal catheter
US4719916A (en) * 1983-10-03 1988-01-19 Biagio Ravo Intraintestinal bypass tube
US4905693A (en) * 1983-10-03 1990-03-06 Biagio Ravo Surgical method for using an intraintestinal bypass graft
US4854316A (en) * 1986-10-03 1989-08-08 Davis Emsley A Apparatus and method for repairing and preventing para-stomal hernias
US5236446A (en) * 1988-03-02 1993-08-17 Dumon Jean Francois Tubular endoprosthesis for anatomical conduits
US5425739A (en) * 1989-03-09 1995-06-20 Avatar Design And Development, Inc. Anastomosis stent and stent selection system
US5084064A (en) * 1989-06-15 1992-01-28 Abiomed Cardiovascular, Inc. Surgical cuff
WO1991019522A1 (en) * 1990-06-14 1991-12-26 Baxter International Inc. Needle assembly for reduced coagulation
US5425761A (en) * 1990-11-21 1995-06-20 Lundgren; Dan Implant with a through passage
US5413597A (en) * 1990-12-29 1995-05-09 Krajicek; Milan Three-layer vascular prostheses
US5234006A (en) * 1991-01-18 1993-08-10 Eaton Alexander M Adjustable sutures and method of using the same
US5911757A (en) * 1991-05-16 1999-06-15 Seare, Jr.; William J. Methods and apparatus for transcutaneous access
US5456712A (en) * 1991-07-03 1995-10-10 Maginot; Thomas J. Graft and stent assembly
US20060225747A1 (en) * 1991-07-03 2006-10-12 Maginot Thomas J Vessel grafting method
US6401721B1 (en) 1991-07-03 2002-06-11 Cardiothoracic Systems, Inc. Endoscopic bypass grafting method utilizing an inguinal approach
US7597697B1 (en) * 1991-07-03 2009-10-06 Boston Scientific Scimed, Inc. Bypass grafting method
US5979455A (en) * 1991-07-03 1999-11-09 Maginot Vascular Systems Method for directing blood flow in the body of a patient with a graft and stent assembly
US5934286A (en) * 1991-07-03 1999-08-10 Maginot Vascular Systems Bypass grafting method which uses a number of balloon catheters to inhibit blood flow to an anastomosis site
US7753946B2 (en) * 1991-07-03 2010-07-13 Boston Scientific Scimed, Inc. Bypass grafting system and apparatus
US6599313B1 (en) 1991-07-03 2003-07-29 Cardiothoracic Systems, Inc. Extravascular bypass grafting method utilizing an intravascular approach
US20070129662A1 (en) * 1991-07-03 2007-06-07 Maginot Thomas J Bypass Grafting System and Apparatus
US20060161173A1 (en) * 1991-07-03 2006-07-20 Maginot Thomas J Endoscopic bypass grafting method utilizing an inguinal approach
US5389088A (en) * 1991-11-14 1995-02-14 Hageman; Marinus J. Grommet
US5667486A (en) * 1993-04-27 1997-09-16 Ams Medinvent, S.A. Prostatic stent
US5480434A (en) * 1993-07-13 1996-01-02 The University Of Miami Method and device for connecting biological duct to a prosthesis
US5693088A (en) * 1993-11-08 1997-12-02 Lazarus; Harrison M. Intraluminal vascular graft
US20040098086A1 (en) * 1994-02-09 2004-05-20 George Goicoechea Bifurcated endoluminal prosthesis
US7780720B2 (en) * 1994-02-09 2010-08-24 Scimed Life Systems, Inc. Bifurcated endoluminal prosthesis
US20040098115A1 (en) * 1994-02-09 2004-05-20 George Goicoechea Bifurcated endoluminal prosthesis
US7942919B2 (en) 1994-02-09 2011-05-17 Scimed Life Systems, Inc. Bifurcated endoluminal prosthesis
US7901449B2 (en) 1994-02-09 2011-03-08 Scimed Life Systems, Inc. Bifurcated endoluminal prosthesis
