초록 ▼

An anastomosis connector comprises a plurality of ring segments (106), together defining a radially expandable ring-like shape (106) having a lumen; at least one pivot bar (114) coupled to at least one of said ring segments (106); at least one spike (109) mounted on said pivot bar (114) and rotatabl

An anastomosis connector comprises a plurality of ring segments (106), together defining a radially expandable ring-like shape (106) having a lumen; at least one pivot bar (114) coupled to at least one of said ring segments (106); at least one spike (109) mounted on said pivot bar (114) and rotatable around said pivot bar (114), wherein radial deformation of said ring-like shape (106) does not substantially directly affect said spike (109) rotational position.

대표청구항 ▼

1. An anastomosis connector; comprising:a plurality of ring segments, together defining a radially expandable ring-like shape having a lumen;at least one pivot bar coupled to at least one of said ring segments; andat least one spike mounted on said pivot bar and rotatable around said pivot bar,where

1. An anastomosis connector; comprising:a plurality of ring segments, together defining a radially expandable ring-like shape having a lumen;at least one pivot bar coupled to at least one of said ring segments; andat least one spike mounted on said pivot bar and rotatable around said pivot bar,wherein radial deformation of said ring-like shape does not substantially directly affect said spike rotational position.2. A connector according to claim 1, wherein rotation of the pivot bar is mechanically decoupled from radial deformation of ring-like shape.3. A connector according to claim 2, wherein said at least one pivot bar comprises at least two pivot bars, wherein said at least one spike is mounted on a first one of said pivot bars and said first pivot bar is mounted on the other pivot bar.4. A connector according to claim 1, wherein said at least one spike is pointed towards said ring-like shape.5. A connector according to claim 1, wherein said at least one spike is pointed away from said ring-like shape.6. A connector according to claim 1, wherein said at least one spike comprises at least two spikes, each mounted on a separate pivot bar, wherein said spikes point in opposite directions along an axis of said connector.7. A connector according to claim 1, wherein said connector is designed such that said at least one spike remains outside of a side vessel in an end-to-side anastomosis.8. A connector according to claim 1, wherein said connector is designed such that said at least one spike enters a side vessel in an end-to-side anastomosis.9. A connector according to claim 1, wherein said pivot bar is comprised in a spike element.10. A connector according to claim 9, wherein said spike element comprises two opposing spikes.11. A connector according to claim 9, wherein said spike element interconnects two adjacent ring segments.12. A connector according to claim 9, wherein said spike element is attached to only a single ring element.13. A connector according to claim 1, wherein said at least one spike has a tip adapted to penetrate a blood vessel.14. A connector according to claim 1, wherein said at least one spike has a tip adapted to lay against a blood vessel without penetrating it.15. A connector according to claim 1, wherein said connector is heat-treated to have said at least one spike perpendicular to said ring.16. A connector according to claim 1, wherein said connector is heat-treated to have said at least one spike parallel to said ring.17. A connector according to claim 1, wherein said connector is heat-treated to have said at least one spike bend.18. A connector according to claim 1, wherein said connector is heat-treated such that said at least one spike does not bend.19. A connector according to claim 1, wherein said connector is heat-treated such that said pivot bar is twisted.20. A connector according to claim 1, wherein said connector is heat-treated such that said pivot bar is not twisted.21. A connector according to claim 1, wherein said pivot bar is within an axial extent of said ring-like shape.22. A connector according to claim 21, wherein said pivot bar is substantially centered relative to said ring like shape.23. A connector according to claim 1, wherein said pivot bar is outside an axial extent of said ring-like shape.24. A connector according to claim 1, wherein said pivot bar is comprised in a pivot mechanism.25. A connector according to claim 24, wherein said pivot mechanism is directly mounted onto at least one of said ring elements.26. A connector according to claim 24, wherein said pivot mechanism is coupled via a single extension to at least one of said ring elements.27. A connector according to claim 24, wherein said pivot mechanism is coupled via at least two extensions to at least one of said ring elements.28. A connector according to claim 24, wherein said pivot bar is coupled to said pivot mechanism via a hinge at each end of said pivot bar.29. A connector according to claim 28, wherein said hinge comprises a thickening of said mechanism relative to said pivot bar.30. A connector according to claim 24, wherein said connector comprises a plurality of alternating ring segments and pivot bar mechanism and wherein said pivot bar mechanisms are axially staggered, to allow a greater radial compression of said ring-like shape.31. A connector according to claim 1, wherein said pivot bar is straight.32. A connector according to claim 1, wherein said pivot bar is piece-wise straight.33. A connector according to claim 1, wherein said pivot bar is curved.34. A connector according to claim 1, wherein said connector is packaged.35. A connector according to claim 34, wherein said packaging indicates a particular vessel type for said connector and for which said connector is adapted.36. A connector according to claim 35, wherein said vessel type comprises a femoral artery.37. A connector according to claim 35, wherein