The present invention relates to sintered structures for a vascular graft and, more specifically, to a vascular graft having a PTFE tube structure one or more discrete portions of which are sintered prior to expansion thereof such that such expansion of the PTFE tube structure results in different microstructures thereof at various locations on the PTFE tube structure.
It is well known to use extruded tube structures of polytetrafluoroethylene (PTFE) as implantable intraluminal prostheses, particularly vascular grafts. PTFE is particularly suitable as an implantable prosthesis as it exhibits superior biocompatibility. PTFE tube structures may be used as vascular grafts in the replacement or repair of a blood vessel as PTFE exhibits low thrombogenicity. In vascular applications, the grafts are manufactured from expanded polytetrafluoroethylene (ePTFE) tube structures. These tube structures have a microporous structure which allows natural tissue ingrowth and cell endothelization once implanted in the vascular system. This contributes to long term healing and patency of the graft. Grafts formed of ePTFE have a fibrous state which is defined by the interspaced nodes interconnected by elongated fibrils.
A vascular graft is frequently subjected to different conditions along its length. For example, handling of the vascular graft may result in significant bending forces at specific longitudinal positions along the graft which may cause kinking of the graft. Another example of different physical forces applied to one or more specific longitudinal sections of the graft is that the graft may be punctured, such as for passage of a suture through the graft which may be for securing the graft to the tissue of the patient. Such puncturing is desirably limited to the site of the puncture to prevent tearing of the graft, which may be longitudinal, from the site of the puncture. The changes in the conditions to which the graft is subjected may occur at specific longitudinal positions on the graft, such as the puncturing thereof for a suture, or more gradually along the length of the graft, such as a bending force gradually applied thereto.
The performance of the vascular graft when subjected to various conditions depends upon the physical characteristics of a vascular graft. The physical characteristics which provide desirable performance typically differ depending on the conditions. For example, a vascular graft which has a high compressive strength will typically require higher bending forces to cause kinking of the graft. However, a graft which has such a high compressive strength uniformly throughout the length thereof may have limited transverse flexibility. Such transverse flexibility is typically desired to facilitate conformance of the graft with a lumen which has curves and bends in the body.
A vascular graft which is integral and of the same extrudate frequently has physical characteristics which are generally uniform longitudinally and transversely relative to the graft. Such vascular grafts may have satisfactory performance when subjected to certain conditions. However, the performance of such vascular grafts when subjected to a variety of conditions is typically limited.
In an effort to provide different physical characteristics to a vascular graft, separately formed structures may be bonded to an integral graft. For example, in applications where kinking is likely, vascular grafts have an additional support structure to prevent kinking. Typically, external support structures, such as helical coils, are bonded around the outer wall surface of the ePTFE tube structure. Alternatively, individual rings may be bonded to the outer wall surface of the ePTFE by injection molding.
Such additional support structures have several disadvantages. For example, the additional support structures are normally bonded to the outer wall surface of the ePTFE tube structure thereby increasing the outer diameter of the graft in the regions of the support structures. As a result, implantation of the graft can become more difficult. For example, when tunneling through tissue is required to implant the graft, such as in vascular access applications, a larger cross-sectional tunnel area is required to allow for insertion of the graft.
Another disadvantage of grafts having added support structures is that they are often made from materials which are different from the material of the graft wall and require added processing steps such as heat bonding or additional materials such as adhesive to adhere the support structure to the graft. Differential shrinkage or expansion of the external support structure relative to the ePTFE tube structure can cause the bond to weaken and/or the graft to twist significantly. Separation of the support structure from the graft is obviously undesirable.
Other ePTFE grafts have included external polymeric ribs which provide radial support to the lumen, but increase the outer diameter and wall thickness of the graft.
The vascular graft of the present invention is for implantation within a body and has a PTFE tube structure including a length and inner and outer wall surfaces. The tube structure has a non-expanded portion formed from sintering a PTFE green tube extrudate and an expanded portion formed subsequent to the sintering. The expanded and non-expanded portions are of the same extrudate. The expanded portion has a region which adjoins the non-expanded portion wherein a degree of expansion of the region is limited by the non-expanded portion. The limiting of the expansion by the non-expanded portion is attenuated at a location of the region which is remote from the non-expanded portion. A method for making the vascular graft facilitates the formation of the non-expanded and expanded portions of the PTFE tube structure.
