CN105266936A - Support precise implantation system of branch vessel - Google Patents

Support precise implantation system of branch vessel Download PDF

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Publication number
CN105266936A
CN105266936A CN 201410294368 CN201410294368A CN105266936A CN 105266936 A CN105266936 A CN 105266936A CN 201410294368 CN201410294368 CN 201410294368 CN 201410294368 A CN201410294368 A CN 201410294368A CN 105266936 A CN105266936 A CN 105266936A
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CN
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stent
vessel
guide
branch
implant system
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CN 201410294368
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Chinese (zh)
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CN105266936B (en )
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李雷
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李雷
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/954Instruments specially adapted for placement or removal of stents or stent-grafts for placing stents or stent-grafts in a bifurcation

Abstract

The invention discloses a support precise implantation system of a branch vessel. The branch vessel comprises main blood vessels (101) which are communicated with each other, and branch blood vessels (102) which are communicated with the main blood vessels. The support precise implantation system comprises a support conveying device (103) which stores a support (104) in a releasable manner and conveys the support, a guiding wire (105) which extends to the branch blood vessel from the main blood vessel, and a positioning wire (106) extending along the main blood vessel. The support conveying device is sleeved out of the guiding wire in a movable manner, wherein the support is provided with a spacing hole (1061). The positioning wire can slidably pass through the spacing hole. Since the branch wire would be clamped on the opening of the branch blood vessel after the support enters the branch blood vessel, the support can be positioned from an axial direction and a circumferential direction. Thus, the support can be precisely implanted into the branch blood vessel, especially be precisely abutted against the opening part. Therefore, abutting effect with the branch blood vessel is good.

Description

分支血管的支架精确植入系统 Accurate branch vessel stent implant system

技术领域 FIELD

[0001] 本发明涉及分支血管的支架植入领域,具体地,涉及一种分支血管的支架精确植入系统。 [0001] FIELD relates to a branch vessel stent of the present invention, in particular, to a branch vessel stent implant system accuracy.

背景技术 Background technique

[0002] 随着老龄化社会的来临,用于径向支撑发生堵塞血管的血管支架的应用越来越多。 [0002] With the advent of aging society, radial support for the application of blood vessel blockage stent more. 其中,随植入位置和治疗病种的不同血管支架的种类、结构和植入方式也各不相同。 Wherein, with different types of stent implant location and treatment of disease, the implant structure and also different manner. 目前,广泛使用的支架包括裸支架、涂层支架和覆膜支架,支架的展开方式可分为球扩方式和自膨方式。 Currently, the widespread use of stents includes a bare stents, coated stents and deployment of the stent graft embodiment, stents can be divided into ball expanded mode and a self-expanding manner. 而植入方式多为将压缩后的支架通过导丝引导至植入位置后再展开。 Multi-way implanted stent after implantation guided to the compressed position and then deployed through the guide wire. 其中,球扩展开方式为通过向位于预置在支架内部的球状气囊中充液(气)以将支架扩开后撤出,自膨展开方式为通过将收纳被压缩支架的导鞘撤离后,通过支架自身的弹性结构弹开。 Wherein the ball is spread by way of the guide after the withdrawal of the sheath to the balloon located inside the spherical preset in the stent filling (gas) to open after the withdrawal of the stent expanded, self-expanding stents expand to be compressed manner by the housing, repelled by a bracket structure own elasticity. 其中无论是球扩还是自膨方式的植入,都存在支架的准确定位和适应多种血管结构的问题。 No matter where the ball is expanding or self-expanding implant way, there accurate positioning of the stent and adaptation to a variety of vascular structures. 例如在具有支血管的分支血管结构的开口部分,不仅血管支架本身的结构需要特殊设计,而且植入方式也需要对应地改善才能够满足在此类位置精确植入支架的目的。 In the example, the structure having the opening portion of the vessel structure of the branch vessel, a vascular stent itself only requires special design, but also requires a corresponding manner the implant to be able to meet the object of improving the precision in such a position stenting. 这是由于支血管和主血管的连接部分即开口部分的结构具有弧形过渡结构并且血管的周向结构也不同,而现有技术中的血管支架本身结构存在难以适应分支血管结构的连接部分结构的问题,并且相应的植入方式也均存在应对分支血管时轴向、周向定位精度差的问题,从而造成支架植入后效果不佳甚至再次发生血管堵塞的问题。 This is because the connecting portion of the main vessel and the vessel i.e., the opening having an arcuate transition moiety and the vascular structure are also different circumferential structure, and there is a connection part of the structure is difficult to adapt the structure of the branch vessels prior art vessel support structure itself problems, and the corresponding axial implant manner were also responding to the presence of the branch vessel, circumferential positioning problem of poor accuracy, resulting in ineffective blood vessel blockage problem occurs even after stent implantation again.

发明内容 SUMMARY

[0003] 本发明的目的是提供一种分支血管的支架精确植入系统,该支架精确植入系统能够使得支架精确地植入在分支血管中。 [0003] The object of the present invention is to provide a precise branch vessel stent implant system, the implant system enables accurate stent precisely the stent implanted in the blood vessel branch.

[0004] 为了实现上述目的,本发明提供一种分支血管的支架精确植入系统,所述分支血管包括相互连通的主血管和与该主血管连通的支血管,所述支架精确植入系统包括可释放地收纳支架并输送该支架的支架输送装置、从所述主血管延伸到所述支血管的导引导丝、以及沿所述主血管延伸的定位导丝,所述支架输送装置可移动地套设在所述导引导丝外,所述支架上设置有限位孔,所述定位导丝可滑动地穿过该限位孔。 [0004] To achieve the above object, the present invention provides an accurate branch vessel stent implant system comprises a branch vessel and the main vessel interconnected vessels in communication with the main vessel, the stent precisely implant system comprising the stent delivery device is releasably housed in the stent and the stent delivery, extending from the main vessel guidewire into the blood vessel of the support, and a positioning guide wire extending along the main vessel, the stent delivery device may be moved sleeve disposed outside said guide wire, said bracket provided with a limit hole, the guidewire slidably positioned through the limiting hole.

