US3916874A - Intraluminal vein holder - Google Patents

Intraluminal vein holder Download PDF

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US3916874A
US3916874A US449726A US44972674A US3916874A US 3916874 A US3916874 A US 3916874A US 449726 A US449726 A US 449726A US 44972674 A US44972674 A US 44972674A US 3916874 A US3916874 A US 3916874A
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core
wall
vein
connector
receive
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US449726A
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Richard Perrin
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges

Definitions

  • A61B 19/00 A device for use in the preparation of a vein for arte- [58] Field of Search 128/1 R, 218 A, 349; rial grafting. A tubular core, closed at one end and 73/38, 40, 49.1, 49.5; 138/90; 431/343; open at the other end to couple with a source of pres- 239/566, DIG. 13; 118/DIG. l0 surized fluid, rests removably adjacent each end on a frame.
  • the core wall is perforated in an area interme- [56] References Cited diate the ends of the core and the outer surface of the UNITED STATES PATENTS Albrecht 73/40 core wall is smooth.
  • This invention relates to the preparation of a arterialgrafting i I j I
  • peripheral arterial or in aortocoronary bypass surgery it is the practice to implant the great saphenous vein taken from the leg.
  • leads are identified and repaired, and the ends of the vein are cleared of adventitia. Two persons are required to perform this work, which is costly and cumbersome and often damages the vein.
  • the invention consists of a device for use in the preparation of a vein for artificial grafting, comprising a tubular core closed at one end to define a chamber and open at the other end to define an inlet to the chamber, the wall of the core being perforated in an area between its ends, and frame means to receive the core removably and to hold it adjacent its ends.
  • the frame means may comprise a base and two spaced, upstanding brackets which receive the core transversely to rest on the brackets.
  • the wall may carry a connector at its open end to couple the core to a pressurized fluid source such as a resevoir located above the core.
  • a pressurized fluid source such as a resevoir located above the core.
  • the core is pliable for threading into the vein in situ.
  • FIG. 1 is a perspective view of an intraluminal vein holder
  • FIG. 2 is a longitudinal cross-sectional view of one end of the core of FIG. 1.
  • the embodiment shown in the drawings consists of an elongated, tubular core having a wall 11 defining a passage or chamber 12 which is perforated in the area of its midsection by a plurality of apertures 13.
  • One end 14 of core 10 is sealed by a plug 16 (FIG. 2) while the other end 18 of the core carries a tubular connector 20 which has a nipple 22 at one end for coupling with a flexible tube and a pair of spaced, coaxial locating rings 24.
  • the outer surface of wall 11 is smooth.
  • vein for Core 10 removably rests in a frame which has a flat base plate 32 and a pair of spaced, upright supporting brackets 34, one bracket being located at each end of the base and the brackets being spaced apart slightly less than the length of the core.
  • An aperture 35 adjacent the top edge of one bracket 34 loosely receives end 14 of core 10 and a U-shaped notch or recess 36 at the top edge of the other bracket 34 loosely receives tubular connector 20 between locating rings 24.
  • a vein 40 removed from the body for grafting is slipped onto core 10, i.e. core 10 is threaded proximally (i.e. in the direction of normal blood flow) through the vein intraluminally, and gathered adjacent connector 20.
  • Core 10 is placed transversely in aperture, 35 and notch 36 of frame 30, spacer rings 24 serving to locate connector 20 in notch 36.
  • One end 42 of vein 30 is then sealed on core 10 between apertures 13 and end 14 of the core while the other end 43 of the vein is sealed on the core adjacent connector 20.
  • Each vein end 42 and 43 is sealed by encircling it with an umbilical tape 44 and weighting the tape with a clamp 46.
  • Core 10 is connected with a reservoir of liquid 52 by a flexible tube 54 which fits onto nipple 22 of connector 20.
  • Reservoir 50 is adjustable vertically to create a column of liquid 52 approximating the level of normal arterial blood pressure.
  • Liquid 52 passes out of core 10 through apertures 13 and distends vein 40 in that area. Any leaks in v'ein 40 are located by the escape of pressurized liquid'52 and they are repaired in the usual manner.
  • the whole length of vein 40 is distended, tested and repaired in this manner by sequentially drawing gathered sections of the vein over the area of apertures 12. Also, the ends of vein 40 are readily accessible to be cleaned in preparation for suturing.
  • To remove prepared vein 40 for implantation core 10 is lifted from frame 30, and the vein is slipped off the core.
  • Core 10 is preferably about 12 inches to 14 inches long with an outer diameter less than 4 millimetres. Vein grafts should be greater than 4 mm in diameter; thus a test for a potential vein graft is its accommodation of core 10 of about that diameter.
  • Core 10 may be constructed of any suitable form retaining material such as SILASTIC (a trade mark) which provides a smooth surface and a pliability sufficient to enable the core to be threaded into the vein in situ in order that the vein may be located more easily for cutting.
  • the device of the present invention allows a single person to scrutinize a severed vein and prepare it for implantation. Also, the relationship of the container of liquid used to distend the veing allows it to be adjusted to simulate normal blood pressure and prevent undue stress being applied against the vein wall.
  • Liquid 52 is preferable to gas for use as a fluid because its escape from the wall of vein 40 is visually identifiable.
  • Tapes 44 and clamps 46 of the example embodiment may be replaced by the hands of the operator who would hold one end of vein 40 on core 10 and distend the vein as described, the undistended end portion of the vein acting as its own seal.
  • a device for use in the preparation of a severed length of vein for arterial grafting comprising:
  • an elongated core having a tubular wall closed at one end to define a chamber and open at the other end to define an inlet to the chamber, the wall being perforated in an area intermediate the ends thereof, the outer surface of the wall being smooth, the core being receivable proximally in the vein intraluminally whereby the vein extends along the core in each direction beyond the perforated area of the wall;
  • frame means constructed and arranged to receive the core removably and to hold the core adjacent the ends of the wall.
  • a device as claimed in claim 1 in which the frame means comprises a base and two spaced, upstanding brackets shaped to receive the core transversely to rest thereon.
  • a device as claimed in claim 2 in which one bracket has an aperture adjacent the upper end thereof to receive axially the closed end of the wall of the core and the other bracket is notched at the upper end thereof to receive transversely the wall of the core adjacent said other end.
  • a device as claimed in claim 2 in which the base comprises a flat plate and the core rests on the brackets parallel to the plate.
  • At least one bracket being notched at the upper end thereof to receive the connector therein between the rings.

