CN107374779A - A kind of local laser artery windowing facility and application thereof - Google Patents
A kind of local laser artery windowing facility and application thereof Download PDFInfo
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- CN107374779A CN107374779A CN201610325365.0A CN201610325365A CN107374779A CN 107374779 A CN107374779 A CN 107374779A CN 201610325365 A CN201610325365 A CN 201610325365A CN 107374779 A CN107374779 A CN 107374779A
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- 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
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- 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
- A61F2002/075—Stent-grafts the stent being loosely attached to the graft material, e.g. by stitching
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Abstract
The invention belongs to medical science and engineering interleaving techniques field, is related to a kind of local laser artery windowing facility and application thereof.It includes the local laser artery windowing facility of the present invention, aorta tectorial membrane stent：Valiant supports, zenith flex supports, Ankura thoracic aorta covered brackets and " chimney " support and laser.The present apparatus is after aorta tectorial membrane stent release, it can be opened a window according to blood vessel situation on the aorta tectorial membrane stent corresponding to branch vessel using laser, and it is implanted into overlay film frame or bare bracket in the branch vessel of windowing, to rebuild the blood flow of branch vessel, reduce and reduce the generation of related complication.The present invention uses standard specification overlay film frame, does not destroy any anatomical structure, it is not necessary to the independent customization support system according to the special anatomic form of individual, available for treatment aortic aneurysm or dissection of aorta disease.
Description
Technical field
The invention belongs to medical science and engineering interleaving techniques field, is related to a kind of local laser artery windowing facility and its use
On the way.The local laser artery windowing facility of the present invention, can be according to blood vessel situation after aorta tectorial membrane stent release
Opened a window using laser on the aorta tectorial membrane stent corresponding to branch vessel, and planted in the branch vessel of windowing
Enter overlay film frame or bare bracket, to rebuild the blood flow of branch vessel, reduce and reduce the generation of related complication.
The local laser artery windowing facility of the present invention can be applied to treat aortic aneurysm or dissection of aorta disease.
Background technology
Data shows that aortic aneurysm and dissection of aorta are a kind of diseases for threatening human life；Wherein, sustainer
It is pathologic to expand beyond the 50% of normal blood vessels diameter, referred to as aortic aneurysm；Aortic aneurysm is divided into true property actively
Arteries and veins knurl and false aortic aneurysm, true aneurysm are that blood vessel broadens and is related to the 3-tier architecture of vascular wall, false aneurysm
It is artery partial fracture, is sealed by clot or adjacent tissue and formed.Dissection of aorta refer to aortic tunica intima and in
After layer damage, inner membrance mouth of the blood through tear enters aorta wall middle level, produces vascular wall and peels off, forms pseudocoelom
Road, impacted with blood flow, it is in Ectasia that blood vessel exfoliation, which gradually extends,.Dissecting aneurysm of aorta can cause pericardium to go out
Blood produces pericardial tamponade, or even big blood vessel rupture bleeding causes patient's die by visitation of God.Data shows its morbidity in recent years
Rate is on the rise, and its annual morbidity is more than 3,0/1,000,000 people.If cannot treat in time, Stanford Type Bs
For interlayer patient 30d case fatality rate more than 10%, high-risk patient can be more than 70%.Surgical operation is still sustainer at present
The effective treatment method of dissecting aneurysm, but its technical difficulty is big, and the requirement to patient and operating room is higher, promotes
Using being limited, the technology needs the descending bypass graft of general anesthesia, and the relatively simple internal medicine intracavitary therapy of operation risk is big,
Operating time, the complication such as post-operative recovery time length, infection, bleeding are relatively more.In recent years, in aorta lumen
The application and development of prosthetic (endovascular aortic repair, EVAR) change the shape of the disease treatment significantly
Condition, its is minimally invasive, safely, effectively the advantages that have been obtained for widely approving in the industry.But practice display, one
Because proximal landing zone deficiency causes the application that limits EVAR in a little patients.In clinical practice, row EVAR
When, overlay film frame proximal landing zone blood vessel is without lesion and long enough (>=15mm), but some patient's interlayer hemotoncus approach
