CN108652786A - Holder windowing facility and stent system - Google Patents
Holder windowing facility and stent system Download PDFInfo
- Publication number
- CN108652786A CN108652786A CN201710208449.0A CN201710208449A CN108652786A CN 108652786 A CN108652786 A CN 108652786A CN 201710208449 A CN201710208449 A CN 201710208449A CN 108652786 A CN108652786 A CN 108652786A
- Authority
- CN
- China
- Prior art keywords
- seal wire
- conduit
- holder
- head end
- overlay film
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
- 239000000463 material Substances 0.000 claims description 21
- 238000011161 development Methods 0.000 claims description 9
- 238000005452 bending Methods 0.000 claims description 6
- 230000002035 prolonged effect Effects 0.000 claims 1
- 238000004804 winding Methods 0.000 claims 1
- 238000005516 engineering process Methods 0.000 abstract description 15
- 238000002513 implantation Methods 0.000 description 10
- 238000010586 diagram Methods 0.000 description 9
- 210000001367 artery Anatomy 0.000 description 8
- 230000003187 abdominal effect Effects 0.000 description 5
- 230000017531 blood circulation Effects 0.000 description 5
- 238000000576 coating method Methods 0.000 description 5
- 238000009792 diffusion process Methods 0.000 description 5
- 238000001356 surgical procedure Methods 0.000 description 5
- 210000000709 aorta Anatomy 0.000 description 4
- 230000036770 blood supply Effects 0.000 description 4
- 210000004204 blood vessel Anatomy 0.000 description 4
- 235000019504 cigarettes Nutrition 0.000 description 4
- 239000007943 implant Substances 0.000 description 4
- 238000000034 method Methods 0.000 description 4
- HLXZNVUGXRDIFK-UHFFFAOYSA-N nickel titanium Chemical compound [Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni] HLXZNVUGXRDIFK-UHFFFAOYSA-N 0.000 description 4
- 229910001000 nickel titanium Inorganic materials 0.000 description 4
- BASFCYQUMIYNBI-UHFFFAOYSA-N platinum Chemical compound [Pt] BASFCYQUMIYNBI-UHFFFAOYSA-N 0.000 description 4
- 208000002223 abdominal aortic aneurysm Diseases 0.000 description 3
- 230000008859 change Effects 0.000 description 3
- 239000003795 chemical substances by application Substances 0.000 description 3
- 239000011248 coating agent Substances 0.000 description 3
- 239000010931 gold Substances 0.000 description 3
- 229910052751 metal Inorganic materials 0.000 description 3
- 239000002184 metal Substances 0.000 description 3
- 239000007769 metal material Substances 0.000 description 3
- 229920001343 polytetrafluoroethylene Polymers 0.000 description 3
- 239000004810 polytetrafluoroethylene Substances 0.000 description 3
- 230000008439 repair process Effects 0.000 description 3
- 229910001220 stainless steel Inorganic materials 0.000 description 3
- WFKWXMTUELFFGS-UHFFFAOYSA-N tungsten Chemical compound [W] WFKWXMTUELFFGS-UHFFFAOYSA-N 0.000 description 3
- 208000036828 Device occlusion Diseases 0.000 description 2
- 206010028980 Neoplasm Diseases 0.000 description 2
- 239000004677 Nylon Substances 0.000 description 2
- 206010033892 Paraplegia Diseases 0.000 description 2
- 239000004721 Polyphenylene oxide Substances 0.000 description 2
- 241000270295 Serpentes Species 0.000 description 2
- 229910000831 Steel Inorganic materials 0.000 description 2
- 208000007536 Thrombosis Diseases 0.000 description 2
- 208000007474 aortic aneurysm Diseases 0.000 description 2
- 238000013459 approach Methods 0.000 description 2
- 230000008901 benefit Effects 0.000 description 2
- 229910000416 bismuth oxide Inorganic materials 0.000 description 2
- 230000000052 comparative effect Effects 0.000 description 2
- 238000010276 construction Methods 0.000 description 2
- TYIXMATWDRGMPF-UHFFFAOYSA-N dibismuth;oxygen(2-) Chemical compound [O-2].[O-2].[O-2].[Bi+3].[Bi+3] TYIXMATWDRGMPF-UHFFFAOYSA-N 0.000 description 2
- PCHJSUWPFVWCPO-UHFFFAOYSA-N gold Chemical compound [Au] PCHJSUWPFVWCPO-UHFFFAOYSA-N 0.000 description 2
- 229910052737 gold Inorganic materials 0.000 description 2
- 210000003090 iliac artery Anatomy 0.000 description 2
- 210000000936 intestine Anatomy 0.000 description 2
- 208000028867 ischemia Diseases 0.000 description 2
- 230000000302 ischemic effect Effects 0.000 description 2
- 230000003902 lesion Effects 0.000 description 2
- 150000002739 metals Chemical class 0.000 description 2
- 229920001778 nylon Polymers 0.000 description 2
- 229910052697 platinum Inorganic materials 0.000 description 2
- 229920000570 polyether Polymers 0.000 description 2
- 230000002980 postoperative effect Effects 0.000 description 2
- 230000008569 process Effects 0.000 description 2
- 230000005855 radiation Effects 0.000 description 2
- 230000009467 reduction Effects 0.000 description 2
- 230000000717 retained effect Effects 0.000 description 2
- 210000000954 sacrococcygeal region Anatomy 0.000 description 2
- 230000000192 social effect Effects 0.000 description 2
- 239000010935 stainless steel Substances 0.000 description 2
- 239000010959 steel Substances 0.000 description 2
- 230000002123 temporal effect Effects 0.000 description 2
- 230000001225 therapeutic effect Effects 0.000 description 2
- 229910052721 tungsten Inorganic materials 0.000 description 2
- 239000010937 tungsten Substances 0.000 description 2
- 210000003462 vein Anatomy 0.000 description 2
- 230000009278 visceral effect Effects 0.000 description 2
- 206010002329 Aneurysm Diseases 0.000 description 1
- 229910002835 Pt–Ir Inorganic materials 0.000 description 1
- HZEWFHLRYVTOIW-UHFFFAOYSA-N [Ti].[Ni] Chemical compound [Ti].[Ni] HZEWFHLRYVTOIW-UHFFFAOYSA-N 0.000 description 1
- 229910045601 alloy Inorganic materials 0.000 description 1
- 239000000956 alloy Substances 0.000 description 1
- 238000004873 anchoring Methods 0.000 description 1
- 238000002583 angiography Methods 0.000 description 1
