CN107374688A - Plugging device in a kind of tube chamber - Google Patents

Plugging device in a kind of tube chamber Download PDF

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Publication number
CN107374688A
CN107374688A CN201710582669.XA CN201710582669A CN107374688A CN 107374688 A CN107374688 A CN 107374688A CN 201710582669 A CN201710582669 A CN 201710582669A CN 107374688 A CN107374688 A CN 107374688A
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China
Prior art keywords
closure
changeover portion
closure end
aneurysm
plugging device
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CN201710582669.XA
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Chinese (zh)
Inventor
姜卫剑
成正辉
邱宇晨
尹周
王端诚
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HUNNA RUIKANGTONG TECHNOLOGY DEVELOPMENT Co Ltd
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HUNNA RUIKANGTONG TECHNOLOGY DEVELOPMENT Co Ltd
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Priority to CN201710582669.XA priority Critical patent/CN107374688A/en
Publication of CN107374688A publication Critical patent/CN107374688A/en
Pending legal-status Critical Current

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12099Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
    • A61B17/12109Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
    • A61B17/12113Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm
    • A61B17/12118Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm for positioning in conjunction with a stent
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12027Type of occlusion
    • A61B17/12031Type of occlusion complete occlusion
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12027Type of occlusion
    • A61B17/12036Type of occlusion partial occlusion
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A61B17/1214Coils or wires
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A61B17/12168Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure
    • A61B17/12172Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure having a pre-set deployed three-dimensional shape
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743Type of operation; Specification of treatment sites
    • A61B2017/00778Operations on blood vessels
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831Material properties
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831Material properties
    • A61B2017/00902Material properties transparent or translucent
    • A61B2017/00915Material properties transparent or translucent for radioactive radiation
    • A61B2017/0092Material properties transparent or translucent for radioactive radiation for X-rays

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Reproductive Health (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Neurosurgery (AREA)
  • Surgical Instruments (AREA)

Abstract

This application discloses plugging device in a kind of tube chamber, it is characterized in that, including closure end (1), changeover portion (2), openend (3), closure end (1) is used to block knurl eck in tube chamber, changeover portion (2) connection closure end (1) is located in vessel lumen with the openend (3), the changeover portion (2).Plugging device in tube chamber provided by the invention, after implantable intravascular, it can stablize and be arranged at vascular bifurcation or blood vessel end latter end, for the closure of intracavitary knurl eck, it can directly block whole last type Aneurysmal neck mouth, last molded breadth carotid aneurysm knurl eck Coil embolization eventually can be also aided in after plugging device is put into.

Description

Plugging device in a kind of tube chamber
Technical field
The application is related to intravascular Interventional Treatment technical field, more particularly to plugging device in a kind of tube chamber.
Background technology
Wall of the lumen (particularly arterial wall), which may be formed, is referred to as aneurysmal pathological dilatation region.Aneurysm is a kind of Common vascular diseases, are due to lesion or the damage of arterial wall, form arterial wall expansion or the result caused by bulging.Human body At vascular bifurcation and blood vessel wide-angle bending place is that aneurysm easily sends out one of position, and aneurysm knurl wall is very thin, the direct punching press of blood flow In aneurysm, if without intervening, the aneurysm can expand always, have the danger of rupture at any time, and aneurysm once ruptures, Great threat will be formed to the life of human body.The position occurred according to aneurysm is different, can be divided into peripheral aneurysm, abdominal aorta Knurl, aneurysm of thoracic aorta, Visceral artery knurl, cerebral aneurysm etc..For aneurysm shaped like balloon, wall is very thin, is easily broken bleeding, in seconds It is able to can be in peril of one's life.At present, the method that can be taken for aneurysm has two kinds of open surgery and intravascular Interventional Treatment.And With the development of interventional technique and updating for apparatus, the advantages that PCI is by minimally invasive, few intercurrent disease, fast post-operative recovery And it is increasingly becoming and treats aneurysmal important method at present.Handle different parts aneurysm, the specific method of PCI with Apparatus is not quite similar, for abdominal aneurvsm, aneurysm of thoracic aorta, at present using it is relatively broad be overlay film frame, and be directed to brain Aneurysm is clogged using relatively broad for turn.
