CN108210134B - Vascular stent - Google Patents
Vascular stent Download PDFInfo
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- CN108210134B CN108210134B CN201810161805.2A CN201810161805A CN108210134B CN 108210134 B CN108210134 B CN 108210134B CN 201810161805 A CN201810161805 A CN 201810161805A CN 108210134 B CN108210134 B CN 108210134B
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- vascular stent
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- 230000002792 vascular Effects 0.000 title claims abstract description 62
- 206010002329 Aneurysm Diseases 0.000 claims abstract description 37
- 210000004204 blood vessel Anatomy 0.000 claims abstract description 15
- 238000002513 implantation Methods 0.000 claims abstract description 5
- 238000000034 method Methods 0.000 claims description 11
- 230000004323 axial length Effects 0.000 claims description 4
- 230000008859 change Effects 0.000 claims description 4
- 206010028980 Neoplasm Diseases 0.000 claims description 3
- 238000010146 3D printing Methods 0.000 claims description 2
- 238000009954 braiding Methods 0.000 claims description 2
- 239000003814 drug Substances 0.000 claims description 2
- 229940079593 drug Drugs 0.000 claims description 2
- 238000010147 laser engraving Methods 0.000 claims description 2
- 239000000463 material Substances 0.000 claims description 2
- 229910052751 metal Inorganic materials 0.000 claims description 2
- 239000002184 metal Substances 0.000 claims description 2
- 229910052755 nonmetal Inorganic materials 0.000 claims description 2
- 238000009434 installation Methods 0.000 claims 1
- 230000007547 defect Effects 0.000 abstract description 3
- 239000008280 blood Substances 0.000 abstract description 2
- 210000004369 blood Anatomy 0.000 abstract description 2
- 238000005516 engineering process Methods 0.000 abstract description 2
- 239000012530 fluid Substances 0.000 description 9
- 208000031481 Pathologic Constriction Diseases 0.000 description 5
- 230000036770 blood supply Effects 0.000 description 5
- 230000036262 stenosis Effects 0.000 description 5
- 208000037804 stenosis Diseases 0.000 description 5
- 238000005381 potential energy Methods 0.000 description 4
- 230000017531 blood circulation Effects 0.000 description 3
- 230000007423 decrease Effects 0.000 description 3
- 230000000694 effects Effects 0.000 description 3
- 201000008450 Intracranial aneurysm Diseases 0.000 description 2
- XEEYBQQBJWHFJM-UHFFFAOYSA-N Iron Chemical compound [Fe] XEEYBQQBJWHFJM-UHFFFAOYSA-N 0.000 description 2
- 229910045601 alloy Inorganic materials 0.000 description 2
- 239000000956 alloy Substances 0.000 description 2
- 208000007474 aortic aneurysm Diseases 0.000 description 2
- 210000001367 artery Anatomy 0.000 description 2
- 238000002560 therapeutic procedure Methods 0.000 description 2
- 241001112695 Clostridiales Species 0.000 description 1
- FYYHWMGAXLPEAU-UHFFFAOYSA-N Magnesium Chemical compound [Mg] FYYHWMGAXLPEAU-UHFFFAOYSA-N 0.000 description 1
- 208000007536 Thrombosis Diseases 0.000 description 1
- 230000001133 acceleration Effects 0.000 description 1
- 230000009471 action Effects 0.000 description 1
- 210000000702 aorta abdominal Anatomy 0.000 description 1
- 210000002376 aorta thoracic Anatomy 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000000903 blocking effect Effects 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 238000001361 intraarterial administration Methods 0.000 description 1
- 238000007917 intracranial administration Methods 0.000 description 1
- 229910052742 iron Inorganic materials 0.000 description 1
- 239000011777 magnesium Substances 0.000 description 1
- 229910052749 magnesium Inorganic materials 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 229910001000 nickel titanium Inorganic materials 0.000 description 1
- 210000000056 organ Anatomy 0.000 description 1
- 230000035790 physiological processes and functions Effects 0.000 description 1
- 229920000747 poly(lactic acid) Polymers 0.000 description 1
- 239000004626 polylactic acid Substances 0.000 description 1
- 230000008569 process Effects 0.000 description 1
- 239000010935 stainless steel Substances 0.000 description 1
- 229910001220 stainless steel Inorganic materials 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents 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
-
- 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
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents 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
- A61F2/91—Stents 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0063—Three-dimensional shapes
Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Life Sciences & Earth Sciences (AREA)
- General Health & Medical Sciences (AREA)
- Transplantation (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Cardiology (AREA)
- Animal Behavior & Ethology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Physics & Mathematics (AREA)
- Optics & Photonics (AREA)
- Prostheses (AREA)
- Media Introduction/Drainage Providing Device (AREA)
Abstract
The invention discloses a vascular stent, and belongs to the technical field of medical vascular stents. The invention provides a novel vascular stent, which aims at the defect that an aneurysm stent can not effectively isolate the pressure in an aneurysm cavity or prevent a branch vessel from supplying blood after a bifurcated vessel is inserted into the stent, wherein the vascular stent is a vascular stent with a local reduced or enlarged section and has a local narrow section and a local expansion section, the pressure value of the local part in the blood vessel can be changed by changing the local diameter of the vascular stent, and the operation difficulty of the existing implantation technology of the vascular stent can not be increased.