- 210000000702 aorta abdominal Anatomy 0.000 description 1
- TZCXTZWJZNENPQ-UHFFFAOYSA-L barium sulfate Chemical group [Ba+2].[O-]S([O-])(=O)=O TZCXTZWJZNENPQ-UHFFFAOYSA-L 0.000 description 1
- 230000015572 biosynthetic process Effects 0.000 description 1
- 229920001400 block copolymer Polymers 0.000 description 1
- 230000000903 blocking effect Effects 0.000 description 1
- 239000008280 blood Substances 0.000 description 1
- 210000004369 blood Anatomy 0.000 description 1
- 238000009954 braiding Methods 0.000 description 1
- 238000006243 chemical reaction Methods 0.000 description 1
- 239000002131 composite material Substances 0.000 description 1
- 229920001577 copolymer Polymers 0.000 description 1
- 238000013461 design Methods 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 230000002708 enhancing effect Effects 0.000 description 1
- 230000007717 exclusion Effects 0.000 description 1
- 210000001105 femoral artery Anatomy 0.000 description 1
- 239000000835 fiber Substances 0.000 description 1
- 230000002209 hydrophobic effect Effects 0.000 description 1
- 210000004185 liver Anatomy 0.000 description 1
- 230000007774 longterm Effects 0.000 description 1
- 239000012528 membrane Substances 0.000 description 1
- 230000003340 mental effect Effects 0.000 description 1
- 210000004249 mesenteric artery inferior Anatomy 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 239000013500 performance material Substances 0.000 description 1
- -1 polytetrafluoroethylene Polymers 0.000 description 1
- 229920002635 polyurethane Polymers 0.000 description 1
- 239000004814 polyurethane Substances 0.000 description 1
- 230000010349 pulsation Effects 0.000 description 1
- 238000004080 punching Methods 0.000 description 1
- 239000012779 reinforcing material Substances 0.000 description 1
- 239000007787 solid Substances 0.000 description 1
- 230000003319 supportive effect Effects 0.000 description 1
- 230000004083 survival effect Effects 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
- A61F2/02—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
- A61F2/95—Instruments specially adapted for placement or removal of stents or 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
- A61F2/02—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
- A61F2002/065—Y-shaped blood vessels
-
- 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
- A61F2240/00—Manufacturing or designing of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2240/001—Designing or manufacturing processes
Abstract
The present invention provides a kind of holder windowing facility and stent systems, the holder windowing facility includes conduit and seal wire, the side opening penetrated through with the inner cavity of conduit is offered on the side wall of the conduit, the seal wire is placed in off working state in conduit, in working condition conduit is stretched out via side opening, the stent system includes overlay film frame and holder windowing facility, and the head portion of the seal wire is stretched out after conduit via side opening for being contacted with overlay film frame to puncture overlay film frame.On the one hand the holder windowing facility of the present invention needs external customization for solving existing windowing stent, it is long to customize the period, on the other hand the problem of customizing high price and restricted application is used to solve the problems, such as that the overlay film frame in chimney technology using standard specification easily to cause to leak incidence in I types.
Description
Technical field
The present invention relates to the field of medical instrument technology, and in particular to a kind of holder windowing facility and stent system.
Background technology
As the raising of living standards of the people and industrial environment deteriorate, abdominal aneurvsm (AAA：Abdominal Aortic
Aneurysm) have become one of the common artery distensibility disease for threatening human survival.It is found according to scale trials,
Complete 5 year life cycle of AAA patient is 65%, and the life cycle of disruptiveness AAA is only 41%.1991, Parodi etc. was reported for the first time
21 Endovascular Graft Exclusion for Abdominal Aortic Aneurysm in road, indicate that treatment of abdominal aortic aneurysms enters the new period.Document shows, abdominal aorta
Tumor endovascular repair (EVAR：Endo-Vascular Aneurysm Repair) success rate it is very high, conversion into open surgery rate is low.So
And the patient that can meet EVAR anatomical standards only accounts for the 20%~50% of sum.Some patientss are usually because proximal part tumor neck
It is too short, stent anchors are difficult and can not receive EVAR.In addition, stent occlusion inferior mesenteric artery and internal iliac artery opening can cause
Corresponding complication includes mainly intestine ischemia, sacrococcygeal region and pelvic cavity ischemic change and paraplegia etc..In view of the above problems, it opens a window
Holder is opened and chimney technology etc. is come into being.
South Korea Jae Hyung professors Park in 1996 initiate windowing technology and repair abdominal aneurvsm.So-called " windowing stent "
Refer to punching on the Visceral arteries aperture positions such as the intracavity implant face arteria renalis, it can be while retaining important Visceral artery
Enough proximal landing zones are created, to effectively block knurl.But the main popularization obstacle of windowing technology is windowing stent
It needs abroad to customize, takes around 2~3 months periods, it is expensive, and the windowing stent customized is mostly according to the foreigner's
Size design needs larger approach blood vessel, therefore part compatriots can not be applicable in especially female patient.