said vessel type comprises an aorta.38. A connector according to claim 34, wherein said packaging indicates a particular vessel size for said connector and for which said connector is adapted.39. A connector according to claim 34, wherein said packaging indicates a particular vessel wall thickness for said connector and for which said connector is adapted.40. A connector according to claim 39, wherein said ring-like shape has an axial extent smaller than said wall thickness.41. A connector according to claim 34, wherein said packaging indicates a particular connection geometry for said connector and for which said connector is adapted.42. A connector according to claim 41, wherein said geometry is a side-to-end geometry.43. A connector according to claim 34, wherein said packaging indicates a particular oblique angle geometry for said connector and for which said connector is adapted.44. A connector according to claim 1, wherein said at least one spike is cut out of an opposing spike of said connector.45. A connector according to claim 1, wherein at least one of said ring segments comprises a plurality of axially spaced elements.46. A connector according to claim 45, wherein said plurality of elements comprises at least three elements.47. A connector according to claim 45, wherein said plurality of elements comprises at least four elements.48. A connector according to claim 45, wherein said plurality of elements comprises at least five elements.49. A connector according to claim 45, wherein all of said plurality of elements have a same geometry.50. A connector according to claim 45, wherein at least two of said plurality of elements have mirrored geometries.51. A connector according to claim 45, wherein at least one of said plurality of elements has a single curve geometry.52. A connector according to claim 45, wherein at least one of said plurality of elements has a dual curve geometry.53. A connector according to claim 45, wherein at least one of said plurality of elements has at least three curves defined thereby.54. A connector according to claim 45, wherein at least one of said plurality of elements has a varying width.55. A connector according to claim 45, wherein all of said plurality of elements have a constant width.56. A connector according to claim 45, comprising a strain dissipation element at a point of connection of at least one of said elements and a spike element to which said ring segment is attached.57. A connector according to claim 56, wherein said strain dissipation element comprises a thickening of said axially spaced element.58. A connector according to claim 57, wherein said thickening defines an aperture.59. A method of everting a blood vessel, comprising:engaging a tip of said vessel at a plurality of points around its circumference;inverting said tip by inverting said engaged points; andpulling said inverted points towards a distal end of said blood vessel.60. A method according to claim 59, wherein said plurality comprises at least four points.61. A method according to claim 59, wherein said engaging comprises engaging using forceps and wherein said inverting comprises rotating said forceps.62. A method according to any one of claims 59?61, wherein said points are inverted simultaneously.63. A method according to any one of claims 59?61, wherein said pulling comprises pulling different ones of said points different amounts.64. Apparatus for graft eversion of a graft over a shaft having a tip, comprising:a handle for engaging said shaft;a plurality of forceps arranged to engage a tip of said graft where it protrudes form said shaft; anda plurality of joints, each one associated with one of said forceps, for rotating said forceps pulling a tip of each of said forceps axially along said shaft.65. A method of measuring a graft size, comprising:mounting a tip of said graft on two extensions, one extension coupled to a spring and one extension coupled to a handle;manipulating said handle such that said extensions separate;reading a measurement on a scale coupled to said spring; andselecting an anastomosis connector responsive to said read measurement.66. A method according to claim 65, comprising further manipulating said handle to stretch said graft tip.67. A hole puncher, comprising:a sharp tip for forming a puncture in a blood vessel;a shaft having a varying diameter and having a depression formed therein for engaging a wall of said blood vessel, said diameter substantially matching a diameter of said tip at one end of the shaft, said diameter increasing away from said tip for a first distance and said diameter then defining a slope of diminishing diameter towards said depression; andan outer tube mounted on said shaft and having an end, said outer tube having an inner diameter of said end that is in a range of diameters defined by said slope of diminishing diameters.68. A puncher according to claim 67, wherein said end of said outer tube has a smaller outer diameter that a more proximal portion of said outer tube.69. A puncher according to claim 67 or claim 68, wherein said diminishing diameter slope is obliquely arrange around said shaft.70. A method of forming an oblique anastomosis connector, comprising:providing a non-oblique anastomosis connector;mounting said connector in a restraint;manipulating said restraints to deform said connector to a desired degree of obliqueness; andheat-treating said connector after said manipulation, to maintain said distortion.71. A method according to claim 70, comprising heat-treating said connector prior to said mounting, to train a deformation of a spike portion of said connector.72. A side mounted delivery system, comprising:a handle including an opening in its side;a graft delivery tool adapted to fit through said opening; anda groove and projection mechanism slidably interconnecting said tool and said handle.73. A system according to claim 72, comprising a snap-lock mechanism for axially fixing said handle relative to said tool.