Or involve left subclavian artery so that overlay film frame has to cover left subclavian artery to obtain enough grapplings
Area；For the patient of left vertebral artery advantage, overlay film frame covering left subclavian artery may cause brain Posterior circle to lack
Blood, to protect patient's left subclavian artery blood flow, the measure that can be taken has " chimney " technology (chimney
Technique), reconstructive vascular operation, " windowing branch " support on the bow of arteria carotis-left subclavian artery bypass graft
Technology.Due to the complexity of bow portion dissection, the excessive risk of cerebral apoplexy so that bow portion lesion is treated as current blood
The huge challenge that pipe surgeon faces.Arch of aorta anatomic form is complicated, in Coronal, sagittal plain and axle position
In the presence of different degrees of distortion, this distortion with age is also constantly changing, and not only increases accurate measurement master
The difficulty that support accurately discharges when the difficulty and intracavitary therapy of arch of aorta cross-sectional diameter, also result in the effective grappling of support
When need longer anchorage zone.And bend top set's blood vessel and upper limbs especially incidence blood supply is provided, limit anchor
Determine arbitrarily moving up for area, also bring bigger risk, the change of its branch for technical operation when handling bow portion's lesion
It is different more to have aggravated its complexity.What therefore the processing of aortic arch lesion should be fine using advanced soft hardware equipment
The anatomical structure in bow portion is measured, patient is on the technical foundation of various processing bow top set blood vessels is familiar with, frequently with individual
The formulation therapeutic scheme of property.
To extend TEVAR application, various new intracavitary therapy apparatuses and new technology are arisen at the historic moment.Mesh
Before be intended to expand or rebuild anchorage zone method include " hybridization " technology, " chimney " technology, " gap " support rack type people
Hematopoiesis pipe, " windowing " support type artifical vascular, " branch " support type artifical vascular." hybridization " technology refers to lead to
Cross behind open by-pass operation expansion anchorage zone an actor's rendering of an operatic tune Stent Placement again, not complete intracavitary minimal invasive techniques, still
There is larger wound.The country's " gap ", " windowing " and " branch " support type artifical vascular needs external customization at present, takes
With height, the customization cycle is grown, and needs superb intracavitary technical support, it is difficult to carries out and makes in emergency treatment disease extensively
With.Chimney support technology is mainly used in the refractory aneurysms patient of proximal landing zone deficiency, in sustainer overlay film
The near-end outer rim implantation support of support, establishes the passage from aorta tectorial membrane stent near-end to branch vessel blood flow, from
And preserve branch's blood flow and obtain more fully proximal landing zone, occur leaking in I types in Follow-up After.
Chimney " technology provides comparatively ideal therapeutic scheme for the aortic arch lesion of above-mentioned anchorage zone deficiency, should
When technology refers to that Endovascular aortic repair aortic stents need to cover Main Branches, in the same of release aortic stents
When, the branch of covering is built into parallel a bare bracket or overlay film frame to keep the unobstructed of branch vessel.
" windowing branch " support is enterprising in the aorta tectorial membrane stent corresponding to branch vessel according to patient vessel's situation
The customization support of row windowing, and it is implanted into overlay film branch at " windowing " place to branch vessel after aorta tectorial membrane stent release
Frame；The advantage of the technology is more completely to protect branch's blood flow, while reduces the formation of leakage in I types.
Based on prior art, present inventor intends providing a kind of local laser artery windowing facility and application thereof,
Especially for treating the application in aortic aneurysm or dissection of aorta disease.
The content of the invention
The purpose of the present invention is to be based on prior art, there is provided a kind of local laser artery windowing facility and application thereof.This
The local laser artery windowing facility of invention, can be according to blood vessel situation corresponding after aorta tectorial membrane stent release
Overlay film is implanted into being opened a window on the aorta tectorial membrane stent of branch vessel using laser, and in the branch vessel of windowing
Support or bare bracket, to rebuild the blood flow of branch vessel, reduce and reduce the generation of related complication.The present invention
Device can be used for treatment aortic aneurysm or dissection of aorta disease in.
