CN102641164A - Branching type aortal vascular stent system - Google Patents

Branching type aortal vascular stent system Download PDF

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Publication number
CN102641164A
CN102641164A CN2011100390530A CN201110039053A CN102641164A CN 102641164 A CN102641164 A CN 102641164A CN 2011100390530 A CN2011100390530 A CN 2011100390530A CN 201110039053 A CN201110039053 A CN 201110039053A CN 102641164 A CN102641164 A CN 102641164A
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blood vessel
bifurcated artery
aortic stents
aortic
support
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CN102641164B (en
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舒畅
王暾
黎明
李全民
欧阳玉蓉
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Second Xiangya Hospital of Central South University
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Abstract

The invention discloses a branching type aortal vascular stent system comprising an aortal vascular stent and three branch arterial vascular stents, wherein a concave part is formed in the middle section of the aortal vascular stent, and provided with three side holes; and the three branch arterial vascular stents are separately mounted in the three side holes. The branching type aortal vascular stent system is capable of isolating aortal lesion involving the aortic arch and the ascending aorta, reestablishing the blood flow of the branch artery and avoiding the customization of the stent; and the branching type aortal vascular stent system is suitable for batch production and can be used for emergency operations.

Description

Branching type aortic stents vascular system
Technical field
The present invention relates to the aortic stents vascular system, relate in particular to branching type aortic stents vascular system.
Background technology
Aneurysm of thoracic aorta and dissection of aorta are the aortic diseases of serious threat patient life security.If untimely treatment, the tumor body of aneurysm of thoracic aorta will increase, and cause breaking and death; Dissection of aorta might be broken, and causes death, and simultaneously, dissection of aorta can cause the bifurcated artery ischemia, liver and kidney failure occurs, paraplegia, severe complications such as lower limb disorder.Under the part situation, aneurysm of thoracic aorta and dissection of aorta need the emergency operation treatment.
Along with the development of intracavity technology, (Thoracic Endovascualr Aortic Repair TEVAR) has become treatment aneurysm of thoracic aorta and the main method of dissection of aorta to chest intracavity aorta recovery technique at present.It puts into support in thoracic aorta, aortic disease is completely cut off beyond support, and the constraint blood flow passes through in support fully, thereby reaches isolated pathological changes, the purpose of protection blood vessel.Multiple aortic stents blood vessel is arranged at present both at home and abroad; In order to guarantee that support fixedly secures endovascular; Prevent blood flow to leak into outside the support from the proximal part or the distal end of support simultaneously, the proximal part of the aortic stents blood vessel that uses at present and distal end need the anchorage zone of 15mm at least.So contiguous or when involving the aortic branch tremulous pulse when aneurysm of thoracic aorta or dissection of aorta, support in the market is when treating it, with shutoff bifurcated artery in various degree, even can't be through the treatment of intracavity technology.
The aortic branch support of special customization is abroad arranged, and its method is: the anatomic condition concrete according to patient, on piped aortic stents blood vessel, make side opening, and the position of side opening is corresponding with the bifurcated artery position; In the operation, when the aortic stents blood vessel is implanted the aortic disease position,, guarantee that the bifurcated artery blood flow is unobstructed, in bifurcated artery, implant small rack more simultaneously with its side opening align fingers tremulous pulse.But this kind method shortcoming is a lot: at first, the support blood vessel must customize according to the concrete anatomy of patient especially, not can manufacture; Its two, the customization support use duration, can not be used for emergency operation; Its three, the support of the band side opening of this customization, when discharging in vivo, side opening must be aimed at the bifurcated artery that is involved, and then possibly cause bifurcated artery circulatory disorders and relevant complication if any deviation, threat to life when serious.
Summary of the invention
The technical problem that the present invention will solve is the deficiency that overcomes prior art, the isolated aortic disease that involves aortic arch portion and ascending aorta of a kind of ability is provided, can rebuild bifurcated artery blood flow, avoid the branching type aortic stents vascular system that customizes support, can produce and can be used for emergency operation in batches.
For solving the problems of the technologies described above, the present invention adopts following technical scheme:
A kind of branching type aortic stents vascular system; Comprise an aortic stents blood vessel and three bifurcated artery support blood vessels; The stage casing of said aortic stents blood vessel is provided with depressed part, and said depressed part is provided with three side openings, and said three bifurcated artery support blood vessels are sub-packed in three side openings.