Abstract

A device for use in the preparation of a vein for arterial grafting. A tubular core, closed at one end and open at the other end to couple with a source of pressurized fluid, rests removably adjacent each end on a frame. The core wall is perforated in an area intermediate the ends of the core and the outer surface of the core wall is smooth.

Description

United States Patent 1191 Perrin Nov. 4, 1975 INTRALUMINAL VEIN HOLDER 2,193,176 3/1940 Krugler, et al 431/343 2,885,892 5/1959 C tt [76] Inventor: Richard Pemn, 45 Coulson Ave., 3,710,777 H1973 g z Toronto, Ontaflo, Canada 3,712,115 1/1973 Miller 138/90 [22] Filed: Mar. 11, 1974 Primary ExaminerRichard A. Gaudet PP 449,726 Assistant Examiner-Henry S. Layton 52 us. (:1 128/1 R; 73/491; 138/90 ABSTRACT [51] Int. Cl. A61B 19/00 A device for use in the preparation of a vein for arte- [58] Field of Search 128/1 R, 218 A, 349; rial grafting. A tubular core, closed at one end and 73/38, 40, 49.1, 49.5; 138/90; 431/343; open at the other end to couple with a source of pres- 239/566, DIG. 13; 118/DIG. l0 surized fluid, rests removably adjacent each end on a frame. The core wall is perforated in an area interme- [56] References Cited diate the ends of the core and the outer surface of the UNITED STATES PATENTS Albrecht 73/40 core wall is smooth.
7 Claims, 2 Drawing Figures US. Patent Nov. 4, 1975 7 3,916,874
'EINTR'A'IJUMINA'L VEIN HOLDER This invention relates to the preparation of a arterialgrafting i I j I In peripheral arterial or in aortocoronary bypass surgery it is the practice to implant the great saphenous vein taken from the leg. To prepare the vein for grafting it is distended, leads are identified and repaired, and the ends of the vein are cleared of adventitia. Two persons are required to perform this work, which is costly and cumbersome and often damages the vein.
It is an object of the invention to provide a simple device to hold a vein during its preparation for arterial grafting.
In its broadest aspect the invention consists of a device for use in the preparation of a vein for artificial grafting, comprising a tubular core closed at one end to define a chamber and open at the other end to define an inlet to the chamber, the wall of the core being perforated in an area between its ends, and frame means to receive the core removably and to hold it adjacent its ends. The frame means may comprise a base and two spaced, upstanding brackets which receive the core transversely to rest on the brackets. Also, the wall may carry a connector at its open end to couple the core to a pressurized fluid source such as a resevoir located above the core. Preferably the core is pliable for threading into the vein in situ.
An example embodiment of the invention is shown in the accompanying drawings in which:
FIG. 1 is a perspective view of an intraluminal vein holder; and
FIG. 2 is a longitudinal cross-sectional view of one end of the core of FIG. 1.
The embodiment shown in the drawings consists of an elongated, tubular core having a wall 11 defining a passage or chamber 12 which is perforated in the area of its midsection by a plurality of apertures 13. One end 14 of core 10 is sealed by a plug 16 (FIG. 2) while the other end 18 of the core carries a tubular connector 20 which has a nipple 22 at one end for coupling with a flexible tube and a pair of spaced, coaxial locating rings 24. The outer surface of wall 11 is smooth.
vein for Core 10 removably rests in a frame which has a flat base plate 32 and a pair of spaced, upright supporting brackets 34, one bracket being located at each end of the base and the brackets being spaced apart slightly less than the length of the core. An aperture 35 adjacent the top edge of one bracket 34 loosely receives end 14 of core 10 and a U-shaped notch or recess 36 at the top edge of the other bracket 34 loosely receives tubular connector 20 between locating rings 24.
