CN107320216A - A kind of integrated bracket for main common iliac artery - Google Patents
A kind of integrated bracket for main common iliac artery Download PDFInfo
- Publication number
- CN107320216A CN107320216A CN201710644952.0A CN201710644952A CN107320216A CN 107320216 A CN107320216 A CN 107320216A CN 201710644952 A CN201710644952 A CN 201710644952A CN 107320216 A CN107320216 A CN 107320216A
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- CN
- China
- Prior art keywords
- branch
- iliac artery
- common iliac
- main common
- integrated bracket
- Prior art date
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2/07—Stent-grafts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2/00—Filters 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
- A61F2/0077—Special surfaces of prostheses, e.g. for improving ingrowth
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2002/065—Y-shaped blood vessels
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2210/0014—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0063—Three-dimensional shapes
- A61F2230/0069—Three-dimensional shapes cylindrical
Abstract
According to the integrated bracket for main common iliac artery involved in the present invention, including the metallic support with interconnected stem portion, the first branch and the second branch, constitute the integrated Y shape matched with the cavity shape of main common iliac artery, with the coating layer being arranged on metallic support, wherein, metallic support is the tubular support by metal wire knitted.What is used in main common iliac artery due to the past is all separating stent-graft, and the integrated bracket for main common iliac artery involved in the present invention is the integrated bracket for being exclusively used in main occlusion of iliac artery intracavitary therapy, because stem portion, the first branch and the second branch of the present invention are connected as a single entity, firm effect is served to whole support, so displacement of the support under the high speed impact of blood flow can be prevented;Further, since main occlusion of iliac artery extent of disease is big, this support can be on the premise of safe and effective release, it is ensured that the complete isolation to lesion, while not influenceing the intracavitary therapy of follow-up distal end lesion also.
Description
Technical field
The invention belongs to medical field, and in particular to a kind of integrated bracket for main common iliac artery.
Background technology
Main occlusion of iliac artery disease refers to the arteriosclerotic disease for involving abdominal aorta end, as shown in Fig. 2 lesion
It may span across aortic bifurcation and involve bilateral iliac artery, patient may occur in which the clinical manifestations such as internal organs ischemia, lower limb ischemia or necrosis.Root
According to general Atlantic Ocean cooperation organizational thinking (TASCII) guide of the second edition, main occlusion of iliac artery belongs to B grades of above lesions.For B grades
Lesion advises row intracavitary therapy, and row open surgery is advised for C, D grades of lesions.Now with intracavitary technology continue to develop and
The continuous renewal of intervening equipment, increasing serious main occlusion of iliac artery venereal disease, which becomes, can use Endovascular or miscellaneous
Fight art is treated.For the selection of therapeutic scheme, the order of severity, entire patient's comprehensive condition and the master of citrus lesion are answered
The technical merit for examining doctor is considered.
Approach selection has three kinds when lower extremity artery pathology implements intracavitary therapy:One is through homonymy femoral artery retrograde puncture.Two
It is simultaneously " to be crossed over a hill " technology (as shown in Figure 4) through offside femoral artery retrograde puncture.Three are punctured through arteria brachialis.The retrograde approach of homonymy
Latent defect one is to be difficult to puncture, because occlusion can not generally touch beating with remote femoral artery, if through this approach
Need to mark positioning or ultrasound guided puncture using bone.Two be it is this enter dataway operation when seal wire enter inner membrance under when in sustainer
Bifurcation is not easily accessed true chamber.Three be that antegrade puncture postoperative compression hemostasis may influence the blood flow of diseased region.In spite of
When using puncture technique seal wire can be guided to return to the true intracavitary of sustainer, but would rather typically select other approaches.Driven in the wrong direction through offside
It is most popular method to puncture " crossing over a hill " technology approach.The advantage of " crossing over a hill " technology is easy puncture, few intercurrent disease, can handle stock
The lesion of shallow artery near-end, post-operative compression cannot be easily caused the lower limb ischemia of Ipsilateral in the limbs of offside.