US5676696A (en) * 1995-02-24 1997-10-14 Intervascular, Inc. Modular bifurcated intraluminal grafts and methods for delivering and assembling same
US5683449A (en) * 1995-02-24 1997-11-04 Marcade; Jean Paul Modular bifurcated intraluminal grafts and methods for delivering and assembling same
US6022312A (en) * 1995-05-05 2000-02-08 Chaussy; Christian Endosphincter, set for releasable closure of the urethra and method for introduction of an endosphincter into the urethra
US6355020B1 (en) * 1995-07-07 2002-03-12 Gerald G. Bousquet Transcutaneous access device
US6818015B2 (en) 1995-11-27 2004-11-16 Schneider (Europe) Gmbh Conical stent
US6533810B2 (en) 1995-11-27 2003-03-18 Schneider (Europe) Ag Conical stent
US5922019A (en) * 1995-11-27 1999-07-13 Schneider (Europe) A.G. Conical stent
US6283992B1 (en) 1995-11-27 2001-09-04 Schneider (Europe) Gmbh Conical stent
US20030139804A1 (en) * 1995-11-27 2003-07-24 Schneider (Europe) Ag, A/K/A Schneider (Europe) Gmbh Conical stent
US9028539B2 (en) 1996-02-28 2015-05-12 Bard Peripheral Vascular, Inc. Flanged graft for end-to-side anastomosis
US20060030935A1 (en) * 1996-02-28 2006-02-09 Bard Peripheral Vascular, Inc. Flanged graft for end-to-side anastomosis
US8603157B2 (en) 1996-06-06 2013-12-10 Biosensors International Group, Ltd. Endoprosthesis deployment methods for treating vascular bifurcations
US9101501B2 (en) 1996-06-06 2015-08-11 Biosensors International Group, Ltd. Bifurcation stent and method of positioning in a body lumen
US8728143B2 (en) 1996-06-06 2014-05-20 Biosensors International Group, Ltd. Endoprosthesis deployment system for treating vascular bifurcations
USRE41448E1 (en) 1997-02-07 2010-07-20 Hemosphere, Inc. Squitieri hemodialysis and vascular access systems
US6582409B1 (en) * 1997-02-07 2003-06-24 Graftcath, Inc. Hemodialysis and vascular access systems
USRE44639E1 (en) 1997-02-07 2013-12-10 Hemosphere, Inc. Hemodialysis and vascular access system
WO1998044869A1 (en) * 1997-04-05 1998-10-15 The Queen's University Of Belfast Haemodynamic control device
US20040111060A1 (en) * 1997-05-02 2004-06-10 Racenet David C. Trocar seal system
US8267898B2 (en) 1997-05-02 2012-09-18 Tyco Healthcare Group Lp Trocar seal system
US8002934B2 (en) 1997-05-02 2011-08-23 Tyco Healthcare Group Lp Trocar seal system
US7896846B2 (en) 1997-05-02 2011-03-01 Tyco Healthcare Group Lp Trocar seal system
US8702657B2 (en) 1997-05-02 2014-04-22 Covidien Lp Trocar seal system
US8192405B2 (en) 1997-05-02 2012-06-05 Tyco Healthcare Group Lp Trocar seal system
WO1998050093A1 (en) * 1997-05-02 1998-11-12 United States Surgical Corporation Trocar seal system
US20040064181A1 (en) * 1997-05-17 2004-04-01 Impra, Inc., A Subsidiary Of C.R. Bard, Inc. Vascular prosthesis
US9445886B2 (en) * 1997-05-17 2016-09-20 Bard Peripheral Vascular, Inc. Vascular prosthesis
US6589278B1 (en) 1997-05-17 2003-07-08 Impra, Inc. Vascular prosthesis
US7615071B2 (en) 1998-02-09 2009-11-10 Trivascular2, Inc. Endovascular graft
US6395019B2 (en) 1998-02-09 2002-05-28 Trivascular, Inc. Endovascular graft
US9867727B2 (en) 1998-02-09 2018-01-16 Trivascular, Inc. Endovascular graft
US8361136B2 (en) 1998-02-09 2013-01-29 Trivascular, Inc. Endovascular graft
