Abstract: Apparatus and methods for performing a surgical anastomotic procedure are disclosed herein. Apparatus according to the present disclosure include a tubular body having a distal end and a proximal end and defining a longitudinal axis, the tubular body including an expandable anchor provided near the distal end thereof and an expandable cuff provided near the distal end of the tubular body and proximal of the expandable anchor, and a joining member (200) configured and adapted to be received about the expandable cuff of the tubular body, the joining member having an annular body portion (202) including a pair of opposed terminal edges (204, 206). The joining member has a retracted position in which the pair of opposed terminal edges overlap by a predetermined amount and an expanded position in which the pair of opposed terminal edges overlap by an amount less than the predetermined amount.

Abstract: A medical device for treatment of affection of anatomical ducts, as in particular for anastomosing blood vessels and vascular prosthesis, with end-to-end or end-to-side configuration. The device has outer containing functions and is associated to an intra-prosthetic stent for sandwiching the overlapping segments being anastomosed to each other of the anatomical ducts and of the prosthesis, a segment of which is located in the duct. The outer containing device is formed by a stent of biocompatibile resilient material having memory effect, in a predetermined nominal position, suitable for extending elastically for engaging the outside of the duct, and returning to said nominal position, with containing function, thus preventing the diameter of the duct from increasing and without compressing the duct. The stent must have at least a length not less than half the outside diameter of the duct. Means are provided for putting the prosthesis in the duct and for arranging the containing device out of the duct.

Abstract: A surgical marker/connector in the form of a ring made of a shape memory alloy such as NITINOL is suitable for laparoscopic installation in a patient's body. The ring preferably includes a plurality of small suture attachments in the form of loops that are disposed on the periphery of the ring and which lie in a plane that includes the ring itself. The loops are large enough to receive sutures which, in turn, can be used to connect the ring to a portion of a patient's body, or to connect separate portions of a patient's body to each other using the marker/connector as an intermediate connector. Prior to installation, the ring can be wrapped tightly about an elongate member such as a mandrel, which than can be inserted into the patient's body through a trochar or cannula. After insertion, the ring will change temperature and resume its original configuration where it can be sutured in place as desired.

Abstract: The present invention provides implantable devices and associated methods for interconnecting human vessels in a side-to-side or an end-to-side arrangement rapidly, safely and in a minimally invasive manner. The devices comprise a vessel connector and a intravascular support mechanism for establishing fluid communication between two vessels. Certain embodiments further include a sealing member for further sealing the openings in the vessels created for inserting the subject devices.

Abstract: The subject invention provides devices and methods for closing and sealing an opening in a conduit. The subject devices consist of an implantable flexible member adapted to conform to and seal with an inner surface of a conduit and further adapted to utilize the internal conduit pressure exerted thereon to form a substantially fluid-tight seal with the inner surface of the conduit whereby substances are prevented from leaking from the opening under normal physiological conditions. In the subject methods, a subject device is provided and positioned inside a conduit, operatively aligned over an opening to be sealed. The device is conformed to and sealed with an inner surface of the conduit and a substantially fluid-tight seal is formed between the device and the inner surface of the conduit utilizing the internal conduit pressure whereby substances within the conduit are prevented from leaking from the opening under normal physiological conditions.

Abstract: A stent for ostial lesions and vascular bifurcations has a tubular body comprised by a succession of sections of skeletal members. In one or both end rows of the tubular body, there are expansive bending devices comprising sectional weakenings and open extremities. In the case of the end row, by a proper expander balloon, expansive bending of longitudinal branches of the end row may be produced. Bending is produced due to sectional weakenings. Open extremities allow producing the expansion in a way such as the flourishing of a flower bloom. Under such conditions, bending of the end row makes possible the adequate coverage of the ostial or bifurcation lesion affecting wall of the application vascular conduit.

Abstract: Devices and methods for treating an abdominal incision or hernia are described. An implant for the restoration or prophylactic treatment of an abdominal wall comprises an elongate element and at least one sheet connected to the elongate element along a longitudinal axis of the elongate element. The elongate element is positioned along the line of incision, and the at least one sheet is secured to the abdominal muscles surrounding the incision.