Aneurysm is divided into side wall type aneurysm and eventually last type aneurysm two according to its position and the difference of haemodynamics Class.Side wall type aneurysm is located at the side of ductus arteriosus wall, the remote of its knurl neck, portions of proximal typically respectively aneurysmal inflow and Efferent tract.Last type aneurysm is located at the top of arteries crotch eventually, and the center section of its knurl neck is usually aneurysmal stream Take part in Taoism, peripheral part is usually aneurysmal efferent tract.Last type aneurysm is also often wide neck aneurysm eventually, and its absolute width >= 4mm, or relatively wide neck (knurl neck and Tumor diameter ratio >=1/2).Wide neck aneurysm is the challenge disease of simple Coil embolization treatment Example, first, being not easy to obtain completeness compactness Coil embolization and easily recur or rupture.There is document report:Wide neck aneurysm causes Close thrombosis rate is only 15%, and non-wide neck aneurysm Dense embolization rate is 85%.Second, turn easily drops to out of aneurysm Parent artery, cause normal feeding artery occlusion and form cerebral arterial thrombosis.In recent years, with sacculus ancillary technique, support The development and application of ancillary technique, double catheter technique technology and close net support blood flow guiding technique, side wall type aneurysm coil bolt The infull difficult point of plug has been hacked.And last molded breadth carotid aneurysm is still the problem that intravascular Interventional Treatment fails to capture eventually, Aneurysm recurrence rate is still very high, and more preferable assistive device needs further to be developed.
For side wall molded breadth carotid aneurysm, support secondary spring circle embolism is more conventional treatment means.Typically first will Across the aneurysm placement of stent delivery catheter, then embolism microtubular is placed in aneurysm away from the 1/2-1/3 of knurl bottom.Lead embolism is micro- After pipe release partial spring circle, push support through stent delivery catheter and support is discharged in parent artery across aneurysm neck, so Aneurysm coil embolism is carried out again afterwards, until completeness compactness aneurysm embolism.In support secondary spring circle embolism side wall In molded breadth carotid aneurysm, the main function of support has at 2 points, first, becoming aneurysmal wide neck as narrow neck, it is therefore prevented that turn is driven Arteries and veins knurl is overflowed, to realize that completeness compactness aneurysm embolism provides structure support;Second, change the row of parent artery Direction and curvature are walked, knurl neck is alleviated and flows into road blood flow momentum, so as to reduce aneurysm recurrence.
For last molded breadth carotid aneurysm eventually, above-mentioned support auxiliary aneurysm embolization technique is only applicable to small number of patients, not Suitable for most of patient.To such aneurysm, Y shape double bracket auxiliary embolization technique has been attempted, but existing defects:It is first, micro- Conduit enters opposite side artery through the 1st piece of stent mesh can not realize sometimes;Second, when the 1st piece of larger open loop of stent mesh During support, the section that the 2nd piece of support passes through the 1st piece of stent mesh is opened not exclusively or even not opened.Therefore, solves last molded breadth eventually The PCI problem of carotid aneurysm is those skilled in the art's urgent problem to be solved.
The content of the invention
In order to solve the above technical problems, first purpose of the present invention is provides plugging device in a kind of tube chamber, it is of the invention Plugging device, be mainly used in the closure of knurl eck (such as aneurysm) in tube chamber, can directly block eventually last type Aneurysmal neck mouth, Also last molded breadth carotid aneurysm knurl eck Coil embolization eventually can be aided in after plugging device is put into.
Technical scheme provided by the invention is as follows:
Plugging device in a kind of tube chamber, including closure end, changeover portion, openend, the closure end are used to block in tube chamber Knurl eck, the changeover portion connection closure end are located in vessel lumen with the openend, the changeover portion.
Preferably, the closure end is all closing or partially enclosed structure.
Preferably, the closure end is provided with mesh.
Preferably, the changeover portion includes sparse section and condensed section, and described sparse section is arranged on the changeover portion close to institute The one end at closure end is stated, the condensed section is arranged on the one end of the changeover portion away from the closure end.
Preferably, described sparse section is provided with one or more side openings.
Preferably, the closure end is using metal material, macromolecule membrane, or metal material and high molecular film material knot Conjunction is made, and the changeover portion, openend are made up of metal material.
Preferably, the metal material is Nitinol, Co-Cr alloys, cobalt nickel-molybdenum alloy, one kind in stainless steel or more Kind.
