CN109199634A - A kind of individuation branch stent type bow portion reconstruction artificial blood vessel - Google Patents
A kind of individuation branch stent type bow portion reconstruction artificial blood vessel Download PDFInfo
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- CN109199634A CN109199634A CN201811435086.5A CN201811435086A CN109199634A CN 109199634 A CN109199634 A CN 109199634A CN 201811435086 A CN201811435086 A CN 201811435086A CN 109199634 A CN109199634 A CN 109199634A
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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
-
- 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
- A61F2002/061—Blood vessels provided with means for allowing access to secondary lumens
Abstract
A kind of individuation branch stent type bow portion reconstruction artificial blood vessel, it is related to a kind of artificial blood vessel.The present invention is in order to solve existing full bow replacement operation due to technical requirements height, and easy bleeding, anthemorrhagic difficulty, operating time is too long, the technical problems such as operation risk height.The present invention includes initiative pulse support blood vessel (1), the line artificial blood vessel part of making of the drop portion initiative pulse support blood vessel (2) of initiative pulse support blood vessel (1) successively extends for bow portion initiative pulse support blood vessel (3) and ascending part initiative pulse support blood vessel (4) to proximal part direction, is issued on bow portion initiative pulse support blood vessel (3) comprising multiple bow parts branch including a branch stent blood vessel (5).Drop portion initiative pulse support blood vessel (2) and bow portion, ascending part of the invention is integrally formed structure, without coincideing, Deep Hypothermia Circulatory Arrest time being down within 5 minutes for 20 minutes or more by routine can be shortened, greatly reduce the risk of ischemia of spinal cord, paraplegia.The present invention performs the operation for Aortic arch replacement.
Description
Technical field
The present invention relates to a kind of artificial blood vessels, and in particular to a kind of individuation branch stent for aorta open surgery
Type bow portion rebuilds artificial blood vessel, belongs to medical instruments field.
Background technique
Dissection of aorta is a kind of big blood vessel acute disease for seriously threatening patient safety.Wherein, acute type A interlayer
(Standford type A), i.e. lesion involve liter, the dissection of aorta in bow portion, is the highest one kind of risk, onset is hurried,
Progress is rapid, lethality is high.Without operative treatment, 24 hours death rates are close to 25%, 48 hour death rate close to 50%, 30
It the death rate is up to 90%.Liter, bow portion blood vessel using surgical resection, displacement lesion are definite effective treatment hands
Section.But the operation of acute type A interlayer is complicated, it is the severe challenge put in face of cardiovascular surgeon that technical requirements are high.To the greatest extent
Pipe, diagnostic techniques and Perioperative Managements measure improve in recent years, but it is reported that acute type A interlayer operative mortality rate still
Up to 15,30%, it would be highly desirable to improve.
Acute type A interlayer operating difficulty is big, and complication is more, in some instances it may even be possible to cause catastrophic big bleeding, limit liter, bow
The development of portion's replacement of aorta operation.Until nineteen eighty-three, it is a wide range of that professor Borst uses trunk artificial blood vessel to carry out in a creative way
Aorta replacement, just succeeds.1991, the improvement of trunk blood vessel was the trunk blood vessel of merging overturning by professor Safi etc., was mentioned
High success rate of operation.It in recent years, is the one of Aortic surgery as trunk vascular treatment dissection of aorta using overlay film frame
Big progress, secondary side open chest surgery needed for can avoid traditional operation.
Currently, bending the common strategy of replacement operation entirely as shown in figure: recycling, stop jumping down in vitro, processing, which rises, in advance leads
Artery and root, then profound hypothermia, stop recycling, by overlay film trunk stented vessel implantation, release it is very intracavitary in descending aorta, complete
Bow portion Four branches aortic graft distal end and the kiss including overlay film trunk stent-graft proximal part and self descending aorta
It closes.The Deep Hypothermia Circulatory Arrest time, this stage, spinal cord blood supply was interrupted mostly more than 20 minutes, increases and spinal cord injury occurs or even cut
The risk of paralysis.After restoring circulation, it is also necessary to complete innominate artery, left common carotid artery, left subclavian artery and artificial blood vessel one by one
On respective branch coincide.Previous anastomotic is more, and especially left subclavian artery position exists deeply, adjoins recurrent nerve and ductus thoracicus,
Dissection is free and coincide more difficult, and time-consuming, and bleeding probability also increases therewith, operative mortality rate and complication rate compared with
It is high.
In conclusion existing full bow replacement operation, due to complicated for operation, technical requirements are high, and operating time is too long, exists
Amount of bleeding is big during patients surgery, the Deep Hypothermia Circulatory Arrest time long problem for easily causing spinal cord lesion etc., so that surgical death
Rate and complication rate are higher.