Intracavitary intervention operation has the advantages that wound is small, the hospital stays is short.Previously closed for the main common iliac artery of complicated long section
Plug is main using abdomen master-bis- iliums (stock) artery artificial blood vessel's bypass grafting, but because the most of patients age is higher, body is general
Situation is poor, and the wound of surgical operation is big, and Peri operative mortality and incidence of complications are high, limit surgical operation
Application.The purpose of intracavitary PCI is to recover main common iliac artery blood flow, due to the complicated long main occlusion of iliac artery of section almost in
Have that serious non-thrombotic is narrow or occlusion at abdominal aortic bifurcation, such as only side common iliac artery row balloon expandable or branch are put up
Shape, then easily cause blood vessel angulation and the problems such as offside blood flow is blocked, therefore, clinically to advocate row to kiss formula stent-assisted angioplasty simultaneously more
Obtain good therapeutic effect.Have longitudinal contraction smaller kiss support technology, it is easy to discharge, position, can reduce to greatest extent
The mismatch region of support and native blood vessel, the advantages of reducing turbulent flow, extravasated blood, increase vascular patency.But, postoperative appearance is again
Narrow is still one of its main complication.Once there is ISR in distal stent, by offside cross over a hill, it is narrow to open
Narrow section of method is then difficult to, therefore, and such a technology still has certain limitation.But intracavitary Surgery this
The best mode of class disease is to use integrated bracket, and integrated bracket as shown in Figure 3 can at utmost reduce abdominal aorta
The anatomical structure of crotch, this dissection fixed form provides longitudinal holding power pair by natural anatomical structure at aortic bifurcation
Support is fixed, and is significantly reduced probability of the support to distal travel, support can be made to be brought into close contact with vascular wall, prevented
Interior leakage.Meanwhile, the haemodynamics in integrated bracket not only contributes to remote organization's organ closer to natural physiological status
Blood perfusion, be more conducive to reduce in-stent restenosis incidence.What is more important, once generation is narrow in support,
Or lesion occurs in distal limb artery, integrated bracket does not influence the offside technology that crosses over a hill to carry out the treatment of unilateral extremity vascular.
Still lack the integrated bracket of the main occlusion of iliac artery for the treatment of at present.
The content of the invention
The present invention is carried out to solve the above problems, it is therefore intended that in main occlusion of iliac artery disease is treated, carried
For one kind on the premise of safe and effective release, both ensure lesion is completely covered, while not influenceing follow-up distal end lesion also
Intracavitary therapy integrated bracket.
The invention provides a kind of integrated bracket for main common iliac artery, have the feature that, including metallic support,
The metallic support has stem portion, the first branch and the second branch positioned at the first branch offside;And
The coating layer on the metallic support is arranged on, wherein, the metallic support is the tubular support by metal wire knitted, institute
State end of the one end of stem portion respectively with first branch and second branch to be connected, constitute and the main ilium
The Y shape for the integral type that the cavity shape of artery matches, the stem portion, first branch and the second branch are phases
Intercommunicated.
In addition, in the integrated bracket provided by the present invention for main common iliac artery, can also have the feature that:Its
In, the material of coating layer is expanded PTFE or PEP.
In addition, in the integrated bracket provided by the present invention for main common iliac artery, can also have the feature that:Its
In, when wire and coating layer are combined, wire be located at the outside of coating layer, inner side or be sandwiched between two layers in it is any one
Kind.
In addition, in the integrated bracket provided by the present invention for main common iliac artery, can also have the feature that:Its
In, metallic support is the tubular support by metal wire knitted, and the external diameter of stem portion is 14~20mm, length is 20~
60mm。
In addition, in the integrated bracket provided by the present invention for main common iliac artery, can also have the feature that:Its
In, a diameter of 6~10mm of the first branch, length is 40~100mm.
In addition, in the integrated bracket provided by the present invention for main common iliac artery, can also have the feature that:Its
In, the junction of stem portion, the end of the first branch and the second branch and the first branch and the second branch is all provided with
Be equipped with multiple metal marker points, for during perspective to the position of the end of stem portion, the first branch and the second branch
And first the position of branch and the junction of the second branch be identified.
In addition, in the integrated bracket provided by the present invention for main common iliac artery, can also have the feature that:Its
In, the material of wire is Nitinol.
In addition, in the integrated bracket provided by the present invention for main common iliac artery, can also have the feature that:Its
In, the length of the first branch and the second branch is identical.
In addition, in the integrated bracket provided by the present invention for main common iliac artery, can also have the feature that:Its
In, the length of the first branch and the second branch is differed.
The effect of invention and effect
According to the integrated bracket for main occlusion of iliac artery lesion involved in the present invention, including metallic support, metal
Support has stem portion, the first branch and the second branch positioned at the first branch offside, wherein, one end of stem portion
The end with the first branch and the second branch is connected respectively, constitutes the one matched with the cavity shape of main common iliac artery
The Y shape of formula, stem portion, the first branch and the second branch are interconnected.
What is used in main common iliac artery due to the past is all separating stent-graft, and involved in the present invention is used for main common iliac artery
The integrated bracket of Occlusion is the integrated bracket for being exclusively used in main occlusion of iliac artery intracavitary therapy, because the trunk of the present invention
Portion, the first branch and the second branch are connected as a single entity, and firm effect is served to whole support, so support can be prevented
Displacement under the high speed impact of blood flow.
