CN107569311A - Ring holder - Google Patents
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- CN107569311A CN107569311A CN201710544054.8A CN201710544054A CN107569311A CN 107569311 A CN107569311 A CN 107569311A CN 201710544054 A CN201710544054 A CN 201710544054A CN 107569311 A CN107569311 A CN 107569311A
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- connecting rod
- support
- hangnail
- ring holder
- trough
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Abstract
The invention discloses a kind of ring holder, it is the waveform annular support formed by end to end connecting rod, the connecting rod is made up of connecting rod near-end, connecting rod main body and connecting rod distal end three parts, two adjacent connecting rod near-ends form support crest, adjacent two connecting rods distal end forms support trough, at least one connecting rod main body is provided with hangnail, and the hangnail is longitudinally disposed along connecting rod;Angle α between the hangnail and connecting rod, 0 ° of < α≤70 °.The present invention provides a kind of grappling performance for improving support and vascular wall, and the fixed effect for strengthening mount proximal end can solve the ring holder that conveyer after support successfully discharges withdraws difficulty.
Description
Technical field
The invention belongs to technical field of medical instruments, and grappling between intravascular stent and vascular wall can be improved by being related to one kind
The support member of performance, more particularly to a kind of ring holder.
Background technology
Aortic aneurysm typically refers to the pathologic expansion of sustainer, more than 50% lesion vesselses of normal blood vessels diameter.
Aortic aneurysm is generally divided into true property aortic aneurysm and false aortic aneurysm.True aneurysm is that blood vessel broadens and is related to vascular wall
Three-decker.False aneurysm is artery partial fracture, is sealed by clot or adjacent tissue and is formed.According to aortic aneurysm
Position can be divided into Ascending Aortic Aneurysm, Aortic arch aneurysm, aneurysm of thoracic aorta and abdominal aneurvsm, wherein abdominal aorta
Knurl is most commonly seen.
With EVAR (Endovascularaortic Repair, EVAR) development, abdominal aneurvsm intracavitary
Prosthetic (Endovascular abdominal aortic aneurysm repair, EVAR) art and aorta pectoralis intracavitary are repaiied
Multiple art (Thoracic endovascular aortic repair, TEVAR) is treatment abdominal aneurvsm and chest active respectively
The conventional means of arteries and veins knurl, with classics open abdomen open chest surgery compared with, EVAR and TVAR have apodeictic minimally invasive advantage, because
This has lower Peri operative mortality, complication rate and shorter is in hospital and the postoperative care time.
With the development of graft material and intracavitary technology, the EVAR repair rate more and more highers of complicated abdominal aneurvsm.Closely
The complicated abdominal aneurvsm of the serious angulation of knurl neck is held in the case of intracavitary therapy is extremely difficult.Typically by proximal arterial
Knurl neck angle is 60 ° and is defined as serious angulation.Traditional view is thought:The Candidacy selection of intracavitary therapy is more below 60 °, with
The progress of intracavitary technology, some 60 °~90 ° of angulations also achieve the success of minimally-invasive treatment.But in EVAR arts, especially
It is in complicated abdominal aneurvsm EVAR arts, conveyer withdraws difficult much after support successfully discharges.
Prevention and the processing strategy of difficult situation are withdrawn for conveyer in complicated abdominal aneurvsm EVAR arts, can be adopted
Preoperative full sustainer CTA and three-dimensional reconstruction is taken to assess approach and knurl neck;Or flexibly use and withdraw skill;Or according to knurl neck
Distortion angle, direction, from appropriate direction, dynamics, stress and frictional force between support and sheath are cut down with external force, takes advantage of outer masterpiece
With lower temporarily distortion correction knurl neck, conveyer is withdrawn;Or it is following horizontal to distortion by suitably withdrawing ultrahard guide wire, reduce
Conveyer tension force, support form is adapted to by conveyer and reduces resistance of the support to conveyer, successfully withdraw to distortion with
Suitably follow up seal wire again after lower level;Also can be by selecting suitable support, reduce conveyer withdraws difficulty.