Description
Technical Field
The invention belongs to the technical field of medical vascular stents, and particularly relates to a vascular stent implanted into an aneurysm or a vascular bifurcation part.
Background
Aneurysms are a frequent disease in the arterial system, which is manifested by local enlargement of the artery and a decrease in the mechanical properties of the vessel wall. Rupture of an aneurysm can be very dangerous or even life threatening. Two types of aneurysms that are common in the clinic and are at great risk are aortic aneurysms and intracranial aneurysms, respectively. Aortic aneurysms are commonly found in the thoracic and abdominal aorta, and are often clostridial. Intracranial aneurysms occur in intracranial arteries, mostly cystic aneurysms with one side enlarged. The interventional approach is one of the main methods of surgically reducing the pressure in the aneurysm, preventing it from increasing and rupturing. The intervention stent at the aneurysm site can weaken the action of intra-arterial pressure on the aneurysm body to a certain extent, but the effect is not obvious.
Vascular interventions also have an intractable situation, where there is a bifurcated vessel at the site of the intervention. After the vascular stent is implanted into a main blood vessel, on one hand, the stent wire can form a certain degree of shielding on the bifurcation vascular inlet, and on the other hand, the shape of the bifurcation vascular inlet can be changed in the stent expanding process. Both of these aspects may affect the blood supply to the bifurcated vessel and thus affect the normal physiological function of organs/tissues downstream of the bifurcated vessel.
Disclosure of Invention
Aiming at the defect that the aneurysm stent can not effectively isolate the pressure in the aneurysm cavity or prevent branch blood supply after a bifurcated vessel is inserted into the stent, the invention provides a novel vascular stent which can not only reduce the pressure value in the aneurysm, but also improve the effect of the aneurysm interventional therapy; and aiming at the defect of reduced blood supply of the bifurcated vessel at the interventional part of the vascular stent, the vascular stent provided by the invention can increase the pressure at the inlet of the bifurcated vessel so as to increase the blood supply of the bifurcated vessel.
The invention provides a vascular stent, which is characterized in that the local radial section near the middle part of the vascular stent is smaller or larger than the radial section of the stent body, and the vascular stent has the functions of supporting the vascular wall and reducing or increasing the local vascular pressure. The partial radial section variable-small part is called a partial narrow section, and the partial radial section variable-large part is called a partial expansion section. The length a of the local narrow section and the opening length b of the cystic aneurysm along the axial direction of the blood vessel satisfy the following conditions: 0.8b < a <1.2b; the length a of the local narrow section and the length c of the tumor body of the spindle-shaped aneurysm along the axial direction of the blood vessel are as follows: 0.8c < a <1.2c; the axial length of the local expansion section is 0.8-3 times of the diameter of the branch blood vessel at the implantation position.
The local diameter of the vascular stent provided by the invention is smaller than the diameter of the stent body when the vascular stent is used for treating aneurysms. When the interventional therapy is performed on the bifurcation part of the blood vessel, the local diameter of the blood vessel stent is larger than the diameter of the stent body. In order to adapt to aneurysms of different shapes and sizes, different body diameters, different body to stenosis or enlargement site diameter ratios and different stenosis or enlargement segment lengths can be designed. Vascular stents of different size series can also be designed for clinical selection to meet clinical needs.
Preferably, the vascular stent material can be metal, such as stainless steel, nickel-titanium alloy, magnesium-based alloy, iron-based alloy and the like, or nonmetal, such as polylactic acid and the like, and the vascular stent can be a bare stent, a drug-coated vascular stent or a degradable vascular stent.
Preferably, the vascular stent can be manufactured by a laser engraving method, a braiding method or a 3D printing method.
The invention has the advantages that:
1. The intravascular stent provided by the invention can change the pressure value of a local part in a blood vessel by changing the local diameter of the intravascular stent.
