CN102599996A

CN102599996A - Preparation method of absorbable stent in cerebral vascular bypass surgery and angioplasty

Info

Publication number: CN102599996A
Application number: CN2011100245908A
Authority: CN
Inventors: 赵维刚
Original assignee: Individual
Current assignee: Individual
Priority date: 2011-01-24
Filing date: 2011-01-24
Publication date: 2012-07-25

Abstract

The invention relates to a preparation method of an absorbable stent in cerebral vascular bypass surgery and angioplasty. The preparation method includes the steps of selecting a straight through tube to serve as an absorbable stent body; arranging a through pipe made from the same material as the stent body in the middle of the stent body vertically and then connecting the through tube with the stent body into a whole; or, at one end of the stent body, arranging two inclined through tubes which are made from the same material as the stent body and communicated with the stent body, and then connecting the inclined through tubes with the stent body into a whole; or, processing two ports at the two ends of the stent body into inclined-section ports respectively. The prepared stent has excellent safety, and in clinical application, the prepared stent can prevent blood from leaking out of an anastomosis, promote the healing of the anastomosis and avoid anastomosis stenosis; and long-term administration of anticoagulant drugs can be avoided.

Description

Can absorb the method for preparing of support in cerebrovascular bridging, the plastic operation

Technical field

The present invention relates to a kind of method for preparing of intravascular stent, can absorb the method for preparing of support in specifically a kind of cerebrovascular bridging, the plastic operation.

Background technology

Cerebrovascular bypass surgery clinically and angioplasty all are the high-leveled and difficult operations of neurosurgery.At present, be mainly used in: (1). chronic cerebral ischemia property treatment of diseases; (2). giant aneurysm and netraneurysm that a part is complicated, because of folder closes or the patient's that the thromboembolism difficulty must inaccessible parent artery parent artery far-end ischemia can not tolerate again operative treatment; (3). the minority tumor of base of skull is invaded and the intracranial important blood vessels, in order to cut tumor entirely, needs vascular bypass surgery in advance.

Cerebrovascular is put up a bridge, the postoperative complication of plastic operation mainly contains two aspects: one is cerebral ischemia in the art; Another is a postoperative anastomotic stoma thrombosis.Two kinds of complication all cause the serious consequence of patient's compromised brain function.

Need interim blocking-up cerebrovascular in vascular bypass, the plastic operation process, vascular anastomosis and angiopoiesis can be opened interim blocking-up after sewing up and accomplishing.Cerebral tissue is the most weak tissue of whole body to the ischemia tolerance, and the Ischemia Time that tolerates under the situation of blocking blood flow fully is no more than 5 minutes, and the irreversibility infringement just takes place the long cerebral tissue of Ischemia Time.Mainly be to rely on to use cerebral protective agent prolongation cerebral ischemia tolerance time in the art at present; Improve vascular anastomosis microsurgery skill and shorten operating time, two kinds of cerebral ischemia infringements that approach prevents to perform the operation and causes.But because the cerebrovascular position is dark, blood vessel wall is thin, caliber is thin, the angiostomy open country is narrow and small, and the effect of these two kinds of ways is still limited.

The thrombotic reason of postoperative anastomotic stoma is still the vascular anastomosis technical problem.Mainly be that operation process medium vessels endothelial injury weighs and the not good blood flow of anastomotic stoma geometry forms due to the turbulent flow.

In view of excessive risk, the thrombotic severe complication of postoperative anastomotic stoma of cerebral ischemia in vascular anastomosis, angiopoiesis technical difficulty and the art, current cerebrovascular is put up a bridge, angioplasty worldwide can't generally be carried out.How to improve vascular bypass surgery vascular anastomosis speed and identical quality and just become the key that cerebrovascular bypass surgery technology is carried out, and the outlet that solves this key issue is to provide multiple available and support preliminary election and the employing scheme that can make with reference to Same Way.

Summary of the invention

Technical problem to be solved by this invention provides the method for preparing that can absorb support in a kind of cerebrovascular bridging, the plastic operation; Its purpose is exactly that this method is produced the support that can supply to use safely in the art and can be accelerated the vascular bypass speed of coincideing through this support, avoids the cerebral ischemia infringement due to the interim blood blocked brain stream overlong time in the vascular anastomosis process; The anastomosis of blood vessel coupling is adapted to, and the anastomotic stoma geometric shape is good, avoids anastomotic stoma place blood flow turbulent flow to occur, prevents postoperative anastomotic stoma place thrombosis.

For this reason; The technical scheme that the present invention solves said problem is: the method for preparing that can absorb support in a kind of cerebrovascular bridging, the plastic operation; Comprise step: choose one section straight pipe as the body that can absorb support; On the center of said relatively body and upright position, be provided with one with the siphunculus of body with material, more said siphunculus and said body are held together; Perhaps, an end of said relatively body be provided with respectively two with said body with material and oblique siphunculus that be connected with said body, more said oblique siphunculus and said rack body are held together; Perhaps, the two ends port with said rack body is made into the inclined-plane port respectively.