Specifically, a kind of local laser artery windowing facility provided by the invention, it includes sustainer overlay film branch
Frame：Valiant supports, zenith flex supports, Ankura thoracic aorta covered brackets and " cigarette
Chimney " support and laser, the laser, which corresponds on the aorta tectorial membrane stent of branch vessel, to be applied.
In the present invention, described " chimney " support includes Boston Expess SD, MARIS (outside self-inflated
All supports) INVATEC supports, Wallstent bare brackets.
The invention provides described local laser artery windowing facility in treatment aortic aneurysm or dissection of aorta disease
In application, it includes, using the characteristic of laser technology, after aorta tectorial membrane stent release, according to patient's blood
Pipe situation is opened a window on the aorta tectorial membrane stent corresponding to branch vessel using laser, and in the branch of windowing
Vascular implantation overlay film frame or bare bracket, to rebuild the blood flow of branch vessel, reduce and reduce related complication
Occur.
Application of the described local laser artery windowing facility in treatment aortic aneurysm or dissection of aorta disease, its
Comprise the steps：
(1) aorta tectorial membrane stent is determined,
Including aorta tectorial membrane stent：Valiant supports (Medtronic companies), zenith flex supports
(Cook companies), Ankura thoracic aorta covered brackets (Shenzhen Xian Jian Science and Technology Co., Ltd.)；" cigarette
Chimney " support：Boston Expess SD (Boston Scientific companies), MARIS (self-inflated peripheral branches
Frame) INVATEC supports (Medtronic companies), Wallstent bare brackets (Boston Scientific)
Interlayer is more than natural arterial diameter 10%~15%, support more than the aneurysm of Normal aorta bore 5%~10%
Near-end bore range of choice is 30~44mm, and distal end bore range of choice is 28~44mm, and graft length is selected
It is selected as 140~200mm, the selection of bifurcated artery graft diameter：It is straight that graft diameter is more than bifurcated artery implantation region
Footpath 1mm, length are 37~57mm, and graft includes E-Luminexx, and from swollen support, (U.S. BARD is public
Department), Fluency is from swollen support (BARD companies of the U.S.), Viabhn supports (GORE companies of the U.S.), Zenith
(China is first good for for support (COOK companies of the U.S.), Talent supports (Medtronic companies of the U.S.) and Ankura supports
Scientific ＆ technical corporation)；
(2) selection of main body rack
In aorta pectoralis intracavitary therapy, when selecting main body rack, stent diameter is that aorta pectoralis measures internal diameter amplification
About 10%, both to meet the stabilization of postoperative support, and reduce because support support force crosses the occlusion of good general " windowing " support pressure
Or aorta pectoralis is expanded or burst, in Thoracic Aortic Diameters (knurl body with change in location and in the case of changing greatly
Upper and lower internal diameter difference is larger), pedestal lower end expansionary force too senior general's chest master is prevented again while in order to obtain preferable support
Asrteriectasia, before the main body rack of isolation is inserted, first discharge one piece of restricted branch in aortic aneurysm body lower end
Frame, to limit the expansion of main support lower end；
Reasonable selection support is used in the present invention, avoids interior leakage from occurring, good patch between support and aorta wall
Close, inconsistent, the grappling section length of chimney support and aortic stents in itself it is still relatively limited relevant, therefore, be
To be leaked out in reduction danger, the selection of support is particularly important,
When selecting main body rack, the estimation of aortic stents diameter is equivalent to anchorage zone aorta diameter+1/2 " chimney "
Stent diameter, if aorta diameter is not the circle of standard, aorta diameter can be estimated as [sustainer maximum gauge+most
Minor diameter]/2；Have for sustainer and expand the patient of tendency, age less than 70 years old, aorta diameter is actual diameter
× (1.05~1.1) mm；Near-end may be selected without the stronger support of naked frame, adhesion of the overlay film part to big curved side, this
Sample had both met the stabilization of postoperative support, also reduced because support support force crosses the occlusion of good general " chimney " support pressure or will
