CN108095857A - 一种用于分叉处血管病变的可降解支架系统 - Google Patents

一种用于分叉处血管病变的可降解支架系统 Download PDF

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CN108095857A
CN108095857A CN201711366202.8A CN201711366202A CN108095857A CN 108095857 A CN108095857 A CN 108095857A CN 201711366202 A CN201711366202 A CN 201711366202A CN 108095857 A CN108095857 A CN 108095857A
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sacculus
branch
biodegradable stent
crotch
expanding part
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祁勇翔
罗雷
霍勇
聂芳芳
唐乃杰
缪永生
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Shanghai Pulse Medical Equipment Co Ltd
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Shanghai Pulse Medical Equipment Co Ltd
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/04Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06Blood vessels
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • A61F2/915Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/954Instruments specially adapted for placement or removal of stents or stent-grafts for placing stents or stent-grafts in a bifurcation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/958Inflatable balloons for placing stents or stent-grafts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/04Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06Blood vessels
    • A61F2002/061Blood vessels provided with means for allowing access to secondary lumens
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/04Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06Blood vessels
    • A61F2002/065Y-shaped blood vessels
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • A61F2/915Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
    • A61F2002/9155Adjacent bands being connected to each other
    • A61F2002/91558Adjacent bands being connected to each other connected peak to peak
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • A61F2/915Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