Abstract: A body tissue graft for use in a patient includes a frame structure made of a first elastic material, a covering of a second elastic material on the frame structure, the covering substantially filling openings in the frame structure, and a connector connected to the frame structure. Projections are secured to the connector structure. The projections facilitate attachment of the tubular graft in a patient by securing the graft to the body tissue with which the graft is employed. The connector selectively circumferentially expands and the projections selectively circumferentially expand. This may be done using an inflatable balloon to circumferentially expand the projections. A restraining member may be provided to restrain the projections in a cone shape so that an end of the graft may be used to open an aperture through a side wall of existing body organ tubing and a portion of the projections may enter the aperture.

Abstract: An endoscopic device separates ingested food from gastric fluids or gastric fluids and digestive enzymes, to treat obesity. In a particular embodiment a gastric bypass stent comprises a tubular member and two or more stent members defining a lumen. The tubular member has a substantially liquid impervious coating or covering and one or more lateral openings to permit one-way liquid flow.

Abstract: Devices and methods for altering gaseous flow within a lung to improve the expiration cycle of an individual, particularly individuals having chronic obstructive pulmonary disease. The methods and devices create channels in lung tissue and maintain the patency of these surgically created channels in tissue. Maintaining the patency of the channels allows air to pass directly out of the lung tissue which facilitates the exchange of oxygen ultimately into the blood and/or decompresses hyper-inflated lungs.

Abstract: Endovascular stent insertion methods are provided. In one embodiment for end-to-side anastomosis the method includes disposing an endovascular stent in a transparent sheath; inserting a guide wire through a guide needle into first and second blood vessels; sliding the endovascular stent into both the first and second blood vessels along the guide wire and the guide needle to dispose in a position between spaced first and second blood vessels; and pulling the sheath when an intermediate annular marker band of the endovascular stent seen through the transparent sheath is substantially disposed between the first blood vessel and the second blood vessel to release the endovascular stent so that the endovascular stent is adapted to expand to securely hold the facing ends of the first and second blood vessel together.

Abstract: An implantable tissue connector (1; 1 a) adapted to be connected to a tubular part of living tissue (70; 80) within a patient's body (100) comprises a conduit (2) and at least one flexible sleeve (10) adapted to axially extend and closely fit around at least part of the outer surface (6) of the conduit. The conduit is inserted into the tubular part of living tissue and the flexible sleeve placed over the tubular part of living tissue. Various alternatives are described of how the living tissue may be prevented form slipping off of the conduit.

Abstract: A handle assembly facilitates the removal of a sterile inner tray containing sterile medical instruments from a medical kit during an OR procedure. The handle assembly may have a handle coupled with an elongated member having a male end and a female end. The inner tray may be wrapped in medical packaging. Subsequently, the elongated member may be wrapped around the inner tray and the male and female ends interconnected. The inner tray may be positioned inside of an outer tray. A bacterial barrier may be formed over a portion of the outer tray to enclose the inner tray. The inner tray, including the medical instruments, may then be sterilized by a sterilization process. During an OR procedure, the handle assemble allows a sterile nurse to remove the sterile inner tray from the non-sterile outer tray without making contact with the non-sterile outer tray and/or contaminating the sterile medical instruments.

Abstract: A method for performing end-to-end vessel anastomosis includes providing a vessel support including a vessel receiving portion and a handle portion extending therefrom. The vessel receiving portion is an annulus. The vessel receiving portion is positioned around the end of a first vessel and the end of the first vessel is everted about the outer diameter of the vessel receiving portion such that the inner surface of the vessel is directed outwardly. The end of the second vessel is positioned over the everted end of the first vessel such that the inner surface of the second vessel is disposed against the inner surface of the first vessel. The ends of the vessel are secured either with a suture or a surgical adhesive. The handle portion of the vessel support may be removed.

Abstract: Tissue management methods can include inserting a clamping device into a vessel and clamping a vessel wall via the clamping device. Tissue can be dilated about the clamping device and an anastomotic device provided to the vessel.

Abstract: A gastrointestinal implant device is anchored in the duodenum and extends beyond the ligament of Treitz. All food exiting the stomach is funneled through the device. The gastrointestinal device includes an anchor for attaching the device to the duodenum and an unsupported flexible sleeve. The anchor can include a stent and/or a wave anchor and is collapsible for catheter-based delivery and removal.

Abstract: A sheath is configured for elongation from a first length to a second, longer length and a retention member retains the sheath at the first length. A portion of the retention member is removed or disengaged, the sheath is released and expands in situ to the second longer length. A method for releasing the retention member is also disclosed.