In the operation of the device a vein 40 removed from the body for grafting is slipped onto core 10, i.e. core 10 is threaded proximally (i.e. in the direction of normal blood flow) through the vein intraluminally, and gathered adjacent connector 20. Core 10 is placed transversely in aperture, 35 and notch 36 of frame 30, spacer rings 24 serving to locate connector 20 in notch 36. One end 42 of vein 30 is then sealed on core 10 between apertures 13 and end 14 of the core while the other end 43 of the vein is sealed on the core adjacent connector 20. Each vein end 42 and 43 is sealed by encircling it with an umbilical tape 44 and weighting the tape with a clamp 46.
Core 10 is connected with a reservoir of liquid 52 by a flexible tube 54 which fits onto nipple 22 of connector 20. Reservoir 50 is adjustable vertically to create a column of liquid 52 approximating the level of normal arterial blood pressure. Liquid 52 passes out of core 10 through apertures 13 and distends vein 40 in that area. Any leaks in v'ein 40 are located by the escape of pressurized liquid'52 and they are repaired in the usual manner. The whole length of vein 40 is distended, tested and repaired in this manner by sequentially drawing gathered sections of the vein over the area of apertures 12. Also, the ends of vein 40 are readily accessible to be cleaned in preparation for suturing. To remove prepared vein 40 for implantation, core 10 is lifted from frame 30, and the vein is slipped off the core.
Core 10 is preferably about 12 inches to 14 inches long with an outer diameter less than 4 millimetres. Vein grafts should be greater than 4 mm in diameter; thus a test for a potential vein graft is its accommodation of core 10 of about that diameter. Core 10 may be constructed of any suitable form retaining material such as SILASTIC (a trade mark) which provides a smooth surface and a pliability sufficient to enable the core to be threaded into the vein in situ in order that the vein may be located more easily for cutting.
It will be appreciated that the device of the present invention allows a single person to scrutinize a severed vein and prepare it for implantation. Also, the relationship of the container of liquid used to distend the veing allows it to be adjusted to simulate normal blood pressure and prevent undue stress being applied against the vein wall.
Liquid 52 is preferable to gas for use as a fluid because its escape from the wall of vein 40 is visually identifiable. Tapes 44 and clamps 46 of the example embodiment may be replaced by the hands of the operator who would hold one end of vein 40 on core 10 and distend the vein as described, the undistended end portion of the vein acting as its own seal.
I claim:
1. A device for use in the preparation of a severed length of vein for arterial grafting, comprising:
an elongated core having a tubular wall closed at one end to define a chamber and open at the other end to define an inlet to the chamber, the wall being perforated in an area intermediate the ends thereof, the outer surface of the wall being smooth, the core being receivable proximally in the vein intraluminally whereby the vein extends along the core in each direction beyond the perforated area of the wall; and
frame means constructed and arranged to receive the core removably and to hold the core adjacent the ends of the wall.
2. A device as claimed in claim 1 in which the frame means comprises a base and two spaced, upstanding brackets shaped to receive the core transversely to rest thereon.
3. A device as claimed in claim 2 in which one bracket has an aperture adjacent the upper end thereof to receive axially the closed end of the wall of the core and the other bracket is notched at the upper end thereof to receive transversely the wall of the core adjacent said other end.
4. A device as claimed in claim 2 in which the base comprises a flat plate and the core rests on the brackets parallel to the plate.
rings, at least one bracket being notched at the upper end thereof to receive the connector therein between the rings.
7. A device as claimed in claim 1 in which the core is pliable.