US8801769B2 (en) 1998-02-09 2014-08-12 Trivascular, Inc. Endovascular graft
US7081129B2 (en) 1998-02-09 2006-07-25 Boston Scientific Santa Rosa Corp. Endovascular graft
US6371981B1 (en) 1998-05-06 2002-04-16 Av Healing Llc Vascular graft assemblies and methods for implanting same
US5989287A (en) * 1998-05-06 1999-11-23 Av Healing Llc Vascular graft assemblies and methods for implanting same
US6261255B1 (en) * 1998-11-06 2001-07-17 Ronald Jay Mullis Apparatus for vascular access for chronic hemodialysis
US7553316B2 (en) 1998-12-08 2009-06-30 Bard Peripheral Vascular, Inc. Flanged graft for end-to-side anastomosis
US6746480B2 (en) * 1998-12-08 2004-06-08 Bard Peripheral Vascular, Inc. Flanged graft for end-to-side anastomosis
US20040210302A1 (en) * 1998-12-08 2004-10-21 Bard Peripheral Vascular Flanged graft for end-to-side anastomosis
US6338724B1 (en) * 1999-03-29 2002-01-15 Christos D. Dossa Arterio-venous interconnection
US9814869B1 (en) 1999-06-15 2017-11-14 C.R. Bard, Inc. Graft-catheter vascular access system
US6086553A (en) * 1999-07-01 2000-07-11 Akbik; Mohamad J. Arteriovenous shunt
US7686845B2 (en) 2000-05-30 2010-03-30 Devax, Inc. Noncylindrical stent deployment system for treating vascular bifurcations
US8236041B2 (en) 2000-05-30 2012-08-07 Biosensors International Group, Ltd. Noncylindrical stent deployment system for treating vascular bifurcations
US20070100425A1 (en) * 2000-05-30 2007-05-03 Jacques Sequin Noncylindrical stent deployment system for treating vascular bifurcations
US6821295B1 (en) * 2000-06-26 2004-11-23 Thoratec Corporation Flared coronary artery bypass grafts
US6585762B1 (en) 2000-08-10 2003-07-01 Paul Stanish Arteriovenous grafts and methods of implanting the same
WO2002054987A2 (en) * 2000-12-21 2002-07-18 Sulzer Carbomedics Inc. Prosthetic graft device with ventricular apex attachment apparatus
WO2002054987A3 (en) * 2000-12-21 2003-02-13 Sulzer Carbomedics Inc Prosthetic graft device with ventricular apex attachment apparatus
US7252680B2 (en) 2001-04-18 2007-08-07 Alveolus, Inc. Removable essentially cylindrical implants
US7547321B2 (en) 2001-07-26 2009-06-16 Alveolus Inc. Removable stent and method of using the same
US20040073282A1 (en) * 2001-08-06 2004-04-15 Paul Stanish Distally-narrowed vascular grafts and methods of using same for making artery-to-vein and artery-to-artery connections
US7766954B2 (en) 2001-12-20 2010-08-03 Trivascular2, Inc. Advanced endovascular graft
US7147661B2 (en) 2001-12-20 2006-12-12 Boston Scientific Santa Rosa Corp. Radially expandable stent
US7147660B2 (en) 2001-12-20 2006-12-12 Boston Scientific Santa Rosa Corp. Advanced endovascular graft
US20090105841A1 (en) * 2002-03-11 2009-04-23 Oded Nahlieli Polymeric stent useful for the treatment of the salivary gland ducts and method for using the same
US7195646B2 (en) * 2002-03-11 2007-03-27 Oded Nahleili Polymeric stent useful for the treatment of the salivary gland ducts and method for using the same
US20070162148A1 (en) * 2002-03-11 2007-07-12 Oded Nahlieli Polymeric stent useful for the treatment of the salivary gland ducts and method for using the same
US20050125071A1 (en) * 2002-03-11 2005-06-09 Oded Nahleili Polymeric stent useful for the treatment of the salivary gland ducts and method for using the same