Abstract: A vascular graft includes an elongated main body portion having a distal end portion defining a first opening and a second proximal end portion defining a second opening. The vascular graft also includes a first sewing ring having a base portion securely attached to the first distal end portion of the elongated body portion, and a second sewing ring having a base portion securely attached to the first distal end portion at a location proximal to the first sewing ring. The first and second base portions form a channel for receiving an end portion of a blood vessel.

Abstract: Improved methods and apparatuses for treatment of incontinence or pelvic organ prolapse are provided. A neo ligament for increasing the supportive function of the tissues supporting the urethra, bladder neck, or rectum is disclosed. Methods of using such a neoligament to treat incontinence are disclosed. Additionally, a self tensioning elastic tissue bolster for support of the tissues that support the urethra, rectum, and bladder neck are disclosed. A method of treating incontinence by injecting proliferative agents into supportive structures is disclosed. Methods and apparatus for transvaginal and transperitieai pelvic floor bolster treatment of incontinence and bladder pillar systems are also disclosed.

Abstract: A prosthetic device is provided that is used in end-to-side, end-to-end, and side-to-side anastomosis without clamping and sutureless, or with expeditious clamping and sutureless, wide, single or multiple, at the same time, without the risk of kinking, where the graft is inserted in at least one of the intraluminal portions of the prosthesis tubular member. The tubular member is flangeless and comprises double holes or small external handles in its extension where wires pass to fix the prosthesis to the organ walls and/or the grafts to prosthesis.

Abstract: A device (10) is provided for use in reinforcing a boundary wall of a patient's abdominal cavity at a site at which a portion of the patient's alimentary tract passes through that boundary wall. The device comprises a collar portion (11) for extending, in use, around the alimentary tract (17) at the approach of the alimentary tract to the interior of the boundary wall at said site. The device also comprises a plurality of petal-like elements (12) extending from the collar portion (11), said elements being arranged so as to extend, in use, outwardly with respect to the longitudinal axis of the portion of the alimentary tract passing through the collar portion and to be attached, in use, to the interior of the boundary wall around said side. The device is preferably, but not exclusively, for use in the prevention or treatment of parastomal herniation in patients having a colostomy or ileostomy or the like.

Abstract: Apparatus (90) is provided for use in a stomach of a subject. The apparatus includes a balloon (92), adapted for placement in the stomach, and all anchor (102), coupled to the balloon. The anchor is adapted to prevent the balloon from passing into a duodenum of the subject. The apparatus further includes an inflation tube (96), coupled to the balloon to permit inflation of the balloon, and is adapted to stretch from the stomach to a mouth of the subject to facilitate inflation of the balloon. Other embodiments are also described.

Abstract: A rolling instrument for rolling the outside surface of the stomach for reducing stomach volume in bariatric surgery includes an elongated tubular body that is sufficiently flexible to allow for access to the outside surface. The tubular body includes a proximal end and a distal end. The proximal end is shaped and dimensioned for use by the medical practitioner performing the medical procedure and includes a handle for manipulation of the rolling instrument. The distal end of the tubular body includes a mechanism allowing for gripping of the stomach in a manner permitting rolling thereof. A coiled retainer shaped and dimensioned is provided for application to the rolled portion of the stomach in a manner holding the rolled portion of the stomach in its rolled configuration. The coiled retainer includes a helically coiled body having a first end and a second end, the first end is pointed such that it may puncture tissue as the coiled body is rotated during its application to the stomach.

Abstract: A surgical fastener for use with an anastomosis of two tissues includes a base leg and an upright leg. The base leg is selectively deformable and includes a traumatic tip for piecing tissue. The surgical fastener also includes at least one capillary disposed on the base leg which has a reservoir defined therein for retaining a liquid, e.g., bioadhesive, bonding agent, medicament, etc. Each of the capillaries is ruptureable upon deformation of the surgical fastener to dispense the liquid to the anastomosis site.

Abstract: A device, system and method provides mitral valve therapy. The device is implantable in the coronary sinus of the heart to partially encircle the mitral valve annulus. The device is elongated, is resilient, and has a preformed arched configuration. When the device is implanted in the coronary sinus, the device exerts a substantially radially inward force to the mitral valve to restore mitral valve annulus geometry.