Chimney technology refers to during being placed in aorta intracavity implant, because operation needs that important branch must be covered
When, between capped branch vessel and active proximal arteries and veins side by side using overlay film frame or bare mental stents and aortic prosthesis
Anchoring, achievees the purpose that save capped branch's blood supply from damage.Compared with windowing stent, the advantage of chimney technology is, the overlay film of use
Holder is standard specification, the independent customization support system without the anatomic form according to individual.However, according to pertinent literature,
There are leakage incidence in higher I types, (presence of holder makes active pulsation therewith side by side to chimney technology i.e. in branch vessel
Frame can not completely be attached with arterial wall).Also, theoretically speaking the quantity of chimney holder is more, holder is bigger, causes interior leakage
Possibility it is also bigger, so, the long-term patency rate of late result and chimney holder has to be seen.
Invention content
The purpose of the present invention is to provide a kind of holder windowing facility and stent systems, can be in overlay film frame in internal
After release, the trepanning formation window at the corresponding branch vessel of overlay film frame is solved out with realizing branch vessel reservation or repairing
The customization of window holder is of high cost, the customization period is long, the scope of application is small, there are dangers etc. of leaking out in I types for complicated for operation and cigarette stove holder
Problem.
In order to solve the above technical problems, the present invention provides a kind of holder windowing facility, opened up on the side wall of the conduit
Have a side opening penetrated through with the inner cavity of the conduit, the seal wire includes seal wire head end and guidewire body, the guidewire body it is straight
Diameter is less than the diameter of the conduit, and the full-size of the cross section of the seal wire head end is less than the aperture of the side opening；It is described to lead
Silk have it is opposite proximally and distally, the seal wire head end is located at the distal end of the seal wire.
Further, the seal wire have it is opposite proximally and distally；The seal wire includes point, is set to described lead
The conduit is stretched out on the distal end of silk and via the side opening.
Further, the point has taper sharp edges.
Further, the seal wire head end has a bending angle relative to the guidewire body, and the bending angle is 0
Between~180 °.
Further, the guidewire body include at least core filaments and wrapping wire, the core filaments have it is opposite proximally and distally,
The wrapping wire is wrapped in along the axial direction of the core filaments in the core filaments from the proximal end of the core filaments；The wrapping wire extends the core
The part of the distal end of silk forms the seal wire head end.
Further, the guidewire body further includes security thread, is arranged between the core filaments and the wrapping wire；The peace
Full wire have it is opposite proximally and distally, the distal end of the security thread extends to the seal wire head end.
Further, the seal wire head end includes a development section, and the development section is made of the material with developing performance.
Further, the quantity of the side opening is one or more, is provided with developability on the hole wall of the side opening
The material of energy.
Further, the conduit includes at least conduit head end and main paragraph, and the hardness of the main paragraph is more than described lead
The hardness at tube head end, the main paragraph are at least three-decker, are at least arranged one layer between the outer layer and internal layer of the main paragraph
The intensity of enhancement layer, the enhancement layer is higher than the outer layer and/or the internal layer.
Further, the present invention separately provides a kind of stent system, including described in overlay film frame and above-mentioned any one
Holder windowing facility, after another part of the seal wire stretches out the conduit via the side opening, be used for and the overlay film branch
Bridge joint is touched forms window to puncture the overlay film frame.
The overlay film frame includes main body rack and side branch stent, and the side stand is by the window to the main body branch
Extend on the outside of frame.
The holder windowing facility and stent system of the present invention has the following advantages that：
The first, on the one hand holder windowing facility of the invention needs external customization, customization week for solving existing windowing stent
On the other hand the problem of phase is long, customization price height and restricted application is used to solve in chimney technology using standard specification
Overlay film frame easily causes the problem of leakage in I types.Specifically, since the windowing stent of customization preparatory period early period of not only performing the operation is long,
And more para-operational device is needed, but the holder windowing facility of the present invention is only in conventional overlay film frame uplifting window,
Since the implantation process of conventional overlay film frame is relatively easy and clinical application comparative maturity, holder of the invention is opened
The application of window device shortens the operation preparatory period, reduces the usage amount of para-operational device, has saved surgery cost, simplifies
Surgical procedure, particularly, conventional overlay film frame can be adapted for the applicability of General Population, especially female patient more
Therefore height improves the therapeutic domain of such operative treatment, be improved particularly in abdominal aneurvsm intervention operation and received EVAR's
Ratio has good social effect.
The second, holder windowing facility of the invention directly matches in overlay film frame uplifting window, foundation and branch vessel
Window, in use, by window and branch vessel pairing, to ensure the blood supply of branch vessel, in this way, in cigarette stove technology, it can
To reduce the usage amount of the overlay film frame of implantation branch vessel, the postoperative risk for occurring to leak in I types of patient is reduced.
The use of the holder windowing facility of third, the present invention so that windowing stent can be continuing with conventional overlay film branch
The implantation of frame and method for releasing enable holder release operation difficulty reduce, and learning time shortens, and then operation temporal is made to contract
Short, comparing agent dose and ray radiation reduces, and reduces patient's case fatality rate of average of operation periods.
4th, holder windowing facility of the invention, can be according to the lesion feelings of patient when implementing the windowing of overlay film frame
Condition opens a window, and flexibility is high, moreover, the window formed has accurately positioning with branch vessel, therefore, it is possible to establish
Good channel of blood flow effectively reduces the latter problem because of caused by branch vessel thrombosis.