Preferably, the high molecular film material is polyethylene terephthalate, polytetrafluoroethylene (PTFE), e-PTFE One or more in ethene.
Preferably, closure end, changeover portion, the openend of the plugging device be by laser engraving or braiding once into Type, or connect shaping after being manufactured separately.
Preferably, the plugging device also includes one or more indicatings, the indicating using gold, tantalum, platinumiridio, One or more metals in tungsten are made, the indicating by way of welding or crimping or wind with the plugging device phase Even.
The plugging device of the present invention, is mainly used in the closure of knurl eck (such as aneurysm) in tube chamber, can directly block whole end Type Aneurysmal neck mouth, last molded breadth carotid aneurysm knurl eck Coil embolization eventually can be also aided in after plugging device is put into.This hair It is bright to block end, changeover portion, openend by setting, it is possible to achieve the fixation of tip stabilization, safety at vascular bifurcation and envelope Plugging intracavitary knurl eck.The closure end is used for the closure of knurl eck in tube chamber, and changeover portion is placed in vessel lumen, for propping up Support the closure end and the openend.Openend is set to be easy to blood circulation in tube chamber.
Closure end diameter can be more than or equal to knurl neck finish diameter, also be smaller than knurl neck finish diameter.When setting, closure end is straight Footpath is more than or equal to aneurysm neck finish diameter, is easy to block being bonded for end and aneurysm eck, and end is blocked meanwhile, it is capable to increase Stability.And when the diameter for blocking end is less than knurl neck finish diameter, as long as closure end can prevent most of blood flow from entering in knurl, It can then ensure that intraluminal knurl does not rupture, reach closure knurl eck, ensure the effect of patients ' lives safety.Block end diameter with The size of approach blood vessel is relevant, and because plugging device needs to reach lesion by blood vessel, the size of plugging device is by lesion Locate the limitation of approach blood vessel size.When approach blood vessel diameter is big, the closure end using large-size can be selected, or use full envelope The closure end seal closed blocks up knurl eck;When approach hemadostewnosis or distortion angulation, the closure end using small diameter can only be selected, Or semi-enclosed closure end, whole plugging device is passed through blood vessel and reach lesion region, realize the closure to knurl eck.
Changeover portion is arranged in approach blood vessel, and openend is arranged on the other end of the changeover portion away from closure end, that is, is arranged on Away from that aneurysmal one end in approach blood vessel, it is to ensure that the blood circulation of approach blood vessel is smooth, make whole to set openend Individual plugging device can realize the closure to knurl mouth, and the influence of the normal operation to blood vessel is preferably minimized.
The plugging device of the present invention, the diameter at closure end can be set to be more than or equal to the diameter of the changeover portion, also may be used To set the diameter at closure end to be less than the diameter of the changeover portion.The size that the diameter of changeover portion is generally mated approach blood vessel is set Put, to reach stable fixation, while do not influence the effect of blood circulation, the diameter of usual changeover portion could be arranged to be slightly larger than into The diameter of road blood vessel, so as to provide enough radial supports.And the diameter for blocking end needs the diameter for coordinating knurl eck in tube chamber (such as aneurysm neck breadth) is set, while the approach blood vessel that is dimensioned to pass through for blocking end reaches knurl eck.When approach blood vessel Diameter is big, can select the closure end using large-size, or block up knurl eck using totally enclosed closure end seal;When approach blood vessel When narrow, the closure end using small diameter can only be selected, or selects semi-enclosed closure end, whole plugging device is smoothly led to Cross blood vessel and reach lesion region, realize the closure to knurl eck.Therefore, according to the knurl neck finish diameter in different lesions region, and The difference of approach blood vessel size, closure end also can be different from the diameter of changeover portion, therefore closure end diameter and changeover portion it is straight Footpath is compared, according to the difference of lesion region, can set closure end diameter greater than, equal to or less than changeover portion diameter.
The change of closure end diameter can be arranged to be mutated, and can also be arranged to gradual change.