Abstract: A connector for surgical anastomoses is disclosed. The connector has a sleeve with an inlet and an outlet. The inlet is for fluid connection with a first blood vessel. The inlet is generally co-axial with the first blood vessel. The outlet is for fluid connection with a second blood vessel. The outlet is generally orthogonal to the second blood vessel.

Abstract: A vascular conduit device and a delivery system for intraoperative repair damaged portion of an artery or vein and methods of use are provided. The device has a cylindrical body and may include a shaped member, such as a microbarb, configured to anchor into the tunica intima and the tunica media of the vessel wall, and not to the tunic adventitia and vasa vasorum. Various configurations and orientations of the microbarbs are provided, including microbarbs that are preferably aligned at an acute angle in the range of about 5 to 30 degrees and having a substantially parallel surface. The delivery system preferably has a translatable dilator tip that when retracted is configured to engage with the device during delivery. When the dilator tip is extended, the device can be implanted into the vessel wall. The vascular conduit device can be assembled during the emergency open surgical procedure.

Abstract: Methods, apparatuses, computer program products, devices and/or systems are described that include a blood vessel sleeve that is custom-fitted for the outside of a blood vessel at least partly based on anatomical blood vessel data from an individual.

Abstract: This is directed to methods and devices suited for maintaining an opening in a wall of a body organ for an extended period. More particularly devices and methods are directed maintaining patency of channels that alter gaseous flow within a lung to improve the expiration cycle of, for instance, an individual having chronic obstructive pulmonary disease.

Abstract: A surgical marker/connector in the form of a ring includes a plurality of small suture attachments that are disposed about the ring. The suture attachments preferably are in the form of loops that lie in a plane that includes the ring itself. The loops are large enough to receive sutures which, in turn, can be used to connect the ring to a portion of a patient's body, or to connect separate portions of a patient's body to each other using the marker/connector as an intermediate connector. At least a portion of the marker/connector is made of a material that can be observed by fluoroscopic examination.

Abstract: Described herein are methods and devices for loading an anastomotic seal into a delivery lumen. A loading device can fold the seal into a configuration for insertion into the delivery lumen. For example, the loading device can fold the seal into a prolate spheroidal shape. The delivery lumen can then be inserted into the loading device and mated with the folded seal.

Abstract: A medical staple formed from a nitinol wire, the staple having two elongated arms which extend upwardly and outwardly from a central loop in two opposing generally semicircular courses forming an arc extending upwardly and outwardly and an end second comprising a sharpened endpoint, the endpoint being the arms bendable under resistance, is disclosed. In some embodiments the arms extend upwardly on a parallel course and then outwardly. The material is preferably an alloy with hyperelastic characteristics.

Abstract: Devices and methods for treating or repairing a heart are disclosed. The device includes at least one anchor configured to engage tissue of a heart and a thread or other elongate member adapted to be coupled to the anchor and secured to heart tissue. The anchor may be attached to papillary muscle tissue and an elongate member may be attached to a valve leaflet for creating artificial chordae tendinae, thereby treating mitral valve prolapse. In another application, multiple anchors may be deployed within a ventricle and the threads pulled together for reducing dilation of a ventricle. A locking mechanism is provided for capturing and locking the threads together, thereby maintaining the ventricle in the reshaped condition.

Abstract: Methods, apparatuses, computer program products, devices and systems are described that include accepting one or more blood vessel sleeve dimensions based on blood vessel data from an individual; and making a rapid-prototyped blood vessel sleeve at least partly based on the one or more blood vessel sleeve dimensions.

Abstract: A vascular system comprising a catheter having a first end portion, a second end portion and a plurality of lumens wherein the first end portion is dimensioned for insertion into a vascular graft and the second end portion is dimensioned for insertion into a vein of a patient to create a conduit from the artery to the vein.

Abstract: An implantable shunt for the repair of a blood vessel, which is capable of remaining in place temporarily or for extended periods, which comprises a hollow tube, and flanges positioned at regular intervals along the tube's length, ending at both ends. The shunt is made of non-coagulative material. In operation, damaged vessels are severed and bridged by this implantable shunt, which is secured in place inside a vessel by applying ligatures to flanges on its end.