Description of the drawings
Fig. 1 is the structural schematic diagram for the holder windowing facility that one embodiment of the invention provides；
Fig. 2 is the sectional view of the seal wire of the holder windowing facility of one embodiment of the invention；
Fig. 3 is that the conduit implantation of the holder windowing facility of one embodiment of the invention needs the signal of the branch vessel retained
Figure；
Fig. 4 is that the seal wire of one embodiment of the invention is inserted into conduit shown in Fig. 3 and seal wire head end passes through side opening to stretch out conduit
Schematic diagram；
Fig. 5 is that the seal wire head end of seal wire shown in Fig. 4 orients the schematic diagram of trepanning on the overlay film frame to implant；
Fig. 6 is the cross-sectional view of the main paragraph of the conduit of one embodiment of the invention.
The reference numerals are as follows：
10- holder windowing facilities；11- conduits；12- seal wires；111- side openings；112- conduit head ends；113- main paragraphs；
1131- outer layers；1132- internal layers；1133- enhancement layers；The control sections 114-；115- diffusion-induced stress pipes；121- seal wire head ends；
1210- points；122- core filaments；123- wrapping wires；124- security threads；20- branch vessels；30- overlay film frames.
Specific implementation mode
To keep present disclosure more clear and easy to understand, below in conjunction with Figure of description 1~6, the holder of the present invention is opened
Window device and stent system are described further.Certainly the invention is not limited to the specific embodiment, the technology of this field
General replacement known to personnel is also encompassed within the scope of the invention.
Secondly, the present invention has carried out detailed statement using schematic diagram, but these schematic diagrames are only for the purposes of being described in detail this hair
Bright example, should not be to this restriction as the present invention.As used in the specification and the appended claims, singulative
"a", "an" and "the" includes plural reference, in addition in addition non-content explicitly points out.Such as in this specification and appended right
Used in it is required that, term "or" is typically to be used with the meaning including "and/or", except non-content is in addition clear
It points out outer.Term " proximal end " is typically referred to by one end of proximal operator, and " distal end " refers to one end far from operator.Phase in attached drawing
Same or similar reference numeral represents same or analogous component.
The stent system of the present invention includes holder windowing facility 10 and overlay film frame 30, and the holder windowing facility 10 is used for
Trepanning is to form an at least window on overlay film frame 30, and the window with the entrance of branch vessel 20 for being aligned, to ensure
The blood supply of branch vessel 20 avoids because of branch vessel 20 latter problem caused by the stent occlusion on main blood vessel.
It is the structural schematic diagram of the holder windowing facility 10 of one embodiment of the invention referring to figs. 1 to Fig. 5, Fig. 1, Fig. 2 is this
The sectional view of the seal wire 12 of the holder windowing facility 10 of an embodiment is invented, Fig. 3 is the holder windowing dress of one embodiment of the invention
Setting 10 implantation of conduit 11, to need the schematic diagram of branch vessel retained, Fig. 4 be that the seal wire 12 of one embodiment of the invention is inserted into Fig. 3
Shown in conduit 11 and seal wire head end 121 pass through side opening 111 to stretch out the schematic diagram of conduit 11, Fig. 5 be seal wire 12 shown in Fig. 4 it
Seal wire head end 121 orients the schematic diagram of trepanning on the overlay film frame 30 to implant.
As shown in Fig. 1~5, the holder windowing facility 10 includes conduit 11 and seal wire 12, on the side wall of the conduit 11
The side opening 111 penetrated through with the inner cavity of conduit 11 is offered, in use, the seal wire 12 is inserted into conduit 11, and the seal wire 12
A part be arranged in conduit 11, another part of the seal wire 12 can stretch out conduit 11 via side opening 111, for releasing
Overlay film frame 30 and 20 corresponding position of branch vessel of abdominal aneurvsm are put, the overlay film frame 30 for puncturing corresponding position is (practical only to need
Puncture the overlay film of overlay film frame 30).
The use principle of the holder windowing facility 10 of the present embodiment includes：
The first step：As shown in figure 3, in the case where routinely intervening, by means of the guiding of DSA equipment, conduit 11 is implanted into human body, and
The conduit head end 112 of conduit 11 is enabled to be inserted into branch vessel 20 (the branch vessel 20 e.g. arteria renalis, the mesenterium for needing to retain
Upper artery, coeliac trunk, arch of aorta branch or femoral profound artery etc.) in；It can be shown by Fig. 3, can first be placed in common seal wire to branch's blood
Pipe 20 so that conduit 11 is navigated to along common seal wire in branch vessel 20, makes the conduit head end 112 of the conduit 11 with certain
Angle bending is inserted into branch vessel 20, so that in the side opening 111 and 30 aperture position phase of branch vessel of conduit head end 112
It is corresponding, play the role of being accurately positioned 30 aperture position of branch vessel；
Later, second step：As shown in figure 4, seal wire 12 is inserted into conduit 11 and is moved along the extension path of conduit 11,
Until the seal wire head end 121 of seal wire 12 reaches 111 position of side opening of conduit 11；
Then, third walks：As shown in figure 5, being for example implanted into overlay film frame 30 by femoral artery approach, arrived in overlay film frame 30
Up to diseased region and after giving release, (implantation of overlay film frame 30 is preferably monitored in real time by digital subtraction angiography (DSA)
Position), pierce through overlay film using the region for the overlay film frame 30 corresponding to branch vessel 20 of seal wire head end 121 for stretching out side opening 111
Holder 30 realizes that the orientation of overlay film frame 30 is perforated to establish window；
Then, the 4th step：Seal wire 12 is withdrawn to the inside of conduit 11, and seal wire 12 and conduit 11 are withdrawn into people together
Body；
Finally, as optional 5th step：According to actual needs, after by seal wire 12 by being withdrawn from completely in conduit 11, more
It changes and uses guiding wire, balloon expandable is carried out along guiding wire to expand window, or merging at the window of overlay film frame 30
Another overlay film frame, another overlay film frame establish permanent reliable channel of blood flow for being implanted into branch vessel 20.Tool
For body, the overlay film frame 30 includes separate main body rack and side branch stent, and the side branch stent passes through foundation
The window extends out to main body rack outside and is implanted into branch vessel 20, and guiding wire is withdrawn from after channel of blood flow foundation
And foley's tube or stent delivery system.