Claims (7)

1. A device for use in the preparation of a severed length of vein for arterial grafting, comprising: an elongated core having a tubular wall closed at one end to define a chamber and open at the other end to define an inlet to the chamber, the wall being perforated in an area intermediate the ends thereof, the outer surface of the wall being smooth, the core being receivable proximally in the vein intraluminally whereby the vein extends along the core in each direction beyond the perforated area of the wall; and frame means constructed and arranged to receive the core removably and to hold the core adjacent the ends of the wall.
2. A device as claimed in claim 1 in which the frame means comprises a base and two spaced, upstanding brackets shaped to receive the core transversely to rest thereon.
3. A device as claimed in claim 2 in which one bracket has an aperture adjacent the upper end thereof to receive axially the closed end of the wall of the core and the other bracket is notched at the upper end thereof to receive transversely the wall of the core adjacent said other end.
4. A device as claimed in claim 2 in which the base comprises a flat plate and the core rests on the brackets parallel to the plate.
5. A device as claimed in claim 1 in which the wall carries a connector at the open end thereof, the connector having means to couple to pressurized fluid source thereto.
6. A device as claimed in claim 5 in which the connector is tubular coaxial with the wall of the core, the connector carrying a pair of spaced circumferential rings, at least one bracket being notched at the upper end thereof to receive the connector therein between the rings.
7. A device as claimed in claim 1 in which the core is plIable.
US449726A 1974-03-11 1974-03-11 Intraluminal vein holder Expired - Lifetime US3916874A (en)