The body of the absorbed support of in above-mentioned steps, selecting for use, its timbering material are the macromolecule absorbable material, can be respectively polylactic acid-polyglycolic acid or polylactic acid or PLLA or nano biological degraded drug release materials etc.

And as the external diameter of straight pipe of the body that can absorb support be by between 1.5 millimeters to 4.0 millimeters and per 0.1 millimeter be a model, its pipe thickness is 0.05 to 0.3 millimeter.

As and can absorb siphunculus that the body of support is connected as a single entity, tiltedly its diameter range of siphunculus is chosen between 1.5 millimeters to 3.5 millimeters.

Compare prior art, the good effect that manufacture method had that the present invention relates to is: prepared stent safety ability is good and use this body support frame can in clinical practice, avoid anastomotic leakage blood, can promote anastomotic healing, prevents anastomotic stricture; Can avoid obeying for a long time anticoagulant.

Description of drawings

Fig. 1 is the overall structure sketch map of rack body;

Fig. 2 is that straight pipe and rack body are holistic structural representation;

Fig. 3 is that two oblique siphunculus and rack body are holistic structural representation;

Fig. 4 is the clinical implementation example structural representation about Fig. 2;

Fig. 5 is the structural representation about the clinical implementation example of Fig. 2;

Fig. 6 is the structural representation about the clinical implementation example of Fig. 1;

Fig. 7 is the structural representation about the clinical implementation example of Fig. 6;

Fig. 8 is the structural representation that has the inclined-plane about the rack body two ends port of Fig. 1 and Fig. 2 improvement;

Fig. 9 is the rack making schematic flow sheet that the present invention relates to.

Among the figure: the 1-rack body, 11-rack body inclined-plane port, the 2-siphunculus, the 21-bridge blood vessel, the oblique siphunculus of 3-, the 4-cerebrovascular, the 41-lesion vessels, the 42-angiopoiesis is sewed up mouth, 5-perforating branches tremulous pulse, 6-perforating branches tremulous pulse corresponding position opening, 7-operative incision.

The specific embodiment

Referring to accompanying drawing 1 to accompanying drawing 9; The present invention relates to absorb in a kind of cerebrovascular bridging, the plastic operation method for preparing of support; Comprise step: choose one section straight pipe as the body that can absorb support; On the center of said relatively body and upright position, be provided with one with the siphunculus of body with material, more said siphunculus and said body are held together; Perhaps, an end of said relatively body be provided with respectively two with said body with material and oblique siphunculus that be connected with said body, more said oblique siphunculus and said rack body are held together; Perhaps, the two ends port with said rack body is made into the inclined-plane port respectively.

Because cerebrovascular is put up a bridge, the particularity of plastic operation, the support when repairing blood vessel should be selected the absorbable polymer absorbable material for use.The invention provides with polylactic acid-polyglycolic acid (polylactic acid polyglycolic acid; PLGA) be main absorbable material; Also can select alternative material: polylactic acid (polylactic acid, PLA) or PLLA (PLLA) or nano biological degraded drug release material etc.

Its caliber of employed rack body also has specific requirement in the art, and for example, as its external diameter of straight pipe of rack body selection and per 0.1 millimeter between 1.5 millimeters to 4.0 millimeters being arranged is a model, pipe thickness be 0.05 to 0.3 millimeter.In like manner, and rack body be connected as one siphunculus, tiltedly its diameter range of siphunculus is selected between 1.5 millimeters to 3.5 millimeters.The model of specifically selecting for use be according to put up a bridge, the bore of shaping blood vessel decides, such as: superficial temporal artery-middle cerebral artery is put up a bridge, and superficial temporal artery and ramose bore thereof are at 1.6～2.5 millimeters, and the bore of middle cerebral artery is in 3.0 millimeter.Carotid diameter is at 8.0～10.0 millimeters; The internal carotid artery diameter is 5.0～7.0 millimeters; Therefore when doing carotid artery intima and stripping off angiopoiesis, the absorbed support bore of selecting for use must 4.0～11.0 millimeters, and pipe thickness also will be thickeied and reached 0.5 millimeter even thicker.Can absorb support in the art that superficial temporal artery-middle cerebral artery Coronary Artery Bypass uses and can be used as a series, carotid artery intima is stripped off angioplasty with absorbing support as another series.

Specifically, said rack body is a straight pipe 1, on the center of said relatively straight pipe and upright position, is provided with a siphunculus 2, and its siphunculus 2 holds together with said straight pipe 1.According to clinical needs, at an end of said relatively straight pipe 1 two oblique siphunculus 3 that are connected with said straight pipe can be set, its oblique siphunculus 3 holds together with said straight pipe 1.In like manner, according to clinical needs, the two ends port of its straight pipe 1 is respectively an inclined-plane port 11.

Fig. 2, Fig. 4, Fig. 1, Fig. 3, Fig. 5, Fig. 8 are respectively that the stent applications that the present invention relates to is faced structural representation in several kinds of shapes in the cerebrovascular Coronary Artery Bypass.Wherein, Fig. 4. be rack body example in the use in art, its bridge blood vessel 21 is socketed on the support siphunculus 2 of straight pipe 1 top.