    • A61F2002/9155Adjacent bands being connected to each other
    • A61F2002/91575Adjacent bands being connected to each other connected peak to trough

Abstract

本发明公开了一种用于分叉处血管病变的可降解支架系统,包括可降解支架和异形球囊,可降解支架包括主体支撑部以及设于主体支撑部、能够锚定并贴紧于主干血管与分支血管的连接处的开口外扩部;异形球囊包括:沿主干血管延伸、且设于主体支撑部内侧、用以支撑主体支撑部外扩以实现主体支撑部贴紧主干血管的球囊主干部;与球囊主干部相连、且设于开口外扩部内侧的球囊分支部;球囊分支部沿分支血管延伸,且能够支撑开口外扩部外扩。上述可降解支架系统,通过开口外扩部发生塑性变形,紧贴分支血管壁,避免了网孔结构对分支血管处血流的阻碍,避免了长期血流冲击下的支架移位,起到复杂病变下的支架姿态矫正作用,提高了手术过程中支架定位的准确性。

Description

一种用于分叉处血管病变的可降解支架系统
技术领域
本发明涉及医疗器械技术领域,特别涉及一种用于分叉处血管病变的可降解支架系统。
背景技术
心脑血管疾病已经成为全世界第一大死因。目前,针对缺血性心脏病的治疗方法主要有三种:使用药物的基础治疗、进行冠脉搭桥的手术治疗、通过置入冠脉支架等从而解除冠脉狭窄的介入治疗。上述几种治疗方法在治疗冠状动脉狭窄方面都取得了明显的效果,但各自仍存在一些显著的问题。
其中,冠脉支架植入术是将支架系统通过穿刺介入的方式输送到目标区域,球囊扩张释放支架,撑开狭窄病变血管,恢复血供,治疗缺血性心脏病。目前临床上使用的支架主要分为金属支架和可降解支架。金属支架可以强力撑开病变血管,缓解症状,但其永久植入人体,需要长期服用双抗和抗免疫药物,患者机体和经济负担较重。同时,金属支架长期的通畅率较低,远期需要进一步的治疗。可降解支架植入人体后,能撑开病变血管,并通过内皮细胞生长包覆支架,支架随后逐渐降解,血管恢复原始解剖学形态,进而远期恢复血管收缩舒张功能。
然而,现有技术中常见的可降解支架主要运用于直段血管,针对分叉病变时,多网孔结构会阻碍分支血管的血流,形成局部湍流,造成分支血管狭窄或闭塞;传统可降解支架随着时间推移,对血管壁的支撑力逐渐降低,在长期血流冲击下会发生迁移;在处理复杂病变时,传统可降解支架的释放位置会出现偏差,影响管腔通畅率。
综上所述,如何有效地解决可降解支架在治疗分叉病变时,阻碍分支血管的血流、长期血流冲击下迁移、复杂病变下释放精确度偏差等问题,是目前本领域技术人员急需解决的问题。
发明内容
本发明的目的是提供一种用于分叉处血管病变的可降解支架系统,可以解决现有可降解支架植入人体后,阻碍分支血管血流、长期血流冲击下可降解支架迁移以及在复杂病变下释放精度偏差较大的问题。
为实现上述目的,本发明提供一种用于分叉处血管病变的可降解支架系统,包括可降解支架和异形球囊,
所述可降解支架包括:
沿主干血管延伸、用以放置于主干血管中的主体支撑部;
设于所述主体支撑部、能够锚定并贴紧于主干血管与分支血管的连接处的开口外扩部;
所述异形球囊包括:
沿主干血管延伸、且设于所述主体支撑部内侧、用以支撑所述主体支撑部外扩以实现所述主体支撑部贴紧主干血管的球囊主干部;
与所述球囊主干部相连、且设于所述开口外扩部内侧的球囊分支部;所述球囊分支部沿分支血管延伸,且能够支撑所述开口外扩部外扩,以实现所述开口外扩部锚定并贴紧于主干血管与分支血管的连接处。
相对于上述背景技术,本发明提供的用于分叉处血管病变的可降解支架系统,采用球囊分支部对开口外扩部进行塑形扩张,避免了多网孔结构对分支血管血流的阻碍;开口外扩部固定在分支血管壁中,起到了锚定的作用,避免了在长期血流冲击下可降解支架的迁移;针对复杂病变扩张时,处于分支血管中的开口外扩部能起到对可降解支架的姿态矫正的作用,提高了释放精确度。
优选地,所述开口外扩部具体为多个均匀分布于所述主体支撑部开口四周的锚定爪。
优选地,所述主体支撑部具体为具有开环孔或闭环孔的柱形网状体。
优选地,所述锚定爪具体呈直杆形、弯曲杆形、三角形或者菱形。
优选地,所述球囊分支部设于所述球囊主干部的近端、中段或者远端。
优选地,所述球囊主干部的近端与远端分别具有用以供主导丝穿过的近端主导丝口和远端主导丝口;所述球囊主干部的近端与所述球囊分支部的远端分别具有用以供分支导丝穿过的近端分支导丝口和远端分支导丝口。
优选地,在压握前,所述球囊分支部依次贯穿所述主体支撑部和所述开口外扩部。
优选地,所述可降解支架由PLA或PCL材质制成;所述异形球囊由尼龙材质制成。
优选地,所述可降解支架为激光切割、编织、3D打印成型,所述异形球囊为吹塑、3D打印成型。
