CA2106971C

CA2106971C - Vascular prosthesis

Info

Publication number: CA2106971C
Application number: CA002106971A
Authority: CA
Inventors: David Stuart Brookstein; John Skelton; Peter J. Schmitt
Original assignee: Meadox Medicals Inc
Current assignee: Maquet Cardiovascular LLC
Priority date: 1991-03-25
Filing date: 1992-03-24
Publication date: 1998-06-23
Anticipated expiration: 2012-03-24
Also published as: DE69219593T2; DE69219593D1; EP0576517A1; CA2106971A1; ATE152597T1; AU1422992A; JPH06506369A; AU658176B2; IE71172B1; FI934176A; JP2749447B2; IE920927A1; EP0576517B1; PT100297A; FI934176A0; MX9201330A; WO1992016166A1; US5697969A

Abstract

The present invention provides a vascular prosthesis which comprises a braided tubular fabric comprising a plurality of braid layers wherein each layer includes at least one interlocking yarn which extends from that layer into another layer to form an interlock therewith. In one aspect of the invention, the plurality of braid layers may include a substantially non-absorbable first surface layer and a substantially resorbable second surface layer.

Description

DESCRIPTION
VASCULAR PROSTHESIS

The present invention relates to a vascular prosthesis.

In surgery, tubular vascular prostheses are typically used for the replacement of damaged or worn-out blood vesseis. Such a prosthesis should desirably have ~oyelLies of radial and longitudinal elasticity which resemble closely the corresponding properties of natural blood vessels, thereby to avoid aneurysm at the anastomosis and to maintain patency of the implant. Further, it is desirable that a synthetic vascular prosthesis should allow tissue ingrowth to form a smooth, non-thrombotic endothelium of'natural cellular tissue. It will be appreciated, therefore, that after implantation the prosthesis should provide a porous support structure which gives the implant an intrinsic strength matching the strength of a natural blood vessel and allows cellular growth to invade the prosthesis to form a neointimal vessel lining having an organised cell structure. However, immc~iately on implantation the prosthesis is desirably LmpPrm~Ahle to blood, thereby to avoid bleeding without the requirement for preclotting which hinders tissue ingrowth and promotes thrombosis.

S A typical tubular vascular prosthesis comprises a tubular fabric which includes a resorbable yarn component, and a non-absorbable yarn component. The yarns are incorporated in the fabric to form a prosthesis which is initially imp~rmPAhle to blood and, over a period of time following implantation, the biologically absorbable fibres are resorbed, thereby increasing p-u~essively the porosity of the prosthesis to allow ingrowth.

Hitherto, synthetic vascular prostheses have been made hy weaving, braiding, knitting or crochetting, but tubular vascular prostheses made of synthetic fibre yarns by weaving or knitting are not suitable for use when the diameter of the prosthesis is less than about 6mm. Problems such as kinking and anastomotic hy~e~lasia at the interface between a natural artery or vein and such a tubular prosthesis ~Le~,ent the use of such a graft having an internal diameter of less than 6mm.

W O 92/16166 PCTtGB92/00538 21069~1 European Patent Specification No. A0397500 discloses a vascular prosthesis which is formed by weaving, knitting or braiding a synthetic semi-absorbable composite yarn to form a tubular fabric. The composite yarn comprises a non-absorh~hle elastic core which imparts resiliency to the composite yarn and an absorbable, relatively inelastic sheath which imparts transverse tensile strength to the composite yarn. In use, the sheath material is ~Loylesslvely resorbed, whereby a porous structure develops which provides a scaffold for tissue ingrowth and exhibits structural opel~ies resembling the dynamic fluid pressure les~onse characteristics of natural vascular tissue.
The vascular prosthesis of EP-A-0397500 has an initial lS low permeability to ~le~ent blood leakage in pre-heparinized patients without the requirement for pre-clotting and an increasing permeability in use to allow the ~l~y~essive development of a smooth, non-th o..~ge,~ic neointima. However, the intrinsic structural characteristics of the prosthesis change as the sheath material is eroded. The graft, therefore, is not satisfactory unless the erosion of the sheath is matched by tissue ingrowth to maintain the strength of the prosthesis.

According to one aspect of the present invention there is provided a vascular prosthesis which comprises a braided tubular fabric comprising a plurality of braid layers wherein each layer includes at least one interlocking yarn which extends from that layer into another layer to form an interlock therewith.

