CN109662804A - The dedicated endovascular stent of TIPS operation - Google Patents

The dedicated endovascular stent of TIPS operation Download PDF

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Publication number
CN109662804A
CN109662804A CN201910037486.9A CN201910037486A CN109662804A CN 109662804 A CN109662804 A CN 109662804A CN 201910037486 A CN201910037486 A CN 201910037486A CN 109662804 A CN109662804 A CN 109662804A
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China
Prior art keywords
overlay film
skeleton
anchor portion
tube shape
straight tube
Prior art date
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Pending
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CN201910037486.9A
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Chinese (zh)
Inventor
李卫校
翟水亭
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Individual
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Individual
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Priority to CN201910037486.9A priority Critical patent/CN109662804A/en
Publication of CN109662804A publication Critical patent/CN109662804A/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/04Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06Blood vessels
    • A61F2/07Stent-grafts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/04Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06Blood vessels
    • A61F2/07Stent-grafts
    • A61F2002/075Stent-grafts the stent being loosely attached to the graft material, e.g. by stitching
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/04Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06Blood vessels
    • A61F2/07Stent-grafts
    • A61F2002/077Stent-grafts having means to fill the space between stent-graft and aneurysm wall, e.g. a sleeve
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0096Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers
    • A61F2250/0098Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers radio-opaque, e.g. radio-opaque markers

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Public Health (AREA)
  • Transplantation (AREA)
  • Cardiology (AREA)
  • Veterinary Medicine (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Pulmonology (AREA)
  • Physics & Mathematics (AREA)
  • Optics & Photonics (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Prostheses (AREA)

Abstract

The present invention relates to a kind of endovascular stents for TIPS art, to cause portal vein and Hepatic venous flow to be severely impacted when solving the problems, such as that straight tube shape overlay film frame is applied to TIPS art, while solving the problems, such as that traditional bare bracket is easy to appear tissue and leads to stent occlusion to the intracavitary hyperplasia of stand tube.It includes straight cylindrical skeleton and tubulose overlay film;The tubulose overlay film is fixed at the middle part of the straight cylindrical skeleton, so that the both ends of the straight cylindrical skeleton form exposed anchor portion.Its both ends are capable of forming the anchor portion with open-work, and locating effect is excellent, and open-work can reduce the influence to blood flow intravascular at anchoring in application by blood flow.

