CN108553202A - A kind of holder for treating Type B dissection of aorta - Google Patents
A kind of holder for treating Type B dissection of aorta Download PDFInfo
- Publication number
- CN108553202A CN108553202A CN201810719924.5A CN201810719924A CN108553202A CN 108553202 A CN108553202 A CN 108553202A CN 201810719924 A CN201810719924 A CN 201810719924A CN 108553202 A CN108553202 A CN 108553202A
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- Prior art keywords
- aorta
- holder
- dissection
- big
- carrier unit
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Classifications
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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
-
- 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
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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Cardiology (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Pulmonology (AREA)
- Gastroenterology & Hepatology (AREA)
- Prostheses (AREA)
Abstract
The invention belongs to medicine and engineering crossing domain, it is related to manufacturing a kind of holder of novel treatment Type B dissection of aorta, the tapered structure of aortic stents, proximal part is fully wrapped around by overlay film frame, there is no bare metal stent, overlay film frame outer side covering can encounter the material that blood slowly expands, holder is connected and composed close to big 1 2cm of curved side by small " V " the font carrier unit woven, big curved side distal end is connected and composed by big " V " the font carrier unit woven, and holder lesser curvature side is connected and composed by small " V " font carrier unit.The aorta tectorial membrane stent system adapts to the anatomical structure of the insufficient Stanford Type B dissection of aorta for involving left subclavian artery in Stanford Type Bs dissection of aorta especially proximal landing zone, the cut of complete isolation dissection of aorta, blood vessel suitable for variation various normal and out of shape, it is applied widely, customization support is avoided, can be produced in batches.
Description
Technical field
The invention belongs to medical auxiliary apparatus technical fields, and in particular to a kind of novel treatment Type B dissection of aorta
Holder.
Background technology
Dissection of aorta is a kind of disease for threatening human life.Dissection of aorta refers to aortic tunica intima and medial injury
Afterwards, inner membrance mouth of the blood through tearing enters aorta wall middle level, generates vascular wall stripping, forms false cavity.It is impacted with blood flow,
It is in Ectasia that blood vessel exfoliation, which gradually extends,.Dissecting aneurysm of aorta can cause pericardium bleeding to generate pericardial tamponade, or even big
Angiorrhoxis bleeding leads to patient's die by visitation of God.Data shows that its incidence is on the rise in recent years, and annual morbidity is more than
30/1000000 people.If cannot treat in time, Stanford Type B interlayer patient 30d case fatality rate is more than 10%, high-risk patient
Can be more than 70%.Surgical operation is still the effective therapy of dissecting aneurysm of aorta at present, but its technical difficulty is big, right
Patient and operating room it is more demanding, promote and apply limited, but the technology needs general anesthesia downlink bypass graft, operation risk
Relatively simple internal medicine intracavitary therapy is big, and operating time, post-operative recovery time are long, and the complication such as infection, bleeding are relatively more.
In recent years, the application and development of aorta lumen endoprosthesis (endovascular aortic repair, TEVAR) change significantly
The situation of the disease treatment, it is minimally invasive, safely, effectively the advantages that have been obtained for widely approving.Among the patients, by
In proximal landing zone, deficiency limits the application of TEVAR.When row TEVAR, overlay film frame proximal landing zone blood vessel is without lesion and foot
Enough long (>=15mm), but some patient's interlayer hemotoncus are close or involve left subclavian artery so that and overlay film frame has to cover
Left subclavian artery is to obtain enough anchorage zones.For the patient of left vertebral artery advantage, overlay film frame is covered and is moved under left clavicle
Arteries and veins may lead to brain Posterior circulation ischemia.To protect these patient's left subclavian artery blood flows, " chimney " technology can be taken at present
Reconstructive vascular operation, " windowing branch " branch on the bow of (chimney technique), arteria carotis-left subclavian artery bypass graft
Frame technology.Due to the complexity of bow portion dissection, the high risk of cerebral apoplexy so that bow portion lesion is treated as current vascular surgery
The huge challenge that doctor faces.Arch of aorta anatomic form is complicated, exists in Coronal, sagittal plain and axle position and turns round in various degree
Song, with age this distortion are also constantly changing, and not only increase the accurate difficulty for measuring arch of aorta cross-sectional diameter
The difficulty that holder accurately discharges when degree and intracavitary therapy, also results in when holder is effectively anchored and needs longer anchorage zone.And bend
Top set's blood vessel provides upper limb especially incidence blood supply, limits arbitrarily moving up for anchorage zone, is also processing bow portion disease
Technical operation when change brings the risk of bigger, and the variation of branch has more aggravated its complexity.Therefore aortic arch disease
The anatomical structure for measuring bow portion that the processing of change should use advanced soft hardware equipment fine, patient is on being familiar with various processing bows
In the technical foundation of branch vessel, personalized formulation therapeutic scheme.