Summary of the invention
The purpose of the present invention is to solve existing full bow replacement operations due to complicated for operation, and technical requirements are high, operation
Overlong time, there are amount of bleeding during patients surgery is big, the Deep Hypothermia Circulatory Arrest time long problem for easily causing spinal cord lesion etc.,
So that operative mortality rate and the higher problem of complication rate.And then provide a kind of individuation branch stent type bow portion reconstruction people
Work blood vessel.
The technical scheme is that
A kind of individuation branch stent type bow portion reconstruction artificial blood vessel, including initiative pulse support blood vessel, aortic stents blood
The line artificial blood vessel part of making of the drop portion initiative pulse support blood vessel of pipe successively extends for bow portion aortic stents to proximal part direction
Blood vessel and ascending part initiative pulse support blood vessel are issued comprising including a branch stent blood vessel on bow portion initiative pulse support blood vessel
Multiple bow parts branch；Drop portion initiative pulse support blood vessel includes making line artificial blood vessel and multiple descending aorta metallic supports, drop master
Artery metallic support is annular metal bracket, makes and is sewed with multiple cyclic annular descending aorta metal branch on the inner wall of line artificial blood vessel
Frame；Branch stent blood vessel includes thin-walled artificial blood vessel and multiple branch's metallic supports, and branch stent openings in blood vessels is in the active of bow portion
Arteries and veins stented vessel latter end upper limb, branch's metallic support are annular metal bracket, and the inner wall of thin-walled artificial blood vessel is sewed with multiple rings
Shape metallic support.
Further, bow portion initiative pulse support blood vessel include unsupported bow portion make line blood vessel main body, branch stent blood vessel,
Y shape bow part branch, bow part Zhi Si and collar shape sutural margin one；Make line blood vessel main body upper limb connection Y shape bow before middle section in bow portion
Part is propped up, and Y shape bow part branch is further divided into bow part branch one and bow part branch two, and the root of Y shape bow part branch is made with bow portion
The junction of line blood vessel main body connects collar shape sutural margin one outward, and bow portion makes line blood vessel main body and is connected to bow portion in middle section facies ventralis
Branch four, bow portion make line blood vessel main body and suture connected component's stented vessel by suture in latter end upper limb.
Further, the thin-walled artificial blood vessel of branch stent blood vessel external extends for one section in branch root and unsupported covers
Film, the latter end upper limb that this section of overlay film makes line blood vessel main body with bow portion are coincide and are connected by suture.
Further, it further includes fixed ring, and the interface of line blood vessel main body is made in the root and bow portion of branch stent blood vessel
Place is supported by fixed ring.
Preferably, descending aorta metallic support is the annular metal carrier unit of closure, between each unit independently of one another, whole
Straight tube shape or tapered cylindrical shape are constituted on body.
Further, ascending part initiative pulse support blood vessel includes that unsupported ascending part makes line blood vessel main body and collar shape sutural margin
Two, the middle section that ascending part makes line blood vessel main body is radial to being externally connected with collar shape sutural margin two.
Preferably, the total length of initiative pulse support blood vessel is 260-360mm, and the diameter of initiative pulse support blood vessel is 22-
32mm, wherein the length 100-180mm of drop portion initiative pulse support blood vessel.
Preferably, Y shape bow part props up, bends point that part branch one, bow partially prop up two, branch stent blood vessel, bow part Zhi Si
Branch diameter is 6-18mm, the length 10-50mm of branch stent blood vessel；Bow part Zhi Yiyu bends the angle that part is propped up between two
30°-150°。
Further, it further includes conveying device, and conveying device includes two groups of mutually independent release systems: i.e. drop portion
Initiative pulse support blood vessel discharges system and branch stent blood vessel release system composition, and drop portion initiative pulse support blood vessel discharges system peace
Mounted in the side of drop portion initiative pulse support blood vessel, branch stent blood vessel release system is mounted on the side of branch stent blood vessel；Its
In, drop portion initiative pulse support blood vessel release system includes that drop portion pulls back bar and drop portion lashing wire, and drop portion lashing wire is looped around back and forth
Drop portion pulls back on bar；Branch stent blood vessel release system includes branching back to pull rod and branch's lashing wire, the round-trip ring of branch's lashing wire
It is wound on and branches back on pull rod.