[0005] 优选地,所述限位孔由连接在所述支架上的限位环形成。 [0005] Preferably, the stop hole is formed by a bracket attached to said stop ring.

[0006] 优选地,所述支架输送装置包括可沿导丝移动的导芯、可滑动地套设在所述导芯外的顶芯、收纳所述支架前端的第一导鞘和收纳所述支架后端的第二导鞘,所述第一导鞘连接在所述导芯上并且后端开放,所述第二导鞘前端开放,所述顶芯可滑动地套设在所述第二导鞘内且抵顶所述支架的后端。 [0006] Preferably, the stent delivery device comprises a guide movable along the guide wire core, is slidably disposed in the outer sleeve of the guide core top core, sheath and the first guide housing accommodating the front end of the holder second guide bracket rear end of the sheath, the sheath is connected to the first conductive core and an open rear end of the guide, the second guide sheath distal end opening, said top core slidably disposed in said second guide sleeve intrathecal and abutting the rear end of the stent.

[0007] 优选地,所述第一导鞘的前端封闭并连接于所述导芯。 [0007] Preferably, the front end of the first guide sheath is closed and connected to the guide core.

[0008] 优选地,所述第一导鞘的前端形成为具有流线型结构的导引头。 [0008] Preferably, the distal end of the sheath is formed as a first guide having a streamlined structure seeker.

[0009] 优选地,所述支架精确植入系统还包括多个控制装置,所述第二导鞘、所述顶芯和所述导芯向后延伸并分别连接于各自的所述控制装置。 [0009] Preferably, the stent further comprises a plurality of precise implant system control means, the second conductive sheath, said core and said top guide core extends rearwardly and are connected to a respective said control means.

[0010] 优选地,所述第二导鞘的前端尺寸小于所述第一导鞘的后端尺寸并且平滑过渡。 [0010] Preferably, the size of the front end of the second guide sheath is smaller than the size of the first rear end of the guide sheath and a smooth transition.

[0011] 优选地,所述支架具有主体部和位于该主体部后端的开口部,所述主体部形成为直筒结构,所述开口部形成为喇叭型结构。 [0011] Preferably, the bracket having a body portion and an opening portion located at the rear end of the body portion, the body portion is formed as a straight structure, the opening portion is formed in a flared structure.

[0012] 优选地,所述支架具有主体部和位于该主体部后端的开口部,所述主体部形成为直筒结构,所述开口部的开口平面相对于所述主体部的轴线倾斜设置。 [0012] Preferably, the bracket having a body portion and an opening portion located at the rear end of the body portion, the body portion is formed as a straight structure, the opening portion of the opening plane inclined to the axis of said main body portion.

[0013] 优选地,所述限位孔形成在所述主体部的后端或开口部。 [0013] Preferably, said limiting hole or opening formed in the rear end portion of the main body portion.

[0014] 通过上述技术方案,由于分支导丝在支架进入支血管后会卡在支血管的开口处,从而能够在轴向和周向上定位支架,从而使得支架能够精确地植入分支血管中,尤其是精确贴合于开口部分,因此与分支血管的贴合效果好。 [0014] By the above aspect, since the guide wire into the vessel after stent will be stuck at an opening of the vessel so that the stent can be positioned in axial and circumferential direction, so that the branch stent can be accurately implanted in the blood vessel, in particular precisely bonded to the opening portion, the branch vessel with good bonding effect.

[0015] 本发明的其他特征和优点将在随后的具体实施方式部分予以详细说明。 [0015] Other features and advantages of the present invention will be described in detail in a subsequent portion of the detailed description.

附图说明 BRIEF DESCRIPTION

[0016] 附图是用来提供对本发明的进一步理解,并且构成说明书的一部分,与下面的具体实施方式一起用于解释本发明,但并不构成对本发明的限制。 [0016] The drawings are provided for further understanding of the invention and constitute a part of this specification, the following detailed description serve to explain the embodiments of the present invention, but not limit the present invention. 在附图中: In the drawings:

[0017] 图1是本发明优选实施方式提供的具有喇叭型开口的分支血管的支架精确植入系统在植入过程中的结构示意图; [0017] FIG. 1 is a schematic view of a preferred embodiment of the present invention provides accurate stent implant system having a branching vessel at the horn openings during implantation;

[0018] 图2是图1中A部的放大结构示意图; [0018] FIG. 2 is a schematic configuration diagram of an enlarged portion A 1;

[0019] 图3是本发明优选实施方式中所采用的具有斜切口的支架植入在分支血管中的结构示意图。 [0019] FIG. 3 is a schematic oblique cuts holder having a preferred embodiment of the present invention employed in the implant of the branch vessel.

[0020] 附图标记说明 [0020] REFERENCE NUMERALS

[0021] 101 主血管 102 支血管 [0021] 101 main vessel 102 vessel

[0022] 103 支架输送装置104 支架 [0022] The stent delivery device 104 the stent 103

[0023] 105 导引导丝 106 定位导丝 [0023] 105 guide wire 106 is positioned guidewire

[0024] 107 导芯 108 顶芯 [0024] The conductive core 108 of the core 107

[0025] 109 第一导鞘 110 第二导鞘 [0025] The first guide 109 of the sheath 110 of the second guide sheath

[0026] 1041 主体部 1042 开口部 [0026] The body portion 1042 opening 1041

[0027] 1061 限位孔 1091 导引头 [0027] 1061 1091 seeker limiting hole

具体实施方式 detailed description

[0028] 以下结合附图对本发明的具体实施方式进行详细说明。 [0028] The following specific embodiments of the present invention will be described in detail in conjunction with the accompanying drawings. 应当理解的是,此处所描述的具体实施方式仅用于说明和解释本发明,并不用于限制本发明。 It should be understood that the specific embodiments described herein are only to illustrate and explain the present invention and are not intended to limit the present invention.