Abstract: The present invention relates generally to a surgical instrument. In particular, the present invention relates to a fastener remover for use during the repair of abdominal aortic aneurysms. The fastener remover, in accordance with an embodiment of the present invention, comprises an outer catheter, an inner sheath, and a gripping member. The outer catheter comprises a hollow passage with a proximal end and a distal end. The inner sheath is disposed within the hollow passage of the outer catheter, extending from the outer catheter's proximal end to the distal end. The gripping member is located within the inner sheath, extending from the outer catheter's proximal end to the distal end. The gripping member comprises a connector portion connected to an elongated stem.

Abstract: A system for performing anastomosis between a graft vessel and a target vessel includes a tissue effector that may be configured to deploy a user-selectable number of connectors. The system includes an anvil that enters the wall of the target vessel through an entry hole that is spaced apart from the anastomosis site, and at least one anvil entry hole sealer may be utilized to substantially seal the anvil entry hole upon withdrawal of the anvil. The system may include a shield and a cutter, both of which are movable relative to the anvil, where the shield is configured to protect the graft vessel from the cutter. The cutter may include an incising element movable from a stowed position to an active position.

Abstract: An anastomotic device for use in the joining of a first tubular structure and a second tubular structure is provided. The anastomotic device includes a cylindrical sleeve configured and dimensioned for placement at least partially within the first tubular structure, the cylindrical sleeve defining a bore therethrough; an inverting member configured and dimensioned for placement at least partially within the second tubular structure, the inverting member defining a bore therethrough which is configured and dimensioned to selectively receive the cylindrical sleeve therein; and a constricting member selectively positionable on the inverting member and movable onto the cylindrical sleeve when the cylindrical sleeve is at least partially positioned within the bore of the inverting member.

Abstract: The ligation clip applicator and ligation clip design are provided which are particularly applicable to placement of a surgical ligation clip during a laparoscopic surgical procedure. The clip includes a support member and a clamping arm having enlarged portions thereon. The applicator device has a magazine including first and second longitudinally extending partially closed channels within which the enlarged portions of the support member and the clamping arm are received with the clip held in an open position. First and second articulated jaws are attached to the magazine and have first and second channel extensions therein aligned with the first and second channels of the magazine, so that a clip can be received from the magazine in the jaws with the first and second enlarged portions of the support member and the clamping arm being received in the first and second channel extensions of the jaws. The channel extensions include first and second releasing openings.

Abstract: A coupler is configured to connect a first tubular vessel to an aperture in a second tubular vessel. The coupler includes one or more radially extending members and a substantially nonmetallic tubular member. The substantially nonmetallic tubular member include an outer wall, an inner wall defining a lumen having an open distal end and an open proximal end, and a circumferential ridge encircling the outer wall, the radially extending members extending from the distal end of the tubular member. A method of fabricating a coupler the method including fabricating radially extending members; placing the radially extending members within a mold; injecting a material into the mold; allowing the material to cure to form the coupler; and removing the coupler from the mold. The coupler includes a tubular member having an outer wall, an inner wall defining a lumen having an open distal end and an open proximal end, and a circumferential ridge encircling the outer wall.

Abstract: An implant for bridging a gap in a severed spinal cord or nerve and for promoting nerve regeneration has a matrix comprising a biocompatible, biodegradable, polymeric material. The matrix has a proximal end for connection to a first end of severed spinal cord and a distal end for connection to a second end of severed spinal cord. The matrix includes internal guidance channels extending between the proximal end and the distal end to facilitate rejoining of the first end and the second end of the severed spinal cord. A bioactive agent may be dispersed in the matrix, or disposed in the channels, or included within microspheres in the channels. The channels may be arranged such that guidance channels correspond to spinal cord tracts. Alternatively, guidance channels may be spaced apart at the proximal end of the matrix and converge inward toward the axis of the matrix at the distal end.

Abstract: The present invention is directed to gastrointestinal or enteric (including biliary) anastomosis and the like. The anastomotic device of the invention is a three dimensional woven tube of wire. The outer loops or ends of the tube fold or loop back on deployment in a manner which holds the luminal interface of the anastomotic site into apposition at the deployment site. The woven tube is deployed using a protective sleeve and nose assembly. Adjustment of the wire diameter and/or material properties of the wire can cause the anastomotic device to remain in place permanently or, for example, in the case of the intestine to slough through the two apposing walls of the lumen resulting in the device safely passing through the intestine leaving a naturally healed, properly functioning anastomosis.