The risk that aorta pectoralis is expanded or burst,
In the present invention, when selecting " chimney " support, stent diameter is unsuitable excessive, otherwise can increase the generation of leakage in I types
Probability；The radial support power of self-inflated bare bracket is weaker, and its compliance is good, has certain elasticity, contribute to
Aortic stents type artificial blood vessel completes preferably fitting, and 6F sheaths are used in art, small to injury of blood vessel；For blood
Tube opening position involvement patient can preferred overlay film frame, because being avoided that branch vessel opening to form blood because blood is vortexed
Bolt and may caused by postoperative apoplexy complication generation；Ball expand formula bare bracket can provide bigger radial support power and
More accurately position, " front jumping " phenomenon when can avoid the support to discharge to a certain extent, be adapted to blood vessel situation to answer
Miscellaneous patient, its long-term patency rate may be more preferable；
(3) selection of " chimney " support
The selection of " chimney " support both can be overlay film frame or bare bracket, larger straight when selecting support
" windowing " support in footpath has a risk for causing leakage in I types, and longer " chimney " support long-term patency rate is not high；It is right
In LSA " windowing " support, because overlay film frame imports a diameter of 8F~10F of sheath, arteria brachialis may be caused to damage
Wound, it should be cut from left brachial artery and directly import stent delivery system with seal wire；For LCCA, it is necessary in direct-view incision
Open and puncture Access artery sheath, prevent air enters from causing cerebral embolism；The head end for inserting " windowing " support exceedes master
Body support frame overlay film end about 5~10mm, it is too short to cause anchored side by side area deficiency and shift, in long increase I types
The risk of leakage, while reduce the long-term patency rate of " windowing " support；
(4) the unobstructed degree of " chimney " support is assessed in art
Operation necessary comprehensive radiography before terminating, passes through multi-angle and throws photograph and prolonging exposure time, it is ensured that " chimney " support institute
In vascular patency；Find in time and correct potential narrow or interior leakage, it is narrow to be more than 50% or lower planes contraction pressure difference
It must be corrected during more than 20mmHg, row balloon expandable or stenter to implant；
(5) perioperative drug therapy, preventing and treating Perinatal Therapy complication
Preoperative strict decompression, analgesia therapy and postoperative strict control blood pressure be it is important, it is postoperative should carry out in early days it is double
Treatment-resistant.
The local laser artery windowing facility of the present invention uses through practice, as a result shows, is passed through by distal vessels approach
Lumen of vessels imports stent graft and is isolated diseased region and body circulation, be avoided that the conventional therapy of standard because
Exposure aorta pectoralis, temporary transient aorta clamping and internal organs ischemia/renal ischaemia to caused by the influence of overall health of patients compared with
High complication and case fatality rate, it can be applied to treat in aortic aneurysm or dissection of aorta disease.
It is an advantage of the present invention that suitable for (1) exist other merge disease, general status is poor, row general anesthesia and
The larger patient of the upper bypass risk of surgery bow；(2) emergency treatment row EVAR patient is being needed, because it only slightly increases hand
Art time, relative " hybridization operation " are simple and easy；(3) it is unexpected due to support front jumping during support release
When upper blood vessel is bent in covering, remedial technology can be carried out and retain branch vessel by using " chimney technology ".
Advantages of the present invention has：
The overlay film frame used does not destroy any anatomical structure for standard specification, it is not necessary to according to the special solution of individual
Form and individually customization support system are cutd open, can be in art according to the blood vessel situation of patient, applicating laser technology is in overlay film
Opened a window on support, more completely rebuild branch vessel blood flow, while reduce the generation of leakage in I types.