Fig. 5. be another example in the use in the rack body art, rack body inserts cerebrovascular 4, realizes the end-to-side anastomosis of cerebrovascular 4 and bridge blood vessel 21, further the anastomotic stoma micro suture is accomplished vascular bypass surgery.

Fig. 6, Fig. 7. be correlated sketch map before and after the angiopoiesis that coincide of rack body and the perforating branches tremulous pulse 5 in the angioplasty.

Fig. 8 provides its two ends port of support that adopts in the art to be inclined plane shape, coincideing when being convenient to vascular suture.

Fig. 9 is the preparation flow figure that makes the support that the present invention relates to, and its flow path can be prepared as required in the difform art and use support.

In sum, the support product that the present invention relates to has making, uses two broad aspect technical contributions.The first is made, and according to " T " shape support of the produced different size of bore of common cerebrovascular bridge blood vessel, its timbering material is that biology can absorb material; In vascular bypass surgery, select the absorbed support of suitable bore subsequent use; In order to prevent that residual gas forms aeroembolism in thrombosis, the anti-hemostatic tube, should on support, overlap and in support, be full of heparin saline when connecting bridge blood vessel; Its heparin saline that is full of is meant heparin-saline solution, and concentration is: 62.5 units per ml.Operation in the art is: block cerebrovascular temporarily, cut tube wall, with the heparin saline flushing, insert " T " shape and can absorb support, cerebrovascular and bridge blood vessel are sewed up two pins fix; Open cerebrovascular is blocked temporarily, open bridge blood vessel; Under the sufficient situation of cerebral blood flow, sewed up anastomotic stoma calmly like a cork, bridge blood vessel is smoothly coincide with unfolding.The needlework of sewing up blood vessel in the art are generally selected the micro-eyeless suture needle line (needlework one) of 7-0 to 11-0 for use, and that commonly used is 10-0, and the needle gage of stitching is the twice of vascular wall thickness, and external caliber is big, the vascular suture spacing of thickness of pipe wall is 1.0 millimeters.The general 8-10 pin of sewing up.

It two is to use, and in the angioplasty process, inserts earlier and can absorb support, under the situation that keeps the blood flow regular supply, sews up blood vessel at leisure, improves the angiopoiesis quality greatly.Can absorb the effect that support plays interim shunt tube.Can also avoid the cerebral ischemia of perforating branches vascular occlusion in the perforate of respective holder position according to perforating branches blood vessel situation.Sketch map is seen Fig. 6 and Fig. 7.

In addition, also need a spot of straight type (Fig. 1), Y type (Fig. 3) and T type improvement support (Fig. 4) in clinical, can in like manner prepare, supply use in the operation.T type improvement support (Fig. 4) is to change the holder part shape to go in order to Rhizoma Atractylodis Macrocephalae is mid-.

Owing to adopted above support casing connection technology, guaranteed that operation can recover cerebral blood supply and avoid the encephaloclastic generation of cerebral ischemia in the art in the very short time; Again because support is inserted to make and do not had anastomotic leakage blood phenomenon in the anastomosis procedures, and the art open country is totally clear, and the patient can sew up blood vessel at leisure at microscopically, reduce the infringement and the surrounding tissue infringement of blood vessel wall simultaneously, the postoperative healing is fast; Support is inserted and is also made anastomotic stoma place geometry good, avoids postoperative anastomotic stoma blood formation turbulent flow and anastomotic stoma thrombosis occurs; And support adopts absorbable material to make, the postoperative short time absorb fully do not have residual, so postoperative needn't need be taken anticoagulant for a long time as other intravascular stents are inserted.

Claims

1. the method for preparing of support is put up a bridge, can be absorbed in the plastic operation to a cerebrovascular; It is characterized in that; Comprise step: choose one section straight pipe as the body that can absorb support; On the center of said relatively body and upright position, be provided with one with the siphunculus of body with material, more said siphunculus and said body are held together; Perhaps, an end of said relatively body be provided with respectively two with said body with material and oblique siphunculus that be connected with said body, more said oblique siphunculus and said rack body are held together; Perhaps, the two ends port with said rack body is made into the inclined-plane port respectively.

2. can absorb the method for preparing of support in cerebrovascular bridging according to claim 1, the plastic operation; It is characterized in that; The said body that absorbs support; Its timbering material is the macromolecule absorbable material, can be respectively polylactic acid-polyglycolic acid or polylactic acid or PLLA or nano biological degraded drug release material.

3. can absorb the method for preparing of support in cerebrovascular bridging according to claim 1, the plastic operation; It is characterized in that; Between the said body that absorbs support, 1.5 millimeters to 4.0 millimeters of the external diameters of its straight pipe and per 0.1 millimeter be a model, its pipe thickness is 0.05 to 0.3 millimeter.

4. cerebrovascular according to claim 1 is put up a bridge, can absorb the method for preparing of support in the plastic operation, it is characterized in that, the said body that absorbs support, and its siphunculus that is connected as a single entity, tiltedly the diameter of siphunculus between 1.5 millimeters to 3.5 millimeters.