[0029] 在本发明中,在未作相反说明的情况下,使用的方位词如“内、外”通常是指相应物体轮廓的内和外,“远、近”则是某部件相对于另一部件的远近位置,“前、后”则通常是以支架及相关部件沿血管的植入方向为基础定义的,即,相应部件向前进入血管,向后退出血管。 [0029] In the present invention, have not been the case to the contrary, the orientation of use of the word, such as "inner, outer" generally refers to the inner and the corresponding boundary of an object, the "far and near" is a member relative to the other distance of the position of a member, "front, rear" is typically a stand and related components implanted in the blood vessel based on the definition of the direction, i.e., respective forward member into the vessel, vessel back exit. 这些方位词只用于说明本发明,并不用于限制本发明。 The position of the word to illustrate the invention only and not intended to limit the present invention.

[0030] 如图1所示,在血管支架植入手术中,常常会遇到在具有分支的分支血管,即该分支血管包括主血管101以及与该主血管101连通的支血管102,即支血管102连接在主血管101的侧壁上,由于支血管102和主血管101之间的连接区域具有弧形过渡,使得支血管102的接近主血管101的开口的尺寸呈现向外扩展的喇叭形结构,这样如果植入现有的直筒型支架,将使得支架在支血管102开口处不能完好地贴合于血管壁,这样将使得该区域的支架和血管壁形成血栓从而造成血管病变。 [0030] As shown, the vessel stenting surgery, often encountered in a branch vessel with the branch 1, i.e., the vessel 101 comprises a main branch vessel and a vessel in communication with the main vessel 101 102, i.e. branched vessel 102 is connected to the side wall of the main vessel 101, since the connection area between the main vessel and the vessel 102 has an arcuate transition 101, such that vessel 102 is close to the main vessel 101 of the size of the opening presented outwardly flared extension structure, so that if the conventional straight stent implantation, the vessel 102 such that the openings in the stent can not fit well in the vessel wall, so that the stent and the vessel wall in the region of the formation of thrombi resulting in vascular lesions. 因此,需要使用一种喇叭形开口支架,该支架的开口形成为向外开放的喇叭形,从而能够良好地贴合于例如的分支血管的支血管102的开口过渡区域。 Therefore, use of a flared open bracket opening of the bracket is formed as an open flared outwardly, it is possible to satisfactorily fit the opening bonded to the transition region, for example, a branch vessel of a vessel 102. 另外,当支血管102与主血管101之间具有倾斜角度时,如果仍使用直筒型支架,在支架定位后,之间的后端开口将部分地伸入主血管101中,这样会造成对主血管101的堵塞,因此需要一种具有斜切口的支架以能够适应倾斜的支血管102。 Further, when an inclined angle between the main vessel 102 and the vessel 101, if still using the straight stent, the stent is positioned at the rear end between the openings partly into the main vessel 101, this will cause the main blockage of a blood vessel 101, and therefore a need for a stent having a helical cut to adapt to the vessel 102 is inclined. 然而,无论是喇叭形或斜切口结构的开口,都将面临需要将支架的周向方向准确定位的问题,否则将不能适应支血管102的开口在周向方向上的形状,造成支架效果差。 However, both the oblique cuts or openings flared structure, we will face the problem need to accurately locate the stent circumferential direction that would otherwise not meet the vessel opening 102 branched in the circumferential direction on the shape, causing poor stent. 因此,在植入过程中,对支架的周向方向和轴向位置的控制均具有较高要求。 Thus, during implantation of the stent has a higher circumferential request to control the direction and the axial position. 据此,如图1所示,本发明提供一种用于分支血管的支架精确植入系统和方法,能够有效保证支架的轴向位置和周向方向的精确定位。 Accordingly, as shown in Figure 1, the present invention provides a stent system and method for precise implantation of a branch vessel, can effectively guarantee the axial and circumferential position of the carriage in the direction precise positioning.

[0031] 其中,如图1所示,在一种实施方式中,需要植入的支架104包括主体部1041和位于主体部1041后端的开口部1042,主体部1041形成为直筒结构以适应相应分支血管的血管壁,而开口部1042形成为向外开放的喇叭形结构以适应分支血管的开口,具体地,开口部1042形成为向外开放的弧形过渡结构,以适应分支血管开口的形状。 [0031] wherein 1, in one embodiment, the implanted stent requires 104 includes a body portion 10411042, the body portion of the body portion and an opening portion 1041 is formed as a straight rear end 1041 to accommodate the respective branch structure vascular vessel wall, and an opening portion 1042 is formed to open outwardly flared opening structure to accommodate branch vessels, in particular, an opening portion 1042 is formed to open outwardly arcuate transition structure to accommodate the shape of the opening of a branch vessel. 其中该喇叭形结构的具体结构需要取决于所植入支血管202开口的结构,对于各种变形均落在本发明的保护范围中。 Wherein the flared structure of the specific configuration required depends on the structure of the vessel opening 202 is implanted, for a variety of modifications as fall within the scope of the present invention.