In another aspect of the ~lesellt invention, the plurality of braid layers may comprise a substantially non-~hsorh~hle first surface layer and a substantially resorbable second surface layer.

The braided t1~h~ r fabric may be formed by interbraiding one yarn of a non-lesolbable material with another yarn of a biologically lesolbable material. The first surface layer may be formed substantially only of said one yarn, and the second surface layer may be formed substantially only of said other yarn. Typically, the resorbable material may be selected from catgut (collagen sutures derived frcm sheep intestinal -submucosa), reconstituted collagen, polyglycolic acid (PGA) and its lactide copolymers, polydioxanone (PDS) and poly(glycolide-trimethylene carbonate). The non-absorbable material may be selected from natural fibres such, for example, as sllk and cotton synthetic fibres such, for example, as polyethylene, poly-propylene, polyamide, polyester, polytetrafluoroethylene and stainless steel.
Accordlng to one aspect the outer surface layer of the fabrlc is substantially non-absorbable, and the inner or luminal surface layer is substantlally resorbable. The fabric may also comprise one or more lntermedlate layers between sald surface layers. Each intermediate layer may be formed of said two yarns interbraided wlth one another. The proportlon of sald yarn ln each layer may decrease progresslvely, and the proportion of said other yarn in each layer may increase progresslvely from one of said surface layers to the other surface layer.
In accordance with the present lnventlon there ls provided a prosthetic devlce, comprising an implantable three-dlmenslonal tubular structure characterized by a plurality of braided layers wherein each layer includes at least one interlocking yarn whlch extends lnto the next ad~acent layer to form an lnterlock therewith, one of said layers comprislng a substantlally resorbable materlal and another of sald layers comprlslng a substantlally nonabsorbable materlal.
Accordlng to a particular aspect of the lnventlon, the diameter of the tubular braided prosthesis may be about 6mm or less; although the lnvention also comprehends prostheses having diameters greater than 6mm.

.- ~

In some em~c~im~nts, the tubular fabric may include non-absorbable, external support means. The said support means may comprise at least one wrap which follows a helical or spiral path around the exterior of the fabric; and in one aspect the support means includes two wraps, each wrap following a spiral path of opposite handedness to the other wrap.

Each wrap may be formed of an elongate textile 5tructure having a suitably high bending modulus or stiffness. According to some embodiments, each wrap comprises a monofilament or yarn having a high denier.
Alternatively, the wrap may be a multifilament yarn or braid formed of a plurality of strands having a high composite denier and a linear density greater than that of the braided tubular fabric.

The wrap may be attached to the external surface of the fabric by any suitable adhesive or by heating to form fibre-to-fibre bonds. Preferably, however, each wrap is incoL~olated into one or more of the intermediate or external surface layers of the braid forming the fabric. In a particular aspect of the invention, the wrap may be incorporated in the braid 210~971 structure of the said external surface layer to follow a helical path; more particularly, the said wrap may be incorporated in the braided external surface layer such that it does not form an interlock with any of the other braid layers. The wrap(s) may be formed of any suitable non-absorbable material; in one embodiment, a polyester wrap may be utilized.

A suitable method and apparatus for forming a t1~h~ r braided fabric for use as a vascular prosthesis in accordance with the present invention is disclosed in the specification as published under Internàtional Patent Publication No. W09l/10766, the disclosure of which is incol~Lated herein by reference. According to this method, a braided fabric comprising a plurality of interlocked layers is produced by a plurality of package carriers of yarn which are constrained by track module means to ~ ve along a plurality of serpentine paths; the track module means being arranged to extend in a first direction to define a longitudinally extending path co~les~Gnding to a first layer of the braided fabric and in a second direction to provide at least one cross-over path between adjacent serpentine paths. The package WO 92/16166 PCT/GB92/00~3X
2106~71 carriers are moved in said first direction to create a first layer of braid and along a cross-over path between adjacent serpentine paths to cause the yarn ~ forming said first layer of braid to be transported to interlock with the braid of an adjacent layer.

The apparatus for the production of such a braided fabric cumprises: a tw~-dimensional array of rotatable horn gears in toothed engagement; driving means for driving said array, each horn gear being arranged to rotate in a direction contrary to each intereng~ging gear; track means overlaying said array; and a plurality of yarn package carriers movable along said track means by said horn gears. The track means comprises a plurality of track modules which together define a plurality of serpentine paths extending in a first direction, each serpentine path COr le~nding to a braid layer in said fabric and in which selected track modules include at least one cross-over path section extending in a second direction between one serpentine path and the next adjacent serpentine path to cause or allow the package carriers to move between adjacent serpentine paths to ,7210697~

_ g _ effect interbraiding of yarns between adjacent layers.