2. The operation difficulty of the existing implantation technology of the vascular stent is not increased.
Drawings
FIG. 1A is a schematic illustration of the shape of a stent with localized stenosis provided in the present invention;
FIG. 1B is a schematic illustration of the shape of a stent with locally enlarged segments provided in the present invention;
FIG. 2 is a schematic view showing the placement of a stent into a shuttle-type aneurysm site in example 1;
FIG. 3 is a schematic view showing the placement of a stent into a cystic aneurysm in example 2;
FIG. 4 is a schematic view showing the placement of a stent into a bifurcated vessel site in example 3.
In the figure:
1.A vessel wall; 2. a vascular stent.
Detailed Description
The application is further illustrated below in conjunction with specific examples. It is to be understood that these examples are illustrative of the present application and are not intended to limit the scope of the present application. Furthermore, it should be understood that various changes and modifications can be made by one skilled in the art after reading the teachings of the present application, and such equivalents are intended to fall within the scope of the application as defined in the appended claims.
According to the bernoulli equation, fluid flow velocity and pressure in a pipe change with each other (i.e., kinetic energy and pressure potential energy are converted into each other) under the condition that a height factor is ignored.
The Bernoulli equation (Bernoulli equation), or Bernoulli principle (Bernoulli principle), is the basic equation and principle in fluid mechanics. This principle describes the functional relationship of an ideal fluid, i.e. a non-viscous incompressible fluid, when it is flowing steadily in a gravitational field. The formula is expressed as:
wherein: p is the local pressure, ρ is the fluid density, v is the fluid linear velocity, g is the gravitational acceleration, h is the position altitude value, and subscripts 1, 2 represent positions 1 and2, respectively.
It can be understood that when the ideal fluid is flowing stably, the sum of the pressure potential energy (pressure) and the kinetic energy and gravitational potential energy in unit volume is constant at any section of the same flow tube.
The invention approximates the blood flow in the arterial vessel to satisfy Bernoulli equation, and the change of the gravitational potential energy item (ρgh) is small and can be ignored for the vessel part of the vascular stent intervention. So that only the sum of the first two terms remains constant in the formula. When the diameter of the blood flow tube is reduced, the flow speed (v) can rise, and the kinetic energy of the unit volume of blood along the flow directionThe pressure (p) decreases with increasing pressure. Similarly, when the flow pipe diameter increases, the pressure will rise.
For a stent 2 having a localized stenosis, as shown in fig. 1A, at a site where the local diameter d becomes smaller, the flow rate increases and the pressure decreases at the site according to the fluid continuity equation and bernoulli equation. This Bernoulli effect is more pronounced when the vessel wall 1 is adapted to grow against the outer surface of the stent, or when thrombus forms outside the stent. When the stenosed segment of the vascular stent is placed at the corresponding aneurysm position, the pressure in the aneurysm body is reduced, so that the aneurysm is protected, and the increase or rupture trend of the aneurysm is restrained. The vascular stent with the local stenosis type can be used for a shuttle-type aneurysm and a cystic aneurysm, and can be used for reducing the pressure in the aneurysm by further utilizing the Bernoulli equation principle while blocking the impact of blood flow on the aneurysm, so that the risk of aneurysm enlargement and rupture is reduced.
For a stent 2 having a locally expanded section, as shown in fig. 1B, the flow rate in the region is reduced and the pressure is increased in the locally expanded section of the stent, also according to the fluid continuity equation and bernoulli equation. Thus, the vascular stent with the local expansion section can be used at the bifurcation vessel, which is beneficial to the blood supply of the bifurcation vessel.
Example 1
As shown in fig. 2, the vascular stent 2 with a local narrow section provided by the invention is placed at a cystic aneurysm site by a conventional vascular stent intervention method, the local narrow section is positioned at an aneurysm entrance, and the outer wall of the conventional section of the vascular stent 2 is attached to the vascular wall 1. The ideal state is: the length a of the local narrow section is equal to the opening length b of the aneurysm along the axial direction of the blood vessel, or 0.8b < a <1.2b, and the length a can be set to be a series of sizes so as to be convenient for clinical selection and use. The narrow section area of the local narrow section is not more than 30% of the section area of the inner cavity of the normal blood vessel at the position. The diameter of the vessel stent body is generally designed to be equal to or slightly larger than the inner diameter of the vessel at the desired vessel stent site.