[0032] 另外,除这种具有喇叭形开口结构的支架外,如图3所示,在另一中实施方式中,支架104的开口部1042可以形成为斜切口结构,S卩,开口部1042的开口平面相对于主体部1041的轴线倾斜设置。 [0032] Further, in addition to such a stent flared outer open structure, shown in Figure 3, in another embodiment, the opening portion 1042 of the bracket 104 may be formed oblique cutout, S Jie, the opening portion 1042 the opening plane inclined relative to the axis of the body portion 1041. 这样,该斜切口式支架可以精确适应倾斜设置的支血管的开口,而不会如虚线所示的那样突入主血管中造成主血管堵塞。 Thus, the stent may be oblique cuts precisely fit the opening of the vessel is inclined, without causing inrush main vessel as shown in dashed lines in the main blood vessel blockage. 而能够使用这种斜切口支架的原因,同样得益于本发明提供的支架精确植入系统能够实现支架在周向方向和轴向位置的精确定位。 The reason for this is possible to use oblique cuts stent, stent precise implant system also benefited by the present invention enables precise positioning of the stent in the circumferential direction and the axial position. 从而使得本发明更加适用于分支血管的支架植入。 Such that the present invention is more suitable for branch vessel stent. 其中还可以将如图1所示的喇叭形的开口部1042的开口平面也形成为斜切形式,对于此类实施方式也应落在本发明的保护范围中。 Which may also be flared opening plane of the opening portion 1042 as shown in FIG. 1 is also formed as a chamfer in the form of, for such embodiments should also fall within the scope of the present invention.

[0033] 为了保证能够将该支架104精确地送到分支血管,本发明的构思在于利用分支血管的特殊结构,在引导支架输送装置103的导引导丝105的基础上,增加定位导丝106,以通过定位导丝106实现对支架在轴向位置和周向方向上的定位。 [0033] In order to ensure that the stent can be accurately branch vessel 104 to the concepts of the present invention is characterized by using special branch vessels, on the basis of guiding guidewire stent delivery device 103 of the upper 105 to increase the localization wire 106, by positioning the guide wire 106 to achieve the positioning in the axial direction of the stent and circumferential position. 具体地,定位导丝106与导引导丝105在引入主血管101后将从穿过不同的路径引出,如图1所示,导引导丝105从主血管101引入后延伸到支血管102,而定位导丝106则一直沿主血管101延伸,并且植入系统还包括相对于支架104固定设置并供定位导丝106可滑动地穿过的限位孔1061,具体地,如图2所示,该限位孔1061设置在支架104上。 Specifically, the positioning guide wire 106 and guide wire 105 after the introduction of the main vessel 101 from the lead through different paths, as shown, guide wire 105 extends from the rear in FIG. 1 into the main vessel 101 to vessel 102, and positioning the guide wire 106 extending 101, and the implant system further includes a bracket 104 fixedly disposed with respect to and for slidably positioning the guidewire 106 through the aperture stop 1061, in particular, has been shown in Figure 2 along the main vessel, the limiting hole 1061 provided on the bracket 104. 这样,沿导引导丝105移动的支架104和支架输送装置103在进入支血管102后,由于定位导丝106的存在,定位导丝106会卡在支血管102的入口处,因此限位孔1061所在支架104的位置将无法进入支血管102,从而能够提供支架104在沿支血管102的轴向上的精确定位。 Thus, along the bracket 104 and the stent delivery device 105 of the mobile guide wire 103 into the vessel 102 due to the presence of the fixed guide wire 106, guide wire 106 will be positioned at the entrance card vessel 102, thus limiting hole 1061 location of the stent 104 will not enter the vessel 102, thereby providing precise positioning of the bracket 104 in the axial direction of the vessel 102. 同样,定位导丝106在拉紧后,限位孔1061相对于支架102的周向方向同样是确定的,因此可以使得支架104的周向方向也精确定位,从而实现支架104的周向外形能够和血管壁的特殊结构精确贴合。 Similarly, localization wire 106 taut, limiting hole 1061 with respect to the circumferential direction of the stent 102 is also determined, such that the stent 104 can be also precisely positioned to the circumferential direction to achieve the stent 104 can be a circumferential profile and the special structure of the vessel wall precise fit.

[0034] 其中,限位孔1061形成在支架104上的位置可以取决于支架104的形状和进入支血管102的位置,在本实施方式中,需要喇叭形的开口部1042贴合与支血管102和主血管101的开口过渡区域上,因此可将限位孔1061形成在主体部1041的后端,这样通过卡在支血管102入口的定位导丝106可以使得支架104的主体部1041进入支血管102中,而其开口部1041则与开口弧形过渡区域相对应,从而实现支架在轴向位置的精确定位。 Position [0034] wherein the limiting hole 1061 formed in the bracket 104 may depend on the shape of the stent into the vessel 104 and the position 102 in the present embodiment, the opening portion 1042 needs to horn 102 engaged with the vessel the transition region and the upper opening of the main vessel 101, thus limiting hole 1061 may be formed at the rear end of the body portion 1041, so that the vessel 102 through the card inlet 106 of the guidewire may be positioned such that the body portion 104 of the stent 1041 into the vessel 102, and an opening portion 1041 and the opening corresponding to the curved transition region to achieve an accurate positioning of the stent at the axial position. 对于为了适应特殊血管的限位孔1061的位置变化均落在本发明的保护范围中。 To accommodate for special restriction hole 1061 of the blood vessel position change all fall in the scope of the present invention.

[0035] 另外,为了不影响支架104的功能,如图2所示,本发明优选实施方式中的限位孔106由连接在支架104上的限位环形成,以能够用于约束定位导丝106。 [0035] Further, in order not to affect the function of the holder 104, as shown in FIG limiting hole preferred embodiment of the present invention is formed by a ring 106 attached to the holder 104 of the stopper 2, it can be used to constrain guidewire positioning 106. 该限位环的尺寸很小可以直接随支架104植入人体中而不会影响支架104的功能。 The small size of the stop ring may function without affecting the frame 104 with the holder 104 is directly implanted in the human body. 此外,限位孔106也可以直接由支架104本身的结构形成,对于这种变形方式均落在本发明的保护范围中。 In addition, limiting hole 106 may be formed directly by the support structure 104 itself, for this modified embodiment all fall in the scope of the present invention.

[0036] 需要说明的是,能够实现上述发明构思的实施方式有多种,例如支架进入支血管102所用支架输送装置103的具体结构等,为了方便说明本发明,在此只重点介绍其中的优选实施方式,该优选实施方式只用于说明本发明,并不用于限制本发明。 [0036] Incidentally, a variety of embodiments can achieve the above concepts, such as a stent into the vessel 102 stent specific configuration of the device 103 transporting the like, for convenience of explanation of the present invention, there is only focuses wherein preferably embodiment, this preferred embodiment of the present invention is for illustration only and not intended to limit the present invention.