优选地,所述可降解支架和所述异形球囊能够被一体径向压握。
附图说明
为了更清楚地说明本发明实施例或现有技术中的技术方案,下面将对实施例或现有技术描述中所需要使用的附图作简单地介绍,显而易见地,下面描述中的附图仅仅是本发明的实施例,对于本领域普通技术人员来讲,在不付出创造性劳动的前提下,还可以根据提供的附图获得其他的附图。
图1为本发明实施例所提供的用于分叉处血管病变的可降解支架系统的结构示意图;
图2(a)为一种实施方式的可降解支架展开后的示意图;
图2(b)为图2(a)中可降解支架的立体结构示意图;
图2(c)为图2(a)中可降解支架立体结构的另一角度的示意图;
图3(a)为图1中的主体支撑部的第一种具体实施方式的示意图;
图3(b)为图1中的主体支撑部的第二种具体实施方式的示意图;
图3(c)为图1中的主体支撑部的第三种具体实施方式的示意图;
图3(d)为图1中的主体支撑部的第四种具体实施方式的示意图;
图3(e)为图1中的主体支撑部的第五种具体实施方式的示意图;
图3(f)为图1中的主体支撑部的第六种具体实施方式的示意图;
图4(a)为图1中的开口外扩部的第一种具体实施方式的示意图;
图4(b)为图1中的开口外扩部的第二种具体实施方式的示意图;
图4(c)为图1中的开口外扩部的第三种具体实施方式的示意图;
图4(d)为图1中的开口外扩部的第四种具体实施方式的示意图;
图4(e)为图1中的开口外扩部的第五种具体实施方式的示意图;
图5(a)为一种实施方式的异形球囊的总体示意图;
图5(b)为图5(a)中的异形球囊的细节示意图;
图6为图1中的可降解支架系统在压握前的结构示意图;
图7为图1中的可降解支架系统在压握时的结构示意图;
图8为图1中的可降解支架系统在输送中的结构示意图;
图9为图1中的可降解支架系统在释放时的结构示意图。
具体实施方式
下面将结合本发明实施例中的附图,对本发明实施例中的技术方案进行清楚、完整地描述,显然,所描述的实施例仅仅是本发明一部分实施例,而不是全部的实施例。基于本发明中的实施例,本领域普通技术人员在没有做出创造性劳动前提下所获得的所有其他实施例,都属于本发明保护的范围。
为了使本技术领域的技术人员更好地理解本发明方案,下面结合附图和具体实施方式对本发明作进一步的详细说明。
请参考图1至图9,图1为本发明实施例所提供的用于分叉处血管病变的可降解支架系统的结构示意图;图2(a)为一种实施方式的可降解支架展开后的示意图;图2(b)为图2(a)中可降解支架的立体结构示意图;图2(c)为图2(a)中可降解支架立体结构的另一角度的示意图;图3(a)为图1中的主体支撑部的第一种具体实施方式的示意图;图3(b)为图1中的主体支撑部的第二种具体实施方式的示意图;图3(c)为图1中的主体支撑部的第三种具体实施方式的示意图;图3(d)为图1中的主体支撑部的第四种具体实施方式的示意图;图3(e)为图1中的主体支撑部的第五种具体实施方式的示意图;图3(f)为图1中的主体支撑部的第六种具体实施方式的示意图;图4(a)为图1中的开口外扩部的第一种具体实施方式的示意图;图4(b)为图1中的开口外扩部的第二种具体实施方式的示意图;图4(c)为图1中的开口外扩部的第三种具体实施方式的示意图;图4(d)为图1中的开口外扩部的第四种具体实施方式的示意图;图4(e)为图1中的开口外扩部的第五种具体实施方式的示意图;图5(a)为一种实施方式的异形球囊的总体示意图;图5(b)为图5(a)中的异形球囊的细节示意图;图6为图1中的可降解支架系统在压握前的结构示意图;图7为图1中的可降解支架系统在压握时的结构示意图;图8为图1中的可降解支架系统在输送中的结构示意图;图9为图1中的可降解支架系统在释放时的结构示意图。
本发明提供的一种用于分叉处血管病变的可降解支架系统,如附图1所示,主要包括可降解支架1和异形球囊2;其中,可降解支架1包括主体支撑部11和开口外扩部12,异形球囊2包括球囊主干部21和球囊分支部22,可降解支架1可以采用分别采用PLA、PCL、PGA、PLGA、镁合金、铁合金等可降解材质制成,异形球囊2可以采用尼龙等高分子材质制成。
主体支撑部11沿主干血管41延伸,大体呈圆柱网孔状,用于放置在主干血管41中,主体支撑部11的两端分别位于分支血管42的两侧,开口外扩部12设于主体支撑部11,具有外扩的功能,能够锚定于分支血管42和主干血管41的连接处。其中,可降解支架1优选为激光切割成型设置,当然,还可以采用编织、3D打印成型等方式制成。异形球囊2则可以采用诸如吹塑、3D打印等方式制成。