A base bed may be provided on which a plurality of gear modules may be arranged in an infinite array, and over which the track modules may be positioned. The base bed may be disposed in a cylinder and provides a tubular multilayer tubular braid in which the layers are interlocked or interbraided one with another.
A multi-layer braided t~1h11t~r prosthesis according to the present invention may have the advantage that the structural characteristics of the fabric do not change as the esolbsble material is absol~ed. In use, therefore, the change in permeability of the fabric as the resorbable material is eroded may coincide with the development of a neointimal surface. Furthermore, it has been found that the use of an interlocked, multi-layer tubular braid of the type disclosed in W~9l/lO766 permits the production of a prosthesis having a diameter of about 6mm or less which exhibits an increased resistance to kinking as compared with known prostheses. A small diameter implant in accordance with the present invention may have WO 92/16166 PCT/GB92/00~38 2106~7-1 particular application as a prosthetic graft e.g. for the aorto-coronasy artery or the femoral-popliteal artery.

A t~1h~ r braided fabric having interlocked layers produced by the method and apparatus of WO9l/10766 may be stronger than a conventional t11h11~ braided structure having layers which are not inter-connected.
The ~Lo~euLies of such a prosthesis tend to degrade - lO over time~ and the improved initial strength assists materially the lon~e~ity of the prosthesis. The braid prosthesis of the present invention, therefore, may be less vulnerable to kinking when bent. The relatively high radial compression resistance may minimise the effects of anastomotic hyperplasia, and the relatively low radial compliance in tension may accommodate the systolic pressure pulse.

A significant advantage of the vascular prosthesis in accordance with the present invention is that with the braided fabric the lay of the bulk of ~he yarns constituting the braid is at a significant angle to the longitudinal axis of the prosthesis. In the prior art methods using woven fabrics, one of the yarns of ~l~69~l weave usually extends in the longitudinal direction.
This means that in use, bending and flexing of such woven prostheses results in much greater stress and strain on such longitudinal yarns thus resulting in kinking and sometimes premature failure of the prosthesis. The angular disposition of the yarns of the prosthesis of the present invention permits of sharp bends in the prosthesis without im~2rting such strain on the yarns forming the braid.
Following ls a description by way of example only and with reference to the accompanying drawings of methods of carrying the present invention into effect.

In the drawings:-Figure 1 is a schematic illustration of a cross-section of a fragment of a multi-layer braided fabric tubular prosthesis in accordance with the present invention;

Figure 2 is a graph of the radial stress strain relationship of the multi-layer braided tubular fabric of Flgure l.

2 1 0 ~ 9 71 PCT/GB92/0053X

Figure 3 is a schematic illustration of a braided prosthesis according to the present invention including exterior helical support means;

Figure 4 is a schematic illustration of a different supported tubular braided prosthesis in accordance with the present invention.

Figure 5 is two photomi~.~yLaphs at Xll magnification which show the external surface of the supported tubular braided prosthesis of Figure 4;

Figure 6 is two photomicl~y.aphs at X12 magnification of the prosthesis of Figure 4.
Figure 7 is two photomi~loyLaphs at X20 and X25 magnification respectively of the inner surface of the prosthesis of Figure 4.

Figure 8 is two photomicl~y~aphs at X43 and X90 magnification respectively of the inner surface of the prosthesis of Figure 4.

W O 92/16166 210 6 9 ~1 PCT/GB92/00538 Figure 9 is two photomicrographs at X14 and X33 magnification respectively which show a cross-sectional view of the prosthesis of Figure 4.

Figure 10 is two photomicl~yLaphs at X45 and X75 magnification respectively of the cross-section of Figure 9.

Figure 11 is a schematic illustration which shows the effect of systole on the prosthesis of Figure 4;

Figures 12, 13 and 14 are photomic,oy~aphs at X50, X50 and X15 magnification Le~ec~ively which show the interior and exterior surfaces of a braided prosthesis in accordance with the present invention.

Figure 15 shows a graph of radial displacement as a function of positive radial pressure for each of six sample prosthesis in accordance with the present invention.