The limitation of the degree of expansion of the expanded region which adjoins the non-expanded region and the attenuation of the limitation at a location which is remote from the non-expanded portion provides the graft with different physical characteristics at different locations thereof. Consequently, different locations of the vascular graft may be provided with specific physical characteristics which provide improved performance for the specific conditions to which the various locations of the vascular graft may be subjected. This improves the performance of the entire vascular graft by providing for the tailoring of the physical characteristics of the vascular graft to match the different conditions to which different locations of the graft may be subjected. Since a vascular graft is frequently subjected to different conditions within the body of a patient, varying the physical characteristics of the vascular graft to provide the desired performance thereof for the respective conditions will improve the overall performance of the vascular graft within the body.
Further variation in the physical characteristics of the vascular graft is provided by the non-expanded portion thereof. The non-expanded portion is typically harder and stiffer than the expanded portion which provides the vascular graft with further variation in the physical characteristics thereof. This enables the formation of a vascular graft with at least three regions of differing physical characteristics which include the non-expanded portion, the region of the expanded portion which adjoins the non-expanded portion, and the region of the expanded portion which is remote from the non-expanded portion.
The vascular graft may have more than three regions which have different physical characteristics. This may be provided, for example, by having more than one non-expanded region and by varying the shape and orientation of one or more of the non-expanded regions relative to the tube structure. Additionally, the transitions between the regions of the vascular graft which have different physical characteristics may vary. For example, the transitions may be gradual which may establish a gradient between the regions having different physical characteristics. Alternatively, the transitions between the regions may be defined by discrete boundaries which provide distinct demarcations between the regions having different physical characteristics.
These and other features of the invention will be more fully understood from the following description of specific embodiments of the invention taken together with the accompanying drawings.
In the drawings:
Corresponding reference characters indicate corresponding parts throughout the several views of the drawings.
Referring to the drawings and more particularly to
The tube structure 12 includes first and second longitudinal sections 18, 20. The first longitudinal section 18 includes four non-expanded portions 22 formed from sintering a PTFE green tube extrudate. The region of the first longitudinal section 18, which is not included in the non-expanded portions 22, is expanded such that the first longitudinal section has an expanded portion 23 in addition to the non-expanded portions 22. The second longitudinal section 20 is expanded such that it constitutes another expanded portion 24.
The non-expanded portions 22 are each elongate and have a longitudinal central axis which is contained in a corresponding longitudinal cross-sectional plane 25 of the PTFE tube structure 12. The non-expanded and expanded portions 22, 23, 24 are of the same extrudate.
Adjacent pairs of the non-expanded portions 22 are separated from one another circumferentially relative to the PTFE tube structure 12 by an angular dimension equal to 90 degrees, as shown in
The vascular graft 10 may be formed according to the method 30 shown in
Following the pre-sintering step 36, the method 30 includes an expansion step 41 during which a uniform longitudinal tensile force 42 is applied to the extrudate 34. The application of the tensile force 42 produces expansion of the extrudate 34 and longitudinal elongation of the portions thereof which are not pre-sintered. Such expansion produces a node and fibril microstructure in the regions of the extrudate 34 which are expanded. Consequently, the expanded regions of the extrudate 34 constitute the expanded portions 23, 24 and the pre-sintered discrete portions 38 constitute the non-expanded portions 22.