Currently for the technique for fixing of EVAR supports, mainly there is two ways, a kind of is the knurl for complying with blood vessel natural form
Neck is fixed, and it mainly by increasing near-end hangnail, extending bare bracket length, increases support compliance to reach the fixation of near-end
Effect, support select predominantly separating stent-graft;Another kind is fixed for dissection, and it mainly utilizes dichotomous integrated bracket
Straddle on abdominal aortic bifurcation, comply with the intrinsic anatomical features of human body, so as to reach the firm effect not moved down of support.
But either which kind of mode, complicated knurl neck are all easier the situation that conveyer withdraws difficulty occur after successfully support is discharged,
Once dealing with improperly, the complication such as graft displaced will be caused so that operative failure, severe patient's aneurysm rupture jeopardize
Patient vitals.
There is a kind of endovascular stent for abdominal aorta in the prior art, be respectively provided with the mount proximal end bare bracket crest and trough
A pair of anticreep fixed structure hangnails.Although the design method improves support integrally anchoring properties, and conveyer after stenter to implant is returned
The problem of removing difficulty plays certain mitigation;But two hangnails on this design bare bracket at crest or trough
Excessively concentrate and the hangnail quantity of support entirety is more, stimulation of the bare bracket to vascular wall is considerably increased, so as to increase branch
The postoperative complications probability of frame implantation.
The content of the invention
The technical problem to be solved in the present invention is that being withdrawn for the conveyers occurred of EVAR in the prior art causes to prop up
The problem of frame shifts, there is provided it is a kind of to improve the grappling performance of support and vascular wall, and strengthen the fixed effect of mount proximal end, can
Solves the ring holder that conveyer after support successfully discharges withdraws difficulty.
The technical solution adopted for the present invention to solve the technical problems is:A kind of ring holder, it is by end to end
The waveform annular support that connecting rod is formed, the connecting rod is by connecting rod near-end, connecting rod main body and connecting rod distal end three
It is grouped into, adjacent two connecting rod near-ends form support crest, and adjacent two connecting rod distal ends form support ripple
Paddy, at least one connecting rod main body are provided with hangnail, and the hangnail is longitudinally disposed along connecting rod;The hangnail is with being connected
Angle α between bar, 0 ° of < α≤70 °.
In described ring holder, preferably described hangnail is longitudinally cutting and outside along connecting rod by connecting rod main body
Turn down the hangnail of the integrative-structure formed.
In described ring holder, preferably described connecting rod main body is provided with the hangnail setting unit for being used for opening up hangnail,
The width of the hangnail setting unit is more than the width of connecting rod main body other parts.
In described ring holder, the hangnail setting unit that is preferably set in two adjacent connecting rods phase in the axial direction
Mutually staggeredly, and the projection of two adjacent hangnail setting units diametrically is not overlapping.
In described ring holder, in the longitudinal direction of the longitudinal centre line of preferably described hangnail and the connecting rod where it
The projection of heart line diametrically overlaps.
In described ring holder, the angle α between preferably described hangnail and connecting rod, 20 °≤α≤70 °.
In described ring holder, preferably described hangnail is arranged at intervals on annular support, sets the company of the hangnail
Extension bar is mutually non-conterminous.
In described ring holder, the preferably all of hangnail and the junction of connecting rod main body are put down positioned at same
On face, and the plane is vertical with the axis of support frame.
In described ring holder, preferably described annular support sets at least two circles;The annular support of wherein one circle
Connecting rod is provided with hangnail;
The support crest of one loop support is connected with the support trough of adjacent another loop support or the two one
Structure;Or passed through between the support crest of the loop support and the support trough of adjacent another loop support
Connecting rod is crossed to link into an integrated entity.
In described ring holder, preferably described support crest or/and support trough are circular arc, the circular arc
Arc length be not less than circumference half.
In described ring holder, preferably described support crest or/and support trough are dish type, the branch of the dish type
Frame crest or/and support trough are provided with the connecting hole for being used for installing suture.
The waveform annular support of the present invention, is that hangnail is provided with connecting rod main body, sets hangnail can in this place
The overall stability of support frame and the fatigue resistance of hangnail are improved, and is being reduced in the prior art in support crest and branch
Set excessive hangnail to cause stimulation of the bare bracket to vascular wall at frame trough, hangnail is set in connecting rod main body, may be such that branch
Hangnail quantity still is able to play preferable anchorage effect in the case of reducing on support, reduces thorn of the bare bracket to vascular wall
Swash, so as to increase the postoperative complications probability of stenter to implant.