21~G971 Example 1 In Figure l a fragment of a multilayer braided fabric tubular vascular prosthesis comprises four inter-locked layers (lO), (12), (lS) and (17). Each layer is formed by interbraiding two lengths of yarn which follow generally serpentine paths, one path superimposed on and out of phase by half a cycle with respect to the other path. Part of one of the lengths of yarn of each layer is diverted from its serpentine path to extend across to a second layer to be interbraided with one of the yarns forming that second layer; whereafter the one length of yarn is returned to its seL~e,1~ine path in the first layer. In being interbraided with the yarn of the second layer, the length of yarn is passed around the yarn of the second layer so that the two layers are interlocked. In each layer the diverted portion of the one length of yarn is replaced by a similar diverted portion of yarn diverted from another layer which is interbraided with the first mentioned yarn for interlocking.

2106~71 The layer (10) that forms the outer surface layer of the tubular prosthesis is formed by non-resorbable yarn material only; parts (lLA) of the main length (11) of that material being diverted to interlock with one of the yarns that forms juxtaposed layer (12). In addition to the diverted portions (lLA) of the yarn material (11), said juxtaposed layer (12) is formed of portions of each of other lengths (13) and (14) of yarn; length (13) also being formed of non-resorbable material, while the length (14) is formed of resorbable material.

Next juxtaposed layer (15) is formed of portions of three different yarns: yarn (14), diverted portions (13B) of the length of non-resorbable yarn (13) and diverted portions of a length of resorbable yarn (16) which forms lnner surface layer (17). Inner layer (17) is also formed of diverted portions (14B) of yarn (14) which are interbraided with yarn (16).
With reference to Figure 2 the stress/strain relationship of the tllh~ r prosthesis of ~x~mrle has a relatively hiqh radial compression resistance and a low radial c~"~liance in tension which 21~6971 minimises the tendency for the prosthesis to kink and reduces the possibility of aneurysm at the anast ~osis.

Example 2 With reference to Figure 3, a 5-layer interbraided tllhlll~r prosthesis (30) was made on a 6mm diameter steel mandrel using a 48-carrier braiding machine.
The inner braid layer (not shown) was formed substantially of 48 yarns of resorbable 7/0 ~ nofilament suture yarn which is commerically available from Messrs Davis & Geck under the Trade Mark MAXON: the outer braid layer was formed substantially of 46 polyester multifilament yarns of 70 denier of the type commerically avaiiable under the Trade Mark "DACRON" type 56 and 2 polyester monofilaments (32) of 0.012" diameter: and the three intermediate layers were each formed substantially of 48 yarns of 70 denier DACRON type 56.

The said polyester ~ nofilaments (32) were ~ incorporated into the braid structure of the outer layer to form two helical wraps in the outer surface of the prosthesis (30); the wraps being of opposite handedness one from the other. After braiding, the prosthesis was ~ ed from the mandrel and placed over a 5mm diameter mandrel and heat-set at 150~C for 30 minutes.

Example 3 In Figure 4, a t-~h1~1~r vascular prosthesis (40) was made in the same way as described in Example 2 above, but the outer braid layer was formed with only one helical wrap (42) of polyester monofilament.

Figures 5 to l0 show various photomicrographs of the prosthesis (40). In Figures 5, 6, 9 and l0 the photomiclog.aphs show clearly the helical wrap (42) of polyester monofilament which is incorporated into the braid structure of the outer braid layer of the prosthesis (40). Wrap (42) is interbraided with the DACRON polyester multifilament yarns (44) and is not interlocked with yarns in any of the int~rme~i~te layers or inner braid layer. In Figures 7 and 8, the inner braid layer (46) of prosthesis (40) includes non-absorbable DACRON multifilament polyester yarns (44) which are interbraided with the said resorbable MAXON suture yarns (48).

Figure ll sh~ws schematically the effect of cardiac systole on the prosthesis (40) which has a stress-strain relationship similar to that shown in Figure 2 in connection with Example l above. It will be appreciated that a tubular braid structure allows reorganisation and relative movement of the interbraided yarns to accommodate or allow changes in diameter of the tl1h~ r braid, and the low radial compliance of prosthesis (40) allows the diameter of the prosthesis (40) to expand during systole in a manner which matches closely the systolic response of lS natural blood vessels.

