WO2000053121A1 - Greffon veineux autologue ameliore - Google Patents

Greffon veineux autologue ameliore Download PDF

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Publication number
WO2000053121A1
WO2000053121A1 PCT/EP2000/002059 EP0002059W WO0053121A1 WO 2000053121 A1 WO2000053121 A1 WO 2000053121A1 EP 0002059 W EP0002059 W EP 0002059W WO 0053121 A1 WO0053121 A1 WO 0053121A1
Authority
WO
WIPO (PCT)
Prior art keywords
use according
vein
casing
prosthesis
sheath
Prior art date
Application number
PCT/EP2000/002059
Other languages
German (de)
English (en)
Inventor
Jürgen C. FRÖLICH
Axel Haverich
Original Assignee
Froelich Juergen C
Axel Haverich
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
Application filed by Froelich Juergen C, Axel Haverich filed Critical Froelich Juergen C
Priority to AU41045/00A priority Critical patent/AU4104500A/en
Publication of WO2000053121A1 publication Critical patent/WO2000053121A1/fr

Links

Classifications

    • 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
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/28—Materials for coating prostheses
    • A61L27/34—Macromolecular materials
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
    • A61L27/38—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix containing added animal cells
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/50—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
    • A61L27/507—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials for artificial blood vessels

Definitions

  • the invention relates to the use of a covering of autologous veins as a material for arteriovenous and arterio- (aorto -) - arterial connections to improve the short and long-term function in vein transplants.
  • the sheath is able to successfully prevent the early and late failure of autogenous vein material.
  • autologous veins are routinely used as aorto-coronary bypasses or as arterio-arterial bypasses. This material is also used as an arteriovenous connection in dialysis shunts.
  • varicose veins have sack or nodular ectasia and differ fundamentally from pathologically unchanged, continuous vein tissue.
  • the metal grid improves the patency of the varicose veins.
  • a sheath is used for the routine manufacture of venous prostheses using non pathologically modified veins, increasing the shear force in the vein and preventing its expansion under arterial pressure.
  • transplanted veins are expanded strongly and irregularly and the walls are covered with thrombotic masses, through which a tiny blood clot meanders, which is inadequate in relation to the initial and necessary amount of blood.
  • thrombotic masses through which a tiny blood clot meanders, which is inadequate in relation to the initial and necessary amount of blood.
  • angina pectoris and myocardial infarction occur again, and in the case of arterio-arterial bypass, circulatory disorders.
  • NO also known as EDRF or nitric oxide
  • prostacyclin Both Substances inhibit platelet adhesion and aggregation and the adhesion of monocytes / macrophages and the expression of VCAM "1 (vascular celt adhesion molecule '1 ) (DeCatarina, R., P.
  • Nitnc oxide selectively reduces endothelial expression of adhesion molecules and proinflammatory cytokmes J. Clin. Invest. 1995, 96: 60-68).
  • the diameter also increases due to the high pressure and further growth (so-called remodeling) due to the growth factors described above This reduces the shear force and the production of the antithrombotic and antiproliferative mediators NO and PGI 2 , and the formation of wall-like thrombi as well as vasodilation and ectasia.
  • the invention has for its object to prevent the expansion of the vessel, to maintain the shear force and thus to ensure the production of NO, PGI 2 and other shear force-dependent mediators. This prevents the wall thrombi and the release of the growth factors and thus the remodeling.
  • the prevention of the expansion of the vein under arterial pressure and the increase in shear force are achieved according to the invention in that a mesh, sheath or sleeve is placed around the vein, which brings the vein diameter to an optimal level and stops there Appropriate procedures and can be combined in different areas and in different ways to achieve optimal results.
  • the simplest variant is a sleeve made of structured PTFE or another plastic.
  • the plastic can be designed as a mesh.
  • a porous tube with a pore size that allows capillaries to sprout and thus integrate into the tissue (pore size 200 - 800 ⁇ m) can be used.
  • the covering can be elastic, for example so elastic that a pulse wave is passed on. It is known that pulsatile flow requires PGI 2 production from endothelial cells (JA Frangos, SG Eskin, LV Mclntire, CL Ives Flow effects on prostacyclin production by cultured human endothelial cells, Science, March 22, 1985, pp. 1477-79 )
  • the covering can also consist of resorbable biological or artificial material.
  • these materials are collagen, polyglycolic acid, polyhydroxyctanoid, poly-4-hydroxybutyrate and polylactidic acid.
  • growth factors or drugs can be incorporated into these materials which influence tissue formation and function, as well as the cells of the blood flowing through (e.g. granulocytes, thrombocytes)
  • the ends of the covering can be funnel-shaped, so that the terminal or lateral anastomotic areas are also covered and the covering can be fixed in this area by suitable measures.
  • the covering can taper from the high-pressure side to the low-pressure side, as in a normal blood vessel.
  • the cross-section of the covering can be non-circular (e.g. ehptoid) and thus increase the shear force.
  • the covering can be combined with a tube made of the body's own fibroblasts or exclusively from such consist of the body's own smooth muscle cells and combinations of fibroblasts and muscle cells with and without plastic
  • the sheath can also be coated with autogenous genetically engineered endothelial cells. Tissue glue can be used to fix the sheath or vein or to open certain areas after absorption.
  • the materials can be designed to deliver certain drugs that mimic or support the antithrombotic and growth-inhibiting effects of endothelial cells.
  • Example I A vein with an inner diameter of 4 mm and a length of 8 cm is perfused with Krebs-Henseleit buffer. Then it is pulled into a tube so that its inner diameter is now 2.0 mm. The NO production increased by 160% through this procedure.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Transplantation (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Dermatology (AREA)
  • Biomedical Technology (AREA)
  • Medicinal Chemistry (AREA)
  • Engineering & Computer Science (AREA)
  • Epidemiology (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Botany (AREA)
  • Vascular Medicine (AREA)
  • Cell Biology (AREA)
  • Zoology (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Pulmonology (AREA)
  • Cardiology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne l'utilisation d'un flexible, d'une gaine ou d'un tube comme enveloppe de veine pour une prothèse veineuse pour augmenter la force de cisaillement de la veine et éviter qu'elle ne se dilate sous l'effet de la pression artérielle.
PCT/EP2000/002059 1999-03-09 2000-03-09 Greffon veineux autologue ameliore WO2000053121A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU41045/00A AU4104500A (en) 1999-03-09 2000-03-09 Improved autologous vein graft