Further, it further includes built-in；Built-in includes hard bow portion, and hard bow portion is radius of curvature phase
Arc pipe same or equal to the gradually smaller caliber of distal end directional curvature radius from proximal part, hard bow portion is equipped with
Multiple branch's windows and cyclic annular dent, hard bow portion is mounted on inside bow portion initiative pulse support blood vessel.
The present invention has the effect that compared with prior art
1), drop portion initiative pulse support blood vessel of the invention and bow portion, ascending part are integrally formed structures, can without coincideing
Shorten the Deep Hypothermia Circulatory Arrest time to be down within 5 minutes within 20 minutes or more by conventional, greatly reduces ischemia of spinal cord, paraplegia
Risk.
2), branch stent blood vessel of the invention carries out intracavitary therapy to left subclavian artery, avoid position it is deep a left side
Subclavian artery carries out identical, reduces operating difficulty and risk.
3), the built-in hard bow portion of the invention design, application, can quickly, definitely control bleeding, greatly
Reduce bow, the visual area bleeding of drop portion, or even can realize above-mentioned visual area without bleeding, solves the maximum difficult point of full bow replacement technique,
Greatly reduce operation risk and difficulty.
4), bow portion of the invention and ascending part make collar shape sutural margin is preset in line blood vessel main body can be with self aorta wall
It is sutured, realizes that bow portion and ascending part make line internal blood vessel, the small probability event of long-term postoperative bleeding can be effectively prevent.
5), branch stent blood vessel of the invention is made line blood vessel main body with bow portion by one section of overlay film and is communicated, the soft knot of this section
Structure improves the compliance for the individuation variation that branch stent issues left subclavian artery in bow portion, avoids that branch stent occurs
Displacement and interior leakage.The interface that branch stent vascular root and bow portion make line blood vessel main body is equipped with elastomeric fixed ring, prevents
It is smooth to guarantee that left subclavian artery blood supply flows into for component inlet compressive deformation.
Detailed description of the invention
Fig. 1 is existing full bow displacement+trunk stenter to implant schematic diagram；
Fig. 2 is that individuation branch stent type bow portion of the invention rebuilds the structural schematic diagram after artificial blood vessel's release；
Fig. 3 is that individuation branch stent type bow portion of the invention rebuilds artificial blood vessel and its conveying device before releasing,
Spare schematic diagram under restrained condition；
Fig. 4 is that individuation branch stent type bow portion of the invention rebuilds artificial blood vessel and its built-in hard bow portion is using
Perspective diagram under state；
Fig. 5 is the schematic diagram that the internalization of the arch of aorta, aorta ascendens is realized using collar shape sutural margin；
Fig. 6 is the schematic diagram that the internalization of the arch of aorta, part aorta ascendens is realized using collar shape sutural margin；
Fig. 7 is the side view in hard bow portion；
Fig. 8 is the top view in hard bow portion；
Figure label: 1, initiative pulse support blood vessel；2, drop portion initiative pulse support blood vessel；3, bow portion initiative pulse support blood vessel；
4, ascending part initiative pulse support blood vessel；5, branch stent blood vessel；6, Y shape bow part is propped up；7, bend part Zhi Si；8, bow part branch one；
9, bow part branch two；10, collar shape sutural margin one；11, collar shape sutural margin two；12, drop portion aorta metallic support 12；13,
Fixed ring；14, bow portion makes line blood vessel main body；15, ascending part makes line blood vessel main body；16, drop portion pulls back bar；17, drop portion lashing wire；
18, pull rod is branched back to；19, branch's lashing wire；20, hard bow portion；21, branch's window one；22, branch's window two；23, branch's window
Mouth three；24, cyclic annular dent；25, hard ascending part；26, fixation hole；A-1, thin-walled artificial blood vessel；A-2, branch's metallic support.
Specific embodiment
Specific embodiment 1: illustrating present embodiment, a kind of individuation branch of present embodiment in conjunction with Fig. 2 to Fig. 8
Support rack type bow portion rebuilds artificial blood vessel, including initiative pulse support blood vessel 1, the drop portion aortic stents blood of initiative pulse support blood vessel 1
The line artificial blood vessel part of making of pipe 2 successively extends for bow portion initiative pulse support blood vessel 3 and ascending part active pulsation to proximal part direction
Frame blood vessel 4 issues on bow portion initiative pulse support blood vessel 3 comprising multiple bow parts branch including a branch stent blood vessel 5；
Drop portion initiative pulse support blood vessel 2 includes making line artificial blood vessel and multiple descending aorta metallic supports 12, descending aorta metallic support
12 be annular metal bracket, makes and is sewed with multiple cyclic annular descending aorta metallic supports 12 on the inner wall of line artificial blood vessel；Branch's branch
Frame blood vessel 5 includes thin-walled artificial blood vessel A-1 and multiple branch's metallic support A-2, and branch stent blood vessel 5 is opened on bow portion aorta
3 latter end upper limb of stented vessel, branch metallic support A-2 are annular metal bracket, and the inner wall of thin-walled artificial blood vessel A-1 is sewed with more
A annular metal bracket A-2.