The present invention a kind of local laser artery windowing facility and its for treating aortic aneurysm or dissection of aorta
The purposes of disease, there is its original advantage for the patient of proximal aorta anchorage zone deficiency in EVAR, expand
Opened up the idicatio scope of arotic disease internal medicine minimally-invasive treatment, reduce the operation risk of patient, the hospital stays and
The generation of surgical operation related complication, and Follow-up After and have no that serious adverse events occur, for a kind of peace
Entirely, reliable intervening measure.Without waiting for support customization is carried out when the present invention uses, it is relatively simple to implement surgical procedure
Single, expense is relatively low, and can obtain comparatively ideal Follow-up After result.
Brief description of the drawings：
Fig. 1：External implantation aorta pectoralis support schematic diagram,
Wherein；A is sustainer and branch model；B is Medtronic overlay film frames；C is implantation active pulsation
Frame；D is that sustainer is positioned at the arch of aorta.
Fig. 2：External row aorta laser windowing technology schematic diagram, wherein,
A fixes sacculus to open；B is laser positioning in left common carotid artery opening；C opens a window for laser in-situ；D is
Row balloon expandable overlay film frame；E is the bore that lateral view examines laser in-situ windowing；F is that normotopia observation laser in-situ is opened
The bore of window.
Fig. 3：Internal row porcine aorta laser windowing technology schematic diagram,
Wherein；A is that normotopia porcine aorta bends radiography；B is that left front 45 ° of porcine aortas bend radiography；C is positioning and releases
Put aorta tectorial membrane stent and open fixed sacculus；D is that laser positioning is covered in the parallel balloon expandable of left common carotid artery opening
Membrane support；E is implantation branch stent；F is to partially open branch stent；G is opening branch stent completely；H is
It is implanted into pigtail catheter；I is that aortic arch angiography prompts the obvious interior leakage of the unobstructed nothing of branch stent development to be formed；J is body
Outer gross examination of skeletal muscle local laser windowing branch stent situation.
Fig. 4：Subclavian artery schematic diagram is rebuild in internal row patient sustainer laser in-situ windowing, wherein,
A is the preoperative sustainer CTA radiographies of patient；B is aortic arch angiography；C covers to position and discharging sustainer
Membrane support simultaneously opens fixed sacculus；D is that laser positioning in the parallel balloon expandable overlay film frame of left common carotid artery opening and is planted
Enter branch stent；E is that aortic arch angiography prompts the obvious interior leakage of the unobstructed nothing of branch stent development to be formed；F、G、H
Local laser windowing branch stent situation is observed for the postoperative CTA of patient.
Embodiment
Embodiment 1
Using including aorta tectorial membrane stent：Valiant supports, zenith flex supports, Ankura chests are actively
The local laser artery windowing facility of arteries and veins overlay film frame and " chimney " support and laser, for treating sustainer
In knurl or dissection of aorta disease；The laser, which corresponds on the aorta tectorial membrane stent of branch vessel, is answered
With.
Using the characteristic of laser technology, after aorta tectorial membrane stent release, according to patient vessel's situation corresponding to
Opened a window on the aorta tectorial membrane stent of branch vessel using laser, and overlay film branch is implanted into the branch vessel of windowing
Frame or bare bracket, to rebuild the blood flow of branch vessel, reduce and reduce the generation of related complication；
The preoperative inspection and evaluation for carrying out medical history and complication of all patients of preoperative evaluation, while row aorta CT blood
Pipe radiography (computed tomography angiography, CTA) checks, using 64 row CT (Scan slice thickness 0.6mm)
It is horizontal from head scanning to femoral artery, main the first break location for assessing dissection of aorta, aortic arch branch
Situation, true and false chamber and celiac branch blood vessel blood supply situation, aneurysm size, scope, degreeof tortuosity, lateral thrombus feelings
Condition, brain blood supply (including arteria carotis, Vertebral-basilar artery and Willis rings etc.) situation, it is accurate measure the first cut upper limb or
Knurl body near-end is to LSA and left common carotid artery (left commoncarotid artery, LCCA) or innominate artery