球囊主干部21沿主干血管41延伸,球囊主干部21的两端分别位于分支血管42的两侧,且大体呈圆柱状,能够贴紧于主干血管41的内壁;球囊分支部22与球囊主干部21相连,两者具有一定角度,异形球囊2优选为吹塑成型设置;球囊分支部22沿分支血管42延伸,球囊主干部21和球囊分支部22均能够充压并扩张,当球囊主干部21和球囊分支部22扩张后,球囊主干部21能够带动主体支撑部11扩张,使得主体支撑部11紧贴于主干血管41的内壁;开口外扩部12在异形球囊2的扩张作用下向外延伸,使得开口外扩部12锚定于分支血管42和主干血管41的连接处,如附图9所示。针对上述充压过程,可以采用充入生理盐水或造影剂等液体介质实现。
如此设置,当异形球囊2充压扩张后,开口外扩部12能够实现外扩,发生塑性变形,开口外扩部12整体由主干血管41伸出并外扩锚定于分支血管42的内侧壁,也即,开口外扩部12在异形球囊2充压扩张的作用下发生形变,形变后的立体结构起到了锚定的作用,锚定于分支血管42和主干血管41的连接处,避免在长期血流冲击下发生可降解支架1迁移的现象。
附图2(a)至附图2(c)示出了可降解支架1的结构,主体支撑部11具有主体支撑部近端111、中段112和主体支撑部远端113,结合附图1可知,开口外扩部12位于主体支撑部11的中段112位置,也即位于主体支撑部11的中间位置。
如附图3(a)至附图3(f)所示,主体支撑部11可以为具有开环孔或闭环孔的柱形网状体。也即,主体支撑部11整体呈圆柱网孔状,用以支撑主干血管41,而主体支撑部11的侧壁具有网孔,网孔为开环孔或闭环孔,且形状尺寸可以有多种形式;如此设置,能够实现在异形球囊2充压扩张的作用下主体支撑部11发生外扩,从而确保主体支撑部11紧密贴合于主干血管41的内侧壁;与此同时,主体支撑部11具有较好的径向支撑力和柔顺性,当可降解支架系统植入后具有较高的管腔通畅率。
如附图4(a)至附图4(e)所示,开口外扩部12可以设置为锚定爪,优选将多个锚定爪均匀分布于主体支撑部11的中段112;可以看出,锚定爪可以为直杆形、弯曲杆形、三角形或者菱形;其中,直杆形的长度,弯曲杆形的弯曲曲率、三角形的类型以及菱形的尺寸等均可以根据实际需要而定,本文并不作出具体限定;如此设置,在植入可降解支架系统、充压扩张异形球囊2和可降解支架1时,球囊分支部22外扩,开口外扩部12发生塑性变形,从而避免多网孔结构对分支血管42血流的阻碍;由于开口外扩部12固定在分支血管42的管壁中,因而起到锚定作用,同时避免在长期血流冲击下可降解支架1的迁移;此外,针对复杂病变扩张时,处于分支血管42中的开口外扩部12起到对可降解支架1姿态的矫正作用,进而提高了支架的释放精度。
以附图4(a)至附图4(e)为例,锚定爪的顶部位置,即能够发生外扩的部位,发生塑性变形,贴合于分支血管42内侧壁,而锚定爪的下部位置位于主干血管41中,也即锚定爪整体实现了锚定于分支血管42和主干血管41的连接处的目的。
如附图5(a)至附图5(b)所示,球囊分支部22可以设于球囊主干部21的近端212、中段215或者远端211。附图5(a)与附图5(b)示出了球囊分支部22设于球囊主干部21中段215的情形;球囊主干部21的近端212与远端211即为上文所述的两端,球囊主干部21的近端212与远端211分别位于分支血管42的两侧。
球囊主干部21的近端212与远端211分别具有近端主导丝口214和远端主导丝口213,主导丝31能够贯穿近端主导丝口214和远端主导丝口213,如说明书附图8所示;球囊主干部21的近端212还设有近端分支导丝口224,球囊分支部22的远端221设有远端分支导丝口223,而分支导丝32能够穿过近端分支导丝口224和远端分支导丝口223。
如说明书附图6所示,可降解支架系统压握前,球囊分支部22依次贯穿主体支撑部11和开口外扩部12;且开口外扩部12和主体支撑部11之间的过渡区域与球囊分支部22和球囊主干部21之间的过渡区域相贴合。
如说明书附图7所示,在压握时,主体支撑部11、开口外扩部12、球囊主干部21和球囊分支部22均被径向压握。在压握时,对可降解支架系统施加径向向内位移,对异形球囊2抽真空负压,确保较小的系统轮廓直径。
参考说明书附图5(b)和附图8可知,在输送可降解支架系统时,主导丝31和分支导丝32分别被输送到目标的主干血管41和分支血管42中。其中,主导丝31和分支导丝32不动,远端主导丝口213为主导丝31入口,远端分支导丝口223为分支导丝32入口,前推可降解支架输送系统,近端主导丝口214为主导丝31出口,近端分支导丝口224为分支导丝32出口。当输送完成时,确保主体支撑部11和球囊主干部21位于目标的主干血管41中,球囊分支部22和开口外扩部12的至少一部分位于目标的分支血管42中。
参考附图9,在可降解支架系统中,释放时,对异形球囊2进行充压扩张,可降解支架1受扩并支撑起血管,其中主体支撑部11紧贴主干血管41,开口外扩部12受到异形球囊2的扩张作用,发生塑性变形,锚定并紧贴在主干血管41与分支血管42的连接处。