The present invention is because of its drop portion initiative pulse support blood vessel 2 and bow portion initiative pulse support blood vessel 3 and ascending part aortic stents blood
Pipe 4 is integrally formed structure, reduces previous anastomotic, can shorten Deep Hypothermia Circulatory Arrest time being down to for 20 minutes or more by routine
Within 5 minutes, the risk of ischemia of spinal cord, paraplegia is greatly reduced.Meanwhile because the design in creative built-in hard bow portion,
Using, can quickly, definitely control bleeding, considerably reduce bow, the visual area bleeding of drop portion, in addition can realize above-mentioned visual area without go out
Blood solves the maximum difficult point of full bow replacement technique, greatly reduces operation risk and difficulty.
The blood vessel wall thickness of the thin-walled artificial blood vessel A-1 meaning of present embodiment is 0.2mm hereinafter, to guarantee branch stent blood
Pipe can be sufficiently spread out in small-bore left subclavian artery, guarantee interior lumen bore close to normal physiological condition bore.
The utility model can significantly shorten the Deep Hypothermia Circulatory Arrest time, avoid or mitigate ischemia of spinal cord damage.Avoid a left side
Coincideing for subclavian artery, reduces previous anastomotic quantity, hence it is evident that reduces intraoperative hemorrhage, shortens extracorporal circulatory system and operating time, reduces
Operating difficulty improves success rate of operation.
Specific embodiment 2: illustrating present embodiment, the bow portion aortic stents of present embodiment in conjunction with Fig. 2 to Fig. 4
Blood vessel 3 includes that unsupported bow portion makes line blood vessel main body 14, branch stent blood vessel 5, Y shape bow part branch 6, bow part 47 and of branch
Collar shape sutural margin 1；Make line blood vessel main body 14 upper limb connection Y shape bow part branch 6, Y shape bow part branch 6 before middle section in bow portion
It is further divided into bow part branch 1 and bow part branch 29, make the company of line blood vessel main body 14 for the root and bow portion of Y shape bow part branch 6
Place's connection collar shape sutural margin 1 outward is connect, bow portion makes line blood vessel main body 14 and is connected to bow part branch 47, bow in middle section facies ventralis
It makes line blood vessel main body 14 and connected component's stented vessel 5 is sutured by suture in latter end upper limb in portion.It is arranged such, it can be achieved to complete
The treatment of size brachial artery proximal end, including to position it is deep left subclavian artery carry out quick intracavitary therapy, reduce and coincide
Operating time is shortened in operation.Being preset with collar shape sutural margin can be sutured with self aorta wall, realize that bow drop portion is intravascular
Portion can effectively prevent the small probability event of long-term postoperative bleeding.Other compositions and connection relationship and specific embodiment one
It is identical.
Specific embodiment 3: illustrating present embodiment in conjunction with Fig. 2 to Fig. 4, outside the branch stent blood vessel 5 of present embodiment
The thin-walled artificial blood vessel A-1 of layer extends for one section of unsupported overlay film in branch root, this section of overlay film and bow portion make line blood vessel master
The latter end upper limb of body 14 is coincide and is connected by suture.So set, improving branch stent to left subclavian artery in bow portion
The compliance of the individuation variation of sending, avoids displacement and interior leakage that branch stent occurs.Other compositions and connection relationship and tool
Body embodiment two is identical.
Specific embodiment 4: illustrate that present embodiment, present embodiment further include fixed ring 13 in conjunction with Fig. 2 to Fig. 4, point
The interface that line blood vessel main body 14 is made in the root and bow portion of branch stented vessel 5 is supported by elastomeric fixed ring 13.So set,
Component inlet compressive deformation is prevented, it is smooth to guarantee that left subclavian artery blood supply flows into.It is other composition and connection relationship with specifically
Embodiment one, 2 is three identical.
The elastomeric fixed ring 13 of present embodiment is worked out using elastic material silk, such as titanium alloy wire.
Specific embodiment 5: illustrating present embodiment, the descending aorta metal branch of present embodiment in conjunction with Fig. 2 to Fig. 4
Frame 12 is the annular metal carrier unit of closure, between each unit independently of one another, constitutes straight tube shape or tapered cylinder on the whole
Shape.So set, can compress after bracket release, close false chamber, restore effective true chamber blood supply.Other compositions and company
It is identical to meet relationship and specific embodiment one, two, three or four.