US7507258B2 (en) 2002-03-11 2009-03-24 Oded Nahleili Polymeric stent useful for the treatment of the salivary gland ducts and method for using the same
US7993386B2 (en) 2002-06-25 2011-08-09 Boston Scientific Scimed, Inc. Implantable prosthesis with displaceable skirt
US20030236567A1 (en) * 2002-06-25 2003-12-25 Scimed Life Systems, Inc. Implantable prosthesis with displaceabe skirt
US7044962B2 (en) 2002-06-25 2006-05-16 Scimed Life Systems, Inc. Implantable prosthesis with displaceable skirt
US20060184229A1 (en) * 2002-06-25 2006-08-17 Scimed Life Systems, Inc. Implantable prosthesis with displaceable skirt
US7875068B2 (en) 2002-11-05 2011-01-25 Merit Medical Systems, Inc. Removable biliary stent
US7959671B2 (en) 2002-11-05 2011-06-14 Merit Medical Systems, Inc. Differential covering and coating methods
US8206436B2 (en) 2002-11-05 2012-06-26 Merit Medical Systems, Inc. Coated stent with geometry determinated functionality and method of making the same
US7637942B2 (en) 2002-11-05 2009-12-29 Merit Medical Systems, Inc. Coated stent with geometry determinated functionality and method of making the same
US7527644B2 (en) 2002-11-05 2009-05-05 Alveolus Inc. Stent with geometry determinated functionality and method of making the same
US8864817B2 (en) 2002-11-08 2014-10-21 Jacques Séguin Endoprosthesis for vascular bifurcation
US8231667B2 (en) 2002-11-08 2012-07-31 Jacques Séguin Endoprosthesis for vascular bifurcation
US7390317B2 (en) 2002-12-02 2008-06-24 Applied Medical Resources Corporation Universal access seal
US8109911B2 (en) 2002-12-02 2012-02-07 Applied Medical Resources Corporation Universal access seal
US20040106942A1 (en) * 2002-12-02 2004-06-03 Applied Medical Resources Corporation Universal access seal
US20080091143A1 (en) * 2002-12-02 2008-04-17 Applied Medical Resources Corporation Universal access seal
US8079986B2 (en) 2002-12-02 2011-12-20 Applied Medical Resources Corporation Universal access seal
US20080077169A1 (en) * 2002-12-02 2008-03-27 Applied Medical Resources Corporation Universal access seal
US20050137614A1 (en) * 2003-10-08 2005-06-23 Porter Christopher H. System and method for connecting implanted conduits
US20060064159A1 (en) * 2003-10-08 2006-03-23 Porter Christopher H Device and method for vascular access
US8690815B2 (en) 2003-10-08 2014-04-08 Hemosphere, Inc. Device and method for vascular access
US7762977B2 (en) 2003-10-08 2010-07-27 Hemosphere, Inc. Device and method for vascular access
US20110060264A1 (en) * 2003-10-08 2011-03-10 Hemosphere Inc. Device and method for vascular access
US20100069819A1 (en) * 2003-10-17 2010-03-18 Laufer Michael D Minimally invasive gastrointestinal bypass
US7803178B2 (en) 2004-01-30 2010-09-28 Trivascular, Inc. Inflatable porous implants and methods for drug delivery
US8267989B2 (en) 2004-01-30 2012-09-18 Trivascular, Inc. Inflatable porous implants and methods for drug delivery
US8282591B2 (en) 2004-03-29 2012-10-09 Iftikhar Khan Hybrid arteriovenous shunt
US7887579B2 (en) 2004-09-29 2011-02-15 Merit Medical Systems, Inc. Active stent
US8096966B2 (en) * 2005-01-19 2012-01-17 Gi Dynamics, Inc. Eversion resistant sleeves