To extend the application range of TEVAR, various new intracavitary therapy instruments and new technology are come into being.It is intended at present
Expansion or the method for rebuilding anchorage zone include " hybridization " technology, " chimney " technology, " gap " support type artifical vascular, " windowing " branch
Frame type artificial blood vessel, " branch " support type artifical vascular." hybridization " technology refers to expanding anchorage zone by open by-pass operation
An actor's rendering of an operatic tune Stent Placement, not complete intracavitary minimal invasive techniques still have larger wound again afterwards.Current country's " gap " " is opened
Window " and " branch " support type artifical vascular need external customization, and costly, the customization period is long, and needs superb intracavitary skill
Art is supported, it is difficult to be carried out extensively and be used in emergency treatment disease.Chimney support technology is mainly used in the insufficient complexity in proximal landing zone
In aneurysm patient, holder is implanted into the proximal end outer rim of aorta tectorial membrane stent, establish from aorta tectorial membrane stent proximal end to point
The channel of branch vessel blood flow occurs in Follow-up After in I types to preserve branch's blood flow and obtain more fully proximal landing zone
Leakage.
" chimney " technology provides ideal therapeutic scheme for the insufficient aortic arch lesion in this anchorage zone.It refers to
When Endovascular aortic repair aortic stents need to cover Main Branches, by point of covering while discharging aortic stents
Branch is built into parallel a bare bracket or overlay film frame to keep the unobstructed of branch vessel, but postoperative interior leakage and holder is closed again
The incidence of plug is higher.
" windowing branch " holder 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 after aorta tectorial membrane stent release overlay film frame is implanted into branch vessel at " windowing ".It should
The advantage of technology is more completely to protect branch's blood flow, while reducing the formation leaked in I types.
The intracavitary therapy for involving the dissection of aorta for doing subclavian artery is always the hot spot and difficult point of vascular surgery.Due to
The variability of the anatomical structure and branch of arch of aorta complexity is done in aorta pectoralis endovascular repair (TEVAR) and is moved under clavicle
The reconstruction of arteries and veins still faces great risk and challenge, once occurring surprisingly, patient may cause cerebral infarction because of cerebral ischemic, seriously
Person's threat to life.The study found that dissection of aorta or aneurysm row subclavian artery laser to involving left subclavian artery
Orthotopic fenestration is treated, and the left subclavian artery involved is quickly rebuild, and not only eliminates that conventional therapy wound is big, risk is high
The shortcomings of, even more greatly push the process of the full intracavitary therapy of aortic disease.Traditional aortic stents implantation proximal part is past
Toward having bare metal stent and barb, when being implanted in dissection of aorta and aneurysm patient, bare metal stent and barb may
Puncturing aorta vessel leads to angiorrhoxis, patient's death etc..For the aortic stents without bare metal stent and barb,
Big curved often small " V " the font carrier unit connection structure in side, connection is dense, makes the orthotopic fenestration hand for involving bow top set
Art process is excessively complicated, reduces the success rate of orthotopic fenestration operation and increases central nervous system complication, extends hand
The operating time of art improves the risk of operation.And mount proximal end and distal end be not close with cradle fits, increases in art and art
Odds is leaked in afterwards.
Invention content
For the above problem of the existing technology, Type B dissection of aorta is treated the purpose of the present invention is to provide a kind of
Holder.