Example 2
As shown in fig. 3, the vascular stent with the local narrow section provided by the invention is placed at the spindle-shaped aneurysm site by a conventional vascular stent intervention method, the local narrow section is positioned at the aneurysm site, and the outer wall of the conventional section of the vascular stent 2 is attached to the vascular wall 1. The ideal state is: the length a of the local narrow section on the vascular stent is equal to the tumor body length c of the aneurysm along the axial direction of the blood vessel, or 0.8c < a <1.2c, and a can be set to be a series of sizes so as to be convenient for clinical selection and use. The narrow cross-sectional area of the local narrow section is not more than 30% of the cross-sectional area of the normal vessel inner cavity at the position. The diameter of the vessel stent body is generally designed to be equal to or slightly larger than the inner diameter of the vessel at the desired vessel stent site.
Example 3
As shown in fig. 4, the vascular stent with the locally expanded segment provided by the invention is placed at a bifurcated vascular site by a conventional vascular stent intervention method, and the outer wall of the conventional segment of the vascular stent 2 is attached to the vascular wall 1. The ideal state is: the local expansion section is placed at the inlet of the bifurcated vessel, the expansion sectional area of the local expansion section is not more than 30% of the sectional area of the main vessel at the bifurcation, the axial length a of the local expansion section is 0.8-3 times of the vessel diameter d at the implantation position, and the axial length a can also be set to be a series of sizes, so that the clinical selection and use are facilitated.
Claims (3)
1. A vascular stent, characterized in that: the local radial section of the vascular stent is smaller or larger than the radial section of the vascular stent body near the middle part;
The partial radial section reduced part is called a partial narrow section;
The local radial section enlargement part is called a local expansion section;
the length a of the local narrow section and the opening length b of the cystic aneurysm along the axial direction of the blood vessel satisfy the following conditions: 0.8b < a <1.2b;
The length a of the local narrow section and the length c of the tumor body of the spindle-shaped aneurysm along the axial direction of the blood vessel are as follows: 0.8c < a <1.2c;
the axial length of the local expansion section is 0.8-3 times of the diameter of the branch blood vessel at the implantation site;
the change of the sectional area of the local narrow section or the local expansion section is not more than 30% of the sectional area of the inner cavity of the normal blood vessel at the installation position.
2. A vascular stent as defined in claim 1, wherein: the vascular stent material is metal or nonmetal, and the vascular stent is a bare stent or a drug-coated vascular stent or a degradable vascular stent.
3. A vascular stent as defined in claim 1, wherein: the vascular stent is manufactured by a laser engraving method, or is manufactured by a braiding method, or is manufactured by a 3D printing method.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201810161805.2A CN108210134B (en) | 2018-02-27 | 2018-02-27 | Vascular stent |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201810161805.2A CN108210134B (en) | 2018-02-27 | 2018-02-27 | Vascular stent |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN108210134A CN108210134A (en) | 2018-06-29 |
| CN108210134B true CN108210134B (en) | 2024-05-10 |
Family
ID=62662206
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201810161805.2A Active CN108210134B (en) | 2018-02-27 | 2018-02-27 | Vascular stent |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN108210134B (en) |
Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6645242B1 (en) * | 2000-12-11 | 2003-11-11 | Stephen F. Quinn | Bifurcated side-access intravascular stent graft |
| CN101426454A (en) * | 2004-05-25 | 2009-05-06 | 切斯纳特医学技术公司 | Flexible vascular occluding device |
| CN104042356A (en) * | 2013-03-13 | 2014-09-17 | 德普伊新特斯产品有限责任公司 | Improved modifiable occlusion device |
| CN104918565A (en) * | 2012-11-13 | 2015-09-16 | 柯惠有限合伙公司 | Occlusive devices |
| CN208435872U (en) * | 2018-02-27 | 2019-01-29 | 北京航空航天大学 | A kind of intravascular stent |
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| US9486346B2 (en) * | 2013-03-01 | 2016-11-08 | Medtronic Vascular, Inc. | Balloon expandable stent graft and apparatus and method for expanding a balloon expandable stent graft |
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|---|---|---|---|---|
| US6645242B1 (en) * | 2000-12-11 | 2003-11-11 | Stephen F. Quinn | Bifurcated side-access intravascular stent graft |
| CN101426454A (en) * | 2004-05-25 | 2009-05-06 | 切斯纳特医学技术公司 | Flexible vascular occluding device |
| CN104918565A (en) * | 2012-11-13 | 2015-09-16 | 柯惠有限合伙公司 | Occlusive devices |
| CN104042356A (en) * | 2013-03-13 | 2014-09-17 | 德普伊新特斯产品有限责任公司 | Improved modifiable occlusion device |
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| Publication number | Publication date |
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| CN108210134A (en) | 2018-06-29 |
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