Specific embodiment 6: illustrating present embodiment, the ascending part aortic stents of present embodiment in conjunction with Fig. 2 to Fig. 4
Blood vessel 4 includes that unsupported ascending part makes line blood vessel main body 15 and collar shape sutural margin 2 11, and ascending part is made in line blood vessel main body 15
Section is radial to being externally connected with collar shape sutural margin 2 11.It is arranged such, it can be achieved that the arch of aorta, part aorta ascendens blood vessel
Internalization can effectively prevent the small probability event of long-term postoperative bleeding.Other compositions and connection relationship and specific embodiment five
It is identical.
Specific embodiment 7: illustrating present embodiment, the initiative pulse support blood vessel 1 of present embodiment in conjunction with Fig. 2 to Fig. 4
Total length be 260-360mm, the diameter of initiative pulse support blood vessel 1 is 22-32mm, wherein drop portion initiative pulse support blood vessel 2
Length 100-180mm.So set, convenient for being suitable for different use environments.Other compositions and connection relationship and specific implementation
Mode six is identical.
Specific embodiment 8: illustrating present embodiment, the Y shape bow part branch 6 of present embodiment, bow in conjunction with Fig. 2 to Fig. 4
Part branch 1, bow part prop up 29, branch stent blood vessel 5, branch's diameter of bow part branch 47 is 6-18mm, branch stent
The length 10-50mm of blood vessel 5；Angle between bow part branch 1 and bow part branch 29 is 30 ° -150 °.So set, being applicable in
Range is wide, and other compositions and connection relationship are identical as specific embodiment seven.
Specific embodiment 9: illustrating present embodiment in conjunction with Fig. 2 to Fig. 8, present embodiment further includes conveying device, defeated
Sending device includes two groups of mutually independent release systems: i.e. drop portion initiative pulse support blood vessel release system and branch stent blood vessel are released
Place system composition, drop portion initiative pulse support blood vessel release system are mounted on the side of drop portion initiative pulse support blood vessel 2, branch stent
Blood vessel release system is mounted on the side of branch stent blood vessel 5；Wherein, drop portion initiative pulse support blood vessel release system includes drop portion
It pulls back bar 16 and drop portion lashing wire 17, drop portion lashing wire 17 is looped around drop portion back and forth and pulls back on bar 16；The release of branch stent blood vessel
System includes branching back to pull rod 18 and branch's lashing wire 19, and branch's lashing wire 19 is looped around branches back on pull rod 18 back and forth.So
Setting, is easy to implement the smooth delivery of power of blood vessel.Other compositions and connection relationship are identical as specific embodiment seven.
Specific embodiment 10: illustrating that present embodiment, present embodiment further include built-in in conjunction with Fig. 4 to Fig. 8；
The first built-in includes hard bow portion 20, and hard bow portion 20 is that radius of curvature is identical or from proximal part to remote
The equal arc pipe of the gradually smaller caliber of heart extreme direction radius of curvature, hard bow portion 20 are equipped with multiple branch's windows and ring
Shape dent 24, hard bow portion 20 are mounted on inside bow portion initiative pulse support blood vessel 3；
Second of built-in includes hard ascending part, and hard ascending part is in straight or hettocyrtosis tubular, in hard bow portion 20
Equipped with fixation hole 26 and cyclic annular dent 24, hard ascending part is mounted on the inside of aorta ascendens Yu ascending part initiative pulse support blood vessel 4, firmly
Matter bow portion 20 is mounted on inside bow portion initiative pulse support blood vessel 3.
So set, realizing the suture connection of aorta ascendens rapid free, other compositions and connection relationship and specific embodiment
Seven is identical.
Preceding upper limb in the middle section in hard bow portion 20 is equipped with branch's window 1, is equipped with branch's window two in its latter end upper limb
22, section facies ventralis is equipped with branch's window 3 23 wherein；Between branch's window 1 and branch's window 2 22 and hard bends
The bow portion surface of 20 proximal part of portion is equipped with cyclic annular dent 24.
The opening that branch's window 1 and branch's window 3 23 are round or oval, branch's window 2 22 are half
The open hole of rounded distal.
The distal end of hard ascending part is equipped with fixation hole 26, and the middle part surface of hard ascending part is equipped with cyclic annular dent 24.
When hard bow portion 20 is in the tubular of hettocyrtosis, bending angle refers to 30 ° -90 °, and caliber (diameter) is
22-32mm, bending radius 30-60mm.