The front portion of said bifurcated artery support blood vessel passes said side opening, and the rear portion of bifurcated artery support blood vessel is provided with and is the fixed part that umbrella shape struts, and the rear portion of bifurcated artery support blood vessel is fixed through fixed part and aortic stents blood vessel.
The front portion of said bifurcated artery support blood vessel is straight tubular.
The forward caliber of said bifurcated artery support blood vessel reduces to distal end from proximal part gradually.
Said aortic stents blood vessel and bifurcated artery support blood vessel are formed by artificial blood vessel and support.
Compared with prior art, the invention has the advantages that:
1, branching type aortic stents vascular system of the present invention is provided with depressed part in the stage casing of aortic stents blood vessel, when the aortic stents blood vessel is positioned at thoracic aorta; The depressed part in its stage casing is positioned aortic arch portion; The set side opening of depressed part discharges the aortic stents blood vessel then towards the bifurcated artery of aortic arch portion, because aortic stents blood vessel stage casing is provided with depressed part; So side of sending at the bifurcated artery of aortic arch portion; A long and narrow space is arranged, owing to above-mentioned long and narrow space communicates with the side opening and the bifurcated artery opening of aortic stents blood vessel simultaneously, so the aortic stents blood vessel is after release between aortic stents blood vessel and the aorta wall; Can the shutoff bifurcated artery, avoided the risk of bifurcated artery ischemia; Because above-mentioned long and narrow space has been avoided the risk of bifurcated artery ischemia; During aortic stents blood vessel location; Only need its stage casing be positioned aortic arch portion, side opening is towards the bifurcated artery opening, and do not need exactly each side opening to be aimed at each bifurcated artery opening fully; So reduced the operation technique difficulty effectively, shortened operating time; Because the existence of above-mentioned long and narrow space; Each side opening of aortic stents blood vessel does not need to aim at fully each bifurcated artery opening; So anatomy customization that this aortic stents blood vessel need be not concrete according to the patient; Avoided customization support consumed time, and support can produce in batches, can be applicable to emergency operation; Because the existence of above-mentioned long and narrow space; Seal wire and conduit that intracavitary therapy is used have enough working places, so after the aortic stents blood vessel discharged in thoracic aorta, seal wire can pass through side opening and above-mentioned space; Send in the bifurcated artery fast; And implant bifurcated artery support blood vessel, and rebuild three main bifurcated artery channel of blood flow of aortic arch portion, the pathological changes with aortic arch portion completely cuts off at this beyond cover branching type aortic stents vascular system fully simultaneously; Because the existence of above-mentioned long and narrow space; After bifurcated artery support blood vessel is implanted; Even the side opening of aortic stents blood vessel does not have the opening of align fingers tremulous pulse; Bifurcated artery support blood vessel also can be suitably crooked in above-mentioned long and narrow space, and the adjustment angle can not cause the serious pressurized of bifurcated artery intravascular stent and obturation.Aortic stents blood vessel and bifurcated artery support blood vessel are the difference independent structures; So can be according to the concrete condition of pathological changes; Select the aortic stents blood vessel and the bifurcated artery support blood vessel of suitable dimension respectively; Be combined into the most suitable patient's support vascular system of a cover, avoided according to concrete anatomic condition customization support.This branching type aortic stents vascular system can completely cut off aortic disease effectively, simultaneously safety, rebuild the bifurcated artery of aortic arch portion easily, so alternative full aortic arch replacement operation that can be has to a certain degree been avoided the wound and the risk of open chest surgery; During installation, the leading portion of aortic stents blood vessel is positioned ascending aorta, so as long as the ascending aorta pathological changes has certain distance apart from aortic valve and coronary ostium, this branching type aortic stents vascular system can both be isolated effectively with it.
2, bifurcated artery support blood vessel rear portion is provided with and is the fixed part that umbrella shape struts, and can make bifurcated artery support blood vessel firmly be connected, fit tightly with the aortic stents blood vessel, has reduced the risk of leaking blood from connecting portion effectively; Because the design of " umbrella shape " has been adopted at bifurcated artery support blood vessel rear portion; The side opening of aortic stents blood vessel can be big slightly than the opening of its corresponding bifurcated artery initial part; Like this, when using bifurcated artery support reconstructing blood vessel bifurcated artery blood flow, bifurcated artery support blood vessel can suitably be adjusted the position; Make the para-position of itself and bifurcated artery more accurate; And be the fixed part that umbrella shape struts, also guarantee the side opening of its ability complete closed aortic stents blood vessel when suitably adjusting the position, and can not cause leaking blood.