The application of the tensile force 42 produces longitudinal elongation of the non-expanded portions 22 and the expanded portions 23, 24. The microstructure of the non-expanded portions 22 resist elongation to a greater degree than the microstructure of the expanded portions 23, 24. Consequently, the non-expanded portions 22 restrict the elongation of the regions of the expanded portions 23 in close proximity to the non-expanded portions, because the non-expanded and expanded portions are integral with one another as a result of being of the same extrudate 34. Consequently, the elongation of the expanded portion 23 is limited because of the longitudinal position thereof relative to the extrudate 34 being the same as the longitudinal position of the non-expanded portions 22 relative to the extrudate. The elongation of the expanded portion 24 is not significantly limited by the non-expanded portions 22 because of the different longitudinal positions thereof relative to the extrudate. Consequently, the elongation of the first longitudinal section 18, which contains non-expanded and expanded portions 22, 23, is less than the elongation of the second longitudinal section 20, which does not contain any of the non-expanded portions, where such elongation results from the application of a longitudinal tensile force 42 to the extrudate 34, including the first and second longitudinal sections 18, 20, after the pre-sintering step 36. In a preferred embodiment, the elongations of the first and second longitudinal sections 18, 20 are 200% and 800%, respectively. Alternatively, if the first and second longitudinal sections 18, 20 are to be elongated by generally the same amount, then a slightly greater tensile force is required to be applied to the first longitudinal section as compared to the tensile force applied to the second longitudinal section. Additionally, the elongation of the first longitudinal section 18 may be varied by changing the fraction of the cross-section area thereof which is constituted by the non-expanded portions 22. The amount of the cross-sectional area of the first longitudinal section 18 constituted by the non-expanded portions 22 may be varied by changing the number or transverse dimension of the non-expanded portions.
The first and second longitudinal sections 18, 20 are each expanded where the degree of expansion of the first longitudinal section is less than the degree of expansion of the second longitudinal section. The respective degrees of expansion of the first and second longitudinal sections 18, 20 correspond to the respective longitudinal elongations thereof. The reduced degree of expansion of the first longitudinal section 18 relative to the second longitudinal section 20 results from the first longitudinal section containing the non-expanded portions 22. The non-expanded portions 22 limit the degree of expansion of the region of the PTFE tube structure 12 which adjoins the non-expanded portions. This limiting of the degree of expansion becomes increasingly attenuated at locations of the region of the PTFE tube structure 12 which are increasingly remote from the non-expanded portions 22. Consequently, the degree of expansion of the second longitudinal section 20 is not significantly affected by the non-expanded portions 22.
The reduced longitudinal elongation of the first longitudinal section 18 can be controlled by varying the number, width and location of the non-expanded portions 22 relative to the PTFE tube structure 12. Consequently, the magnitudes of the longitudinal elongations of the first and second longitudinal sections 18, 20 resulting from the same longitudinal tensile force may be optimized. The longitudinal elongation of the PTFE tube structure 12 is related to the density thereof such that the density may be controlled by control of such elongation. Additionally, different portions of the PTFE tube structure 12 may be formed to have different densities by controllably varying the longitudinal elongation of the corresponding portions. In a preferred embodiment, the first longitudinal section 18 is elongated by 200% and the second longitudinal section 20 is elongated by 800%.
The relative elongations of the first and second longitudinal sections 18, 20 may be varied by altering the rate at which the longitudinal tensile force 42 is applied to the extrudate 34. For example, applying the force 42 at a sufficiently rapid rate may result in the elongations of the first and second longitudinal sections 18, 20 being 400% and 600%, respectively. Alternatively, applying the force 42 at a sufficiently slow rate may result in the elongations of the first and second longitudinal sections 18, 20 being 0% and 1000%, respectively.
Alternative embodiments of the vascular graft 10 have one or more non-expanded portions which have shapes, dimensions, and locations relative to the tube structure 12 which differ from the non-expanded portions 22 shown in
The shape, dimensions and location relative to the tube structure 12 of the one or more non-expanded portions may be selected such that the limiting of the elongation of the non-expanded portions by the non-expanded portions is increasingly attenuated at locations of the region which are increasingly remote from the non-expanded portion. This may provide a gradient of elongation of the expanded portion in which the elongation gradually increases in regions of the expanded portion which are increasingly remote from the non-expanded portion.