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Cited By (23)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3958557A (en) * 1975-03-10 1976-05-25 Texas Medical Products, Inc. Coronary artery bypass graft testing device and method
US4108161A (en) * 1975-10-28 1978-08-22 Samuels Peter B Graft forming device
US4135494A (en) * 1977-03-09 1979-01-23 The United States Of America As Represented By The Secretary Of The Air Force Over-pressure protection device
US4144744A (en) * 1977-09-21 1979-03-20 Thoratec Laboratories Corporation Vein preparation and testing device
US4212192A (en) * 1978-06-28 1980-07-15 The Kendall Company Balloon testing device
US4232659A (en) * 1979-01-08 1980-11-11 Codman And Shurtleff, Inc. Vein holder assembly
EP0032826A2 (en) * 1980-01-18 1981-07-29 Shiley Incorporated Vein distention apparatus
US4329985A (en) * 1980-01-18 1982-05-18 Shiley, Inc. Vein distention system
US4736850A (en) * 1986-10-17 1988-04-12 W. L. Gore & Associates, Inc. Endothelial cell harvesting kit
EP0281736A1 (en) * 1987-03-05 1988-09-14 GebràœDer Sulzer Aktiengesellschaft Device for storing and treating operatively gained fragments of vein
US4990131A (en) * 1987-09-01 1991-02-05 Herbert Dardik Tubular prostheses for vascular reconstructive surgery and process for preparing same
US5041091A (en) * 1986-10-20 1991-08-20 Herring Malcolm B Kit and method for harvesting endothelial cells and inoculating a vascular prosthesis
US5122110A (en) * 1987-08-21 1992-06-16 Cryolife, Inc. Device and method for cryopreserving blood vessels
US5902228A (en) * 1996-10-11 1999-05-11 Cornell Research Foundation, Inc. Method and apparatus for support and tubularization of surgical grafts
US6419625B1 (en) * 1997-01-03 2002-07-16 Robin G. Smith Methods and devices for ex vivo irradiation of autologous coronary bypass conduit
US6554764B1 (en) * 2000-11-13 2003-04-29 Cardica, Inc. Graft vessel preparation device and methods for using the same
US20040236178A1 (en) * 2003-02-14 2004-11-25 Cardica, Inc. Method for preparing a graft vessel for anastomosis
US20080027272A1 (en) * 2006-07-26 2008-01-31 Terumo Cardiovascular Systems Corporation Device for processing blood vessel harvested for bypass graft surgery
US20090112053A1 (en) * 2006-07-26 2009-04-30 Terumo Cardiovascular Systems Corporation Blood Vessel Preparation and Preservation Kit
WO2015009992A1 (en) * 2013-07-18 2015-01-22 The General Hospital Corporation Vessel treatment systems, methods, and kits
US10292381B2 (en) 2012-07-20 2019-05-21 The General Hospital Corporation Vessel treatment systems, methods, and kits
US10478284B2 (en) 2012-07-20 2019-11-19 The General Hospital Corporation Methods for tissue passivation
US20210290212A1 (en) * 2020-03-17 2021-09-23 Bruce Mindich System and method for preparing a harvested blood vessel for grafting

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US1990013A (en) * 1934-01-18 1935-02-05 Albrecht Edward Stocking inspecting and testing machine
US2193176A (en) * 1938-03-28 1940-03-12 Phillips Petroleum Co Gas heater
US2885892A (en) * 1958-01-24 1959-05-12 Charleston Rubber Company Inflatable inspection device
US3710777A (en) * 1970-12-23 1973-01-16 C Sparks Method and apparatus for growing graft tubes in place
US3712115A (en) * 1970-10-09 1973-01-23 Lofaso G Pipe testing apparatus

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US1990013A (en) * 1934-01-18 1935-02-05 Albrecht Edward Stocking inspecting and testing machine
US2193176A (en) * 1938-03-28 1940-03-12 Phillips Petroleum Co Gas heater
US2885892A (en) * 1958-01-24 1959-05-12 Charleston Rubber Company Inflatable inspection device
US3712115A (en) * 1970-10-09 1973-01-23 Lofaso G Pipe testing apparatus
US3710777A (en) * 1970-12-23 1973-01-16 C Sparks Method and apparatus for growing graft tubes in place