After above-mentioned several steps, just blood flow is established between the branch vessel 20 that overlay film frame 30 and needs retain
Channel, and then the latter problem because caused by blocking 20 coating membrane support 30 of branch vessel is avoided, such as will be moved under mesenterium
Arteries and veins and internal iliac artery opening block, and cause intestine ischemia, sacrococcygeal region and the complication such as pelvic cavity ischemic change and paraplegia.Moreover,
Relative to cigarette stove holder, by the way that in main blood vessel, (herein, main blood vessel is accordingly defined as aorta, and branch vessel corresponds to point
Branch artery) in overlay film frame on establish window, have and the overlay film in aorta can be enabled to avoid the use of multiple rows of overlay film frame
Holder can realize good attaching with arterial wall, reduce the risk of holder leakage.
Further, the quantity of the side opening 111 is not limited to one, can also be multiple, by not in practical applications
Same side opening 111 establishes the window corresponding to different branch vessels on overlay film frame 30.In order to reduce cost and simplify operation,
It is preferred that establishing different windows on overlay film frame 30 by a side opening 111, specifically, it is only necessary to adjust seal wire head end 121 and stretch
Go out the angle after side opening 111, different location and the window of direction can be quickly and easily opened up on overlay film frame 30.
Obviously, the present invention to the shape of the side opening 111, size and opens up direction and does not limit particularly, can be convenient for seal wire
Head end 121 passes through.
Preferably, the conduit head end 112 has developability, such as the conduit head end 112 includes a development section, this is aobvious
Shadow section is made of the material with developing performance, and available metal developing agent is selected from barium sulfate (BaSO4), bismuth oxide
(Bi2O3) or tungsten powder etc. it, can be monitored in real time under routinely intervention operation, such as by DSA, preferably to track conduit 11
Implantation position.In one embodiment, the development section of the conduit head end 112 is directly added by the material with developing performance
Work forms, and coats one layer of material with developing performance in other embodiments, in the development section of the conduit head end 112
Material.
It is highly preferred that the hole wall of the side opening 111 has developability, to determine position and the direction of side opening, with accurate
Window is established in ground on overlay film frame 30.For example one layer of material with highlighted developing performance is coated on the hole wall of side opening 111,
Such as Pt-Ir alloys, Ta metals or Au metals etc., coated part can be a part for annular or annular, preferably ring
Shape.
Further, in addition to conduit head end 112, the conduit 11 further includes main paragraph 113, the conduit head end 112 with
The mode that can be bent relative to main paragraph 113 connects the distal end of main paragraph 113.Particularly, the hardness of the main paragraph 113 is more than
The hardness of conduit head end 112, using the flexibility of conduit head end 112 to be well adapted to complicated human anatomic structure, simultaneously
Using the supportive of main paragraph 113 preferably to push conduit.The conduit head end 112 is relative to main paragraph 113, according to applicable
The different of position can have different bending shapes, as Cobra 2 (can be matched with cobra conduit), RH (can be matched with liver
Arterial duct) etc..
In the present embodiment, the outer diameter of the conduit head end 112 and main paragraph 113 can be identical, and preferably outer diameter is 6F
~12F.
Further, the conduit 11 further includes control section 114, is fixed at the proximal end of main paragraph 113, and is used for
Driver under stress main paragraph 113 moves, such as conduit 11 is pushed under the driving of control section 114, or torsion conduit 11.
Further, the conduit 11 further includes diffusion-induced stress pipe 115, is set in the proximal end (master of main paragraph 113
Body section 113 have it is opposite proximally and distally, the distal end connecting conduit head end 112 of the main paragraph 113), and the control unit
114 are divided to be fixed on diffusion-induced stress pipe 115, and the hardness of the diffusion-induced stress pipe 115 is less than the hardness of main paragraph 113.
By the setting of diffusion-induced stress pipe 115, torsion or axial force convenient for control section 114 to be subject to equably are conducted to main paragraph
113。
In a preferred embodiment, as shown in fig. 6, the main paragraph 113 is at least trilaminate material composite construction, institute
It states and one layer of enhancement layer 1133, the intensity of the enhancement layer 1133 is at least set between the outer layer 1131 of main paragraph 113 and internal layer 1132
Higher than internal layer 1132 and outer layer 1131.Optionally, it is embedding to be selected from polytetrafluoroethylene (PTFE), polyamide-polyether for the material of the internal layer 1132
Section copolymer or other high molecular materials with low-friction coefficient, can also be the combination of these materials.The enhancement layer
1133 material is selected from one or more combinations in stainless steel (SUS304, SUS304V), Nitinol, Kev drawing and nylon,
The shape of the enhancement layer 1133 can be stainless steel wire, titanium-nickel wire, Kafra fiber or nylon wire etc., preferably by braiding or
The technology modes such as person's wrapping wire form the enhancement layer 1133.The material of the outer layer 1131 is selected from polyurethane and polyamide-polyether
One or more combinations in block copolymer.The outer layer 1131 of the present embodiment refers to the part of contact tissue, described
Internal layer 1132 refers to the part of contact seal wire, as long as and filling at least one layer of enhancing between the outer layer 1131 and internal layer 1132
Material, and be not limited to reinforcing material between the outer layer 1131 and the internal layer 1132, can also fill and internal layer
1132 or 1131 identical material of outer layer.Either outer layer 1131 or internal layer 1132, it is desirable that the outer wall of the outer layer 1131 with
And the inner wall smooth of the internal layer 1132, that is, friction coefficient is relatively small, passes through the smooth reduction seal wire 12 of internal layer 1132
Resistance is pushed, tissue is avoided damage to by the push resistance of the smooth reduction conduit 12 of outer layer 1131 simultaneously.