When the closure end of the present invention is arranged to totally enclosed structure, it can be provided closure dish structure, by aneurysm eck All or part of covering.When closure end is arranged to semi-enclosed structure, it can be provided the structure of ring is blocked, it can also be provided that One side of something closure, the half of structure not blocked, as long as partial aneurysm eck can be covered, you can what reduction aneurysm crushed can Energy property, or prevent turn from dropping out.The closure end is provided with mesh.Closure end mesh can set closeer, or block Polymeric membrane is set in end, enters for obstructing blood in aneurysm, changes blood flow direction, to aneurysm eck at closure end Part carries out totally-enclosed;It is also settable diluter to block end mesh, or coordinates the structures such as semi-enclosed closure ring, to prevent embolism from moving Padding (such as turn) drops out aneurysm eck during arteries and veins knurl.Whether closure end sets macromolecule membrane, or the net at closure end Hole setting is intensive or sparse, can need to set according to actual operation.Macromolecule membrane can coordinate the mesh of comparatively dense common Set, also sparse mesh can be coordinated to set jointly, macromolecule membrane can also be separately provided.
In practical application, when closure end is arranged to totally enclosed such as closure disk structure, mesh sets closeer or blocked When macromolecule membrane is provided with end, closure end can be placed at aneurysm eck, aneurysm directly be blocked, the process Therapeutic device can be avoided to enter in aneurysm, evaded the risk of apparatus puncturing arteries knurl wall, but to transfer passage (i.e. approach Blood vessel) size require it is higher, it is necessary to the transfer passage of large-size.For thering is transfer passage, larger-size lesion to adopt Take totally enclosed closure disk to set, realize once-through operation, block wide neck aneurysm.When closure end is arranged to semi-enclosed closure ring Set diluter or when being separately provided macromolecule membrane etc. structure, mesh, its insulating effect to blood flow is poor, but can reduce institute The size of the transfer passage needed, for the less lesion of transfer passage size, semi-enclosed closure ring or diluter net can be taken The closure end of eye, secondary spring circle aneurysm embolization, it can effectively prevent turn from charging into parent artery, the cause of increase spring filling Density, padding during aneurysm embolization is prevented to drop out aneurysm eck.
The changeover portion of the present invention can set sparse section and condensed section, and sparse section at vascular bifurcation, is easy to blood vessel blood Stream circulation, especially the blood flow of collatoral vessel can smoothly circulate;Condensed section is placed on vessel lumen (such as approach blood vessel straight section) In, support strength and enough support forces are provided for closure end, prevents plugging device from shifting.To ensure enough blood circulations, also One or more side openings can be set at sparse section, further be easy to blood circulation.Side opening is located at vascular bifurcation, at sparse section Set side opening to easily facilitate the blood circulation of collatoral vessel, the influence that organ runs well will be minimized.
Metal material used in the plugging device can be Nitinol, Co-Cr alloys, cobalt nickel-molybdenum alloy (such as SUS316), the metal of the good biocompatibility such as stainless steel, or the combination of various metals.The molding mode of changeover portion can be with The methods of using self-expanding or balloon expandable.The macromolecule membrane that the closure end uses, material can be poly terephthalic acid Glycol ester (PET), polytetrafluoroethylene (PTFE) (PTFE), expanded PTFE (e-PTFE) etc. can be used for the material of organism.It is logical For often, the macromolecule membrane, for the thickness of its overlay film between 0.01-0.1mm, the mode of connection can use suture or heat Bonding etc..Metal material, macromolecule membrane can be used alone, and also can be combined metal material with high molecular film material makes With.
Closure end, changeover portion, the openend of the plugging device can also may be used by laser engraving or braiding one-shot forming With the shaping that links together after being manufactured separately, connected mode can be the various ways such as welding or mechanical engagement connection, as long as energy Firm connecting components simultaneously can be used for the connected mode of organism.
Plugging device sets one or more indicatings, generally sets multiple indicatings, such as 2-10,4-6 indicating, facilitates hand Develop during art.Indicating can be made by the one or more in the roentgenopaque metal such as gold, tantalum, platinumiridio, tungsten It is standby.
Plugging device in tube chamber provided by the invention, after implantable intravascular (such as arteries), it can stablize and be arranged on blood vessel Crotch or blood vessel end latter end, for the closure of intracavitary knurl eck (such as aneurysm), it can directly block last type Aneurysmal neck eventually Mouth, last molded breadth carotid aneurysm knurl eck Coil embolization eventually can be also aided in after plugging device is put into.The plugging device of the present invention, Can solve the problems, such as that traditional support secondary spring circle embolism is not suitable for most of end last molded breadth carotid aneurysm treatments, and can solve Certainly there is the problem of second piece of stenter to implant is difficult and opening is not complete or even does not open in Y shape double bracket secondary spring circle embolism.