Cited By (32)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3958557A (en) * 1975-03-10 1976-05-25 Texas Medical Products, Inc. Coronary artery bypass graft testing device and method
US4108161A (en) * 1975-10-28 1978-08-22 Samuels Peter B Graft forming device
US4135494A (en) * 1977-03-09 1979-01-23 The United States Of America As Represented By The Secretary Of The Air Force Over-pressure protection device
US4144744A (en) * 1977-09-21 1979-03-20 Thoratec Laboratories Corporation Vein preparation and testing device
US4212192A (en) * 1978-06-28 1980-07-15 The Kendall Company Balloon testing device
US4232659A (en) * 1979-01-08 1980-11-11 Codman And Shurtleff, Inc. Vein holder assembly
US4323072A (en) * 1980-01-18 1982-04-06 Shiley, Incorporated Cannula for a vein distention system
EP0032826A3 (en) * 1980-01-18 1981-08-12 Shiley Incorporated Vein distention apparatus
EP0032826A2 (en) * 1980-01-18 1981-07-29 Shiley Incorporated Vein distention apparatus
US4329985A (en) * 1980-01-18 1982-05-18 Shiley, Inc. Vein distention system
US4736850A (en) * 1986-10-17 1988-04-12 W. L. Gore & Associates, Inc. Endothelial cell harvesting kit
US5041091A (en) * 1986-10-20 1991-08-20 Herring Malcolm B Kit and method for harvesting endothelial cells and inoculating a vascular prosthesis
EP0281736A1 (en) * 1987-03-05 1988-09-14 GebràœDer Sulzer Aktiengesellschaft Device for storing and treating operatively gained fragments of vein
CH671683A5 (en) * 1987-03-05 1989-09-29 Sulzer Ag
US5122110A (en) * 1987-08-21 1992-06-16 Cryolife, Inc. Device and method for cryopreserving blood vessels
US4990131A (en) * 1987-09-01 1991-02-05 Herbert Dardik Tubular prostheses for vascular reconstructive surgery and process for preparing same
US5902228A (en) * 1996-10-11 1999-05-11 Cornell Research Foundation, Inc. Method and apparatus for support and tubularization of surgical grafts
US6419625B1 (en) * 1997-01-03 2002-07-16 Robin G. Smith Methods and devices for ex vivo irradiation of autologous coronary bypass conduit
US6575898B2 (en) 1997-01-03 2003-06-10 Emory University Methods and devices for ex vivo irradiation of autologous coronary bypass conduit
US6554764B1 (en) * 2000-11-13 2003-04-29 Cardica, Inc. Graft vessel preparation device and methods for using the same
US6786862B2 (en) 2000-11-13 2004-09-07 Cardica, Inc. Graft vessel preparation device and methods for using the same
US20040236178A1 (en) * 2003-02-14 2004-11-25 Cardica, Inc. Method for preparing a graft vessel for anastomosis
US20090112053A1 (en) * 2006-07-26 2009-04-30 Terumo Cardiovascular Systems Corporation Blood Vessel Preparation and Preservation Kit
US20080027272A1 (en) * 2006-07-26 2008-01-31 Terumo Cardiovascular Systems Corporation Device for processing blood vessel harvested for bypass graft surgery
US8123672B2 (en) 2006-07-26 2012-02-28 Terumo Cardiovascular Systems Corporation Blood vessel preparation and preservation kit
US10292381B2 (en) 2012-07-20 2019-05-21 The General Hospital Corporation Vessel treatment systems, methods, and kits
US10478284B2 (en) 2012-07-20 2019-11-19 The General Hospital Corporation Methods for tissue passivation
WO2015009992A1 (en) * 2013-07-18 2015-01-22 The General Hospital Corporation Vessel treatment systems, methods, and kits
US11350625B2 (en) 2013-07-18 2022-06-07 The General Hospital Corporation Vessel treatment systems, methods, and kits
US20210290212A1 (en) * 2020-03-17 2021-09-23 Bruce Mindich System and method for preparing a harvested blood vessel for grafting
US11540816B2 (en) * 2020-03-17 2023-01-03 Bruce Mindich System for preparing a harvested blood vessel for grafting
EP4076273A4 (en) * 2020-03-17 2024-04-03 Law Offices Of Helaine S Brick Cabot System and method for preparing a harvested blood vessel for grafting

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