Vessel grafting method

Abstract

Minimally invasive techniques utilized in bypass grafting are disclosed. For instance, a method of implanting and end portion of a graft in the body of a patient during a bypass grafting procedure includes the steps of (i) advancing a medical instrument within a circulatory system of said body, (ii) guiding a distal end of said medical instrument out of said circulatory system through an opening defined in said circulatory system after said medical instrument advancing step, (iii) advancing said end portion of said graft within said medical instrument after said guiding step, and (iv) securing said end portion of said graft to a blood to vessel of said circulatory system after said end portion advancing step.

1 . A medical procedure for connecting a blood-conveying conduit to a blood vessel in a patient's body to provide blood flow outside of the blood vessel, the method comprising: 
 creating an arteriotomy in the blood vessel by extravascular manipulation at a selected location through an incision at a location on the patient's body inferior to the selected location; and    forming an anastomosis between the blood-conveying conduit and the blood vessel at the selected location by extravascular manipulation through said incision to provide blood flow in the blood-conveying conduit outside the blood vessel.    
     
     
         2 . The medical procedure according to  claim 1  in which the blood vessel is the aorta.  
     
     
         3 . The medical procedure of  claim 2  in which the selected location is above the iliac arterial bifurcation of the aorta and the incision is located inferior the inguinal ligament.  
     
     
         4 . The medical procedure according to  claim 2  further comprising: 
 positioning through the incision an end of the blood-conveying conduit outside the aorta and near the arteriotomy at the selected location; and    anastomosing the end portion of the blood-conveying conduit to the selected location on the aorta by extravascular manipulation including through the incision.    
     
     
         5 . A medical procedure for connecting a blood-conveying conduit to the aorta in a patient's body, the method comprising: 
 creating an arteriotomy in the aorta at a selected location by extravascular manipulation through an incision on the patient's body inferior to the selected location;    positioning an inflow end of the blood-conveying conduit near the arteriotomy at the selected location via the incision at a location near a femoral artery below the linguinal ligament; and    anastomosing the end portion of the blood-conveying conduit and the aorta at the selected location to provide blood flow in the blood-conveying conduit outside of the aorta.    
     
     
         6 . A medical procedure for connecting a blood-conveying conduit to a blood vessel, the method comprising: 
 extravascularly creating an arteriotomy in the blood vessel at a selected location by manipulation through an incision located inferior to the selected location;    forming an anastomosis between the blood-conveying conduit and the blood vessel at the selected location; and    positioning a visualization device adjacent the selected location while creating said arteriotomy and forming said anastomosis.    
     
     
         7 . A medical procedure for connecting a blood-conveying conduit to an aorta, the method comprising: 
 extravascularly positioning an end of an instrument having a lumen therethrough near a selected location along the aorta through an incision located inferior to the selected location;    advancing an end portion of the blood-conveying conduit through the lumen of the instrument to the selected location adjacent the aorta; and    forming an anastomosis between said blood-conveying conduit and the aorta at the selected location.    
     
     
         8 . The medical procedure according to  claim 7  in which the instrument includes an endoscope, further comprising: 
 positioning an end of the endoscope near the selected location; and    advancing an end portion of the blood-conveying conduit through the lumen of the endoscope to the selected location.    
     
     
         9 . A medical procedure for connecting a blood-conveying conduit to an aorta, the method comprising: 
 positioning an end of an endoscopic instrument having a lumen therethrough near a selected location along the aorta through an incision located near a femoral artery below the inguinal ligament;    advancing an end portion of the blood-conveying conduit through the lumen of the endoscopic instrument to the selected location adjacent the aorta; and    forming an anastomosis between the said blood-conveying conduit and the aorta at the selected location.    
     
     
         10 . A medical procedure for connecting a blood-conveying conduit to the aorta, the method comprising: 
 advancing an end portion of the blood-conveying conduit to a selected location adjacent the aorta through an incision located inferior to the selected location;    extravascularly positioning through the incision and near the selected location along the aorta a distal end of an instrument having a lumen extending therethrough between distal and proximal ends thereof;    manipulating a surgical device extending through the lumen in the instrument to create an arteriotomy in the aorta at the selected location; and thereafter    forming an anastomosis between the blood-conveying conduit and the blood vessel at the selected location.