[0037] 在本发明的优选实施方式中,为了更好地实现对具有喇叭形开口或斜切口的支架104的输送,本发明采用的支架104为自膨支架,即在释放支架104后,其会自动弹开。 [0037] In a preferred embodiment of the present invention, in order to better achieve the delivery of the stent 104 having a flared open or oblique incision of the present invention employs a self-expanding stent as the stent 104, i.e. after releasing the stent 104 It will automatically bounce. 为了更好地应对这种自膨支架在弹开过程中保持精度,本发明提供的可释放地收纳支架104并输送该支架104的支架输送装置103采用分段收纳和解锁的方式,即如图1所示,为了将支架104引导到支血管102中,支架输送装置103可移动地套设在导引导丝105外,并且包括可沿导丝移动的导芯107、可滑动地套设在导芯107外的顶芯108、收纳支架104前端的第一导鞘109和收纳支架104后端的第二导鞘110,第一导鞘109连接在导芯107上并且后端开放,第二导鞘110前端开放,顶芯108可滑动地套设在所述第二导鞘110内且抵顶支架104的后端。 To better respond to the self-expanding stent delivery apparatus such stents to maintain accuracy during bounce, the present invention provides a stent releasably receiving and transporting the stent 104 104 103 piecewise manner and unlocking the housing, i.e., in FIG. 1, in order to guide the stent 104 to the vessel 102, the stent delivery device 103 may be movably disposed in the sleeve outer guide wire 105, and includes a guide core is movable along the guide wire 107 is slidably disposed in the guide sleeve Mandrel core 107 outside 108 the housing 104 distal first guide sheath holder 109 and the second housing 104 the rear end of the guide sheath holder 110, a first guide sheath 109 is connected to the conductive core 107 and an open rear end, a second guide sheath open distal end 110, a top die 108 may be slidably disposed within the sheath 110 and the second guide frame 104 abuts against the rear end. 因此通过分别收纳主体部1041和分支部1042的第一导鞘109和第二导鞘110,在释放支架时,可实现主体部1041和1042的分别释放,从而很好地控制自膨支架的弹性,保证支架的位置和方向精度。 Therefore, by separately storing the body portion 1041 of the sheath and the branch portion 1042 of the first guide 109 and second guide sheaths 110, upon release of the stent, the body portion 1041 may be implemented and 1042 are released, so that good control of the elastic self-expanding stent , to ensure accuracy of the position and orientation of the stent. 下文中将具体介绍支架104的输送和释放过程。 Hereinafter specific description delivery and release of the stent 104.

[0038] 其中,第一导鞘的前端封闭并连接于导芯107以与导芯107同步运动。 [0038] wherein the closed distal end of the core 107 and is connected to the guide 107 with the guide core synchronized movement of the first guide sheath. 更优选地,该封闭的前端形成为导引头1091,该导引头1091可以形成为圆锥形状等利于第一导鞘109向前运动的流线型结构,即该导引头1091与第一导鞘109 —体成型,此外导引头1091还可以与第一导鞘109分别形成而位于第一导鞘109的前方,对于这种变形方式也应落在本发明的保护范围中。 More preferably, the closed front end of the head 1091 is formed as a guide, the guide head 1091 may be formed as a streamlined structure facilitates forward movement of the first guide sheath 109 and the like conical shape, i.e., the seeker and the first guide sheath 1091 109 - shaping, in addition seeker 1091 may also be formed with the first guide 109 are positioned in front of the first guide sheath and the sheath 109, for this modified embodiment should also fall within the scope of the present invention. 其中,导芯107为空心结构以套在导引导丝105外并能够沿导引导丝105移动,导芯107可以以向后延伸到体外的方式得到操控,例如连接体外端的控制装置。 Wherein a hollow guide core structure 107 can be moved along the guide sleeve and the guide wire 105 outside the guide wire 105 moves, so as to guide core 107 may extend rearwardly to the control obtained in vitro, for example, the control device is connected to the outer end.

[0039] 另外,第二导鞘110的前端与顶芯108的前端之间的间隔用于收纳支架104的开口部1042,后端沿主血管101向后延伸并可以以延伸到体外的方式得到操控,例如连接体外端的控制装置。 Embodiment [0039] Further, the interval between the distal end of the second guide sheath core 110 and the top 108 of the bracket 104 for receiving an opening portion 1042, a rear end 101 extends rearwardly along the main vessel and to extend to the outside can be obtained control, such as control means is connected to the outer end. 其中,为了实现分别释放支架104,第二导鞘110的前端和第一导鞘109的后端不具有连接关系,例如为了向前移动顺畅,可以将第二导鞘110的前端尺寸设计小于第一导鞘109的后端尺寸,并且使第二导鞘110的前端和第一导鞘109的后端平滑过渡。 Wherein, in order to achieve the release of the stent 104, respectively, a first and a second guide guiding the rear end of the sheath distal end 110 of the sheath 109 does not have the connection relation, for example in order to move forward smoothly, the front end can be designed smaller than the size of the second guide sheath 110 a rear guide sheath size 109, and the front end of the first guide and second guide sheaths the rear end 109 of the sheath 110 a smooth transition. 这样有效地避免了第二导鞘110的前端刮到血管壁的问题,更好地保护了血管壁。 This effectively avoids the problem of scrape the vessel wall distal of the second guide sheath 110, the better protection of the vessel wall.