Brief description of the drawings
Below in conjunction with drawings and Examples, the invention will be further described, in accompanying drawing:
Fig. 1 is the structural representation of the embodiment of the present invention 1;
Fig. 2 is the expanded view of the ring holder of embodiment 1;
Fig. 3 is the individual pen ring holder peak structure figure of embodiment 1;
Fig. 4 is the individual pen ring holder trough structure chart of embodiment 1;
Fig. 5 is the barb structure figure of embodiment 1;
Fig. 6 is branch type overlay film frame figure of the embodiment 1 with hangnail ring holder;
Fig. 7 is the aspect graph after branch type overlay film frame implantable intravascular of the embodiment 1 with hangnail ring holder;
Fig. 8 is partial enlarged drawing at I in Fig. 7;
Fig. 9 is thoracic aorta covered bracket figure of the overlay film first lap of embodiment 2 with hangnail ring holder;
Figure 10 is the structural representation of the ring holder of embodiment 3;
Figure 11 is the expanded view of the ring holder of embodiment 3;
Figure 12 is the structural representation of the ring holder of embodiment 4;
Figure 13 is the expanded view of the ring holder of embodiment 4;
Figure 14 is the structural representation of the ring holder of embodiment 5.
Embodiment
In order to which technical characteristic, purpose and the effect of the present invention is more clearly understood, now compares accompanying drawing and describe in detail
The embodiment of the present invention.
Bearing definition:Proximal part refers to stenter to implant blood vessel after-poppet close to one end of heart, and distal end is away from the heart
Dirty one end.The axis direction of axial finger ring shape support frame, the direction vertical with axis is radially.
As shown in figures 1-8, a kind of ring holder, it is the waveform ring-type branch formed by end to end connecting rod 102
Frame, the connecting rod 102 is made up of connecting rod near-end, connecting rod main body and connecting rod distal end three parts, described in adjacent two
Connecting rod near-end forms support crest 103, and adjacent two connecting rod distal ends form support trough 104, at least one company
Extension bar main body is provided with hangnail 101, and the hangnail 101 is longitudinally disposed along connecting rod 102;The hangnail 101 and connecting rod 102
Between angle α, 0 ° of < α≤70 °.
It is the expanded view of ring holder as shown in Figure 2, in the present embodiment, ring holder expansion is in wavy, by 5
Individual V-type unit 102A joins end to end to be formed, and each V-type unit 102A includes two connecting rods 102, and two connecting rods 102 are connected
Place forms support crest 103 or support trough 104, general one end for set close heart after ring holder implantation human body as
Support crest 103, the one end for being relatively distant from heart are support trough 104.The support crest of ring holder in the present embodiment
103 quantity is 5, and the quantity of support trough 104 is 5, and the quantity of connecting rod 102 is 10, and all connecting rods 102 are wide
Spend identical, the width dimensions scope of connecting rod 102 is 0.5mm~0.8mm, preferably 0.55mm, two neighboring connecting rod 102
Angular range is 30 °~90 °, preferably 60 °, vertical range between support crest 103 and support trough 104 for 10mm~
20mm, preferably 18mm.
Structure at support crest 103, support trough 104 has a numerous embodiments, and one kind is open architecture, Yi Zhongshi
Closed loop configuration.It is illustrated in figure 3 open architecture, the support crest 103 or/and support trough 104 are circular arc, the circle
The arc length of arc is not less than the half of circumference, and the arc length of circular arc is long so that whole support crest 103 or/and support
The outer rim of trough 104 is all circular arc, reduces the probability for puncturing blood vessel.This shape can be only in support crest 103 or support ripple
Paddy 104 is set, and can also all be set at two.The support crest 103 of arc-shaped, support trough 104 are circular arc at least in outer rim
Shape so that support crest 103, support trough 104 do not have sharp point, do not stab blood vessel.Circular arc is centrally formed half
The groove 103A of structure is surrounded, groove 103A is used to install suture, and groove 103A shape does not limit, and can be arbitrary shape,
It is preferred that semicircle, arc.And support crest 103, the support trough 104 of arc-shaped, which can be widened, thickeies two connecting rods 102
Junction, be more beneficial for inserting.Support crest 103, the width of support trough 104 are 0.5mm~0.8mm, preferably 0.8mm, groove
103A inner ring radius is 0.5mm~1.0mm, preferably 0.8mm.