20 bent angle alpha of hard bow portion is 30 °, and caliber d is 22mm, radius of curvature R 40mm.Hard bow portion 20 constitutes material
Material is titanium alloy, stainless steel or polypropylene plastics, preferably titanium alloy.
Embodiment 1
A kind of individuation branch stent type bow portion reconstruction artificial blood vessel, comprising: initiative pulse support blood vessel 1, drop portion is actively
The line vasculature part of making of arteries and veins stented vessel 2 extends for bow portion initiative pulse support blood vessel 3 and ascending part aortic stents blood to proximal part
Pipe 4, bow portion initiative pulse support blood vessel 3 are issued comprising multiple bow parts branch including a branch stent blood vessel 5；Actively
The principal length of arteries and veins stented vessel 1 is 300mm, and diameter 24mm, initiative pulse support blood vessel 2 length in drop portion is 120mm；Branch
The structural schematic diagram that support rack type bow portion is rebuild after artificial blood vessel's release is as shown in Figure 2；
The branch stent blood vessel 5, including drop thin-walled artificial blood vessel A-1 and multiple branch's metallic support A-2, thin-walled people
Work blood vessel A-1 is sewed with multiple cyclic annular branches' metallic supports in Nei Bi, branch root extend for one section of unsupported overlay film with
The latter end upper limb that bow portion makes line blood vessel main body 14 is coincide and is connected by suture；5 length of branch stent blood vessel is 32mm, and diameter is
12mm, thin-walled artificial blood vessel's A-1 constituent material is polyester woven object, cylindrical such as thin dacron fabric blood vessel.
Drop portion initiative pulse support blood vessel 2 is by descending aorta metallic support 12 and makes line artificial blood vessel and forms, and makes the artificial blood of line
Inside pipe wall is sewed with multiple cyclic annular descending aorta metallic supports 12；The main body of drop portion initiative pulse support blood vessel 2 and ascending part 4, bow portion 3
Be it is integrated make line blood vessel, constituent material is polyester woven object, such as dacron blood vessel.
The descending aorta metallic support 12 is the annular enclosed carrier unit of Z-shaped or wavy shaped configuration, each bracket
Between unit independently of one another, by wave crest to wave crest or trough to trough in the form of arrange.Metallic support 12 is closed by nickel-titanium shape memory
Gold or cochrome silk etc. customize, and constitute straight tube shape on the whole.
Bow portion initiative pulse support blood vessel 3, main body issue Y shape bow part branch 6, bow part branch 47, branch stent blood
Pipe 5 bends part branch three, and Y shape bow part branch 6 is further separated into bow part branch 1 and bow part branch 29；Above-mentioned branch's diameter is
10-16mm；9 one-tenth 60 ° of bow part branch 1 and bow part branch 2.
The ascending part initiative pulse support blood vessel 4, bow portion initiative pulse support blood vessel 3 are respectively in the former middle section, the latter and its Y shape
The junction of the root of bow part branch 6, collar shape sutural margin 2 11, collar shape sutural margin are connected each by medical suture outward
One 10.Collar shape sutural margin constituent material is polyester woven object, such as terylene or polytetrafluoroethylene (PTFE) (PTFE).
The conveying device is by two groups of mutually independent release systems: drop portion initiative pulse support blood vessel 2 discharges system and divides
Branch stented vessel 5 discharges system composition, and initiative pulse support blood vessel 2 release system in drop portion is pulled back bar 16 and drop portion lashing wire by drop portion
17 compositions, 5 release system of branch stent blood vessel are formed by branching back to pull rod 18 and branch's lashing wire 19.Before implantation, use is medical
Suture respectively fetters drop portion initiative pulse support blood vessel 2 and branch stent blood vessel 5, greatly reduces the two cross-sectional diameter
In stand-by state, as shown in Figure 3.
The built-in hard bow portion 20 is the arc pipe that radius of curvature, caliber are equal, wherein section preceding upper limb,
Latter end upper limb and middle section facies ventralis are respectively equipped with branch's window 1, branch's window 2 22, branch's window 3 23；In branch's window
Cyclic annular dent 24 is equipped between one 21 and branch's window 2 22 and on the bow portion surface of 20 proximal part of hard bow portion.
When operation, it can be intubated and be irrigated through right side axillary artery, profound hypothermia after stopping circulation, splits a liter master along antetheca long axis
Artery and the arch of aorta, the branch stent type bow portion after taking binding rebuild artificial blood vessel such as Fig. 3, drop portion initiative pulse support blood vessel
2 and branch stent blood vessel 5 be inserted into descending aorta and the true chamber of left subclavian artery respectively simultaneously, adjust the angle, successively pull back branch
Pull back bar 18, drop portion pulls back bar 16, and medical suture is freed therewith, and branch stent blood vessel 5 and drop portion initiative pulse support blood vessel 2 are immediately
It is released in place, the intracavitary therapy of corresponding two arteries of completion.