[0040] 需要注意的是,由于定位导丝106的存在,第一导鞘109和第二导鞘110具有的相对位置需要保证穿过支架104上限位孔1061的定位导丝106自由穿过,即二者之间具有一定的间隙。 [0040] It is noted that, due to the positioning of the guide wire 106, the relative position of the sheath 109 having a first guide 110 and second guide sheaths need to ensure that the bracket 104 through holes 1061 of the upper limit localization wire 106 to pass freely through, having a certain gap therebetween, ie. 在有些实施方式中,可以将第二导鞘110的前端嵌入第一导鞘109的后端中,此时可在第一导鞘109和/或第二导鞘110上形成供定位导丝106穿过的通孔。 In some embodiments, the front end of the second guide sheath 110 may be embedded in the rear end of the first guide sheath 109, may be formed at this time for the guidewire 106 positioned on the first guide sheath 109 and / or the second guide sheath 110 a through hole through which. 对于这种变形方式均落在本发明的保护范围中。 For this modified embodiment all fall in the scope of the present invention.

[0041] 顶芯108用于保证在输送和解锁过程中支架104的位置稳定,其前端面用于抵顶支架104的开口部1042,顶芯108同样可以以向后延伸到体外的方式得到操控,例如体外端的控制装置。 [0041] Mandrel 108 for securing the bracket 104 in the conveying position and the unlocking process stability, which abut against the front end face of an opening portion 1042 of the bracket 104, the top die 108 may also be manipulated to give way to extend rearwardly in vitro , for example, a control device for the extracorporeal end.

[0042] 上述介绍了本发明提供的植入系统的结构,下面详细介绍本发明提供的植入系统在将支架104安装到支血管102的植入方法。 [0042] The above describes the structure of the implant system of the present invention provides the following detailed description implant system of the present invention will be provided in the mounting bracket 104 to the vessel 102. The method of implantation.

[0043] 首先,在准备步骤中,将导引导丝105从主血管101引入延伸到支血管102,且支架104压缩以收纳在第一导鞘109和第二导鞘110内。 [0043] First, in the preparatory step, the guide wire 105 extending from a main vessel 101 is introduced into the vessel 102, and the carriage 104 to receive the compression sheath 109 within the first guide 110 and second guide sheaths. 并将定位导丝106穿过限位孔1061后沿主血管101延伸。 And the localization wire passes through the limiting hole 106 extending in the main vessel 101 1061.

[0044] 然后,进行将支架104引入支血管102的步骤,首先,操作各自的控制装置以控制导芯107、顶芯108和第二导鞘110沿导引导丝105在血管内同步向前移动,其中,通过导芯107带动第一导鞘109移动,以保证第一导鞘109所收纳的支架104的主体部1041移入支血管102。 [0044] Then, the step of introducing the stent 104 of the vessel 102, first, the operation of the respective control device, the top die 108 and the second guide 110 along the guide wire sheath 105 is moved forward to the synchronization control guide core 107 within the vessel , wherein the guide core 107 driven by a first guide sheath 109 is moved to ensure that the body portion 1041 of the first guide 109 of the sheath holder 104 is accommodated into vessel 102. 此时,当限位孔1061所在主体部1041的后端位置到达支血管102的入口时,定位导丝106会挡在支血管102的入口处,从而在移动方向上定位支架104在支血管102的轴向位置,即使得开口部1042能够与支血管102的开口过渡区域对齐,并且,通过拉紧定位导丝106,具有张力的定位导丝106还能够在周向方向上定位支架104,从而使得支架104不论主体部1041还是开口部1042的位置均能够精确定位,S卩,能够保证支架104在扩展后准确地贴合到分支血管的开口部分处。 At this time, when the rear end position where the limiting hole 1061 reaching the body portion 1041 of the vessel inlet 102, the guide wire 106 will be positioned at the entrance vessel stopper 102, thereby positioning the stent in the vessel 104 in the moving direction 102 axial position, even when the opening portion 1042 can be aligned to give the opening a transition region with vessel 102, and, by tightening the localization wire 106, having a fixed guide wire 106 can also be positioned tension holder 104 in the circumferential direction, whereby so that the holder main body portion 104 regardless of the position of the opening portion 1041 or 1042 are able to pinpoint, S Jie, precisely to ensure that the stent 104 attached to the opening in the extended portion of the branch vessel.

[0045] 下面介绍支架104的解锁步骤,首先,通过操作各自控制装置,保持顶芯108不动,并沿导引导丝105向后拉动第二导鞘110,从而通过固定的顶芯108的抵顶,使得支架104的开口部1042得到释放,这时,开口部1042也能够展开从而精确贴合到支血管102的开口过渡区域。 [0045] The following describes the steps to unlock the holder 104, first, the operation of the respective control means, holding the top of the core 108 does not move, and along the guide wire sheath 105 is pulled back the second guide 110, so that by abutting the fixed top die 108 a top, an opening portion 1042 so that the bracket 104 to be released, this time, it is possible to expand the opening portion 1042 so as to precisely fit into the opening 102 of the vessel transition region. 然后,固定第二导鞘110和顶芯108不动,操作导芯107沿导引导丝105向前移动,从而带动第一导鞘109同步向前移动,由于定位导丝106的存在,此时第一导鞘109将脱离支架104的本体部1041,以使得主体部1041展开并贴合于支血管102的血管壁。 Then, the second fixed guide sheath 110 and top die 108 does not move, the operation guide core 107 moves forward along the guide wire 105, so as to drive the first guide sheath 109 is moved forward synchronization, due to the fixed guide wire 106, in which case the guide sheath 109 from a first body portion 1041 of the holder 104, so that the body portion 1041 is deployed and attached to the vessel wall of the vessel 102. 艮P,采用首先释放支架后端再释放支架前端的方式。 Gen P, by way of the rear end of the stent is released first and then release the stent distal end. 这样可以更好地保证支架104的开口部1042的定位精确性。 This will better ensure the positioning accuracy of the opening portion 1042 of the support 104. 在其他操作方式中,也可以首先释放支架前端再释放支架后端或者两端同时释放,对于这种操作方式均落在本发明的保护范围中。 In another mode of operation, the stent may be released first and then release the stent distal end or both ends while releasing the rear end, for this mode of operation all fall in the scope of the present invention. 这样,通过本发明特有的两端释放的特点,能够很好地控制自膨支架的展开过程,并且特别适应于具有主体部1041和分支部1042的支架,使得支架104能够精确地贴合于分支血管的开口部分,保证其与支架和血管的形状良好配合。 Thus, the release of both ends of the unique features of the present invention, the deployment process can be well controlled self-expanding stents, and particularly adapted to the body of the stent 1041 having a branch portion 1042 and such that the stent 104 can be accurately bonded to the branch the opening portion of the vessel, ensure a good fit to the shape of the blood vessel and the stent.