当释放完成后,先撤回异形球囊1,后撤回主导丝31和分支导丝32,可降解支架1支撑起病变血管,保持血流通畅。当新生内膜化完成后,可降解支架1在人体内逐渐降解消失,血管恢复原始解剖学形态,重新实现脉搏压下收缩舒张的功能。
综上,在本发明所提供的用于分叉血管病变的可降解支架系统中,可降解支架系统包括:可降解支架1和异形球囊2,可降解支架1包括主体支撑部11和开口外扩部12,全部开口外扩部12与主体支撑部11相连,异形球囊2包括球囊主干部21和球囊分支部22,全部球囊主干部21和球囊分支部22相连,全部可降解支架1和异形球囊2通过径向压握相结合。
本申请的技术方案通过对可降解支架系统的结构和使用方法设计,采用异形球囊2对可降解支架1进行扩张,球囊分支部22会同时造成开口外扩部12发生塑形变形,避免了对分支血管42中血流的阻碍;开口外扩部12固定在分支血管42中,起到了锚定的作用,避免在长期血流冲击下可降解支架1的迁移;针对复杂病变扩张时,处于分支血管42的开口外扩部12还起到了对可降解支架1姿态矫正的作用,提高了释放精确度。
需要说明的是,在本说明书中,诸如第一和第二之类的关系术语仅仅用来将一个实体与另外几个实体区分开来,而不一定要求或者暗示这些实体之间存在任何这种实际的关系或者顺序。
以上对本发明所提供的用于分叉处血管病变的可降解支架系统进行了详细介绍。本文中应用了具体个例对本发明的原理及实施方式进行了阐述,以上实施例的说明只是用于帮助理解本发明的方法及其核心思想。应当指出,对于本技术领域的普通技术人员来说,在不脱离本发明原理的前提下,还可以对本发明进行若干改进和修饰,这些改进和修饰也落入本发明权利要求的保护范围内。

Claims (10)

1.一种用于分叉处血管病变的可降解支架系统,包括可降解支架(1)和异形球囊(2),其特征在于,
所述可降解支架(1)包括:
沿主干血管(41)延伸、用以放置于主干血管(41)中的主体支撑部(11);
设于所述主体支撑部(11)、能够锚定并贴紧于主干血管(41)与分支血管(42)的连接处的开口外扩部(12);
所述异形球囊(2)包括:
沿主干血管(41)延伸、且设于所述主体支撑部(11)内侧、用以支撑所述主体支撑部(11)外扩以实现所述主体支撑部(11)贴紧主干血管(41)的球囊主干部(21);
与所述球囊主干部(21)相连、且设于所述开口外扩部(12)内侧的球囊分支部(22);所述球囊分支部(22)沿分支血管(42)延伸,且能够支撑所述开口外扩部(12)外扩,以实现所述开口外扩部(12)锚定并贴紧于主干血管(41)与分支血管(42)的连接处。
2.根据权利要求1所述的用于分叉处血管病变的可降解支架系统,其特征在于,所述开口外扩部(12)具体为多个均匀分布于所述主体支撑部(11)开口四周的锚定爪。
3.根据权利要求2所述的用于分叉处血管病变的可降解支架系统,其特征在于,所述主体支撑部(11)具体为具有开环孔或闭环孔的柱形网状体。
4.根据权利要求2所述的用于分叉处血管病变的可降解支架系统,其特征在于,所述锚定爪具体呈直杆形、弯曲杆形、三角形或者菱形。
5.根据权利要求1所述的用于分叉处血管病变的可降解支架系统,其特征在于,所述球囊分支部(22)设于所述球囊主干部(21)的近端、中段或者远端。
6.根据权利要求5所述的用于分叉处血管病变的可降解支架系统,其特征在于,所述球囊主干部(21)的近端与远端分别具有用以供主导丝(31)穿过的近端主导丝口(214)和远端主导丝口(213);所述球囊主干部(21)的近端与所述球囊分支部(22)的远端分别具有用以供分支导丝(32)穿过的近端分支导丝口(224)和远端分支导丝口(223)。
7.根据权利要求1~6任意一项所述的用于分叉处血管病变的可降解支架系统,其特征在于,在压握前,所述球囊分支部(22)依次贯穿所述主体支撑部(11)和所述开口外扩部(12)。
8.根据权利要求7所述的用于分叉处血管病变的可降解支架系统,其特征在于,所述可降解支架(1)由PLA或PCL材质制成,所述异形球囊(2)由尼龙材质制成。
9.根据权利要求8所述的用于分叉处血管病变的可降解支架系统,其特征在于,所述可降解支架(1)为激光切割、编织、3D打印成型,所述异形球囊(2)为吹塑、3D打印成型。
10.根据权利要求9所述的用于分叉处血管病变的可降解支架系统,其特征在于,所述可降解支架(1)和所述异形球囊(2)能够被一体径向压握。
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Application publication date: 20180601