Then, referring again to Fig. 2, the seal wire 12 includes seal wire head end 121 and guidewire body, the seal wire head end 121 with
The mode that can be bent relative to guidewire body connects the distal end of guidewire body, it is preferable that the support strength of the seal wire head end 121
Higher than guidewire body, smoothly to pierce through overlay film frame 30.Preferably, the seal wire head end 121 has developability, specifically, institute
It includes a development section to state seal wire head end 121 accordingly, and the development section of the seal wire head end 121 includes having highlighted developing performance
Material.The angle that the seal wire head end 121 is bent relative to the guidewire body is between 0~180 °, such as shown in Fig. 2 leads
Silk head end 121 is initially set to be bent into 180 ° relative to guidewire body, that is, forms semicircular structure.
In addition, the end of the seal wire head end 121 has certain sharpness, smoothly to puncture covering for overlay film frame 30
Film.Optionally, the end set of the seal wire head end 121 is useful for puncturing the point 1210 of overlay film, the point 1210
With taper sharp edges.Identical or different coating, institute can be coated on the seal wire head end 121 and the outer wall of guidewire body
The material for stating coating is the hydrophobic coatings such as hydrophilic coatings or PTFE such as PVP, MA.
In the present embodiment, the guidewire body includes at least core filaments 122 and wrapping wire 123, and the wrapping wire 123 is along core filaments 122
Axial direction be wrapped in core filaments 122, and the wrapping wire 123 extends through the part of 122 distal end of core filaments and forms seal wire head end 121.
The wrapping wire 123 of the present embodiment is helically wound in core filaments 122.
Preferably, the guidewire body further includes security thread 124, it is arranged between wrapping wire 123 and core filaments 122.The peace
The distal end of full wire 124 extends to seal wire head end 121, and in the present embodiment, one end of the security thread 124 connects point 1210.
The core filaments 122 are solid construction in the present embodiment, and hardness is more than the hardness of wrapping wire 123, on the one hand passes through
The high intensity of core filaments 122 supports seal wire, on the other hand protects tissue by the flexibility of wrapping wire 123.The core filaments 122
Material is selected from the metal materials such as stainless steel (SUS304, SUS304V) or Nitinol.The material of the wrapping wire 123 is selected from stainless
The metal materials such as steel (SUS304, SUS304V), Nitinol, gold, platinum or tungsten.The material of the security thread 124 is selected from not
Become rusty the metal materials such as steel (SUS304, SUS304V), Nitinol, gold, platinum or tungsten.
Presently preferred embodiments of the present invention is as described above, but be not limited to the above embodiments disclosed range, such as the present invention
The unlimited windowing for being only used for overlay film frame of holder windowing facility, it can also be used to the reaming of other holders, such as in expanded stent
The size etc. of engraved structure.
On the one hand the holder windowing facility of the present invention needs external customization for solving existing windowing stent, the customization period is long,
The problem of customizing high price and restricted application, the overlay film branch for being on the other hand used to solve to use standard specification in chimney technology
Frame easily causes the problem of leakage incidence in I types.
Specifically, the windowing stent of customization is not only performed the operation, preparatory period early period is long, but also needs more auxiliary surgical device
Tool, but the holder windowing facility of the present invention is only in conventional overlay film frame uplifting window, due to the implantation of conventional overlay film frame
Process is relatively easy and clinical application is with comparative maturity, and therefore, the application of holder windowing facility of the invention shortens operation standard
In the standby period, the usage amount of para-operational device is reduced, surgery cost has been saved, simplifies surgical procedure, it is particularly, conventional
Overlay film frame can be adapted for the applicability higher of General Population, especially female patient, therefore, improve such operative treatment
Therapeutic domain, be improved particularly in abdominal aneurvsm intervention operation and received the ratio of EVAR, there is good social effect.
In addition, what the holder windowing facility of the present invention directly matched in overlay film frame uplifting window, foundation and branch vessel
Window, in use, by window and branch vessel pairing, to ensure the blood supply of branch vessel, in this way, in cigarette stove technology, it can
To reduce the usage amount of the overlay film frame of implantation branch vessel, the postoperative risk for occurring to leak in I types of patient is reduced.
In addition, the use of the holder windowing facility of the present invention so that windowing stent can be continuing with conventional overlay film branch
The implantation of frame and method for releasing enable holder release operation difficulty reduce, and learning time shortens, and then operation temporal is made to contract
Short, comparing agent dose and ray radiation reduces, and reduces patient's case fatality rate of average of operation periods.
Particularly, holder windowing facility of the invention, can be according to the lesion of patient when implementing the windowing of overlay film frame
Situation opens a window, and flexibility is high, moreover, the window formed has accurately positioning with branch vessel, therefore, it is possible to build
Good channel of blood flow is found, the latter problem because of caused by branch vessel thrombosis is effectively reduced.
Foregoing description is only the description to present pre-ferred embodiments, not to any restriction of the scope of the invention, this hair
Any change, the modification that the those of ordinary skill in bright field does according to the disclosure above content, belong to the protection of claims
Range.
