This invention refers to the safe and blood-proof connection of a vessel with a vascular graft either by an automatic device or by hand.

The anastomosis of a vessel to a vascular graft is problematic by nature due to the pathological and brittle state of the vessel wall in cases where part of the vessel must be replaced by a vascular graft e.g. aortic aneurysm and due to the presence of hydraulic pressures and pulse leading to sporadic ruptures of the wall by the stapler clip itself e.g. stitch employed for the anastomosis.

The anastomosis of vessel - vascular graft must be blood- proof otherwise the patient's life is in great danger. The application of such an anastomosis requires the interruption of the blood flow through the vessel which is accomplished by the placement of a vascular clamp. The duration of the interruption of the blood flow is a major factor for the outcome of the operation and must be the least possible one considering the numerous side effects which it causes to the organism.

The currently, extensively applied suturing means exerts great pressure against the vessel wall at the binding point due to its small diameter, resulting in ruptures of this wall, to a smaller or larger extent, frequently leading to uncontrolled haemorrhage. The present invention aims at the safe and blood-proof vessel- vascular graft binding eliminating increased tensions from the stapler clip to the vessel wall and consequently at the preservation of its integrity as well as the execution of this binding in less time. The

above mentioned are accomplished by the use of plug-button ligaments. The invention reveals the alternative ways of their use either by an automatic stapler equipped with such ligaments or by a vascular graft where the plug or the button or both parts of the ligaments are integrated or finally by the application of an annulus first to the vessel by plug-buttons ligaments and then to the vascular graft by a simple mechanic binding.

The short description of the following figures refers to the realisation of the invention given as an example without the intention of limiting it.

Figure 1 : Is the representation of the angiosurgical device.

Figure 2: Is the representation of the attachment of the device, the shaft.

Figure 3: Is the representation of the shaft coated by a vascular graft.

Figure 4: Is the representation of a plug-button connector.

Figure 5: Is the representation of the angiosurgical device equipped with plug-button connectors.

Figure 6: Is the representation in cross-section of the angiosurgical device bringing the vascular graft to the suturing point.

Figure 7: Is the representation of a vascular graft with free double ends at the edge.

Figure 8: Is the representation of a vascular graft with free double ends and integrated plug - button connectors. Figure 9: Is the representation of the suturing of a vessel-vascular graft by plug-button connectors.

During the referred suturing procedure, the vessel wall is maintained in contact with the wall of the vascular graft by

compression among the bases of a much larger surface than the transverse surface of the axis which penetrates the vessel wall.

The attachment is accomplished as the axis of the connector penetrates the vessel and possibly the graft - unless the connectors are integrated in the graft as it is safely "locked" at the button receptor.

The small differences in thickness of the vessel wall are covered either by the fact that, occasionally, the axis enters the button receptor at different depths or in the case of the integrated button in the vascular graft by the fact that the axis can enter the thickness of the graft wall.

The placement and connection of the graft or the ring to the vessel can be employed either by the use of the described device or by hand as long as the connectors are integrated in them, either by clamp placed by each of the plug - button connectors.

Referring to the invention in detail in figure (1) we can see an angiosurgical device which has an attachment at the shaft (11) and mobile mandibles which enclose the shaft and converge towards it during the suturing. The sutured elements are placed in between shaft-mandibles and pressed between the largest perimeter of the shaft and the corresponding points of the inner surface of the mandibles next to their edges (23).

The shaft is bound to the main body of the device with a receptor (13), from which it can be detached, while the mandibles are bound to the main body by the articulations (22).

Figure 2 shows a shaft which has a smooth free edge and its larger perimeter is next to this edge. The free edge of rounded or oval cross-section enters the vessel lumen as far as the largest

perimeter.

Figure 3 shows a shaft coated by a vascular graft whose edge exactly covers the largest perimeter of the shaft (12). The vascular graft enters the vessel lumen together with the edge of the shaft. The vessel and vascular graft are compressed in between the shaft and mandibles when the device is used.

Figure 4 shows a plug-button connector. The thin axis (42) penetrates the vessel wall and enters the button receptor (44) where it locks. The vessel wall is trapped among the wide bases of the plugs (41) and the buttons (43).

Figure 5 shows the angiosurgical device equipped with plug- button connectors. The buttons (43), are at the largest perimeter of the shaft, in receptors, and the plugs (41) are at the corresponding points of the mandibles (23) in such a way so that during the convergence of the mandibles towards the shaft and the pressure on it each plug is bound with the corresponding button.

Figure 6 shows the shaft (11), in cross-section at the suturing level, which has buttons (43) coated by graft (71) and around it the mandibles (21) which have the plugs (41). The buttons are uniformly distributed in the perimeter of the shaft.

Figure 7 shows a vascular graft (71) which by adhesion, has parts made of its own material or of another bio-compatible material (72) which surround this edge of the graft and form free double ends.

Figure 6 shows a vascular graft (71) with free double ends at its edge, which has integrated plug-button ligaments, the buttons (43) are at the edge of the outer surface of the graft tube, the plugs (41) are at the end of the inner part of the adhesive parts (72). The binding with the vessel is executed by trapping the edge of the

vessel between the cut ends of the graft connected to the plug- buttons connectors.

Figure 9 shows the binding of a vessel to a vascular graft executed by the binding of each plug with the corresponding button. Figure 10 shows a vascular annulus (81) consisting of an integral tube that forms at its one edge free double ends, its inner cut end is formed by the edge of the tube (84) and the outer by the part or the parts which can converge and cover the outer surface of the inner cut end. At the edge of the outer surface of the inner cut end (84) are the buttons of the plug-button connectors and at the corresponding points of the inner surface of the outer cut end (83) are the plugs, in such a way that with the convergence of the two cut ends, the plug is bound to the corresponding button trapping the intermediately placed edge of the vessel.

The other edge of the annulus (82) has a receptor for simple mechanic binding to the edge of the graft which has the corresponding receptor.

Figure 11 shows a vascular annulus (81) integrated at the edge of the vascular graft (71) in a way that the vascular graft coats the whole inner surface of the ring. The annulus forms free double ends (41 , 43) as described in figure 9, in a way that the trapping of the vessel (60) between the cut ends of the annulus can create integral continuity of the vessel-vascular graft contact.