To achieve the goals above, the present invention provides following technical scheme：
A kind of holder for treating Type B dissection of aorta, the holder is fully wrapped around by overlay film, does not have metal apterium, described
Holder includes aorta side stand curved greatly and aorta lesser curvature side holder, the big curved side stand at big curved side 1-2cm by
First small " V " font carrier unit of braiding connects and composes, and the big curved side stand distal end is by big " V " the font holder list that weaves
Member connects and composes；The lesser curvature side holder is connected and composed by the second small " V " font carrier unit.The design of big curved side stand is convenient for
Laser in-situ opens a window, and the design of lesser curvature side holder fits closely the generation for reducing beak phenomenon convenient for holder with aorta.
Further, aorta side stand curved greatly and the tapered structure of aorta lesser curvature side holder, conical design are suitable
The morphosis of row aorta from the coarse to fine.
Further, the both ends of aorta side stand curved greatly and aorta lesser curvature side holder are all covered with expansion overlay film
Material, the generation of interior leakage can be prevented by expanding the setting of covering material.
Preferably, the expansion covering material is polytetrafluoroethylene material, polyglycolic acid material or polyester material.
Advantageous effect：The present invention provides a kind of holder for treating Type B dissection of aorta, which is involving left lock
Under bone in the dissection of aorta patient of artery, after aorta tectorial membrane stent discharges, according to patient vessel's situation corresponding to a left side
Orthotopic fenestration is carried out using label laser fiber on the aorta tectorial membrane stent of subclavian artery, and is moved under the left clavicle of windowing
Arteries and veins Vascular implantation overlay film frame or bare bracket, rebuilding the blood flow of left subclavian artery, reducing and reducing related complication
Occur.It is insufficient tired that the aorta tectorial membrane stent system adapts to Stanford Type Bs dissection of aorta especially proximal landing zone
And the anatomical structure of the StanfordB type dissection of aorta of left subclavian artery, the expansion overlay film of proximal end and distal end can be complete
The aortic disease of left subclavian artery is involved in whole isolation, is suitable for the blood vessel of variation various normal and out of shape, the scope of application
Extensively, customization support is avoided, can be produced in batches.In addition holder side curved greatly is by big " V " the font carrier unit connection structure that weaves,
Be conducive to visually descend dynamic application orthotopic fenestration technology to carry out efficiently and quickly opening a window on overlay film frame in DSA or x-ray,
Keep the orthotopic fenestration surgical procedure for involving left subclavian artery greatly simplified, improve the success rate of orthotopic fenestration operation and reduces
Central nervous system complication reduces the risk of operation.
Description of the drawings
Fig. 1 is the structural schematic diagram of aorta of the present invention side stand curved greatly.
Fig. 2 is the structural schematic diagram of aorta lesser curvature side holder of the present invention.
In figure：1, overlay film；2, big curved side stand；3, lesser curvature side holder；4, the first small " V " font carrier unit；5, big " V "
Font carrier unit；6, the second small " V " font carrier unit；7, covering material is expanded.
Specific implementation mode
The invention will now be further described with reference to specific embodiments, but examples are merely exemplary, not to this hair
Bright range constitutes any restrictions.It will be understood by those skilled in the art that without departing from the spirit and scope of the invention
Can the details and form of technical solution of the present invention be modified or be replaced, but these modifications and replacement each fall within the present invention's
In protection domain.
A kind of holder for treating Type B dissection of aorta, as shown in Figs. 1-2, the holder is fully wrapped around by overlay film 1, does not have
Metal apterium, the holder include aorta side stand 2 curved greatly and aorta lesser curvature side holder 3, and the big curved side stand 2 is close
Big curved side 1-2cm is connected and composed by the weave first small " V " font carrier unit 4, and big 2 distal end of curved side stand is by weaving
" V " font carrier unit 5 connects and composes greatly；The lesser curvature side holder 3 is connected and composed by the second small " V " font carrier unit 6.Greatly
The design of curved side stand 2 opens a window convenient for laser in-situ, and the design of lesser curvature side holder 3 fits closely reduction convenient for holder with aorta
The generation of beak phenomenon.Aorta side stand 2 curved greatly and 3 tapered structure of aorta lesser curvature side holder, conical design are suitable
The morphosis of row aorta from the coarse to fine.
The both ends of aorta side stand 2 curved greatly and aorta lesser curvature side holder 3 are all covered with expansion covering material 7,
The setting of expansion covering material 7 can prevent the generation of interior leakage.
The expansion covering material 7 is polytetrafluoroethylene material, polyglycolic acid material or polyester material.