The distance and Aortic arch aneurysm neck diameter of (innominateartery, IA) opening trailing edge.Data above measurement is along actively
Arteries and veins major axis is carried out, because intracavity implant is to must be attached at aorta wall during final grappling.According to collection
Data, tentatively formulate operation plan, intend the overlay film frame size and type of selection；
Conventional dissection left side arteria brachialis, inserts 5F pigtail catheters, row aorta ascendens radiography, specifies aortic arch
State and each bifurcated artery situation, bifurcated artery and bilateral vertebral artery are assessed, leads Amplatz Super Stiff along conduit
It is standby that silk leads to aorta ascendens.Cut or Direct perforantes side femoral artery, catheter guide wire technology are put through femoral artery is retrograde
Cook Lunderquist ultrahard guide wires are put to aorta ascendens, radiography confirms to be located at true chamber.Whole body test tube of hepari, is moved through stock
Arteries and veins imports membrane-covered support conveying system, and radiography confirms to discharge support after lesion and grappling satisfaction is completely covered, now,
LSA is all covered, and 980 optical fiber and sacculus are inserted along left brachial artery, after being accurately positioned using laser burn actively
Pulsation frame, sacculus row predilation is inserted, windowing stent (self-inflated bare bracket or overlay film frame) is led into left lock after expansion
Artery proximal segment under bone, chimney support arch of aorta section is set to be arranged vertically with sustainer inner support as far as possible.Accurate adjustment " cigarette
The position of chimney " support, its head end is set to exceed aorta tectorial membrane stent overlay film 5~10mm of head end, its tail end is in LSA
It is interior, left vertebral artery open proximal.For LCCA " windowing " technology：LCCA stage casings are cut, short sheath is placed and makes
Shadow conduit；Overlay film frame covering LCCA and LSA is placed through femoral artery；980 optical fiber and ball are inserted through the short sheaths of LCCA
Capsule, laser burn aortic stents are applied after being accurately positioned, sacculus row predilation are inserted, by windowing stent after expansion
(self-inflated bare bracket or overlay film frame) is implanted into.After the completion of all " windowing " supports are placed, situation is oppressed according to support
Decide whether to carry out balloon expandable to narrow support.Last contrast examination lesion is isolated situation, branch vessel is led to
Smooth situation, there is non-internal leakage etc., terminate operation.ProGlide suture femoral artery art mouth Elastic bandage Pressure bandages stop
Blood, postoperative safety return to vascular surgery public ward,
Operation is routinely moved in local anaesthesia or intubation and general anaesthesia menisectomy, aortic stents artificial blood vessel through stock
Arteries and veins cuts approach and entered, and no patient death, follow-up CTA is shown：" windowing " support is unobstructed (as shown in Figure 4), no cerebral ischemia
And left upper extremity ischemic, have no in I types and leak.
Claims (4)
1. a kind of local laser artery windowing facility, it is characterised in that it includes, sustainer overlay film branch
Frame：Valiant supports, zenith flex supports, Ankura thoracic aorta covered brackets and " cigarette
Chimney " support and laser, the laser, which corresponds on the aorta tectorial membrane stent of branch vessel, to be applied.
2. the local laser artery windowing facility as described in claim 1, it is characterised in that described " cigarette
Chimney " support be selected from Boston Expess SD, MARIS (self-inflated periphery support) INVATEC supports and/or
Wallstent bare brackets.
3. the local laser artery windowing facility described in claim 1 is for treating aortic aneurysm or aorta clamp
Purposes in layer disease, it includes, using the characteristic of laser technology, after aorta tectorial membrane stent release, according to
Blood vessel situation is opened a window on the aorta tectorial membrane stent corresponding to branch vessel using laser, and in point of windowing
Branch vessel is implanted into overlay film frame or bare bracket, to rebuild the blood flow of branch vessel, reduces and reduces related complication
Generation.
4. the purposes as described in claim 3, it is characterised in that described purposes it include：
(1) aorta tectorial membrane stent is determined,
(2) selection of main body rack,
(3) selection of " chimney " support,
(4) the unobstructed degree of " chimney " support is assessed in art,
(5) perioperative drug therapy, preventing and treating Perinatal Therapy complication.