It is illustrated in figure 4 support crest 103, the closed loop configuration of support trough 104, the support crest 103 or/and branch
Frame trough 104 is dish type, and the support crest 103 or/and support trough 104 of the dish type, which are provided with, to be used to install suture
Connecting hole 105.Disk-shaped top is in arc-shaped, avoids sharply stabbing blood vessel.In support crest 103 or/and support trough 104
Between be provided with connecting hole 105, the shape of connecting hole 105 can select circular, ellipse or slit shape, the present embodiment to select circular hole,
The Circularhole diameter scope is 0.8mm~1.5mm, preferably 1.0mm.Support crest 103, the broad-ruler of support trough 104 of dish type
Very little scope is 1.5mm~2.2mm, preferably 2.0mm, and the support crest 103 of dish type, the altitude range of support trough 104 are 2mm
~2.5mm, preferably 2.5mm, the arc radius size range of disk-shaped top is 0.8mm~1.2mm, preferably 1.0mm.
As shown in figure 5, the connecting rod main body is provided with hangnail 101, the hangnail 101 is preferably by connecting rod main body
Suitable connecting rod 102 is longitudinally cutting and outwards turns down the hangnail 101 of the integrative-structure of formation, by the Nitinol that wall thickness is 0.3mm
Pipe cuts sizing by laser cutting parameter and heat setting process and formed.In addition to integrative-structure, hangnail 101 can also be directly
It is welded in connecting rod main body.
The connecting rod main body is provided with the hangnail setting unit 106 for being used for opening up hangnail 101.The work of hangnail setting unit 106
With being to be used to set hangnail 101, the hangnail 101 in the present invention is directly cut by the hangnail setting unit 106 in connecting rod main body
The integrative-structure of formation, the width of the hangnail setting unit 106 are more than the width of connecting rod main body other parts, are advantageous to down
Thorn 101 opens up, and does not reduce the intensity of the connecting rod 102, can effectively prevent hangnail from discharging and withdrawing in support
It is broken in journey, and improves the pulsating fatigue life-span in hangnail region, the usage time of extending bracket.Because hangnail 101 is cutting
Formed, hangnail 101 forms hangnail in hangnail setting unit 106 after turning down and opens up hole 107, as shown in figure 5, hangnail 101 wraps
Include the hangnail initiating terminal 101A, hangnail main paragraph 101B, hangnail top 101C with the integrative-structure of hangnail setting unit 106.
The projection weight of the longitudinal centre line of hangnail 101 and the longitudinal centre line of the connecting rod 102 where it diametrically
Close so that hangnail 101 is set along the direction of connecting rod 102.Hangnail 101, can be in income sheath, extension along the longitudinal direction of connecting rod 102
Deng during, do not disturbed with adjacent connecting rod 102 or hangnail 101, avoiding being stuck to operate, and this set is non-
It is often convenient to be pierced into blood vessel, play support and positioning action.Angle α between the hangnail 101 and connecting rod 102, preferably 20 °
≤α≤70°.The opening direction of hangnail 101 is towards the direction of support trough 104, and the angular range α of hangnail 101 and connecting rod 102 is more
Preferably 30 °~60 °, most preferably 30 °.The width dimensions scope of hangnail 101 is 0.2mm~0.3mm, preferably 0.2mm, hangnail
101 length dimension scopes are 2mm~3mm, preferably 2.5mm.The width dimensions scope of hangnail setting unit 106 is 0.9mm~1.4mm,
It is preferred that 0.9mm, the length dimension scope of hangnail setting unit 106 is 5mm~8mm, preferably 5mm.
As shown in fig. 6, ring holder 100 is connected with branch type overlay film frame 130 by the technique of suture, annular branch
Support 100 is connected to the initiating terminal of branch type overlay film frame 130, and the stitch points of ring holder 100 are located at ring holder
At connecting hole 105 on 100 support trough 104.Five connecting holes 105 are uniformly sewn to rising for branch type overlay film frame 130
Top, and connecting hole 105 is located in same level.The trough section of ring holder 100 and branch type overlay film frame 130
Overlapping dimension scope is 3mm~4mm.