3, the front portion of bifurcated artery support blood vessel is the similar taper tubular design that straight tubular design or caliber reduce to distal end from proximal part gradually, for the reconstruction bifurcated artery provides multiple choices, and the bifurcated artery pathological changes of suitable different anatomic form.
Description of drawings
Fig. 1 is the side position perspective view of aortic stents blood vessel of the present invention;
Fig. 2 is the normotopia perspective view of aortic stents blood vessel of the present invention;
Fig. 3 is the structural representation (leading portion is straight tubular design) of bifurcated artery support blood vessel of the present invention;
Fig. 4 is the structural representation (leading portion is similar taper tubular design) of bifurcated artery support blood vessel of the present invention;
Fig. 5 is the structural representation after the aortic stents blood vessel discharges in thoracic aorta;
Fig. 6 is after the aortic stents blood vessel discharges in thoracic aorta, in the innominate artery The initial segment, places the structural representation of a bifurcated artery support reconstructing blood vessel innominate artery again;
Fig. 7 discharges in thoracic aorta for the aortic stents blood vessel, after innominate artery is given bifurcated artery support reconstructing blood vessel, in the LCC The initial segment, places the sketch map of a bifurcated artery support reconstructing blood vessel LCC again;
Fig. 8 discharges in thoracic aorta for the aortic stents blood vessel; After innominate artery and LCC are given bifurcated artery support reconstructing blood vessel respectively, in the left subclavian artery The initial segment, place the sketch map of a bifurcated artery support reconstructing blood vessel left subclavian artery again.
Each label is represented among the figure:
1, aortic stents blood vessel; 11, depressed part; 12, side opening; 13, leading portion; 14, stage casing; 15, back segment; 2, bifurcated artery support blood vessel; 21, fixed part; 22, front portion; 23, rear portion; 3, thoracic aorta; 4, innominate artery; 5, LCC; 6, left subclavian artery; 7, long and narrow space.
The specific embodiment
Fig. 1 to Fig. 8 shows a kind of branching type aortic stents vascular system embodiment of the present invention, and this support vascular system comprises an aortic stents blood vessel 1 and three bifurcated artery support blood vessels 2, and aortic stents blood vessel 1 is formed by artificial blood vessel and support with bifurcated artery support blood vessel 2; The stage casing 14 of aortic stents blood vessel 1 is provided with depressed part 11; Depressed part 11 is provided with 12, three bifurcated artery supports of three side openings blood vessel 2 and is sub-packed in three side openings 12, when aortic stents blood vessel 1 is positioned at thoracic aorta 3; With the corresponding aortic arch of the depressed part in its stage casing 14 11 portion; The set side opening 12 of depressed part 11 discharges aortic stents blood vessel 1, because aortic stents blood vessel 1 stage casing 14 is provided with depressed part 11 then towards the bifurcated artery of aortic arch portion; So side of sending at the bifurcated artery of aortic arch portion; A long and narrow space 7 is arranged, owing to above-mentioned long and narrow space 7 communicates with the bifurcated artery opening with the side opening 12 of aortic stents blood vessel 1 simultaneously, so aortic stents blood vessel 1 is after release between aortic stents blood vessel 1 and the aorta wall; Can the shutoff bifurcated artery, avoided the risk of bifurcated artery ischemia; Because above-mentioned long and narrow space 7 has been avoided the risk of bifurcated artery ischemia; During aortic stents blood vessel 1 location; Only need its stage casing 14 be positioned aortic arch portion, side opening 12 is towards the bifurcated artery opening, and do not need exactly each side opening 12 to be aimed at each bifurcated artery opening fully; So reduced the operation technique difficulty effectively, shortened operating time; Because the existence of above-mentioned long and narrow space 7; The side opening 12 of aortic stents blood vessel 1 does not need complete align fingers tremulous pulse opening; So anatomy customization that this aortic stents blood vessel 1 need be not concrete according to the patient; Avoided customization support consumed time, and support can produce in batches, can be applicable to emergency operation; Because the existence of above-mentioned long and narrow space 7; Seal wire and conduit that intracavitary therapy is used have enough working places; So after aortic stents blood vessel 1 discharged, seal wire can be sent in each bifurcated artery through side opening 12 and above-mentioned long and narrow space 7 fast, and implant bifurcated artery support blood vessel 2 in thoracic aorta 3; Rebuild three main bifurcated artery channel of blood flow of aortic arch portion, the pathological changes with aortic arch portion completely cuts off at this