Brief description of the drawings
, below will be to embodiment or existing in order to illustrate more clearly of the embodiment of the present application or technical scheme of the prior art There is the required accompanying drawing used in technology description to be briefly described, it should be apparent that, drawings in the following description are only this Some embodiments described in application, for those of ordinary skill in the art, on the premise of not paying creative work, Other accompanying drawings can also be obtained according to these accompanying drawings.
Fig. 1 is the first structural representation (totally-enclosed) of middle pipe intracavitary plugging device of the embodiment of the present invention;
Fig. 2 is second of structural representation (semiclosed) of middle pipe intracavitary plugging device of the embodiment of the present invention;
Fig. 3 is the third structural representation (totally-enclosed) of middle pipe intracavitary plugging device of the embodiment of the present invention;
Fig. 4 is the 4th kind of structural representation (totally-enclosed) of middle pipe intracavitary plugging device of the embodiment of the present invention;
Fig. 5 is the first schematic diagram of the closure end termination of middle pipe intracavitary plugging device of the embodiment of the present invention;
Fig. 6 is second of schematic diagram of the closure end termination of middle pipe intracavitary plugging device of the embodiment of the present invention;
Fig. 7 is the third schematic diagram of the closure end termination of middle pipe intracavitary plugging device of the embodiment of the present invention;
Fig. 8 is a kind of use state diagram (totally-enclosed) of middle pipe intracavitary plugging device of the embodiment of the present invention;
Fig. 9 is a kind of use state diagram (semiclosed cooperation spring of middle pipe intracavitary plugging device of the embodiment of the present invention Circle);
Reference:1- blocks end;2- changeover portions;Sparse section of 201-;202- condensed sections;203- side openings;3- openends;4- Indicating;
Embodiment
In order that those skilled in the art more fully understand the technical scheme in the application, it is real below in conjunction with the application The accompanying drawing in example is applied, the technical scheme in the embodiment of the present application is clearly and completely described, it is clear that described implementation Example only some embodiments of the present application, rather than whole embodiments.It is common based on the embodiment in the application, this area The every other embodiment that technical staff is obtained under the premise of creative work is not made, it should all belong to the application protection Scope.
Please as shown in Figures 1 to 9, the embodiment of the present invention provides plugging device in a kind of tube chamber, including closure end 1, transition Section 2, openend 3, the closure end 1 are used to block knurl eck in tube chamber, the changeover portion 2 connect the closure end 1 with it is described Openend 3, the changeover portion 2 are located in vessel lumen.
The plugging device of the present invention, is mainly used in the closure of knurl eck (such as aneurysm) in tube chamber, can directly block whole end Type Aneurysmal neck mouth, last molded breadth carotid aneurysm knurl eck Coil embolization eventually can be also aided in after plugging device is put into.This hair It is bright to block end 1, changeover portion 2, openend 3 by setting, it is possible to achieve the fixation of tip stabilization, safety at vascular bifurcation is simultaneously Block knurl eck in tube chamber.The closure end 1 is used for the closure of knurl eck in tube chamber, and changeover portion 2 is placed in vessel lumen, is used In the support closure end 1 and the openend 3.Openend 3 is set to be easy to blood circulation in tube chamber.
The closure diameter of end 1 can be more than or equal to knurl neck finish diameter, also be smaller than knurl neck finish diameter.End 1 is blocked when setting Diameter is more than or equal to aneurysm neck finish diameter, is easy to block being bonded for end 1 and aneurysm eck, meanwhile, it is capable to increase closure The stability at end 1.And when the diameter for blocking end 1 is less than knurl neck finish diameter, as long as closure end 1 can prevent most of blood flow from entering Enter in knurl, then can ensure that intraluminal knurl does not rupture, reach closure knurl eck, ensure the effect of patients ' lives safety.Block end 1 Diameter it is relevant with the size of approach blood vessel, due to plugging device need by blood vessel reach lesion, the size of plugging device Limited by lesion approach blood vessel size.When approach blood vessel diameter is big, the closure end 1 using large-size can be selected, Or block knurl eck using totally enclosed closure end 1;When approach hemadostewnosis or distortion angulation, can only select using smaller straight The closure end 1 in footpath, or semi-enclosed closure end 1, make whole plugging device pass through blood vessel and reach lesion region, realize to knurl The closure of eck.