Density bullet point wherein in Fig. 1 and Fig. 2 is the mark point of aortic stents proximal part, is as developed under x-ray
Label.
The application method of the holder is as follows：
After conventional local anaesthesia or general anesthesia, after conventional art area sterile drape, side femoral artery or left brachial artery are punctured simultaneously
Implantation pigtail catheter drives in the wrong direction to aorta ascendens row DSA radiographies, and position is correctly implanted into 6F long sheaths to left subclavian artery and active afterwards
Arcus haemalis point of interface.It is implanted into overlay film frame in descending aorta, after radiography is in place, the laser in-situ windowing skill of Hang Gong top sets artery
Art, the balloon expandable and Stent of row windowing artery.Radiography shows unobstructed, the holder positioning of main support and windowing stent again
Accurately without angulation, occur without apparent interior leakage situation.Long sheath and conduit are exited, notch, pressure dressing are closed.
Claims (4)
1. a kind of holder for treating Type B dissection of aorta, which is characterized in that the holder is fully wrapped around by overlay film, without metal
Apterium, the holder include aorta side stand curved greatly and aorta lesser curvature side holder, and the big curved side stand is close to big curved side
It is connected and composed by the weave first small " V " font carrier unit at 1-2cm, the big curved side stand distal end is by big " V " that weaves
Font carrier unit connects and composes；The lesser curvature side holder is connected and composed by the second small " V " font carrier unit.
2. a kind of holder for treating Type B dissection of aorta according to claim 1, which is characterized in that the aorta is big
Curved side stand and the tapered structure of aorta lesser curvature side holder.
3. a kind of holder for treating Type B dissection of aorta according to claim 1, which is characterized in that the aorta is big
The both ends of curved side stand and aorta lesser curvature side holder are all covered with expansion covering material.
4. a kind of holder for treating Type B dissection of aorta according to claim 3, which is characterized in that the expansion overlay film
Material is polytetrafluoroethylene material, polyglycolic acid material or polyester material.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201810719924.5A CN108553202A (en) | 2018-07-03 | 2018-07-03 | A kind of holder for treating Type B dissection of aorta |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201810719924.5A CN108553202A (en) | 2018-07-03 | 2018-07-03 | A kind of holder for treating Type B dissection of aorta |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN108553202A true CN108553202A (en) | 2018-09-21 |
Family
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201810719924.5A Pending CN108553202A (en) | 2018-07-03 | 2018-07-03 | A kind of holder for treating Type B dissection of aorta |
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| Country | Link |
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Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109276346A (en) * | 2018-11-01 | 2019-01-29 | 浙江大学 | A kind of separation type blood vessel covered stent |
| CN109846583A (en) * | 2019-03-27 | 2019-06-07 | 吴忠隐 | A kind of aortic stents window controlling system |
| CN111363361A (en) * | 2020-04-23 | 2020-07-03 | 西南石油大学 | Silicone rubber coated high-temperature slow-expansion water-absorbing particle and preparation method thereof |
| WO2023093437A1 (en) * | 2021-11-26 | 2023-06-01 | 上海微创心脉医疗科技(集团)股份有限公司 | Covered stent and covered stent system |
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| CN209107679U (en) * | 2018-07-03 | 2019-07-16 | 上海交通大学医学院附属第九人民医院 | A kind of bracket for treating Type B dissection of aorta |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109276346A (en) * | 2018-11-01 | 2019-01-29 | 浙江大学 | A kind of separation type blood vessel covered stent |
| CN109846583A (en) * | 2019-03-27 | 2019-06-07 | 吴忠隐 | A kind of aortic stents window controlling system |
| CN111363361A (en) * | 2020-04-23 | 2020-07-03 | 西南石油大学 | Silicone rubber coated high-temperature slow-expansion water-absorbing particle and preparation method thereof |
| CN111363361B (en) * | 2020-04-23 | 2021-11-05 | 西南石油大学 | Silicone rubber coated high-temperature slow-expansion water-absorbing particle and preparation method thereof |
| WO2023093437A1 (en) * | 2021-11-26 | 2023-06-01 | 上海微创心脉医疗科技(集团)股份有限公司 | Covered stent and covered stent system |
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Application publication date: 20180921 |