.
Example 4 A flve-layer interbraided tubular prosthesis was made on a 6mm diameter stainless steel mandrel using a braider having 48 package carriers at a nominal braid orientation angle of 55~ to the longit-l~i n~l axis of the mandrel. The inner braid layer was formed substantially of 48 resorbable, polylactic acid-based 7/0 USP suture yarns such as those which are , -rcially available under the Trade Mark MAXON: the next adjacent layer was formed substantially of 24 MAXON 7/0 suture yarns and 24 multifilament polyester yarns of 70 denier commercially available under the Trade Mark DACRON type 56: and the other tw~
intermediate layers and the outer braid layer were each formed substantially of 48 DACRON type 56 yarns of 70 denier. After braiding, the prosthesis was 10 removed from the 6mm mandrel and placed on a 5mm diameter mandrel. The prosthesis was then stretched in a longitudinal direction to cause the prosthesis to form a conformate fit to the surface of the smaller mandrel, and the mandrel/prosthesis was placed for 30 15 minutes in an oven heated to 150~C. After cooling the tubular prosthesis was L~.~ved from the mandrel for use.

Example 5 A tubular, five-layer braided prosthesis was prepared as described above in Example 4. The inner braid layer was formed substantially of 48 MAXON 7/0 suture yarns, and the four other layers were each formed WO 92tl6166 PCr/GB92/00538 substantially of 48 DACRON type 56 yarns of 55 denier.
Figure 6 is a photomicrograph of the surface of the outer braid layer having braided non-absorbable yarns (62). Figure 7 is a photomicrograph of the surface of the inner braid layer which comprises resorbable yarns (72) which are interbraided with yarns (74) of the next adjacent layer diverted into the inner layer to form an interlock therewith.

In Figure 8, the two surfaces are shown side-by-side for comparison.

Example 6 Six tubular prostheses (Examples 6.1 to 6.6) were made as described above under Example 4. Each prosthesis was braided onto a 6mm diameter mandrel and then transferred to a 4.75mm mandrel and heat set for 30 minutes at 150~C. In each case, the prosthesis comprised five interbraided braid layers: the inner braid layer was formed from 48 MAXON 5/0 suture yarns (except Example 6.2), and the three int~r~ te layers were each formed from 48 DACRON type 56 multifilament yarns, each multifilament yarn comprising 34 monofilaments and having a total denier of 70. In the case of Example 6.2, the inner layer was formed of 48 DACRON multifilament yarns. The composition of the outer braid layer of each prosthesis was as follows:-Prosthesis Number Composition of Innerbraid Layer 6.l 48 DACRON type 56 (70 denier, 34 monofilament) multifilament yarns 6.2 48 DACRON type 56 (70 denier, 34 monofilament) multifilament yarns 6.3 47 DACRON type 56 (70 denier, 34 monofilament) multifilament yarns and one braided cord comprising 16 DACRON type 56 (70 denier, 34 monofilament) multifilament yarns 6.4 46 DACRON type 56 (70 denier, 34 monofilament) multifilament yarns and two braided cords, each cord comprising 16 DACRON type 56 (70 denier, 34 monofilament) multifilament yarns.

6.5 46 DACRON type 56 (70 denier, - 34 monofilament) multifilament yarns and two 0.012 mil polyester monofilaments 6.6 47 DACRON type 56 (70 denier, 34 ~ nofilament) multifilament yarns and one braided cord comprising 16 interbraided DACRON type 56 (70 denier, 34 ~ nofilament) - yarns.

WO 92/16166 ' ~ 210 6 9 7 1 PCT/GB92/00538 V ~ '' After heat setting, each prosthesis was cooled and removed from the 4.75mm mandrel. The radial compliance of each prosthesis was then measured by subjecting the prosthesis to internal positive pressure and measuring the radial displacement. The results of such tests are shown in Figure 15 (a) to (f) each of which shows a graph of displacement in millimetres against the outwardly directed radial pressure in mmHg for each of the six prostheses 6.1 to 6.6 ~esy~Lively. In each case, the prosthesis was held under a 400g axial load, and the following tAhle shows the threshold pressure for each prosthesis for the onset of radial displacement.