Expansion of the portion of the first longitudinal section 18 which does not contain the non-expanded portions, and expansion of the second longitudinal section 20 produces expanded portions 23 which have node and fibril microstructures. This microstructure differs from the microstructure of the non-expanded portions 22 which is the same as the microstructure of the PTFE green tube extrudate. The difference in the microstructures of the non-expanded and expanded portions 22, 23 results in differences in the physical characteristics thereof. For example, if a sufficiently large longitudinal tensile force is applied to the tube structure 12, the length of the non-expanded portions 22 will increase while the cross-sectional area thereof will decrease. This combination of changes in the dimensions of the non-expanded portions 22 is sometimes referred to as “necking down” of the non-expanded portions. In contrast, application of a longitudinal tensile force to the expanded portions 23 will cause an increase in the length thereof but the cross-sectional area of the expanded portions will remain essentially the same, although an insignificant decrease in the cross-sectional area is possible. Additionally, application of such a longitudinal tensile force to the expanded portions 23 will cause a decrease in the density and an increase in the porosity of the expanded portions.
Another difference in the physical characteristics of the non-expanded and expanded portions 22, 23 is that application of the same longitudinal tensile force to non-expanded and expanded portions having the same dimensions will normally produce a smaller increase in the length of the non-expanded portion as compared to the length of the expanded portion. However, rapidly applying the longitudinal tensile force to the non-expanded portion 22 will produce a smaller increase in the longitudinal elongation thereof as compared to more slowly applying the force, where the maximum magnitude of the applied force is the same. A rapid application of the longitudinal tensile force may result from reducing the time duration between the initial application of the force and the full magnitude of the force. Increasing this time duration provides a slower application of the force. In contrast, the respective elongations of the expanded portion 23 produced by rapid and slower applications of the longitudinal tensile force thereto are as compared to the differences in the elongation of the non-the expanded portion 22 resulting from the rapid and slower force applications. Consequently, as the speed with which the longitudinal tensile force is applied decreases, the increase in the length of the non-expanded portion 22 becomes closer to the increase in the length of the expanded portion 23.
The limitation on the expansion of the regions of the expanded portions 23, 24 which are sufficiently near the non-expanded portions 22 may provide for the controlled variation in the physical characteristics of the tube structure 12. For example, limiting the elongation of the expanded portions 23, 24 limits the decrease in density thereof which normally results from elongation of the expanded portions. Consequently, forming the tube structure 12 such that the expanded portions 23, 24 have regions with different amounts of elongation provides the corresponding regions to have different densities. This is illustrated in
Alternative embodiments of the non-expanded portions 50, 54, 58, 60, 64, 70, 76, 78, 84, 86, 88, 92, 94 of
One or more of the non-expanded portions 50 may be formed in the tube structure 12b. Each of the non-expanded portions 50 is formed from sintering the PTFE green tube extrudate, such that the non-expanded portions and expanded portions 23b, 24b are of the same extrudate. Each of the non-expanded portions 50 is elongate and has a longitudinal axis which is contained in a longitudinal cross-sectional plane 52 of the PTFE tube structure 12b. In these respects, the non-expanded portions 50 correspond to the non-expanded portions 22 shown in
One or more of the non-expanded portions 54 may be formed in the tube structure 12b. Each of the non-expanded portions 54 is formed from sintering the PTFE green tube extrudate, such that the non-expanded portions and expanded portions 23b, 24b are of the same extrudate. Each of the non-expanded portions 54 is elongate and has a longitudinal axis which is contained in a transverse cross-sectional plane 56 of the PTFE tube structure 12b. One or more of the non-expanded portions 54 may encircle the inner wall surface 14b such that these non-expanded portions are annular.
One or more of the first and second non-expanded portions 58, 60 may be formed in the tube structure 12b. Each of the first and second non-expanded portions 58, 60 is formed from sintering the PTFE green tube extrudate, such that the non-expanded portions and expanded portions 23b, 24b are of the same extrudate. Each of the first and second non-expanded portions 58, 60 is elongate and has a longitudinal central axis which is inclined relative to a transverse cross-sectional plane 62 of the PTFE tube structure 12b. The first and second non-expanded portions 58, 60 have opposite inclinations and intersect one another, as shown in
One or more of the non-expanded portions 64 may be formed in the tube structure 12b. Each of the non-expanded portions 64 is formed from sintering the PTFE green tube extrudate, such that the non-expanded portions and expanded portions 23b, 24b are of the same extrudate. Each of the non-expanded portions 64 has an elongate saw-tooth configuration, and a longitudinal principal axis 66 which bisects the saw-tooth configuration. The principal axis 66 is contained in a transverse cross-sectional plane 68 of the PTFE tube structure 12b.