As shown in Figure 7,8, after the branch type overlay film frame 130 with ring holder 100 is implanted into human vas 170, annular
Hangnail 101 on support frame 100 is anchored on vascular wall 171, improves the anchoring properties of branch type overlay film frame 130.
Embodiment 2, it is the Application Example of ring holder 100 of the present invention as shown in Figure 9.Aorta pectoralis overlay film in figure
Support 200 includes the bare bracket 210 without hangnail, and the first lap of overlay film main body proximal part is the ring holder of the present invention
100, in addition to it is arranged in other ring holders 230 of the middle part of straight tube-like woven dacron 240 or distal end.Ring holder 100,
220th, 230 it is sewn to by suture 260 on straight tube-like woven dacron 240.Straight tube-like woven dacron 240 is as ring holder
100th, 220,230 suture carrier, surfacing, thickness are about 0.01mm~0.10mm, preferably 0.01mm.
Bare bracket 210 is located at the proximal part of straight tube-like woven dacron 240, and ring holder 100 encloses for independent one, by NiTi
The corrugated circumferential support frame 100 that B alloy wire is made by weaving thermal finalization, nitinol alloy wire string diameter scope are
0.4mm~0.5mm, preferably 0.5mm, wave-height range are 10mm~15mm, preferably 12mm, and the distal end of ring holder 210 passes through
Suture links together with tubulose woven dacron 240, and the overlap distance with the ring-like proximal part of support frame 100 is about 3mm~5mm, ring
The selection of shape support frame 230, structure are identical with bare bracket 210, and difference is that ring holder 230,240 waveforms are more,
Arrangement position is different.
As shown in figure 9, for ring holder 100 of the first lap with hangnail 101, positioned at chest active arteria covering membrane supporter
Near-end position 200A, it is that the vertical range between crest and trough is smaller with the difference of ring holder 100 in embodiment 1,
Size range is 10mm~12mm, preferably 10mm.Ring holder 100 with hangnail 101 is washed by sewing process and straight tube-like
Synthetic fibre cloth 240 is stitched together.Distal end 200B of the opening direction of hangnail 101 towards thoracic aorta covered bracket 200.
Embodiment 3, the present embodiment are the improvement carried out on the basis of embodiment 1.
As shown in figs. 10-11, the ring holder structure of the present embodiment is substantially the same manner as Example 1, and distinctive points are:Two
The axis of hangnail setting unit 106 set in individual adjacent connecting rod 102 is interlaced upwards, and two adjacent hangnail setting units
106 projection diametrically is not overlapping, and the projection of hangnail 101 diametrically is not also overlapping.Radially projecting is directed to annular brace
Projection on the axis of frame 100, adjacent two hangnail setting units 106, adjacent two throwings of the hangnail 101 on axis
Shadow is not overlapping.So cause hangnail setting unit 106 not in the same plane vertical with axis, and adjacent two are fallen
Thorn 101 is axially upper staggered, and two neighboring hangnail setting unit 106 is in when pressure holds state without coincidence in ring holder,
The support is easy into sheath and release.
Remaining structure will not be repeated here with embodiment 1.
Embodiment 4, as illustrated by figs. 12-13, the ring holder of the present embodiment is two coil structures.I.e. described annular support
At least two circles are set;The connecting rod 102 of the annular support 300 of wherein one circle is provided with hangnail 101, another loop support 400
On without hangnail 101.The support trough 104 of the support crest 103 of one loop support 300 and adjacent another loop support 400
It is connected or the two integrative-structure;Or the support crest 103 of the loop support 300 and adjacent another loop branch
Linked into an integrated entity between the support trough 104 of frame 400 by transition connecting rod 102.
As illustrated by figs. 12-13, in the present embodiment, support crest 103 and the branch of the annular support 300,400 of two adjacent rings
Frame trough 104 is fixedly connected or the two integrative-structure.The support crest 103 and support trough 104 to link together forms transition
Area 401.The annular support waveform of this two circles of structure is essentially identical, and waveform is also synchronous.It is fixedly connected with the side using welding
Formula, and integrative-structure is by a tubulose excision forming.
The annular support of two circles can be different with waveform, and position can also interlock.The annular support of this structure can lead to
Transition connecting rod connects.The support crest 103 of i.e. one ring holder 400 and the support trough of ring holder 300
Transition connecting rod is provided between 104.The structure of annular support will not be repeated here with annular support frame structure in embodiment 1.