i 3 1 U

Per/6B ~ 0 5 3 2~ ~IP~ 4 210~971 Table 1 Prosthesis Number Onset of radial displacement/psi 6.1 250 6.2 180 6.3 410 6.4 No significant radial displacement reached 6.5 360 r 6.6 300 When a typical tubular prosthesis in accordance with the present invention is first implanted in a patient, the structure of the prosthesis provides intrinsic support; the braided prosthesis provides a graft which is initially impermeable to blood in -pre-heparinized patients, but, as time pL~ylesses, the biologically resorbable material that forms the inner surface layer and parts of intPr~ te layers is resorbed, and body tissue is allowed to grow into interstices which are formed in the residual braided Un;-t~c, ,'-- ~m ~ t Offi~e PCT l~7~ Jn~,! A,~iiC3~i~n SUBSTI~ E SHEET

PCT16B 9 2 / 0 O 5 ~ 8 2106971 20 A~RIL 199~

structure of non-resorbable yarns, which structure provides a geometrically stable support.

It has been found that the stress-strain relationship of a prosthesis according to the present invention typically exhibits a low radial compliance and a high co.~.~Lession resistance which all~ws the prosthesis to mimic closely the properties of natural blood vessels.
Further, the use of braiding technology as described in the applicant's WO91/10766 allows the provision of a tubular vascular prosthesis having a diameter of 6mm or less which is less liable to kinking and aneurysm as compared with known grafts.

l,'nl-.a~ ~ n ~t Off~e PCT In.~ r'~!r~ ion ¦ SUBS~firVTE SHE~T

Claims

THE EMBODIMENTS OF THE INVENTION IN WHICH AN EXCLUSIVE
PROPERTY OR PRIVILEGE IS CLAIMED ARE DEFINED AS FOLLOWS:

1. A prosthetic device comprising an implantable, three-dimensional tubular structure characterized by a plurality of braided layers wherein each layer includes at least one interlocking yarn which extends into the next adjacent layer to form an interlock therewith, one of said layers comprising a substantially resorbable material and another of said layers comprising a substantially non-absorbable material.

2. The prosthetic device according to claim 1, wherein said substantially resorbable material comprises an inner layer, and wherein said substantially non-absorbable material comprises an outer layer.

3. The prosthetic device according to claim 2, wherein said resorbable material comprises biologically resorbable yarns.

4. The prosthetic device according to claim 3, wherein said yarns are selected from the group consisting of catgut, reconstituted collagen, polyglycolic acid, polydioxanone and poly(glycolide-trimethylene carbonate).

5. The prosthetic device according to claim 3, wherein said structure includes first, second and third layers; and wherein said first layer comprises said outer layer and includes substantially non-absorbable yarns that provides a geometrically stable support structure; and wherein said third layer comprises said inner layer and includes said substantially resorbable yarns which provide initial impermeability to fluid; and wherein said second layer is disposed between said first and third layers and includes both said resorbable and non-absorbable yarns.

6. The prosthetic device according to claim 1, further comprising non-absorbable external support means surrounding said structure.

7. The prosthetic device according to claim 6, wherein said support means includes at least one wrap forming a helical path around the exterior of said structure.

8. The prosthetic device according to claim 7, wherein said wrap is formed of an elongate textile structure having a substantially high bonding modulus.

9. The prosthetic device according to claim 7, wherein said wrap is formed of monofilament yarns having a substantially high denier.

10. The prosthetic device according to claim 7, wherein said wrap is formed of multifilament yarns having a composite denier and linear density greater than that of said braided structure.

11. The prosthetic device according to claim 7, wherein said wrap is externally attached to said structure by an adhesive.

12. The prosthetic device according to claim 7, wherein said wrap is incorporated into a layer of said braided structure.

13. The prosthetic device according to claim 7, wherein said structure includes a first layer which forms an outer surface, and wherein said wrap is incorporated into said first layer and forms a helical path therein.

14. The prosthetic device according to claim 7, wherein said wrap is formed of a non-absorbable material.

15. The prosthetic device according to claim 6 wherein said support means includes first and second wraps forming helical paths around the exterior of said structure, said first wrap forming a helical path opposite to that of said second wrap.

16. A method of repairing a tubular vessel in a patient's body, comprising:
removing a damaged portion of said tubular vessel from said patient's body;
braiding a three-dimensional interlocking structure on a mandrel having an outside diameter corresponding to the inside diameter of said tubular vessel to provide a prosthesis;
positioning said prosthesis into the region of said vessel from which said damaged portion was removed; and securing each end of said prosthesis to a respective end of said vessel whereby a continuous fluid pathway is reestablished along said vessel.