[0046] 需要说明的是,在上述过程中,如果在第一导鞘109和/或第二导鞘110上形成有供定位导丝106的通孔,在需要首先释放抽出定位导丝106。 [0046] Incidentally, in the above process, if the sheath is formed on the first guide 109 and / or the sheath 110 has a second guide for positioning the guide wire through hole 106, the need to release the guidewire 106 positioned out. 否则在两个导鞘释放支架104完毕后再抽出定位导丝106即可,这样通过定位导丝106可一直对释放过程中的支架104进行定位。 Otherwise, the release bracket 104 is completed after two guiding sheath 106 can be withdrawn localization wire, so may have been on the release bracket 104 in the process of positioning by the positioning guide wire 106. 对于这种步骤上的变形方式均落在本发明的保护范围中。 For such a step on the way of modification all fall in the scope of the present invention.

[0047] 最后,待支架104完全贴合于血管壁后,进行植入系统的退出步骤。 [0047] Finally, until the stent 104 is fully bonded to the vessel wall, to exit step performed implant system. 其中,由于支架104已经贴合于血管壁,只需操作导芯107和顶芯108沿导引导丝105向后抽出,以同步带动第一导鞘109向后退出支血管102和主血管101,从而完成分支血管的支架精确植入。 However, since the stent 104 has been bonded to the vessel wall, only the operation guide core 107 and the top die 108 along guide wire 105 drawn back to entrainment of lead sheath 109 back out of the first vessel 102 and the main vessel 101, thereby completing accurate branch vessel stent implantation.

[0048] 综上,本发明提供的血管的植入系统和方法能够实现具有喇叭形开口或斜切形开口的支架104在分支血管的分叉开口处的精确植入,具有较高的实用性和推广价值。 [0048] In summary, implantation of the vascular system and method of the present invention can be implemented to provide an opening having a flared or chamfered bracket-shaped opening 104 at a precise opening implanted bifurcated branch vessel, having high practicality and promotional value. 另外,本发明提供的分支血管的植入系统除用于具有喇叭形开口的支架外,还可以用于其他形状的支架,例如普通直筒型支架的植入。 Further, branch vessels implant system according to the present invention in addition provides for an opening having an outer flared stent, the stent may also be used in other shapes, such as implanted stents common straight type. 此外,本发明提供的支架输送装置除用于在分支血管的植入领域中,还可以用于其他位置血管的支架植入,在不脱离本发明构思的情况下,对于这种应用对象和领域的变形均落在本发明的保护范围中。 Further, the present invention provides a stent delivery device for implantation in addition to the field of the branch vessel, the stent may also be used elsewhere in the blood vessel, without departing from the inventive concept, and for this field of application objects modifications as fall within the scope of the present invention.

[0049] 以上结合附图详细描述了本发明的优选实施方式,但是,本发明并不限于上述实施方式中的具体细节,在本发明的技术构思范围内,可以对本发明的技术方案进行多种简单变型,这些简单变型均属于本发明的保护范围。 [0049] The above description in conjunction with the accompanying drawings of the preferred embodiment of the present invention, however, the present invention is not limited to the specific details of the above embodiment, within the technical scope of the spirit of the present invention, various technical solutions of the present invention. simple variations, these simple modifications belong to the scope of the present invention.

[0050] 另外需要说明的是,在上述具体实施方式中所描述的各个具体技术特征,在不矛盾的情况下,可以通过任何合适的方式进行组合,为了避免不必要的重复,本发明对各种可能的组合方式不再另行说明。 [0050] Note further that each specific technical features of the above described embodiments, in the case where not contradictory, may be combined in any suitable manner, in order to avoid unnecessary repetition, the present invention each possible combinations without further explanation.

[0051] 此外,本发明的各种不同的实施方式之间也可以进行任意组合,只要其不违背本发明的思想,其同样应当视为本发明所公开的内容。 [0051] Further, among various embodiments of the present invention may be arbitrarily combined as long as it does not violate the spirit of the invention, which should also be considered as the disclosure of the present invention.

Claims (10)