Then, the hard bow portion 20 built-in from the insertion of the proximal part of ascending part initiative pulse support blood vessel 4, makes its branch's window one
21, branch's window 2 22, be respectively aligned to Y shape bow part branch 6, the root of branch stent blood vessel 5.With thick line by the self arch of aorta
Vascular wall, bow portion make line blood vessel main body, tighten on the cyclic annular dent 24 in built-in hard bow portion 20, knot.As shown in Figure 4.
By bow part branch 47 carry out antegrade perfusions, be sequentially completed left common carotid artery, innominate artery coincide.Then ascending part master is carried out
Bow portion reconstruction operations are completed at the end end or intralumenal anastomosis of 4 proximal end of arterial bracket blood vessel and aorta ascendens.
For some cases, proximal part lesion can be first handled during cooling, such as the replacement of row aorta root and bilateral hat
Shape arterial ostium transplants (Bentall), the aorta petal for retaining aortic sinus and aorta ascendens and replaces the operation such as (Wheat), it
Afterwards, profound hypothermia, stop recycling, as aforesaid operations carry out the reconstruction of bow portion.It is carrying out 4 proximal part of ascending part initiative pulse support blood vessel and is rising to lead
Artery artificial blood vessel it is identical when, can apply built-in hard ascending part of the invention, carry out rapid free suture connection.
For most of cases, rise, collar shape sutural margin reserved in bow portion initiative pulse support blood vessel main body need not use.
A small number of cases will can rise, in bow portion initiative pulse support blood vessel main body in vitro after circulation terminates to take precautions against long-term postoperative bleeding
Reserved collar shape sutural margin carries out the connection that coincide with corresponding self aorta wall, realize the arch of aorta, aorta ascendens it is interior
Portionization such as figure five.Or the internalization of the arch of aorta, part aorta ascendens such as figure six, for further taking precautions against long-term postoperative bleeding
Small probability event.
Embodiment 2
The principal length of initiative pulse support blood vessel 1 is 320mm, diameter 26mm, and wherein drop portion initiative pulse support blood vessel 2 is main
Body length 140mm；Branch stent blood vessel 5 length 34mm, diameter 14mm.45 ° of 20 bending angle of hard bow portion, caliber are
24mm, bending radius 50mm.Other are same as Example 1.
Embodiment 3
The principal length of initiative pulse support blood vessel 1 is 340mm, diameter 28mm, and wherein drop portion initiative pulse support blood vessel 2 is main
Body length 160mm；Branch stent blood vessel 5 length 36mm, diameter 16mm.60 ° of 20 bending angle of hard bow portion, caliber are
26mm, bending radius 60mm.Other are same as Example 1.
Above-described embodiment is not to limit the present invention, all within the spirits and principles of the present invention, make it is any modification, etc.
With replacement, improvement etc., should all be included in the protection scope of the present invention.
Claims (10)
1. a kind of individuation branch stent type bow portion rebuilds artificial blood vessel, it includes initiative pulse support blood vessel (1), and feature exists
Line artificial blood vessel part is made to proximal part direction successively in: the drop portion initiative pulse support blood vessel (2) of initiative pulse support blood vessel (1)
Extend for bow portion initiative pulse support blood vessel (3) and ascending part initiative pulse support blood vessel (4), bow portion initiative pulse support blood vessel (3)
It is upper to issue comprising multiple bow parts branch including a branch stent blood vessel (5)；
Drop portion initiative pulse support blood vessel (2) includes making line artificial blood vessel and multiple descending aorta metallic supports (12), descending aorta
Metallic support (12) is annular metal bracket, makes and is sewed with multiple cyclic annular descending aorta metallic supports on the inner wall of line artificial blood vessel
(12)；
Branch stent blood vessel (5) includes thin-walled artificial blood vessel (A-1) and multiple branch's metallic supports (A-2), branch stent blood vessel
(5) it is opened on bow portion initiative pulse support blood vessel (3) latter end upper limb, branch's metallic support (A-2) is annular metal bracket, thin-walled people
The inner wall of work blood vessel (A-1) is sewed with multiple annular metal brackets (A-2).