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| CN201610325365.0A CN107374779A (en) | 2016-05-16 | 2016-05-16 | A kind of local laser artery windowing facility and application thereof |
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Cited By (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108606862A (en) * | 2018-05-24 | 2018-10-02 | 上海长海医院 | Dot matrix window type aorta stent graft art component |
| CN111407463A (en) * | 2020-03-19 | 2020-07-14 | 湖南埃普特医疗器械有限公司 | Covered stent system |
| CN115462861A (en) * | 2022-10-31 | 2022-12-13 | 北京华脉泰科医疗器械股份有限公司 | Strutting arrangement is rebuild in anchor area |
| CN116035788A (en) * | 2023-03-30 | 2023-05-02 | 杭州唯强医疗科技有限公司 | Window opening support, tectorial membrane support system and sewing method of window opening support |
| WO2023227431A1 (en) * | 2022-05-23 | 2023-11-30 | Koninklijke Philips N.V. | Devices, methods, and systems for improved planning and guidance in laser fenestration applications |
Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN103349575A (en) * | 2013-06-06 | 2013-10-16 | 武汉杨森生物技术有限公司 | Windowing method for covered stent in vascular cavity |
| CN103349576A (en) * | 2013-06-06 | 2013-10-16 | 武汉杨森生物技术有限公司 | Windowing equipment for covered stent in vascular cavity |
| CN203388961U (en) * | 2013-06-06 | 2014-01-15 | 武汉杨森生物技术有限公司 | Vascular endovascular stent graft windowing equipment |
| CN104027187A (en) * | 2013-03-04 | 2014-09-10 | 上海微创医疗器械（集团）有限公司 | Branching type coated stent, conveying system comprising same and manufacturing method thereof |
-
2016
- 2016-05-16 CN CN201610325365.0A patent/CN107374779A/en active Pending
Patent Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN104027187A (en) * | 2013-03-04 | 2014-09-10 | 上海微创医疗器械（集团）有限公司 | Branching type coated stent, conveying system comprising same and manufacturing method thereof |
| CN103349575A (en) * | 2013-06-06 | 2013-10-16 | 武汉杨森生物技术有限公司 | Windowing method for covered stent in vascular cavity |
| CN103349576A (en) * | 2013-06-06 | 2013-10-16 | 武汉杨森生物技术有限公司 | Windowing equipment for covered stent in vascular cavity |
| CN203388961U (en) * | 2013-06-06 | 2014-01-15 | 武汉杨森生物技术有限公司 | Vascular endovascular stent graft windowing equipment |
Non-Patent Citations (1)
| Title |
|---|
| 刘文奇: "一种主动脉覆膜支架原位开窗技术的可行性研究", 《中国优秀硕士学位论文全文数据库 医药卫生科技辑》 * |
Cited By (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108606862A (en) * | 2018-05-24 | 2018-10-02 | 上海长海医院 | Dot matrix window type aorta stent graft art component |
| CN111407463A (en) * | 2020-03-19 | 2020-07-14 | 湖南埃普特医疗器械有限公司 | Covered stent system |
| WO2023227431A1 (en) * | 2022-05-23 | 2023-11-30 | Koninklijke Philips N.V. | Devices, methods, and systems for improved planning and guidance in laser fenestration applications |
| CN115462861A (en) * | 2022-10-31 | 2022-12-13 | 北京华脉泰科医疗器械股份有限公司 | Strutting arrangement is rebuild in anchor area |
| CN115462861B (en) * | 2022-10-31 | 2023-03-24 | 北京华脉泰科医疗器械股份有限公司 | Support arrangement is rebuild to anchoring zone |
| CN116035788A (en) * | 2023-03-30 | 2023-05-02 | 杭州唯强医疗科技有限公司 | Window opening support, tectorial membrane support system and sewing method of window opening support |
| CN116035788B (en) * | 2023-03-30 | 2023-06-16 | 杭州唯强医疗科技有限公司 | Window opening support, tectorial membrane support system and sewing method of window opening support |
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