Claims (10)
1. a kind of holder windowing facility, which is characterized in that including conduit and seal wire, offered on the side wall of the conduit with it is described
The side opening of the inner cavity perforation of conduit, the seal wire include seal wire head end and guidewire body, and the diameter of the guidewire body is less than institute
The diameter of conduit is stated, the full-size of the cross section of the seal wire head end is less than the aperture of the side opening；The seal wire has phase
To proximally and distally, the seal wire head end is located at the distal end of the seal wire.
2. holder windowing facility according to claim 1, which is characterized in that the seal wire includes point, is set to institute
State seal wire head end.
3. holder windowing facility according to claim 2, which is characterized in that the point has taper sharp edges.
4. holder windowing facility according to claim 1, which is characterized in that the seal wire head end is relative to the seal wire master
Body has a bending angle, and the bending angle is between 0~180 °.
5. holder windowing facility according to claim 1, which is characterized in that the guidewire body include at least core filaments and around
Silk, the core filaments have it is opposite proximally and distally, the wrapping wire from the proximal end of the core filaments along the core filaments axial direction winding
In the core filaments；The part that the wrapping wire extends the distal end of the core filaments forms the seal wire head end.
6. holder windowing facility according to claim 5, which is characterized in that the guidewire body further includes security thread, if
It sets between the core filaments and the wrapping wire；The security thread have it is opposite proximally and distally, the distal end of the security thread is prolonged
Extend to the seal wire head end.
7. holder windowing facility according to claim 1, which is characterized in that the seal wire head end includes a development section, institute
Development section is stated to be made of the material with developing performance.
8. holder windowing facility according to claim 1, which is characterized in that the quantity of the side opening is one or more,
The material with developing performance is provided on the hole wall of the side opening.
9. holder windowing facility according to claim 1, which is characterized in that the conduit includes at least conduit head end and master
Body section, the hardness of the main paragraph are more than the hardness of the conduit head end, and the main paragraph is at least three-decker, the main body
One layer of enhancement layer be at least set between the outer layer and internal layer of section, the intensity of the enhancement layer higher than the outer layer and/or it is described in
Layer.
10. a kind of stent system, which is characterized in that including the branch described in any one of overlay film frame and claim 1 to 9
Frame windowing facility after the seal wire head end of the seal wire stretches out the conduit via the side opening, is used for and the overlay film branch
Bridge joint is touched forms window to puncture the overlay film frame.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710208449.0A CN108652786B (en) | 2017-03-31 | 2017-03-31 | Bracket windowing device and bracket system |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710208449.0A CN108652786B (en) | 2017-03-31 | 2017-03-31 | Bracket windowing device and bracket system |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN108652786A true CN108652786A (en) | 2018-10-16 |
| CN108652786B CN108652786B (en) | 2024-03-15 |
Family
ID=63783711
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201710208449.0A Active CN108652786B (en) | 2017-03-31 | 2017-03-31 | Bracket windowing device and bracket system |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN108652786B (en) |
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109247978A (en) * | 2018-11-02 | 2019-01-22 | 东莞先健畅通医疗有限公司 | Orthotopic fenestration instrument |
| CN109846583A (en) * | 2019-03-27 | 2019-06-07 | 吴忠隐 | A kind of aortic stents window controlling system |
Citations (17)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6652567B1 (en) * | 1999-11-18 | 2003-11-25 | David H. Deaton | Fenestrated endovascular graft |
| US20090259290A1 (en) * | 2008-04-14 | 2009-10-15 | Medtronic Vascular, Inc. | Fenestration Segment Stent-Graft and Fenestration Method |
| CN102458303A (en) * | 2009-04-02 | 2012-05-16 | 医学研究，基础设施和卫生服务基金的特拉维夫医疗中心 | Stent graft fenestration |
| CN103040502A (en) * | 2012-12-04 | 2013-04-17 | 中国人民解放军第三军医大学第三附属医院 | Balloon needle for stent orthotopic fenestration |
| CN103228230A (en) * | 2010-11-16 | 2013-07-31 | W.L.戈尔及同仁股份有限公司 | Fenestration devices, systems, and methods |
| CN103349576A (en) * | 2013-06-06 | 2013-10-16 | 武汉杨森生物技术有限公司 | Windowing equipment for covered stent in vascular cavity |
| CN203841852U (en) * | 2014-02-21 | 2014-09-24 | 许尚栋 | Windowed branched covered stent |
| CN104905892A (en) * | 2015-06-16 | 2015-09-16 | 中国人民解放军第四军医大学 | Integrated multiple-branch interventional aorta arch covered stent |
| CN204766973U (en) * | 2015-06-20 | 2015-11-18 | 窦克非 | Radiography seal wire |
| CN105616045A (en) * | 2016-03-03 | 2016-06-01 | 福建省立医院 | Interventional therapy device and method realizing steering and positioning fenestration through laser catheter |
| CN205286610U (en) * | 2016-01-08 | 2016-06-08 | 朱建成 | Aorta covered stent |