One or more of the non-expanded portions 70 may be formed in the tube structure 12b. Each of the non-expanded portions 70 is formed from sintering the PTFE green tube extrudate, such that the non-expanded portions and expanded portions 23b, 24b are of the same extrudate. Each of the non-expanded portions 70 has an elongate saw-tooth configuration, and a longitudinal principal axis 72 which bisects the saw-tooth configuration. The principal axis 72 is contained in a longitudinal cross-sectional plane 74 of the PTFE tube structure 12b.
Two or more of the transverse non-expanded portions 76, and two or more of the longitudinal non-expanded portions 78, may be formed in the tube structure 12b. Each of the non-expanded portions 76, 78 is formed from sintering the PTFE green tube extrudate, such that the non-expanded portions and expanded portions 23b, 24b are of the same extrudate.
The transverse non-expanded portions 76 each are elongate and have a longitudinal central axis which is contained in a corresponding transverse cross-sectional plane 80 of the PTFE tube structure 12b. The transverse non-expanded portions 76 are separated from one another longitudinally relative to the PTFE tube structure 12b.
The longitudinal non-expanded portions 78 each are elongate and have a longitudinal central axis which is contained in a corresponding longitudinal cross-sectional plane 82 of the PTFE tube structure 12b. The longitudinal non-expanded portions 78 are separated from one another transversely relative to the PTFE tube structure 12b.
The longitudinal non-expanded portions 78 intersect the transverse non-expanded portions 76, as shown in
A first, second and third transverse non-expanded portions 84, 86, 88 may be formed in the tube structure 12b. Each of the non-expanded portions 84, 86, 88 is formed from sintering the PTFE green tube extrudate, such that the non-expanded portions and expanded portions 23b, 24b are of the same extrudate. Each of the non-expanded portions 84, 86, 88 is elongate and has a longitudinal axis which is contained in a transverse cross-sectional plane 90 of the PTFE tube structure 12b. One or more of the non-expanded portions 84, 86, 88 may encircle the inner wall surface 14b such that these non-expanded portions are annular.
A first and second annular non-expanded portions 92, 94 may be formed in the tube structure 12b. Each of the non-expanded portions 92, 94 is formed from sintering the PTFE green tube extrudate, such that the non-expanded portions and expanded portions 23b, 24b are of the same extrudate. The first annular non-expanded portion 92 is located between the first and second transverse non-expanded portions 84, 86 in tangential relation thereto, as shown in
The vascular graft 10b may have one or more non-expanded portions formed from sintering the PTFE green tube extrudate, such that the one or more non-expanded portions and expanded portions 23b, 24b are of the same extrudate, and the one or more non-expanded portions have the configuration of a lattice structure.
Alternative embodiments of the non-expanded portions 22 of
The non-expanded portions 22c, 96 are designated herein as the first non-expanded portion 22c and first supplemental non-expanded portions 96. The non-expanded portions 22c, 96 are each elongate and have a longitudinal central axis which is contained in a first longitudinal cross-sectional plane 25c of the PTFE tube structure, as shown in
The first and first supplemental non-expanded portions 22c, 96 have the same longitudinal dimension and are separated longitudinally from adjacent ones of the first supplemental and first non-expanded portions by uniform dimensions. The second and second supplemental non-expanded portions 98, 100 have the same longitudinal dimension and are separated longitudinally from adjacent ones of the second supplemental and second non-expanded portions by uniform dimensions.
The first and second non-expanded portions 22c, 98 and the first and second supplemental non-expanded portions 96, 100 are each formed from sintering the PTFE green tube extrudate.
The expanded portion 23c is formed from longitudinally elongating the PTFE green tube extrudate 103 in which the non-expanded portions 22c, 96, 98, 100 have been previously formed. The first and second non-expanded portions 22c, 98, the first and second supplemental non-expanded portions 96, 100, and the expanded portions 23c are of the same extrudate 103. The expanded portion 23c corresponds to the expanded portion 23 in that the microstructures of such expanded portions are affected by the respective proximities thereof to the non-expanded portions 22c, 96, 98, 100, 22, as described further hereinbelow.
