Implant for facilitating sutureless side-to-side arteriovenous fistula creation and maintaining patency

Patent metadata

Field	Value
Publication number	US-9687240-B2
Application number	US-201514659117-A
Country	US
Kind code	B2
Filing date	Mar 16, 2015
Priority date	Mar 14, 2014
Publication date	Jun 27, 2017
Grant date	Jun 27, 2017

Abstract

An anastomosis device for facilitating sutureless side-to-side arteriovenous fistula creation and maintenance of patency thereof is presented. The device comprises two device halves each containing an anastomosis window which is in fluid connection with an interior lumen of the device. Further, the device comprises a pair of vessel joining portions in which the bounds of the fistula are created. The invention also has an embodiment wherein a method of joining a vein and an artery in order to create a fistula is presented.

First claim

The invention claimed is:

1. A device for facilitating side-to-side arteriovenous fistula comprising:
a first device half having a first proximal end and a first distal end, the first device half comprising a first inner surface and a first outer surface opposite the first inner surface, the first device half having a first anastomosis window formed therethrough defining a first arch and a second arch opposite the first arch;
a second device half having a second proximal end and a second distal end, the second device half comprising a second inner surface and a second outer surface opposite the second inner surface, the second device half having a second anastomosis window formed therethrough defining a third arch and a fourth arch opposite the third arch; and
a connecting tube having a first end and a second end opposite the first end, the connecting tube having a lumen formed through the first end and second along a longitudinal axis of the connecting tube, the first end being connected to the first inner surface of the first device half at the first anastomosis window, the second end being connected to the second inner surface of the second device half at the second anastomosis window so that the first anastomosis window is in fluid connection with the second anastomosis window, the connecting tube comprising a circumferential surface having a first area and a second area opposite the first area, the first area being between the first and the third arches, the second area being between the second and the fourth arches, the first area having a plurality of first barbs disposed thereon and arranged in a first pair of rows spaced apart oppositely from each other and substantially normal to the longitudinal axis, the first barbs extending inwardly, and the second area having a plurality of second barbs disposed thereon and arranged in a second pair of rows spaced apart oppositely from each other and substantially normal to the longitudinal axis, the second barbs extending inwardly.

2. The device of claim 1 wherein the proximal ends of the device halves further comprise a pair of proximal flanges extending beyond a proximal portion of the connecting tube, and wherein the distal ends of the device halves define a pair of distal flanges extending beyond a distal portion of the connecting tube.

3. The device of claim 2 wherein the proximal flanges are not in contact, defining a proximal flange gap between them, and wherein the distal flanges are not in contact, defining a distal flange gap between them.

4. The device of claim 1 having anastomosis windows that are substantially elliptical.

5. The device of claim 1 having anastomosis windows that are substantially rectangular.

6. The device of claim 1 wherein the connecting tube is substantially cylindrical.

7. The device of claim 1 wherein the connecting tube is substantially prismatic.

8. The device of claim 7 wherein the connecting tube has a cross section which is substantially square in shape.

9. The device of claim 7 wherein the connecting tube has a cross section which is substantially rectangular in shape.

10. The device of claim 1 further comprising a plurality of outer barbs extending from an outer surface of the device halves, the plurality of outer barbs being configured to point away from the device body.

11. A method of facilitating side-to-side fistula along a longitudinal portion of a vein and an artery, the vein having a vein wall, the artery having an artery wall, the method comprising:
incising the vein wall substantially longitudinally to provide a first vein lip and a second vein lip, defining a vein aperture;
incising the vein wall substantially longitudinally to provide a first artery lip and a second artery lip, defining an artery aperture;
implanting an anastomosis device to form the side-to-side fistula, the anastomosis device comprising: a first device half having a first proximal end and a first distal end, the first device half comprising a first inner surface and a first outer surface opposite the first inner surface, the first device half having a first anastomosis window formed therethrough; a second device half having a second proximal end and a second distal end, the second device half comprising a second inner surface and a second outer surface opposite the second inner surface, the second device half having a second anastomosis window formed therethrough; a connecting tube having a first end and a second end opposite the first end, the connecting tube having a lumen formed through the first end and second along a longitudinal axis of the connecting tube, the first end being connected to the first inner surface of the first device half at the first anastomosis window, the second end being connected to the second inner surface of the second device half at the second anastomosis window so that the first anastomosis window is in fluid connection with the second anastomosis window; the connecting tube comprising a circumferential surface having a first area and a second area, the first area having a plurality of first barbs disposed thereon and arranged in a first pair of rows spaced apart oppositely from each other and substantially normal to the longitudinal axis, the first barbs extending inwardly; and the second area having a plurality of second barbs disposed thereon and arranged in a second pair of rows spaced apart oppositely from each other and substantially normal to the longitudinal axis, the second barbs extending inwardly to facilitate side-to-side fistula.

12. The method of claim 11 wherein implanting comprises:
disposing the second artery lip and the second vein lip between the pair of rows of second barbs such that the second arch is disposed inside the wall of the vein and the fourth arch is disposed inside the wall of the artery;
joining the second artery lip to the second vein lip;
disposing the first artery lip and the first vein lip between the pair of rows of first barbs such that the first arch is disposed inside the wall of the vein and the third arch is disposed inside the wall of the artery; and
joining the first artery lip to the first vein lip.

13. The method of claim 12 further comprising a step of securing the first vein lip on at least one of the plurality of first barbs.

14. The method of claim 12 further comprising a step of securing the first artery lip on at least one of the plurality of first barbs.

15. The method of claim 12 further comprising a step of securing the second vein lip on at least one of the plurality of second barbs.

16. The method of claim 12 further comprising a step of securing the second artery lip on at least one of the plurality of second barbs.

17. The method of claim 12 wherein joining an artery lip to a vein lip comprises connecting with surgical glue.

Assignees

• Cook Medical Technologies Llc

Inventors

• Shields Adam
• Milner Keith

Classifications

• A61M1/3655

  Arterio-venous shunts or fistulae · CPC title

• A61B17/11 Primary

  for performing anastomosis; Buttons for anastomosis · CPC title

• A61B2017/1139

  Side-to-side connections, e.g. shunt or X-connections · CPC title

• A61B2017/1107

  for blood vessels · CPC title