Changeover portion 2 is arranged in approach blood vessel, and openend 3 is arranged on the other end of the changeover portion 2 away from closure end 1, that is, sets Put in approach blood vessel away from that aneurysmal one end, set openend 3 be in order to ensure that the blood circulation of approach blood vessel is smooth, Whole plugging device is realized the closure to knurl mouth, and the influence of the normal operation to blood vessel is preferably minimized.
The plugging device of the present invention, the diameter at closure end 1 can be set to be more than or equal to the diameter of the changeover portion 2, The diameter at closure end 1 can be set to be less than the diameter of the changeover portion 2.The diameter of changeover portion 2 is generally mated the chi of approach blood vessel Very little setting, to reach stable fixation, while the effect of blood circulation is not influenceed, the diameter of usual changeover portion 2 could be arranged to omit More than the diameter of approach blood vessel, so as to provide enough radial supports.And the diameter for blocking end 1 needs to coordinate knurl eck in tube chamber Diameter (such as aneurysm neck breadth) set, while block end 1 be dimensioned to pass through approach blood vessel reach knurl eck.When entering Road blood vessel diameter is big, can select the closure end 1 using large-size, or block knurl eck using totally enclosed closure end 1;When During approach hemadostewnosis, the closure end 1 using small diameter can only be selected, or from semi-enclosed closure end 1, make entirely to block Device passes through blood vessel and reaches lesion region, realizes the closure to knurl eck.Therefore, according to the knurl eck in different lesions region Diameter, and the difference of approach blood vessel size, closure end 1 also can be different from the diameter of changeover portion 2, therefore block the diameter at end 1 Compared with the diameter of changeover portion 2, according to the difference of lesion region, can set the diameter at closure end 1 greater than, equal to or be less than Cross the diameter of section 2.
The change of the closure diameter of end 1 can be arranged to be mutated, and can also be arranged to gradual change.
Preferably, the closure end 1 is all closing or partially enclosed structure.
Preferably, the closure end 1 is provided with mesh.
When the closure end 1 of the present invention is arranged to totally enclosed structure, it can be provided closure dish structure, by aneurysm eck All or part of covering.When closure end 1 is arranged to semi-enclosed structure, it can be provided block the structure of ring, can also set The structure not blocked for half of closure, one side of something, as long as partial aneurysm eck can be covered, you can reduce what aneurysm crushed Possibility, or prevent turn from dropping out.The closure end 1 is provided with mesh.Closure end mesh can set closeer, or seal Polymeric membrane is set in stifled end 1, is entered for obstructing blood in aneurysm, is changed blood flow direction, aneurysm eck is being blocked The part at end 1 carries out totally-enclosed;It is also settable diluter to block end mesh, or coordinates the structures such as semi-enclosed closure ring, to prevent Padding (such as turn) drops out aneurysm eck during aneurysm embolization.Whether closure end 1 sets macromolecule membrane, or closure The mesh setting at end 1 is intensive or sparse, can need to set according to actual operation.Macromolecule membrane can coordinate the net of comparatively dense Hole is set jointly, also sparse mesh can be coordinated to set jointly, and macromolecule membrane can also be separately provided.
In practical application, when closure end 1 is arranged to totally enclosed such as closure disk structure, mesh sets closeer or blocked When being provided with macromolecule membrane in end 1, closure end 1 can be placed at aneurysm eck, aneurysm directly be blocked, the mistake Journey can avoid therapeutic device from entering in aneurysm, evade the risk of apparatus puncturing arteries knurl wall, but to transfer passage (be into Road blood vessel) size require it is higher, it is necessary to the transfer passage of large-size.For having transfer passage, larger-size lesion can be with Take totally enclosed closure disk to set, realize once-through operation, block wide neck aneurysm.When closure end 1 is arranged to semi-enclosed envelope The structures such as blocking ring, mesh set diluter or when being separately provided macromolecule membrane, and its insulating effect to blood flow is poor, but can subtract The size of small required transfer passage, for the less lesion of transfer passage size, can take semi-enclosed closure ring or compared with The closure end of dilute mesh, secondary spring circle aneurysm embolization, it can effectively prevent turn from charging into parent artery, increase spring filling Consistency, prevent aneurysm embolization when padding drop out aneurysm eck.