The elongation of the PTFE green tube extrudate 103 which provides for the formation of the expanded portion 23c also causes the first and second non-expanded portions 22c, 98 to be longitudinally displaced relative to one another. This longitudinal displacement between corresponding pairs of the non-expanded portions, such as the first and second non-expanded portions 22c, 98, is referred to herein as the longitudinal offset thereof. The longitudinal offset may provide for parts of corresponding pairs of the non-expanded portions, such as the first and second non-expanded portions 22c, 98, to have the same longitudinal position relative to the tube structure 12c, and other parts of the corresponding pairs of the non-expanded portions to have different longitudinal positions, as shown in
The uniformity of the differences between the longitudinal positions of the corresponding pairs of the non-expanded portions 22c, 96, 98, 100 in the green tube extrudate 103 results in a uniform longitudinal separation between the first and first supplemental non-expanded portions 22c, 96 and between the second and second supplemental non-expanded portions 98, 100 in the tube structure 12c. Additionally, after the elongation of the green tube extrudate 103, the differences between the longitudinal positions of the corresponding pairs of the non-expanded portions 22c, 96, 98, 100 are the same, as shown in
The relative longitudinal displacement between the first and second non-expanded portions 22c, 98 affects the node and fibril microstructure of the expanded portion 23c which includes nodes 104 and fibrils 106. More specifically, the nodes 104 thereof extend between the first and second non-expanded portions 22c, 98, as shown in
The inclinations of the nodes 104 enable the tube structure 12c to be radially compressed when the tube structure is subjected to a sufficiently large transverse force. Such radial compression may result in the transverse dimension of the cross-section of the tube structure 12c being reduced and the shape of the cross-section remaining constant. Consequently, a tube structure 12c which is circular may remain circular during a radial compression thereof with the diameter of the cross-section being reduced as a result of the radial compression. Also, folding of the wall of the tube structure 12c is not necessary. Reducing the transverse dimension of the cross-section of the tube structure 12c may facilitate insertion of the graft 10c into the body of a patient. Alternatively, the inclinations of the nodes 104 may result in the tube structure 12c collapsing transversely into an elliptical or flat cross-sectional configuration when subjected to a sufficiently large transverse force. Such elliptical or flat collapsing of the tube structure 12c may be accompanied by a reduction in one or more transverse dimensions of the tube structure 12c. Collapsing of the cross-section of the tube structure 12c, with or without reduction in one or more of the transverse dimensions, may facilitate insertion of the graft 10c into the body of a patient.
To further illustrate by way of comparison the inclined nodes of the microstructure shown in
The PTFE tube structure 12c contains a substantial number of non-expanded portions 22c, 96, 98, 100, as indicated by
The vascular grafts 10, 10a, 10b, 10c have different physical characteristics which result from the incorporation of the non-expanded portions in the respective tube structures 12, 12a, 12b, 12c. The differences in the physical characteristics result from differences in the positioning of the non-expanded portions relative to the respective tube structures 12, 12a, 12b, 12c. This positioning of the non-expanded portions may be defined by the orientation thereof relative to a transverse cross-sectional plane, such as the planes 62, 114 of the respective tube structures 12b, 12c. Tube structures, such as the tube structures 12, 12c, having different physical characteristics may also be provided by incorporating therein different numbers of the non-expanded portions. Differences in the number and orientation of the non-expanded portions in the respective tube structures 12, 12a, 12b, 12c may provide a corresponding resistance to compression thereof in the respective transverse cross-sectional plane, such as the planes 62, 114.
The entire disclosures of the following U.S. patent applications, each of which is being filed in the USPTO on even date herewith, are hereby incorporated by reference herein:
Title: “Sintered Ring Supported Vascular Graft”; Inventors: Jamie Henderson and Dennis Kujawski; Attorney Docket No. 760-160; and
Title: “Differentially Expanded Vascular Graft”; Inventor: Jamie Henderson; Attorney Docket No. 760-172.
While the invention has been described by reference to certain preferred embodiments, it should be understood that numerous changes could be made within the spirit and scope of the inventive concept described. Accordingly, it is intended that the invention not be limited to the disclosed embodiments, but that it have the full scope permitted by the language of the following claims.