2. a kind of individuation branch stent type bow portion according to claim 1 rebuilds artificial blood vessel, it is characterised in that: bow portion
Initiative pulse support blood vessel (3) includes that unsupported bow portion makes line blood vessel main body (14), branch stent blood vessel (5), Y shape bow part branch
(6), bend part Zhi Si (7) and collar shape sutural margin one (10)；
Bow portion makes line blood vessel main body (14) upper limb connection Y shape bow part branch (6) before middle section, and Y shape bow part branch (6) is further divided
For bow part one (8) of branch and bow part two (9) of branch, make the company of line blood vessel main body (14) for the root and bow portion of Y shape bow part branch (6)
Place's connection collar shape sutural margin one (10) outward is connect, bow portion makes line blood vessel main body (14) and is connected to bow part Zhi Si in middle section facies ventralis
(7), bow portion makes line blood vessel main body (14) and sutures connected component's stented vessel (5) by suture in latter end upper limb.
3. a kind of individuation branch stent type bow portion according to claim 2 rebuilds artificial blood vessel, it is characterised in that: branch
The thin-walled artificial blood vessel (A-1) of stented vessel (5) outer layer extends for one section of unsupported overlay film in branch root, this section of overlay film with
The latter end upper limb that bow portion makes line blood vessel main body (14) is coincide and is connected by suture.
4. a kind of individuation branch stent type bow portion according to claim 1,2 or 3 rebuilds artificial blood vessel, feature exists
In: it further includes fixed ring (13), and the interface that line blood vessel main body (14) is made in the root and bow portion of branch stent blood vessel (5) supports
There are fixed ring (13).
5. a kind of individuation branch stent type bow portion according to claim 4 rebuilds artificial blood vessel, it is characterised in that: drop master
Artery metallic support (12) is the annular metal carrier unit of closure, between each unit independently of one another, constitutes straight tube shape on the whole
Or tapered cylindrical shape.
6. a kind of individuation branch stent type bow portion according to claim 5 rebuilds artificial blood vessel, it is characterised in that: ascending part
Initiative pulse support blood vessel (4) includes that unsupported ascending part makes line blood vessel main body (15) and collar shape sutural margin two (11), ascending part are made
The middle section of line blood vessel main body (15) is radial to being externally connected with collar shape sutural margin two (11).
7. a kind of individuation branch stent type bow portion according to claim 1 or 6 rebuilds artificial blood vessel, it is characterised in that:
The total length of initiative pulse support blood vessel (1) is 260-360mm, and the diameter of initiative pulse support blood vessel (1) is 22-32mm, wherein drop
The length 100-180mm of portion's initiative pulse support blood vessel (2).
8. a kind of individuation branch stent type bow portion according to claim 7 rebuilds artificial blood vessel, it is characterised in that: Y shape
Partially one (8) of branch, bow part two (9) of branch, branch stent blood vessel (5), the branch of bow part Zhi Si (7) are straight for bow part branch (6), bow
Diameter is 6-18mm, the length 10-50mm of branch stent blood vessel (5)；Between bow part one (8) of branch and bow part two (9) of branch
Angle is 30 ° -150 °.
9. a kind of individuation branch stent type bow portion reconstruction artificial blood vessel according to claim 2 or 8, it is characterised in that:
It further includes conveying device, and conveying device includes two groups of mutually independent release systems: i.e. drop portion initiative pulse support blood vessel discharges
System and branch stent blood vessel release system composition, drop portion initiative pulse support blood vessel release system are mounted on drop portion aortic stents
The side of blood vessel (2), branch stent blood vessel release system are mounted on the side of branch stent blood vessel (5)；
Wherein, drop portion initiative pulse support blood vessel release system includes that drop portion pulls back bar (16) and drop portion lashing wire (17), and drop portion is tied
Wiring (17) is looped around drop portion back and forth and pulls back on bar (16)；
Branch stent blood vessel release system includes branching back to pull rod (18) and branch's lashing wire (19), and branch's lashing wire (19) is round-trip
It is looped around and branches back on pull rod (18).
10. a kind of individuation branch stent type bow portion according to claim 9 rebuilds artificial blood vessel, it is characterised in that: it
It further include built-in；Built-in includes hard bow portion (20), and hard bow portion (20) is that radius of curvature is identical or by the nearly heart
The arc pipe equal to the gradually smaller caliber of distal end directional curvature radius is held, hard bow portion (20) is equipped with multiple branches
Window and cyclic annular dent (24), it is internal that hard bow portion (20) is mounted on bow portion initiative pulse support blood vessel (3).
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| CN115517811A (en) * | 2022-11-01 | 2022-12-27 | 北京华脉泰科医疗器械股份有限公司 | Integrated stent artificial blood vessel and artificial blood vessel replacement kit |
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