Abstract: A system for performing an end-to-side vascular anastomosis. including an anastomosis device, an application instrument and methods for performing a vascular anastomosis. The system is applicable for performing an anastomosis between a vascular graft and the ascending aorta in coronary artery bypass surgery, particularly in port-access CABG surgery. A first aspect of the invention includes a vascular anastomosis staple. A first configuration has two parts: an anchor member, forming the attachment with the target vessel wall and a coupling member, forming the attachment with the bypass graft vessel. The anastomosis is completed by inserting the coupling member, with the graft vessel attached, into the anchor member. A second configuration combines the functions of the anchor member and the coupling member into a one-piece anastomosis staple.

Abstract: Medical devices, and in particular implantable medical devices, may be coated to minimize or substantially eliminate a biological organism's reaction to the introduction of the medical device to the organism. The medical devices may be coated with any number of biocompatible materials. Therapeutic drugs, agents or compounds may be mixed with the biocompatible materials and affixed to at least a portion of the medical device. These therapeutic drugs, agents or compounds may also further reduce a biological organism's reaction to the introduction of the medical device to the organism. Various materials and coating methodologies may be utilized to maintain the drugs, agents or compounds on the medical device until delivered and positioned.

Abstract: A body tissue graft for use in a patient includes a frame structure made of a first elastic material, a covering of a second elastic material on the frame structure, the covering substantially filling openings in the frame structure, and a connector connected to the frame structure. Projections are secured to the connector structure. The projections facilitate attachment of the tubular graft in a patient by securing the graft to the body tissue with which the graft is employed. The connector selectively circumferentially expands, and the projections selectively circumferentially expand. This may be done using an inflatable balloon to circumferentially expand the projections. A restraining member may be provided to restrain the projections in a cone shape so that an end of the graft may be used to open an aperture through a side wall of existing body organ tubing, and a portion of the projections may enter the aperture.

Abstract: A medical device which can be implanted at a target site in a living body. The device includes an inner flange formed by radial expansion of the device and an outer flange formed by axial compression of the device. The device can include an implant portion and a discard portion which separate from each other during formation of the outer flange. The separation can occur by fracturing a frangible linkage or by mechanically separating a portion of the outer flange from a deployment tool. The device can be a one piece anastomosis device for connecting a graft vessel to a target vessel without the use of conventional sutures. The inner and outer flanges capture the edges of an opening in a target vessel and secure the graft vessel to the opening in the target vessel. The device greatly increases the speed with which anastomosis can be performed over known suturing methods.

Abstract: The present invention, which addresses the needs described above, resides in an apparatus and method for coupling vascular apertures to a blood supply vessel in a manner that minimizes the time and operator dependent inconsistency in performing vascular anastomoses. In the coronary setting, this concept is fast and can be applied to both conventional and minimally invasive operative techniques. In the preferred embodiment, the present invention relates to an apparatus and method for facilitating end-to-side vascular anastomoses procedure, whereby the present invention acts as a coupling apparatus between a first, blood supplying hollow organ, e.g. the LIMA, radial artery, or a saphenous vein and the side wall of second hollow organ, typically one of the major coronary arteries, such as the left coronary artery (LCA), right coronary artery (RCA) or the circumflex (CX).

Abstract: Anastomotic stents for connecting a graft vessel to a target vessel, and methods of use thereof. The anastomotic stents of the invention are suitable for use in a variety of anastomosis procedures, including coronary artery bypass grafting. One embodiment of the invention comprises a large vessel anastomotic stent for use with large diameter target vessels such as the aorta or its major side branches. Another embodiment of the invention comprises a small vessel anastomotic stent for use on a target vessel which has a small diameter such as a coronary artery. Another aspect of the invention involves applicators for use with the stents of the invention.

Abstract: A system for performing an end-to-side vascular anastomosis. including an anastomosis device, an application instrument and methods for performing a vascular anastomosis. The system is applicable for performing an anastomosis between a vascular graft and the ascending aorta in coronary artery bypass surgery, particularly in port-access CABG surgery. A first aspect of the invention includes a vascular anastomosis staple. A first configuration has two parts: an anchor member, forming the attachment with the target vessel wall and a coupling member, forming the attachment with the bypass graft vessel. The anastomosis is completed by inserting the coupling member, with the graft vessel attached, into the anchor member. A second configuration combines the functions of the anchor member and the coupling member into a one-piece anastomosis staple.