CN107638230B

CN107638230B - Novel split type intracranial covered stent system and use method thereof

Info

Publication number: CN107638230B
Application number: CN201711088212.XA
Authority: CN
Inventors: 管生; �田�浩; 刘过; 徐浩文; 郭新宾; 闫保君
Original assignee: Individual
Current assignee: Individual
Priority date: 2017-11-08
Filing date: 2017-11-08
Publication date: 2020-07-03
Anticipated expiration: 2037-11-08
Also published as: CN107638230A

Abstract

The invention discloses a novel split type intracranial tectorial membrane stent system, which comprises a self-expanding stent system, a conveying catheter and a membrane barrel structure system which is of an independent structure and is provided with an electrolytic lengthening pushing rod; the membrane barrel structure system comprises a plurality of X-ray visible alloy metal wires arranged between support rings at two ends and two support rings, and a frame structure formed by the two support rings and the plurality of alloy metal wires is wholly wrapped or lined with a membrane. The invention ensures the safe implementation of the ideal treatment mode of the self-expanding local tectorial membrane stent in clinic; the device can realize instant and lasting effective plugging on part of intracranial aneurysm, and avoids the defects of dense mesh support and traditional naked support auxiliary spring ring embolism; because the invention adopts the self-expanding bracket system to support the membrane barrel structure, the compliance and the adherence of the invention have more obvious advantages than the prior spherical-expansion laser engraving type full-covered bracket, the serious defects of the latter are overcome, and the invention is helpful for improving the clinical safety and the disease cure rate.

Description

Novel split type intracranial covered stent system and use method thereof

Technical Field

The invention relates to a novel split type intracranial covered stent system and a using method thereof.

Background

For intracranial large aneurysms, particularly for intracranial ruptured and unbroken aneurysms with ejection characteristics of tumor necks visible by contrast of large-sac narrow necks at the upper section of a bed protrusion of an internal carotid artery, conventional treatment at present comprises a dense-mesh stent which has a high recurrence rate, the existing unique willis covered stent is a spherical expansion type laser carving stent external suture membrane, the stent is often difficult to conform to intracranial tortuous vessels, and finally, the surgical operation risk is increased due to the occurrence of proximal internal fistula due to poor antegrade and poor adherence, and even serious complications are caused.

The principle of treating intracranial aneurysm by using covered stent is that a stent with biological-physical barrier is placed in a parent artery, under the condition of keeping the parent artery unobstructed, the aneurysm is isolated and thrombus is formed in the parent artery, so that the purpose of curing lesion is achieved, and the covered stent has great advantages in the treatment of wide neck, huge, interlayer or false aneurysm without adjacent important branch vessels.

The blood flow guiding device is a dense-mesh stent with low mesh rate and high metal coverage rate and has the hemodynamics and biological effects, the stent has the following problems of ① stent delivery difficulty, stent displacement after release, unpredictable stent shortening and the like, ② aneurysm delayed rupture that the exact reason of the delayed rupture is not completely clear and can not realize immediate effective blocking with the opening of the aneurysm neck, ③ aneurysm-carrying arterial thrombosis or transfixion occlusion that collateral or transfixion occlusion easily occurs when a plurality of stents are placed, possibly causing serious complications, ④ aneurysm rupture or aneurysm recurrence risk that the aneurysm in the aneurysm stent is gradually ruptured in the aneurysm sac after the placement, the aneurysm in the aneurysm sac gradually becomes worse after a certain period of operation, and the symptoms of the aneurysm are not likely to recur even though the aneurysm is developed and the whole aneurysm is likely to recur after the development.

Disclosure of Invention

The invention aims to overcome the defects of the existing laser engraving ball expanding type covered stent technology and provide a feasible solution.

In order to solve the technical problems, the invention provides the following technical scheme:

one aspect of the invention discloses a novel split type intracranial tectorial membrane stent system, which comprises a stent system, a delivery catheter and a separately structured membrane barrel structure system with an electrolytically deplencing push rod; the membrane barrel structure system comprises support rings at two ends and a plurality of X-ray visible alloy metal wires between the two support rings, and the structure formed by the two support rings and the plurality of alloy metal wires is integrally wrapped or lined with a membrane.

Further, the membrane is a polytetrafluoroethylene membrane.

Further, the stent system is a self-expanding stent.

The invention also discloses a use method of the novel split type intracranial covered stent system, which comprises the following steps:

s1, introducing and positioning a membrane barrel structure: firstly, guiding a conveying catheter to the far end of a tumor neck by matching a guide catheter with a micro guide wire, placing the head end of the conveying catheter in a tumor-carrying artery at the far end of the tumor neck, withdrawing the micro guide wire, and pushing a membrane barrel structure to the far end of the conveying catheter by the conveying catheter and completely crossing the tumor neck;

s2, releasing the membrane barrel structure: the fixed push rod withdraws the conveying conduit to ensure that the membrane barrel structure is expanded in the distal parent artery cavity of the neck of the tumor, and the fixed push rod withdraws from the conveying conduit;

s3, introducing the same or other slightly thinner delivery catheter from the expanded stent delivery catheter and the membrane bucket: passing the self-expanding stent delivery catheter through the membrane barrel structure under the cooperation of the micro guide wire through the guide catheter, and placing the head end of the delivery catheter at the far end of the membrane barrel structure;