beyond cover branching type aortic stents vascular system fully simultaneously; Because the existence of above-mentioned long and narrow space 7; After bifurcated artery support blood vessel 2 is implanted; Even the side opening 12 of aortic stents blood vessel 1 does not have the opening of align fingers tremulous pulse; Bifurcated artery support blood vessel 2 also can be suitably crooked in above-mentioned long and narrow space 7, and the adjustment angle can not cause bifurcated artery support blood vessel 2 serious pressurizeds and obturation.Aortic stents blood vessel 1 is the difference independent structures with bifurcated artery support blood vessel 2; So can be according to the concrete condition of pathological changes; Select the aortic stents blood vessel 1 and bifurcated artery support blood vessel 2 of suitable dimension respectively; Be combined into the most suitable patient's support vascular system of a cover, also avoided simultaneously according to concrete anatomic condition customization support.Branching type aortic stents vascular system of the present invention can completely cut off aortic disease effectively; Rebuild the bifurcated artery of aortic arch portion simultaneously safely, easily; So alternative full aortic arch replacement operation that can be to a certain degree; Avoided the wound and the risk of open chest surgery, during installation, the leading portion 13 of aortic stents blood vessel 1 is positioned ascending aorta; So as long as the ascending aorta pathological changes has certain distance apart from aortic valve and coronary ostium, branching type aortic stents vascular system of the present invention can both be isolated effectively with pathological changes.
In the present embodiment; Bifurcated artery support blood vessel 2 anterior 22 passes side opening 12; Rear portion 23 is provided with and is the fixed part 21 that umbrella shape struts; The rear portion 23 of bifurcated artery support blood vessel 2 is fixing with aortic stents blood vessel 1 through fixed part 21, is the fixed part 21 that umbrella shape struts and can makes bifurcated artery support blood vessel 2 firmly be connected, fit tightly with aortic stents blood vessel 1, has reduced effectively from the risk of connecting portion leakage blood; Because the design of " umbrella shape " has been adopted at the rear portion 23 of bifurcated artery support blood vessel 2; The side opening 12 of aortic stents blood vessel 1 can be big slightly than the opening of its corresponding bifurcated artery initial part; Like this, when using bifurcated artery support blood vessel 2 to rebuild the bifurcated artery blood flow, bifurcated artery support blood vessel 2 can suitably be adjusted the position; Make the para-position of itself and bifurcated artery more accurate; And be the fixed part 21 that umbrella shape struts, also guarantee the side opening 12 of its ability complete closed aortic stents blood vessel 1 when suitably adjusting the position, and can not cause leaking blood.
In the present embodiment, bifurcated artery support blood vessel 2 anterior 22 is straight tubular.Can the caliber of bifurcated artery support blood vessel 2 anterior 22 be designed to reduce gradually to distal end from proximal part in addition, multiple choices be provided, be fit to the bifurcated artery pathological changes of different anatomic form for rebuilding bifurcated artery.
When implementing operation, three bifurcated artery support blood vessels 2 are used for rebuilding innominate artery 4, LCC 5 and left subclavian artery 6 respectively.Select leading portion 13 and 15 week of back segment footpath and the suitable aortic stents blood vessel 1 in thoracic aorta 3 cross sections week footpath of corresponding position, select anterior 22 week the footpath with the suitable bifurcated artery support blood vessel 2 in week footpath of corresponding each bifurcated artery.As shown in Figure 5; When being expert in the thoracic aorta blood vessel prosthesis of covered stnet blood vessel, aortic stents blood vessel 1 is positioned at the back discharges in the thoracic aorta 3, aortic stents blood vessel 1 leading portion 13 is positioned at ascending aorta; Stage casing 14 is positioned at aortic arch portion, and back segment 15 is positioned at descending aorta.Depressed part 11 1 sides of aortic stents blood vessel 1 are partly propped up the tremulous pulse opening towards aortic arch.Because depressed part 11 all footpaths of aortic stents blood vessel 1 are less than the Zhou Jing of thoracic aorta 3 corresponding positions; So between aortic stents blood vessel 1 and the aorta wall long and narrow space 7 is arranged; This long and narrow space 7 communicates with three side openings 12 of aortic stents blood vessel 1, and links to each other with the opening of innominate artery 4, LCC 5, left subclavian artery 6.As shown in Figure 6; Select the suitable bifurcated artery support blood vessel 2 of size, the seal wire of transluminal operation through aortic stents blood vessel 1 side opening 12 and long and narrow space 7 foremost, is stretched