Abstract The invention is illustrated and described in connection with the growing of a femoro-popliteal artery graft. A tunneling tube is inserted through an incision above the inguinal ligament in the groin area adjacent an upper portion of the femoral artery and thrust downward subcutaneously through the thigh to a point below the knee on the inner or medial side of the leg adjacent a lower portion of the popliteal artery. A flexible silicone mandrel assembly having two layers of knitted Dacron on a flexible silicone rod is inserted in the tunneling tube. Then the tunneling tube is removed and the incision closed. The patient resumes his normal activity for a number of weeks during which time an ingrowth of connective tissue incorporates itself in the Dacron mesh, making an autogenous artery graft grown in the place where it is to be used. In a second operation, a new incision is made below the inguinal ligament to expose the upper end of the graft tube containing the mandrel and an incision is made below the knee to expose the lower end of the graft tube containing the mandrel. Both ends of the graft and mandrel are cut off and the mandrel is pulled out. The graft is then anastomosed to the femoral artery above and the popliteal artery below, using the end-to-side method of anastomosis. The closing of the two incisions completes the operation with the graft providing a shunt for the femoropopliteal artery extending from the groin to a point below the knee.
An autogenous graft tube comprising an ingrowth of connective tissue from a living body in the permanently implanted part of a mandrel assembly having a temporarily implanted part and a permanently implanted part, said temporarily implanted part comprising a flexible mandrel capable of bending with body movements, and said permanently implanted part comprising a fabric tube on said mandrel impregnated with a stiffening agent and a layer of material inside of said fabric tube holding said fabric tube spaced away from said mandrel, the entire outer surface oF said fabric tube being exposed to said ingrowth of connective tissue, said ingrowth of connective tissue having a smooth cast lumen formed by said mandral, and said graft tube having a permanent blood supply established during the ingrowth of said connective tissue.
Claim 2
Dependent Claim
130 words
An autogenous graft tube comprising an ingrowth of connective tissue from a living body in the permanently implanted part of a mandrel assembly having a temporarily implanted part and a permanently implanted part, said temporarily implanted part comprising a flexible mandrel capable of bending with body movements, and said permanently implanted part comprising a fabric tube on said mandrel impregnated with a stiffening agent and a layer of material inside of said fabric tube holding said fabric tube spaced away from said mandrel, the entire outer surface oF said fabric tube being exposed to said ingrowth of connective tissue, said ingrowth of connective tissue having a smooth cast lumen formed by said mandral, and said graft tube having a permanent blood supply established during the ingrowth of said connective tissue.
Claim 3
Dependent Claim
15 words
A graft tube as defined in claim 1, said mandrel being made of silicone rubber.
Claim 4
Dependent Claim
17 words
A graft tube as defined in claim 1, said layer of material comprising a second fabric tube.
Claim 5
Dependent Claim
21 words
A graft tube as defined in claim 3, said second fabric tube being of coarser mesh than said first fabric tube.
Claim 6
Dependent Claim
21 words
A graft tube as defined in claim 3, both of said fabric tubes being impregnated with silicone rubber vulcanized in situ.