  1. 1.一种分支血管的支架精确植入系统,所述分支血管包括相互连通的主血管(101)和与该主血管(101)连通的支血管(102),其特征在于,所述支架精确植入系统包括可释放地收纳支架(104)并输送该支架(104)的支架输送装置(103)、从所述主血管(101)延伸到所述支血管(102)的导引导丝(105)、以及沿所述主血管(101)延伸的定位导丝(106),所述支架输送装置(103)可移动地套设在所述导引导丝(105)外,所述支架(104)上设置有限位孔(1061),所述定位导丝(106)可滑动地穿过该限位孔(1061)。 A branch vessel stent precise implant system, comprising a main vessel branch vessel interconnected (101) and the main vessel (101) vessel (102) in communication, characterized in that the bracket precise implanting a stent delivery system comprises means (103) receiving the bracket (104) and conveying the holder (104) releasably extending from the main vessel (101) to said vessel (102) of the guidewire (105 ), and along a main vessel (101) extending localization wire (106), the stent delivery device (103) sleeved movably on the guide wire (105) outside the holder (104) a limiting aperture is provided on (1061), the positioning guide wire (106) slidably through the limiting hole (1061).
  2. 2.根据权利要求1所述的支架精确植入系统,其特征在于,所述限位孔(1061)由连接在所述支架(104)上的限位环形成。 2. accurate stent implant system according to claim 1, wherein said limiting hole (1061) formed by a connector on the bracket (104) of the stop ring.
  3. 3.根据权利要求1所述的支架精确植入系统,其特征在于,所述支架输送装置(103)包括可沿导丝移动的导芯(107)、可滑动地套设在所述导芯(107)外的顶芯(108)、收纳所述支架(104)前端的第一导鞘(109)和收纳所述支架(104)后端的第二导鞘(110),所述第一导鞘(109)连接在所述导芯(107)上并且后端开放,所述第二导鞘(110)前端开放,所述顶芯(108)可滑动地套设在所述第二导鞘(110)内且抵顶所述支架(104)的后端。 The precise stent implant system according to claim 1, wherein said stent delivery means (103) comprises a conductive core (107) moves along the guide wire may be slidably disposed in the guide core Mandrel (108) (107) outside of the holder housing (104) of the sheath distal end of the first guide (109) and a second guide receiving the stent sheath (104) of the rear end (110), the first guide sheath (109) is connected to the conductive core (107) and an open rear end, the second guide sheath (110) an open front end, said top core (108) slidably disposed in the second guide sheath inner (110) and abutting the rear end of the bracket (104).
  4. 4.根据权利要求3所述的支架精确植入系统,其特征在于,所述第一导鞘(109)的前端封闭并连接于所述导芯(107)。 The implant system of claim accurate stent of claim 3, wherein the front end of the first guide sheath (109) is closed and connected to the conductive core (107).
  5. 5.根据权利要求4所述的支架精确植入系统,其特征在于,所述第一导鞘(109)的前端形成为具有流线型结构的导引头(1091)。 The precise stent implant system as claimed in claim 4, wherein the front end of the first guide sheath (109) is formed as a guide head (1091) has a streamlined structure.
  6. 6.根据权利要求3所述的支架精确植入系统,其特征在于,所述支架精确植入系统还包括多个控制装置,所述第二导鞘(110)、所述顶芯(108)和所述导芯(10)向后延伸并分别连接于各自的所述控制装置。 6. precise stent implant system according to claim 3, wherein said stent further comprises a plurality of precise implant system control means, the second guide sheath (110), said top core (108) and said guide core (10) extend rearwardly and are connected to a respective said control means.
  7. 7.根据权利要求3所述的支架精确植入系统,其特征在于,所述第二导鞘(110)的前端尺寸小于所述第一导鞘(109)的后端尺寸并且平滑过渡。 7. The stent according to precise implant system according to claim 3, wherein said second guide sheath (110) is smaller in size than the front end of the first guide sheath (109) and the size of the rear end of a smooth transition.
  8. 8.根据权利要求1所述的支架精确植入系统,其特征在于,所述支架(104)具有主体部(1041)和位于该主体部(1041)后端的开口部(1042),所述主体部(1041)形成为直筒结构,所述开口部(1042)形成为喇叭型结构。 8. The stent precise implant system of claim 1, characterized in that the bracket (104) having a body portion (1041) and the opening portion (1042) located on the body portion (1041) of the rear end of the body portion (1041) is formed as a straight structure, the opening portion (1042) formed in a horn-type structure.
  9. 9.根据权利要求1所述的支架精确植入系统,其特征在于,所述支架(104)具有主体部(1041)和位于该主体部(1041)后端的开口部(1042),所述主体部(1041)形成为直筒结构,所述开口部(1042)的开口平面相对于所述主体部(1041)的轴线倾斜设置。 9. The stent precise implant system of claim 1, characterized in that the bracket (104) having a body portion (1041) and the opening portion of the main body portion located at (1041) the rear end (1042), said body portion (1041) is formed as a straight structure, the opening plane of the opening portion (1042) is disposed inclined relative to the axis of the main body portion (1041) of.
  10. 10.根据权利要求8或9所述的支架精确植入系统,其特征在于,所述限位孔(1061)形成在所述主体部(1041)的后端或所述开口部(1042)。 10. The implant system of precise stent of claim 8 or claim 9, wherein said limiting hole (1061) formed at a rear end of said main body portion (1041) or the opening portion (1042).
CN 201410294368 2014-06-25 2014-06-25 Accurate branch vessel stent implant system CN105266936B (en)

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PCT/CN2014/084327 WO2015196539A1 (en) 2014-06-25 2014-08-13 System and method for accurately implanting a bifurcated vessel stent

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US7341598B2 (en) * 1999-01-13 2008-03-11 Boston Scientific Scimed, Inc. Stent with protruding branch portion for bifurcated vessels
WO2001070299A3 (en) * 2000-03-22 2002-03-14 Advanced Stent Technologies L Guidewire introducer sheath
CN101594838B (en) * 2006-09-25 2014-06-18 A·维勒 Self-expandable stent systems for bifurcated lesions
US8273115B2 (en) * 2007-04-24 2012-09-25 W. L. Gore & Associates, Inc. Side branched endoluminal prostheses and methods of delivery thereof
CN101897629B (en) * 2009-05-26 2013-08-07 上海微创医疗器械(集团)有限公司 Branched membrane-covered support conveying system and conveying method thereof
WO2011109067A1 (en) * 2010-02-18 2011-09-09 Suhr William S Side branch accessible balloon for bifurcation stenting
CN102415924B (en) * 2011-09-16 2014-11-26 上海微创医疗器械(集团)有限公司 Branched sheath and blood vessel stent conveying and release device applying same
CN102525699B (en) * 2012-01-12 2015-06-10 微创心脉医疗科技(上海)有限公司 Branch type intraoperative stent conveying system and guiding catheter for same
CN203935305U (en) * 2014-06-25 2014-11-12 李雷 Precise support implanting system for branch vessel

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