in the innominate artery 4; Again bifurcated artery support blood vessel 2 is introduced; Through the seal wire guiding, be positioned to discharge after the innominate artery 4 nearly heart portions, rebuild the blood flow of innominate artery 4.The fixed part 21 of bifurcated artery support blood vessel 2 is " umbrella shape " and struts in aortic stents blood vessel 1, and what guaranteed aortic stents blood vessel 1 and bifurcated artery support blood vessel 2 firmly is connected and fits tightly the risk of having avoided connecting portion to leak blood.As shown in Figure 7, select the suitable bifurcated artery support blood vessel 2 of size, use the method identical with rebuilding innominate artery 4, middle the side opening 12 of bifurcated artery support blood vessel 2 from aortic stents blood vessel 1 stretched out the blood flow of reconstruction LCC 5.As shown in Figure 8, select the suitable bifurcated artery support blood vessel 2 of size, use the method identical with rebuilding innominate artery 4, the side opening 12 of bifurcated artery support blood vessel 2 from aortic stents blood vessel 1 rearmost end stretched out, rebuild the blood flow of left subclavian artery 6.After branching type aortic stents vascular system discharged in vivo fully, the pathological changes of thoracic aorta 3 was completely cut off fully beyond branching type aortic stents vascular system of the present invention, makes blood flow be limited in the aortic stents vascular system, to pass through.
Above-mentioned is preferred embodiment of the present invention, is not the present invention is done any pro forma restriction.Though the present invention discloses as above with preferred embodiment, yet be not in order to limit the present invention.Any those of ordinary skill in the art, under the situation that does not break away from technical scheme scope of the present invention, all the technology contents of above-mentioned announcement capable of using is made many possible changes and modification to technical scheme of the present invention, or is revised as the equivalent embodiment of equivalent variations.Therefore, every content that does not break away from technical scheme of the present invention, all should drop in the scope of technical scheme protection of the present invention any simple modification, equivalent variations and modification that above embodiment did according to technical spirit of the present invention.

Claims (5)

1. branching type aortic stents vascular system; Comprise an aortic stents blood vessel (1) and three bifurcated artery support blood vessels (2); It is characterized in that: the stage casing (14) of said aortic stents blood vessel (1) is provided with depressed part (11); Said depressed part (11) is provided with three side openings (12), and said three bifurcated artery support blood vessels (2) are sub-packed in three side openings (12).
2. branching type aortic stents vascular system according to claim 1; It is characterized in that: the front portion (22) of said bifurcated artery support blood vessel (2) passes said side opening (12); The rear portion (23) of bifurcated artery support blood vessel (2) is provided with the fixed part (21) that is umbrella shape and struts, and the rear portion (23) of bifurcated artery support blood vessel (2) is fixing through fixed part (21) and aortic stents blood vessel (1).
3. branching type aortic stents vascular system according to claim 2 is characterized in that: the front portion (22) of said bifurcated artery support blood vessel (2) is straight tubular.
4. branching type aortic stents vascular system according to claim 2 is characterized in that: the caliber of said bifurcated artery support blood vessel (2) anterior (22) reduces to distal end from proximal part gradually.
5. according to each described branching type aortic stents vascular system in the claim 1 to 4, it is characterized in that: said aortic stents blood vessel (1) and bifurcated artery support blood vessel (2) are formed by artificial blood vessel and support.
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WO2015101292A1 (en) * 2013-12-30 2015-07-09 先健科技(深圳)有限公司 Aortic arch intraoperative stent and manufacturing method thereof
CN104905892A (en) * 2015-06-16 2015-09-16 中国人民解放军第四军医大学 Integrated multiple-branch interventional aorta arch covered stent
CN107874877A (en) * 2016-09-30 2018-04-06 苏州茵络医疗器械有限公司 Aorta tectorial membrane stent
CN109009562A (en) * 2018-08-27 2018-12-18 泉州市第医院 Follow-on arch of aorta overlay film frame type blood vessel
CN109069259A (en) * 2016-04-05 2018-12-21 波顿医疗公司 Structural transplantation part and its application method with inner passage and perforation
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US10548709B2 (en) 2013-12-30 2020-02-04 Lifetech Scientific (Shenzhen) Co. Ltd. Aortic arch intraoperative stent and manufacturing method thereof
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US11065100B2 (en) 2014-09-23 2021-07-20 Bolton Medical, Inc. Vascular repair devices and methods of use
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