US20100256776A1 (en) * 2005-01-19 2010-10-07 Gi Dynamics, Inc. Eversion Resistant Sleeves
US7731654B2 (en) 2005-05-13 2010-06-08 Merit Medical Systems, Inc. Delivery device with viewing window and associated method
US8709069B2 (en) 2005-07-01 2014-04-29 C. R. Bard, Inc. Flanged graft with trim lines
US20070005128A1 (en) * 2005-07-01 2007-01-04 C. R. Bard, Inc. Flanged graft with trim lines
US9532865B2 (en) 2005-07-01 2017-01-03 C.R. Bard, Inc. Trimming apparatus
WO2007011689A3 (en) * 2005-07-15 2007-12-13 Brigham & Womens Hospital Sterile access conduit
WO2007011689A2 (en) * 2005-07-15 2007-01-25 The Brigham And Women's Hospital, Inc. Sterile access conduit
US20080319258A1 (en) * 2005-07-15 2008-12-25 Thompson Christopher C Sterile Access Conduit
US20070167901A1 (en) * 2005-11-17 2007-07-19 Herrig Judson A Self-sealing residual compressive stress graft for dialysis
US20090062717A1 (en) * 2006-03-02 2009-03-05 Laufer Michael D Gastrointestinal implant and methods for use
US8376981B2 (en) 2006-03-02 2013-02-19 Michael D. Laufer Gastrointestinal implant and methods for use
US8118767B2 (en) 2006-03-02 2012-02-21 Laufer Michael D Gastrointestinal implant and methods for use
US9277921B2 (en) 2006-03-02 2016-03-08 Michael D. Laufer Gastrointestinal implant and methods for use
US20100191167A1 (en) * 2006-03-02 2010-07-29 Lytn Gastrointestinal implant and methods for use
US20080039878A1 (en) * 2006-07-06 2008-02-14 Williams Michael S Systems and methods for restoring function of diseased bowel
WO2008014752A1 (en) * 2006-08-02 2008-02-07 Michael Heise Tubular vascular transplant
US20080195125A1 (en) * 2007-02-12 2008-08-14 Hoffman Grant T Device for heart bypass surgery and anastomosis
US20090005802A1 (en) * 2007-06-29 2009-01-01 Applied Medical Technology, Inc. Molded and undivided medical penetrating device
US8047986B2 (en) * 2007-06-29 2011-11-01 Applied Medical Technology, Inc. Molded and undivided medical penetrating device
JP2010532232A (en) * 2007-06-29 2010-10-07 アプライド・メディカル・テクノロジー・インコーポレーテッド Molded and undivided medical piercing instrument
US8382664B2 (en) 2007-06-29 2013-02-26 Applied Medical Technology, Inc. Molded and undivided medical penetrating device
US8821507B2 (en) * 2007-07-06 2014-09-02 Howmedica Osteonics Corp. Augmentation delivery device
US20090012521A1 (en) * 2007-07-06 2009-01-08 Howmedica Osteonics Corp. Augmentation delivery device
US8961446B2 (en) 2007-08-02 2015-02-24 Bioconnect Systems Inc. Implantable flow connector
US8690816B2 (en) * 2007-08-02 2014-04-08 Bioconnect Systems, Inc. Implantable flow connector
US9282967B2 (en) 2007-08-02 2016-03-15 Bioconnect Systems, Inc. Implantable flow connector
US8366651B2 (en) 2007-08-02 2013-02-05 Bioconnect Systems, Inc. Implantable flow connector
US9345485B2 (en) 2007-08-02 2016-05-24 Bioconnect Systems, Inc. Implantable flow connector
US20090036817A1 (en) * 2007-08-02 2009-02-05 Bio Connect Systems Implantable flow connector
US8066755B2 (en) 2007-09-26 2011-11-29 Trivascular, Inc. System and method of pivoted stent deployment
US8226701B2 (en) 2007-09-26 2012-07-24 Trivascular, Inc. Stent and delivery system for deployment thereof
US8663309B2 (en) 2007-09-26 2014-03-04 Trivascular, Inc. Asymmetric stent apparatus and method