Further, since what is previously used in main occlusion of iliac artery venereal disease change (including stenotic lesion) is all peripheral arterial disease
The conventional straight-tube-type support that disease is used, needed during treatment two or more overlay film frames or bare bracket be placed in parallel or
Intersect and place, wherein bare bracket implantation long-term patency rate is not high, ISR at a specified future date, occlusion easily occur again, or even sternly
Weight ischemic and overlay film frame implantation needs to be implanted into many pieces of supports, spend high, and change original dissection knot of main common iliac artery
Structure, and generally there is serious peripheral vascular hardening lesion in the patient of main occlusion of iliac artery lesion, implantation in this manner
Frame, has extreme influence to the treatment and patency rate in patient's later stage.The physiological anatomic architecture of original main common iliac artery is changed, is made
Into can not from femoral artery using " cross over a hill technology " across entering contralateral limbs blood vessel after main common iliac artery bifurcated, and then can not carry out pair
The treatment of side extremity vascular, integrated bracket of the invention can be on the premise of safe and effective release, it is ensured that to the complete of lesion
Covering, while not influenceing the intracavitary therapy of follow-up distal end lesion also.
Brief description of the drawings
Fig. 1 is the appearance schematic diagram for the integrated bracket for being used for main common iliac artery in embodiments of the invention;
Fig. 2 is the photo of main occlusion of iliac artery lesion schematic diagram in embodiments of the invention;
Fig. 3 is the photo of the schematic diagram using integrated bracket in embodiments of the invention;And
Fig. 4 is the schematic diagram of technology approach of " being crossed over a hill " through offside femoral artery retrograde puncture.
Embodiment
Main occlusion of iliac artery disease refers to the arteriosclerotic disease for involving abdominal aorta end, as shown in Fig. 2 lesion
It may span across aortic bifurcation and involve bilateral iliac artery, patient may occur in which the clinical manifestations such as internal organs ischemia, lower limb ischemia or necrosis.
In order that the technical means, the inventive features, the objects and the advantages of the present invention are easy to understand, it is real below
Example combination accompanying drawing is applied to be specifically addressed the integrated bracket of main common iliac artery involved in the present invention.
Embodiment
Integrated bracket 10 for main common iliac artery is metallic support, is the tubular support by metal wire knitted.
Integrated bracket 10 includes stem portion 11 as shown in Figure 1, the first branch 12, the second branch 13, Duo Gejin
Belong to mark point 14, in addition to coating layer, Nitinol barb and sealing sleeve pipe.
End of the one end of stem portion 11 respectively with the first branch 12 and the second branch 13 is connected, the second branch
13 are located at the offside of the first branch 12, and the Y shape for constituting the integral type matched with main common iliac artery cavity shape (is that upside down in figure
Y shape), stem portion 11, the first branch 12 and the second branch 13 are interconnected.
In embodiment, metallic support is the tubular support by metal wire knitted, the external diameter of stem portion 11 for 14~
20mm, length is 20~60mm;The external diameter of first branch 12 is 6~10mm, and length is 40~100mm;Second branch 13
External diameter be 6~10mm, length be 10~100mm;The angle of first branch 12 and the second branch 13 is 30~60 degree;The
The length of one branch and the second branch can be identical;Can also be different.
In embodiment, the external diameter of stem portion 11 is 18mm, and length is 25mm, and the external diameter of the first branch 12 is 7mm, length
For 70mm;The external diameter of second branch 13 is 7mm, and length is 55mm;The angle of first branch 12 and the second branch 13 is
48 degree.
During integrated bracket 10 is the tubular support by metal wire knitted, embodiment, integrated bracket 10 is by list
The ring support of silk braiding, the material of wire is Nitinol.
Stem portion 11, the end of the first branch 12 and the second branch 13 and the first branch 12 and the second branch
13 junction is provided with multiple metal marker points 14, for during perspective to stem portion 11, the first branch 12 and
The position of the end of two branches 13 and the first branch 12 and the position of the junction of the second branch 13 are identified.It is real
Apply in example, the quantity that metal marker point 14 is set in the end of stem portion 11 is 2, in the first branch 12 and the second branch
The quantity that 13 end is set is respectively 2, and the quantity set in the junction of the first branch 12 and the second branch 13 is 1
It is individual.
Coating layer is arranged on metallic support, and the material of coating layer is expanded PTFE or PEP.Its
In, when wire and coating layer are combined, wire can be located at the outside of coating layer, inner side or be sandwiched between two layers.Implement
In example, coating layer is located at the outside of nitinol alloy wire, and the material of coating layer is expanded PTFE.
The end of Nitinol barb and a sealing sleeve pipe position what stem portion 11, sealing sleeve pipe is used for tightening leading in conveying
Stem portion 11 on pipe front end, during the material of sealing sleeve pipe is expanded PTFE or PEP, embodiment, sealing
The material of sleeve pipe is expanded PTFE.