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE19910340A DE19910340A1 (de) 1999-03-09 1999-03-09 Verbessertes autologes Venentransplantat
DE19910340.2 1999-03-09

Publications (1)

Publication Number Publication Date
WO2000053121A1 true WO2000053121A1 (fr) 2000-09-14

Family

ID=7900253

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2000/002059 WO2000053121A1 (fr) 1999-03-09 2000-03-09 Greffon veineux autologue ameliore

Country Status (3)

Country Link
AU (1) AU4104500A (fr)
DE (1) DE19910340A1 (fr)
WO (1) WO2000053121A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8734503B2 (en) 2008-11-24 2014-05-27 Vascular Graft Solutions Ltd. External stent
US10052218B2 (en) 2011-04-18 2018-08-21 Vascular Graft Solutions Ltd. Devices and methods for deploying implantable sleeves over blood vessels

Families Citing this family (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE10034583A1 (de) * 2000-07-14 2002-01-31 Axel Haverich Individuelle Venenklappenprothese
DE10137414B4 (de) 2001-07-31 2005-12-29 Aesculap Ag & Co. Kg Ummantelung für Venen und Verwendung in der Chirurgie
DE10232134B4 (de) * 2002-07-12 2006-08-31 Aesculap Ag & Co. Kg Applikationshilfe zum Anbringen einer flexiblen Ummantelung auf einem natürlichen Blutgefässabschnitt und diese enthaltender Kit
US7618948B2 (en) 2002-11-26 2009-11-17 Medtronic, Inc. Devices, systems and methods for improving and/or cognitive function through brain delivery of siRNA
JP4692902B2 (ja) 2003-04-28 2011-06-01 キップス・ベイ・メディカル・インコーポレーテッド 柔軟な静脈移植体
US20050131520A1 (en) 2003-04-28 2005-06-16 Zilla Peter P. Compliant blood vessel graft
US7998188B2 (en) 2003-04-28 2011-08-16 Kips Bay Medical, Inc. Compliant blood vessel graft
DE10355986A1 (de) 2003-11-27 2005-06-30 Forschungszentrum Karlsruhe Gmbh Kompressionsmanschette
DE102007061301A1 (de) 2007-12-10 2009-06-18 Aesculap Ag Ummantelung zur Wiederherstellung der Klappenfunktion variköser Venen und Verwendung der Ummantelung in der Chirurgie

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3974526A (en) * 1973-07-06 1976-08-17 Dardik Irving I Vascular prostheses and process for producing the same
WO1983003536A1 (fr) * 1982-04-19 1983-10-27 Massachusetts Inst Technology Prothese multi-couches bioremplacable de vaisseaux sanguins
US4743251A (en) * 1983-12-08 1988-05-10 Henry Bocquee Vein prothesis and method for producing same
WO1993005730A1 (fr) * 1991-09-16 1993-04-01 Atrium Medical Corporation Dispositif a lumiere primaire implantable a porosite regulee
WO1993020757A2 (fr) * 1992-04-21 1993-10-28 Baxter International Inc. Systeme d'implant vasculaire
US5399352A (en) * 1993-04-14 1995-03-21 Emory University Device for local drug delivery and methods for using the same
US5741283A (en) * 1995-03-24 1998-04-21 Lrt, Inc. Vessel and duct salvage device and method

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3974526A (en) * 1973-07-06 1976-08-17 Dardik Irving I Vascular prostheses and process for producing the same
WO1983003536A1 (fr) * 1982-04-19 1983-10-27 Massachusetts Inst Technology Prothese multi-couches bioremplacable de vaisseaux sanguins
US4743251A (en) * 1983-12-08 1988-05-10 Henry Bocquee Vein prothesis and method for producing same
WO1993005730A1 (fr) * 1991-09-16 1993-04-01 Atrium Medical Corporation Dispositif a lumiere primaire implantable a porosite regulee
WO1993020757A2 (fr) * 1992-04-21 1993-10-28 Baxter International Inc. Systeme d'implant vasculaire
US5399352A (en) * 1993-04-14 1995-03-21 Emory University Device for local drug delivery and methods for using the same
US5741283A (en) * 1995-03-24 1998-04-21 Lrt, Inc. Vessel and duct salvage device and method

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8734503B2 (en) 2008-11-24 2014-05-27 Vascular Graft Solutions Ltd. External stent
US9265632B2 (en) 2008-11-24 2016-02-23 Vascular Graft Solutions Ltd. Methods of supporting a vein
US9949852B2 (en) 2008-11-24 2018-04-24 Vascular Graft Solutions Ltd. Implant for supporting bodily conduits such as blood vessels or/and grafted vessels
US10052218B2 (en) 2011-04-18 2018-08-21 Vascular Graft Solutions Ltd. Devices and methods for deploying implantable sleeves over blood vessels

Also Published As

Publication number Publication date
DE19910340A1 (de) 2000-09-21
AU4104500A (en) 2000-09-28

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