US8083789B2 (en) 2007-11-16 2011-12-27 Trivascular, Inc. Securement assembly and method for expandable endovascular device
US8328861B2 (en) 2007-11-16 2012-12-11 Trivascular, Inc. Delivery system and method for bifurcated graft
US9486219B2 (en) 2007-11-30 2016-11-08 Treus Medical, Inc. Biliary shunts, delivery systems, methods of using the same and kits therefor
US20110071350A1 (en) * 2007-11-30 2011-03-24 Jacques Van Dam Applicator for endoscopic treatment of biliary disease
US20090143760A1 (en) * 2007-11-30 2009-06-04 Jacques Van Dam Methods, Devices, Kits and Systems for Defunctionalizing the Gallbladder
US20090143713A1 (en) * 2007-11-30 2009-06-04 Jacques Van Dam Biliary Shunts, Delivery Systems, Methods of Using the Same and Kits Therefor
US20090143759A1 (en) * 2007-11-30 2009-06-04 Jacques Van Dam Methods, Devices, Kits and Systems for Defunctionalizing the Cystic Duct
US9282968B2 (en) 2007-11-30 2016-03-15 Treus Medical, Inc. Applicator for endoscopic treatment of biliary disease
US20100280598A1 (en) * 2007-12-27 2010-11-04 C.R. Bard, Inc. Vascular graft prosthesis having a reinforced margin for enhanced anastomosis
US9694165B2 (en) * 2008-01-28 2017-07-04 Peter Mats Forsell Implantable drainage device
US8961448B2 (en) * 2008-01-28 2015-02-24 Peter Forsell Implantable drainage device
US20100312164A1 (en) * 2008-01-28 2010-12-09 Peter Forsell Implantable drainage device
US20150157836A1 (en) * 2008-01-28 2015-06-11 Peter Mats Forsell Implantable drainage device
US20100312163A1 (en) * 2008-01-28 2010-12-09 Peter Forsell Implantable fluid movement device
US8079973B2 (en) 2008-03-05 2011-12-20 Hemosphere Inc. Vascular access system
US9055946B2 (en) * 2008-11-26 2015-06-16 Phraxis Inc. Anastomotic connector
US20100130995A1 (en) * 2008-11-26 2010-05-27 Phraxis Inc. Anastomotic connector
EP2432423B1 (en) * 2009-05-21 2016-09-21 Massimiliano Gessaroli Improved vascular prosthesis and relevant method for realising thereof
US20110054381A1 (en) * 2009-05-29 2011-03-03 Jacques Van Dam Biliary shunts, delivery systems, and methods of using the same
US9901347B2 (en) 2009-05-29 2018-02-27 Terus Medical, Inc. Biliary shunts, delivery systems, and methods of using the same
US20110184329A1 (en) * 2010-01-22 2011-07-28 Valentin Kramer Composite Arterial-Venous Shunt System
RU2561864C2 (en) * 2010-06-25 2015-09-10 Антонио САМБУССЕТИ Prosthesis of orthotopic artificial urinary bladder
WO2012018917A1 (en) * 2010-08-03 2012-02-09 World Heart Corporation Conformal cannula device and related methods
US9463268B2 (en) * 2010-09-07 2016-10-11 Paul A. Spence Cannula systems and methods
US20120259157A9 (en) * 2010-09-07 2012-10-11 Spence Paul A Cannula Systems and Methods
US20120116315A1 (en) * 2010-11-08 2012-05-10 Klepac Steven R Vascular access port and catheter
WO2012122220A1 (en) * 2011-03-08 2012-09-13 W.L. Gore & Associates, Inc. Medical device for use with a stoma
CN103501735B (en) * 2011-03-08 2016-04-06 W.L.戈尔及同仁股份有限公司 The medical device for stoma
CN103501735A (en) * 2011-03-08 2014-01-08 W.L.戈尔及同仁股份有限公司 Medical device for use with a stoma
EP3031428A1 (en) * 2011-03-08 2016-06-15 W.L. Gore & Associates, Inc Medical device for use with a stoma