Preferably, the changeover portion 2 includes sparse section 201 and condensed section 202, and described sparse section 201 is arranged on the mistake Section 2 is crossed close to the one end at the closure end 1, the condensed section 202 is arranged on one of the changeover portion 2 away from the closure end 1 End.
Preferably, described sparse section 201 is provided with one or more side openings 203.
The changeover portion 2 of the present invention can set sparse section 201 and condensed section 202, and sparse section 201 is located at vascular bifurcation, It is easy to vascular flow to circulate, especially the blood flow of collatoral vessel can smoothly circulate;Condensed section 202 is placed on vessel lumen (such as Approach blood vessel straight section) in, support strength and enough support forces are provided for closure end 1, prevents plugging device from shifting.To ensure foot Enough blood circulations, one or more side openings 203 can also be set at sparse section 201, further be easy to blood circulation.Side opening 203 At vascular bifurcation, the blood circulation of collatoral vessel is easily facilitated in sparse section 201 setting side opening 203, will be normal to organ The influence of operating minimizes.
Preferably, the closure end 1 is using metal material, macromolecule membrane, or metal material and high molecular film material With reference to being made, the changeover portion 2, openend 3 are made up of metal material.
Preferably, the metal material is Nitinol, Co-Cr alloys, cobalt nickel-molybdenum alloy, one kind in stainless steel or more Kind.
Preferably, the high molecular film material is polyethylene terephthalate, polytetrafluoroethylene (PTFE), e-PTFE One or more in ethene.
Metal material used in the plugging device can be Nitinol, Co-Cr alloys, cobalt nickel-molybdenum alloy (such as SUS316), the metal of the good biocompatibility such as stainless steel, or the combination of various metals.The molding mode of changeover portion 2 can be with The methods of using self-expanding or balloon expandable.The macromolecule membrane that the closure end 1 uses, material can be poly terephthalic acid Glycol ester (PET), polytetrafluoroethylene (PTFE) (PTFE), expanded PTFE (e-PTFE) etc. can be used for the material of organism.It is logical For often, the macromolecule membrane, for the thickness of its overlay film between 0.01-0.1mm, the mode of connection can use suture or heat Bonding etc..Metal material, macromolecule membrane can be used alone, and also can be combined metal material with high molecular film material makes With.
Preferably, the closure end 1 of the plugging device, changeover portion 2, openend 3 are by laser engraving or woven once Shaping, or connect shaping after being manufactured separately.
The closure end 1 of the plugging device, changeover portion 2, openend 3 can by laser engraving or braiding one-shot forming, Link together shaping after can also being manufactured separately, and connected mode can be the various ways such as welding or mechanical engagement connection, only Connecting components can be consolidated and can be used for the connected mode of organism.
Preferably, the plugging device also includes one or more indicatings 4, and the indicating 4 is closed using gold, tantalum, platinoiridita Gold, one or more metals in tungsten are made, and the indicating 4 is by way of welding or crimping or wind and the plugging device It is connected.
Plugging device sets one or more indicatings 4, generally sets multiple indicatings 4, such as 2-10,4-6 indicating 4, side Just develop in surgical procedure.Indicating 4 can be by one kind or more in the roentgenopaque metal such as gold, tantalum, platinumiridio, tungsten It is prepared by kind.
Fig. 1 to Fig. 4 is the structural representation of plugging device in tube chamber provided in an embodiment of the present invention, and plugging device includes envelope Stifled end 1, changeover portion 2, the part of openend 3 three, plugging device can use the webmaster (as shown in Figure 1 and Figure 2) of titanium-nickel wire braiding, Or the NiTi pipe (as shown in Figure 4) after laser engraving, by special shaper, formed after heat treatment.Block end 1, transition Section 2 and openend 3 can be one-shot forming (as shown in Figure 1, Figure 2, Figure 4 shows), can also separate after being molded, and pass through welding or machinery Mode links together (as shown in Figure 3).The plugging device made using shape memory metals such as Nitinols, in human vas It is interior can self-expanding shaping.Plugging device can also use the metal of the non-shape memories such as Co-Cr alloys, stainless steel to make, this Class device is molded in human body domestic demand by balloon expandable.