When placing support, integrated bracket 10 is since (sustainer) end before delivery conduit and towards tail (common iliac artery)
End expansion is as shown in Figure 3.Sealing sleeve pipe is used to maintain the origin-location between intravascular stent and vascular wall.
The effect of embodiment and effect
Because being used for stem portion, the first branch and the second branch of the integrated bracket of main common iliac artery in the present embodiment
Portion is connected as a single entity, and firm effect is played to whole support, so first branch of the support under the impact of high speed blood flow can be prevented
Portion, the second branch and the direct position movement of stem portion.
Main occlusion of iliac artery extent of disease is big, the integrated bracket of the present embodiment can on the premise of safe and effective release,
Ensure lesion is completely covered, rebuild " the main ilium bifurcation structure of physiological ", operating theater instruments A as shown in Figure 4 can be used
Through offside retrograde puncture " cross over a hill " technology approach operation method without influenceing the intracavitary therapy of follow-up distal end lesion, due to " turning over
The advantage of mountain " technology is easy puncture, few intercurrent disease, the lesion that can handle femoral artery,superficial near-end, post-operative compression in offside
Limbs cannot be easily caused the lower limb ischemia of Ipsilateral, because the integrated bracket of the present embodiment can easily use " crossing over a hill " technology
Operation method, so as to reduce the pain of patient.
In addition, the support of the present embodiment has coating layer, the closure scope of support is expanded, is realized to greatest extent complete
Completely cut off lesion.
Further, the end of stem portion and branch has metal marker, and operation positioning is simple, it is easy to which support is accurate
Release.
Above-mentioned embodiment is the preferred case of the present invention, is not intended to limit protection scope of the present invention.
Claims (9)
1. a kind of integrated bracket for main common iliac artery, it is characterised in that including:
Metallic support, the metallic support have stem portion, the first branch and positioned at the first branch offside
Two branches;And
The coating layer on the metallic support is arranged on,
Wherein, the metallic support is the tubular support by metal wire knitted,
End of the one end of the stem portion respectively with first branch and second branch is connected, and constitutes and institute
The Y shape for the integral type that the cavity shape of main common iliac artery matches is stated,
The stem portion, first branch and the second branch are interconnected.
2. the integrated bracket according to claim 1 for main common iliac artery, it is characterised in that:
Wherein, the material of the wire is Nitinol.
3. the integrated bracket according to claim 1 for main common iliac artery, it is characterised in that:
Wherein, the material of the coating layer is expanded PTFE or PEP.
4. the integrated bracket according to claim 1 for main common iliac artery, it is characterised in that:
Wherein, when the wire and the coating layer are combined, the wire be located at the outside of the coating layer, inner side or
Any one in being sandwiched between two layers.
5. the integrated bracket according to claim 1 for main common iliac artery, it is characterised in that:
Wherein, the metallic support is the tubular support by metal wire knitted, the external diameter of the stem portion for 14~
20mm, length is 20~60mm.
6. the integrated bracket according to claim 5 for main common iliac artery, it is characterised in that:
Wherein, the external diameter of first branch is 6~10mm, and length is 40~100mm.
7. the integrated bracket according to claim 1 for main common iliac artery, it is characterised in that:
Wherein, the stem portion, the end of first branch and second branch and first branch with
The junction of second branch is provided with multiple metal marker points, for during perspective to the stem portion, described
The position of the end of first branch and second branch and the company of first branch and second branch
The position at the place of connecing is identified.
8. the integrated bracket according to claim 1 for main common iliac artery, it is characterised in that:
Wherein, the length of first branch and second branch is identical.
9. the integrated bracket according to claim 1 for main common iliac artery, it is characterised in that:
Wherein, the length of first branch and second branch is differed.
Priority Applications (1)
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CN201710644952.0A CN107320216B (en) | 2017-08-01 | 2017-08-01 | A integral type support for main iliac artery |
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CN201710644952.0A CN107320216B (en) | 2017-08-01 | 2017-08-01 | A integral type support for main iliac artery |
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CN107320216A true CN107320216A (en) | 2017-11-07 |
CN107320216B CN107320216B (en) | 2020-03-06 |
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CN108553206A (en) * | 2018-05-15 | 2018-09-21 | 中国医学科学院北京协和医院 | Intravascular stent and blood vessel coating bracket |
CN108836585A (en) * | 2018-05-28 | 2018-11-20 | 上海长海医院 | A kind of absorbable Y type carotid stents from Tu Mo branch of band |
CN110974483A (en) * | 2019-12-10 | 2020-04-10 | 中国人民解放军陆军军医大学第一附属医院 | Membrane-carried bifurcation stent for treating femoral artery opening lesion |
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