Embodiment 5, as shown in figure 14, the present embodiment is also include two loop supports with the identical of embodiment 4, be
Ring holder 400 underlying second with hangnail 101 encloses.The direction of hangnail 101 is directed towards distal end.Remaining knot
Structure will not be repeated here with embodiment 4.
Claims (11)
- The corrugated annular support formed by end to end connecting rod 1. a kind of ring holder, the connecting rod by Connecting rod near-end, connecting rod main body and connecting rod distal end three parts composition, adjacent two connecting rod near-ends form support Crest, adjacent two connecting rod distal ends form support trough, it is characterised in that at least one connecting rod main body is provided with Hangnail, the hangnail are longitudinally disposed along connecting rod;Angle α between the hangnail and connecting rod, 0 ° of < α≤70 °.
- 2. ring holder according to claim 1, it is characterised in that the hangnail is along connecting rod by connecting rod main body The hangnail of integrative-structure that is longitudinally cutting and outwards turning down formation.
- 3. ring holder according to claim 1, it is characterised in that the connecting rod main body, which is provided with, to be used to open up down The hangnail setting unit of thorn, the width of the hangnail setting unit are more than the width of connecting rod main body other parts.
- 4. ring holder according to claim 3, it is characterised in that the hangnail set in two adjacent connecting rods is set Put that portion is interlaced in the axial direction, and the projection of two adjacent hangnail setting units diametrically is not overlapping.
- 5. ring holder according to claim 1, it is characterised in that the longitudinal centre line of the hangnail with its where The projection of the longitudinal centre line of connecting rod diametrically overlaps.
- 6. ring holder according to claim 1, it is characterised in that the angle α between the hangnail and connecting rod, 20°≤α≤70°。
- 7. ring holder according to claim 1, it is characterised in that the hangnail is arranged at intervals on annular support, Set the connecting rod of the hangnail mutually non-conterminous.
- 8. ring holder according to claim 1, it is characterised in that all hangnails and the company of connecting rod main body It is in the same plane to meet place, and the plane is vertical with the axis of support frame.
- 9. ring holder according to claim 1, it is characterised in that the annular support sets at least two circles;Wherein The connecting rod of the annular support of one circle is provided with hangnail;The support crest of one loop support is connected with the support trough of adjacent another loop support or the two integrative-structure; Or connected between the support crest of the loop support and the support trough of adjacent another loop support by transition Bar links into an integrated entity.
- 10. according to the ring holder described in claim 1-9 any one, it is characterised in that the support crest or/and branch Frame trough is circular arc, and the arc length of the circular arc is not less than the half of circumference.
- 11. according to the ring holder described in claim 1-9 any one, it is characterised in that the support crest or/and branch Frame trough is dish type, and the support crest or/and support trough of the dish type are provided with the connecting hole for being used for installing suture.
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CN201710544054.8A CN107569311A (en) | 2017-07-05 | 2017-07-05 | Ring holder |
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CN201710544054.8A CN107569311A (en) | 2017-07-05 | 2017-07-05 | Ring holder |
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Cited By (7)
Publication number | Priority date | Publication date | Assignee | Title |
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WO2020108548A1 (en) * | 2018-11-28 | 2020-06-04 | 杭州唯强医疗科技有限公司 | Developing mechanism for facilitating fixation and vascular stent thereof |
CN112773585A (en) * | 2020-12-30 | 2021-05-11 | 杭州唯强医疗科技有限公司 | Implant stent |
CN112773584A (en) * | 2020-12-30 | 2021-05-11 | 杭州唯强医疗科技有限公司 | Implant stent |
CN113876467A (en) * | 2021-12-08 | 2022-01-04 | 上海微创心脉医疗科技(集团)股份有限公司 | Covered stent |
WO2022057252A1 (en) * | 2020-09-15 | 2022-03-24 | 深圳市健心医疗科技有限公司 | Implant |
CN114587728A (en) * | 2022-04-06 | 2022-06-07 | 江苏理工学院 | Circular blood vessel support |
WO2022267888A1 (en) * | 2021-06-22 | 2022-12-29 | 微创神通医疗科技(上海)有限公司 | Stent and medicine carrying stent |
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