RU2605146C2 (en) * 2011-03-11 2016-12-20 Антонио САМБУССЕТИ Hemisphere for bladder expansion in patients with low compliance
US9308311B2 (en) 2011-06-15 2016-04-12 Phraxis, Inc. Arterial venous spool anchor
US9597443B2 (en) 2011-06-15 2017-03-21 Phraxis, Inc. Anastomotic connector
US9278172B2 (en) 2011-09-06 2016-03-08 Cryolife, Inc. Vascular access system with connector
US8992595B2 (en) 2012-04-04 2015-03-31 Trivascular, Inc. Durable stent graft with tapered struts and stable delivery methods and devices
US9498363B2 (en) 2012-04-06 2016-11-22 Trivascular, Inc. Delivery catheter for endovascular device
CN104394798B (en) * 2012-04-23 2016-12-21 夏洛特-梅克伦堡医院(商业用名:卡罗来纳保健系统) Treatment of Aortic Lesions hybrid and related methods for graft
US9381101B2 (en) * 2012-04-23 2016-07-05 The Charlotte-Mecklenburg Hospital Authority Hybrid graft for therapy of aortic pathology and associated method
CN104394798A (en) * 2012-04-23 2015-03-04 夏洛特-梅克伦堡医院(商业用名:卡罗来纳保健系统) Hybrid graft for therapy of aortic pathology and associated method
US20130282103A1 (en) * 2012-04-23 2013-10-24 The Charlotte-Mecklenburg Hospital Authority D/B/A Carolinas Healthcare System Hybrid graft for therapy of aortic pathology and associated method
US9585991B2 (en) 2012-10-16 2017-03-07 Heartware, Inc. Devices, systems, and methods for facilitating flow from the heart to a blood pump
WO2015023460A1 (en) * 2013-08-13 2015-02-19 Cryolife, Inc. Systems and methods for a fluid carrying conduit of a vascular access system
US9974563B2 (en) 2014-05-28 2018-05-22 Cook Medical Technologies Llc Medical devices having a releasable member and methods of using the same
US9913661B2 (en) 2014-08-04 2018-03-13 Cook Medical Technologies Llc Medical devices having a releasable tubular member and methods of using the same

Similar Documents

Publication Publication Date Title
US3357432A (en) Anastomotic coupling
US3409914A (en) Connector for blood pumps and the like
US3254651A (en) Surgical anastomosis methods and devices
US3461869A (en) Permanent skin exit device
US4366819A (en) Anastomotic fitting
US4643712A (en) Aortic cannula
US4173981A (en) Cannula for arterial and venous bypass cannulation
US6071263A (en) Apparatus and method for retaining a catheter in a blood vessel in a fixed position
US4498902A (en) Catheter guide
US4995863A (en) Catheter with slit valve
US4418693A (en) Vein and tubing passer surgical instrument
CA1150122A (en) Double-lumen cannula
US4753640A (en) Catheters and methods
US5527324A (en) Surgical stent
US4256102A (en) Subcutaneous dialysis system
US6682498B2 (en) Methods and systems for subcutaneous graft implantation
US4562597A (en) Method of supplying blood to blood receiving vessels
US4405319A (en) Porous titanium coating for blood access device
EP0453234A1 (en) Catheter for extracorporeal treatment
US4129129A (en) Venous return catheter and a method of using the same
US4118806A (en) Prosthetic blood vessel
US4502159A (en) Tubular prostheses prepared from pericardial tissue
Jonas et al. A new sealant for knitted Dacron prostheses: minimally cross-linked gelatin
US4214586A (en) Anastomotic coupling device
US3894530A (en) Method for repairing, augmenting, or replacing a body conduit or organ