In the embodiment of the present invention, closure end termination can be on the outside of woven wire or inner side, and metal termination is on the outside of silk screen When, can be with (as shown in Figures 5 to 7) on the inside of recessed closure face.Fig. 8 to Fig. 9 is to be blocked in tube chamber provided in an embodiment of the present invention The use state diagram of device, for the larger-size lesion of transfer passage, it can select to block end 1 as totally-enclosed, closure Hold 1 mesh closeer or closure end 1 in be provided with the plugging device of polymeric membrane, the plugging device is placed at vascular bifurcation, Closure end 1 is covered in aneurysm eck, and the closure diameter of end 1 is slightly larger than knurl neck finish diameter, is easy to the closure of aneurysm eck completely, Meanwhile it can also increase the stability at closure end 1.It may also set up the closure diameter of end 1 and be equal to or less than knurl neck finish diameter, as long as can Block most blood flow, you can ensure that knurl does not rupture.The process, therapeutic device can be avoided to enter in aneurysm, can be dropped In low surgical procedure, the risk of apparatus puncturing arteries knurl wall.For the less lesion of transfer passage size, can select to block end 1 sets diluter plugging device for semiclosed, mesh, and closure end 1 is placed on aneurysm eck, then secondary spring circle embolism, energy It is enough effectively to prevent turn from charging into parent artery, meanwhile, it can also increase the consistency that turn is clogged.
Plugging device in tube chamber provided by the invention, after implantable intravascular (such as arteries), it can stablize and be arranged on blood vessel Crotch or blood vessel end latter end, for the closure of intracavitary knurl eck (such as aneurysm), it can directly block last type Aneurysmal neck eventually Mouth, last molded breadth carotid aneurysm knurl eck Coil embolization eventually can be also aided in after plugging device is put into.The plugging device of the present invention, Can solve the problems, such as that traditional support secondary spring circle embolism is not suitable for most of end last molded breadth carotid aneurysm treatments, and can solve Certainly there is the problem of second piece of stenter to implant is difficult and opening is not complete or even does not open in Y shape double bracket secondary spring circle embolism.
The foregoing description of the disclosed embodiments, professional and technical personnel in the field are enable to realize or using the present invention. A variety of modifications to these embodiments will be apparent for those skilled in the art, as defined herein General Principle can be realized in other embodiments without departing from the spirit or scope of the present invention.Therefore, it is of the invention The embodiments shown herein is not intended to be limited to, and is to fit to and principles disclosed herein and features of novelty phase one The most wide scope caused.

Claims (10)

1. plugging device in a kind of tube chamber, it is characterised in that including closure end (1), changeover portion (2), openend (3), the envelope Stifled end (1) is used to block knurl eck in tube chamber, changeover portion (2) connection closure end (1) and the openend (3), institute Changeover portion (2) is stated to be located in vessel lumen.
2. device according to claim 1, it is characterised in that closure end (1) is all closings or partially enclosed Structure.
3. device according to claim 1, it is characterised in that closure end (1) is provided with mesh.
4. device according to claim 1, it is characterised in that the changeover portion (2) includes sparse section (201) and condensed section (202), sparse section (201) are arranged on the changeover portion (2) close to one end of closure end (1), the condensed section (202) it is arranged on the one end of the changeover portion (2) away from closure end (1).
5. device according to claim 4, it is characterised in that described sparse section (201) are provided with one or more side openings (203)。
6. device according to claim 1, it is characterised in that closure end (1) is thin using metal material, macromolecule Film, or metal material are combined with high molecular film material and are made, and the changeover portion (2), openend (3) are made up of metal material.
7. device according to claim 6, it is characterised in that the metal material is Nitinol, Co-Cr alloys, cobalt One or more in nickel-molybdenum alloy, stainless steel.
8. device according to claim 6, it is characterised in that the high molecular film material is poly terephthalic acid second two One or more in alcohol ester, polytetrafluoroethylene (PTFE), expanded PTFE.
9. device according to claim 6, it is characterised in that the closure end (1) of the plugging device, changeover portion (2), open Mouth end (3) is by laser engraving or weaves one-shot forming, or connects shaping after being manufactured separately.
10. device according to claim 1, it is characterised in that also including one or more indicatings (4), the indicating (4) It is made of one or more metals in gold, tantalum, platinumiridio, tungsten, the indicating (4) is by welding or crimping or wind Mode be connected with the plugging device.
CN201710582669.XA 2017-07-17 2017-07-17 Plugging device in a kind of tube chamber Pending CN107374688A (en)

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