s4, positioning the membrane barrel structure, namely withdrawing the membrane barrel structure along the self-expanding stent conveying catheter under the path diagram to just cross the tumor neck opening and contrast to confirm, withdrawing the micro guide wire, and pushing the self-expanding stent to the target lesion part through the conveying catheter to cross the tumor neck opening and two ends of the membrane barrel structure;

s5, self-expanding stent release: fixing a membrane barrel structure push rod and a self-expanding stent vertebral area, then withdrawing most of the conveying conduit to release the self-expanding stent, and enabling the effective length of the far end of the self-expanding stent to completely support the fixed membrane barrel structure;

s6, reviewing contrast to evaluate the blocking effect, if the aneurysm near end has inner leakage or bad sticking of the stent film barrel, recovering the self-expanding stent, finely adjusting the position of the film barrel structure, then releasing the self-expanding stent until the neck of the aneurysm is blocked satisfactorily, and electrolyzing the film barrel structure;

s7, withdrawing the push rod and the delivery catheter to complete the cerebral angiography.

The invention has the following beneficial effects:

the invention ensures the safe implementation of the ideal treatment mode of the self-expanding local tectorial membrane stent in clinic; the rapid and durable effective plugging can be realized for partial intracranial aneurysm, and the defects of a dense mesh support are avoided; because the invention adopts the self-expanding stent system to support the membrane barrel structure, the compliance and the adherence of the invention have more obvious advantages than the prior spherical-expansion laser engraving type covered stent, the serious defects of the former are overcome, and the invention is helpful to improve the clinical safety and the disease cure rate. For intracranial large aneurysm, especially intracranial rupture and non-rupture aneurysm with ejection sign of large-sac narrow neck contrast on the upper segment of the internal carotid bed process, and large aneurysm with relatively tortuous blood vessel, the invention can solve the problems of poor antegrade performance, poor adherence and high recurrence rate of the covered stent, reduce the operation risk and recurrence rate, and improve the operation success rate and safety.

Drawings

The accompanying drawings, which are included to provide a further understanding of the invention and are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and together with the description serve to explain the principles of the invention and not to limit the invention. In the drawings:

FIG. 1 is a schematic diagram of a membrane cartridge configuration;

FIG. 2 is a schematic view of a delivery device;

FIG. 3 is a schematic illustration of the membrane cartridge structure and self-expanding scaffold after assembly and release;

fig. 4 is a schematic view of the flow structure of the present invention.

Detailed Description

The preferred embodiments of the present invention will be described in conjunction with the accompanying drawings, and it will be understood that they are described herein for the purpose of illustration and explanation and not limitation.

As shown in fig. 1 to 3, a novel split type intracranial tectorial stent system comprises a stent system 1, a delivery catheter 2 and a separately structured membrane barrel structure system 4 with an electrolytically detachable long pushing rod 5; the membrane bucket structure system 4 comprises support rings 401 arranged at two ends, a plurality of X-ray visible alloy metal wires 402 between the two support rings 401, and a structure formed by the two support rings 401 and the four alloy metal wires 402 is integrally wrapped or lined with a membrane 403.

In this example, the membrane is a polytetrafluoroethylene membrane. The stent system is a self-expanding stent.

As shown in FIG. 4, another aspect of the present invention discloses a method for using a novel split type intracranial covered stent system, which comprises the following steps:

s3, drawing up a self-expanding stent delivery catheter (same as the membrane bucket structure delivery catheter or other slightly thinner delivery catheter): passing the self-expanding stent delivery catheter through the membrane barrel structure under the cooperation of the micro guide wire through the guide catheter, and placing the head end of the delivery catheter at the far end of the membrane barrel structure;

s4, positioning the membrane barrel structure, namely withdrawing the membrane barrel structure along the self-expanding stent conveying catheter and the micro guide wire under the path diagram to enable the membrane barrel structure to just cross the tumor neck opening and to be confirmed by radiography, withdrawing the micro guide wire, and pushing the self-expanding stent to the target lesion part through the conveying catheter to cross the tumor neck opening and two ends of the membrane barrel structure;

s5, self-expanding stent release: fixing a membrane barrel structure pushing rod and a self-expanding stent pushing rod, then withdrawing most of the conveying conduit to release the self-expanding stent, so that the effective length of the far end of the self-expanding stent completely supports the fixed membrane barrel structure;

Finally, it should be noted that: although the present invention has been described in detail with reference to the foregoing embodiments, it will be apparent to those skilled in the art that changes may be made in the embodiments and/or equivalents thereof without departing from the spirit and scope of the invention. Any modification, equivalent replacement, or improvement made within the spirit and principle of the present invention should be included in the protection scope of the present invention.

Claims

1. A novel split type intracranial tectorial membrane stent system is characterized by comprising a membrane barrel structure system which is of a single structure and is provided with an electrolytic prolapsing push rod, a self-expanding naked stent system, a delivery catheter and a guide wire for delivering the self-expanding naked stent system; the membrane barrel structure system comprises support rings arranged at two ends and a plurality of X-ray visible alloy metal wires between the two support rings; the effective length of the far end of the self-expanding naked support completely supports and fixes the membrane barrel structure; the membrane bucket structure is configured to be sleeved outside the self-expanding stent.

2. The novel split intracranial covered stent system as defined in claim 1, wherein the membrane in the membrane barrel structure is a polytetrafluoroethylene membrane.

3. The novel split intracranial covered stent system as defined in claim 1, wherein the bare stent is a self-expandable stent, and the self-expandable bare stent is configured to span both ends of the stent barrel structure after release.