| CN105796218A (en) * | 2016-03-08 | 2016-07-27 | 黄连军 | Covered stent |
| CN205391220U (en) * | 2015-11-13 | 2016-07-27 | 上海形状记忆合金材料有限公司 | Support is netted to foraminiferous secret |
| CN105902326A (en) * | 2016-06-29 | 2016-08-31 | 黄连军 | Windowing method and device of covered stent |
| CN106333766A (en) * | 2016-08-16 | 2017-01-18 | 董红霖 | Positioning device for in-situ windowing of endovascular stent-graft |
| US20170086997A1 (en) * | 2014-03-07 | 2017-03-30 | Maquet Holding B.V. & Co. Kg | Catheter device for fenestrating a stentgraft |
| CN207804426U (en) * | 2017-03-31 | 2018-09-04 | 上海交通大学医学院附属新华医院 | Holder windowing facility and stent system |
-
2017
- 2017-03-31 CN CN201710208449.0A patent/CN108652786B/en active Active
Patent Citations (17)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6652567B1 (en) * | 1999-11-18 | 2003-11-25 | David H. Deaton | Fenestrated endovascular graft |
| US20090259290A1 (en) * | 2008-04-14 | 2009-10-15 | Medtronic Vascular, Inc. | Fenestration Segment Stent-Graft and Fenestration Method |
| CN102458303A (en) * | 2009-04-02 | 2012-05-16 | 医学研究，基础设施和卫生服务基金的特拉维夫医疗中心 | Stent graft fenestration |
| CN103228230A (en) * | 2010-11-16 | 2013-07-31 | W.L.戈尔及同仁股份有限公司 | Fenestration devices, systems, and methods |
| CN103040502A (en) * | 2012-12-04 | 2013-04-17 | 中国人民解放军第三军医大学第三附属医院 | Balloon needle for stent orthotopic fenestration |
| CN103349576A (en) * | 2013-06-06 | 2013-10-16 | 武汉杨森生物技术有限公司 | Windowing equipment for covered stent in vascular cavity |
| CN203841852U (en) * | 2014-02-21 | 2014-09-24 | 许尚栋 | Windowed branched covered stent |
| US20170086997A1 (en) * | 2014-03-07 | 2017-03-30 | Maquet Holding B.V. & Co. Kg | Catheter device for fenestrating a stentgraft |
| CN104905892A (en) * | 2015-06-16 | 2015-09-16 | 中国人民解放军第四军医大学 | Integrated multiple-branch interventional aorta arch covered stent |
| CN204766973U (en) * | 2015-06-20 | 2015-11-18 | 窦克非 | Radiography seal wire |
| CN205391220U (en) * | 2015-11-13 | 2016-07-27 | 上海形状记忆合金材料有限公司 | Support is netted to foraminiferous secret |
| CN205286610U (en) * | 2016-01-08 | 2016-06-08 | 朱建成 | Aorta covered stent |
| CN105616045A (en) * | 2016-03-03 | 2016-06-01 | 福建省立医院 | Interventional therapy device and method realizing steering and positioning fenestration through laser catheter |
| CN105796218A (en) * | 2016-03-08 | 2016-07-27 | 黄连军 | Covered stent |
| CN105902326A (en) * | 2016-06-29 | 2016-08-31 | 黄连军 | Windowing method and device of covered stent |
| CN106333766A (en) * | 2016-08-16 | 2017-01-18 | 董红霖 | Positioning device for in-situ windowing of endovascular stent-graft |
| CN207804426U (en) * | 2017-03-31 | 2018-09-04 | 上海交通大学医学院附属新华医院 | Holder windowing facility and stent system |
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109247978A (en) * | 2018-11-02 | 2019-01-22 | 东莞先健畅通医疗有限公司 | Orthotopic fenestration instrument |
| CN109247978B (en) * | 2018-11-02 | 2021-06-01 | 深圳市先健畅通医疗有限公司 | In-situ windowing instrument |
| CN109846583A (en) * | 2019-03-27 | 2019-06-07 | 吴忠隐 | A kind of aortic stents window controlling system |
Also Published As
| Publication number | Publication date |
|---|---|
| CN108652786B (en) | 2024-03-15 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| JP5814949B2 (en) | Aneurysm surgery device | |
| US9545299B2 (en) | Prosthesis deployment device with translucent distal end | |
| JP4315806B2 (en) | System for securing an intraluminal device | |
| JP5332050B2 (en) | Introduction assembly for introducing a prosthesis for repairing a vascular disorder, and catheter used therefor | |
| US20080015671A1 (en) | Method And Apparatus For Treatment Of Cardiac Valves | |
| US8622934B2 (en) | Guidewire with two flexible end portions and method of accessing a branch vessel therewith | |
| EP2638882A1 (en) | Bifurcation blood vessel stent | |
| PL186652B1 (en) | Intravascular implant for use as reconstructive measure to correct damages caused by an abdpminal aortic aneurysm | |
| CN109498210A (en) | Intraluminal stent | |
| CN109938895A (en) | Window type overlay film frame | |
| CN207804426U (en) | Holder windowing facility and stent system | |
| CN108652786A (en) | Holder windowing facility and stent system | |
| CN205198665U (en) | Sacculus expansion pipe of double -deck hypo pipe | |
| CN112569026A (en) | Branch covered stent and branch covered stent implantation device | |
| CN107174376A (en) | A kind of arteria covering membrane supporter | |
| CN109717986B (en) | Branch type tectorial membrane support and branch type tectorial membrane support system | |
| CN214857856U (en) | Branch covered stent and branch covered stent implantation device | |
| CN213789516U (en) | Guide wire cutting medicine balloon | |
| CN212346807U (en) | Covered stent for implanting branch of blood vessel and covered stent system | |
| CN208974229U (en) | Intravascular stent conveying device and its system | |
| CN208851725U (en) | Window type overlay film frame | |
| CN208974226U (en) | Intravascular stent and blood vessel coating bracket | |
| CN112826634A (en) | Covered stent system for implanting into branch blood vessel | |
| EP3354236B1 (en) | Composite vascular flow diverter | |
| CN215351427U (en) | Vessel intervention catheter sheath structure capable of blocking blood vessel in short time |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| PB01 | Publication | ||
| PB01 | Publication | ||
| SE01 | Entry into force of request for substantive examination | ||
| SE01 | Entry into force of request for substantive examination | ||
| GR01 | Patent grant | ||
| GR01 | Patent grant |