Description

The dedicated endovascular stent of TIPS operation
Technical field
The present invention relates to Medical rack technical fields, and in particular to a kind of TIPS(transjugular intrahepatic Portosystemic shunt) the dedicated endovascular stent of operation.
Background technique
In the world, cirrhosis is the fourth-largest lethal factor after tumour, cardiovascular disease, chronic lung disease (non-communicable diseases), in past 20 years, the death rate caused by cirrhosis and liver cancer increases about 50,000,000 every year.Study carefully its original Because being because hepatopathy compensation is powerful, the concealment of hepatopathy onset is asymptomatic.Liver cirrhosis patient is only being developed to decompensation Phase can just show various Decompensated stage symptoms.In cirrhosis patients in decompensation, Esophago-gastric varices will occur in patient.Once The esophageal varices rupture haemorrhage of varicose will cause serious massive hemorrhage of gastrointestinal tract.Alimentary canal caused by Cirrhotic Portal Hypertension Bleeding accounts for about the 70% of entire Diagnosing Gastrointestinal Bleeding.The first time bleeding death rate can reach 15-20%, if liver when patient's bleeding Function is Child-Pugh C grades, and the death rate can reach 30%.
Referring to Fig. 1, transjugular intrahepatic portosystemic shunt (transjugular intrahepatic Portosystemic shunt, TIPS) passing through endovascular stent 2 in liver parenchyma 11 between portal vein 13 and vena hepatica 14 Set up split channel.TIPS art can not only reduce portal venous pressure, but also it is thorough to combine esophageal varices Embolization Treatment Cirrhotic Portal Hypertension caused by hemorrhage of digestive tract.TIPS art has become treatment Cirrhotic Portal Hypertension alimentary canal at present One of most important treatment method of bleeding.The bracket that current TIPS art can use includes bare metal stent, overlay film frame (Fluency, Viabahn) and Viatorr overlay film frame.
There are two types of the production methods of bare metal stent: the first, gone out by laser-induced thermal etching with mesh in tubular metal Tubular bracket, the bare metal stent rigidity that this method is produced is high, and support force is strong, but flexibility is poor;Second, pass through metal Silk knits out the tubular bracket with mesh, and the bare metal stent flexibility that this method is produced is good, but support force is poor.It is using When, body tissue can be grown by mesh into bare metal stent, and the lumen in bare metal stent is caused to block.Overlay film frame (Fluency, Viabahn) and Viatorr compound film laminating bracket are to be covered with PTFE film on the outside of bare metal stent, due to The blocking of PTFE film, tissue will not be to bare metal stent pipe Intracavities, and unobstructed effect at a specified future date is good.
Present inventor studies discovery: 1. when establishing door body split channel in liver using bare brackets, and body tissue can be with By stent mesh to the intracavitary hyperplasia of stand tube, postoperative restenosis incidence is higher;2. bare bracket is unable to closure gate venipuncture The cut at point place, the risk of portal vein point of puncture generation bleeding is higher in art;3. overlay film frame and bare bracket combined application are used, it can With comprehensive two kinds of bracket advantages, but use two pieces of brackets costly, operative process is excessively complicated;4. using Viatorr overlay film frame can simplify partial surgical operation, but the bracket proximal part is overlay film frame, influences vena hepatica trunk And the blood flow of inferior caval vein.
Summary of the invention
Goal of the invention of the invention is to provide a kind of dedicated endovascular stent of TIPS operation, to pass through technical strategies Mode when solving straight tube shape overlay film frame applied to TIPS operation caused by portal vein and vena hepatica blood vessel turnoff blood The technical issues of stream is affected.
In order to solve the above technical problems, the present invention adopts the following technical scheme:
Design a kind of dedicated endovascular stent of TIPS operation, including straight tube shape elastic skeleton and tubulose overlay film;The tubulose covers Film is fixed at the middle part of the straight tube shape elastic skeleton, so that the both ends of the straight tube shape elastic skeleton form exposed anchor Determine portion, open-work is equipped in the anchor portion.
Preferably, the straight tube shape elastic skeleton is laser engraving skeleton, in the laser engraving skeleton and the tubulose The front end boundary of overlay film is equipped with developing mark point in the anchor portion.
Preferably, the straight tube shape elastic skeleton is metal wire knitted skeleton, in the front end of the metal wire knitted skeleton It is formed with swollen thick changeover portion, the tubulose overlay film is equipped on the swollen thick changeover portion.
Compared with prior art, the beneficial effects of the present invention are:
The overlay film part of interlude can prevent the hyperplasia of postoperative inner membrance, improve bracket long-term patency rate;Both ends bare bracket forms band There is the anchor portion of open-work, locating effect is excellent, and open-work can penetrate blood flow, can be greatly reduced in application to portal vein and liver The influence of the blood flow of the blood vessel turnoff of vein.
The present invention can be also used for vena iliaca externa compression syndrome in addition to it can be used for portosystemic shunt in liver (TIPS) operation With on the bow of aorta pectoralis endovascular repair points of artery orthotopic fenestration art.
Detailed description of the invention
Fig. 1 is the effect diagram of portosystemic shunt (TIPS) operation in liver.
Fig. 2 is that a kind of TIPS of the present invention performs the operation 1 structure chart of embodiment of dedicated endovascular stent.
Fig. 3 is the structure chart of the laser engraving skeleton in embodiment 1.
Fig. 4 is that a kind of TIPS of the present invention performs the operation 2 structure chart of embodiment of dedicated endovascular stent.
Fig. 5 is the structure chart of the metal wire knitted skeleton in embodiment 2.
Fig. 6 is portosystemic shunt (TIPS) hand in liver after performing the operation dedicated endovascular stent using a kind of TIPS of the present invention The effect diagram of art.
In figure, 11- liver parenchyma, 12- inferior caval vein, 13- portal vein, 14- vena hepatica, 2- endovascular stent, 21- straight tube shape Elastic skeleton, the front end 211- anchor portion, the rear end 212- anchor portion, 22- tubulose overlay film, 3- developing mark point, the anchoring of the front end L11- Portion's axial length, L12- tubulose overlay film axial length, the rear end L13- anchor portion axial length, the swollen thick section in the front end L21-, L22- are swollen Thick changeover portion, L23- middle part, the swollen thick changeover portion of L24-, the swollen thick section in the rear end L25-.
Specific embodiment
Illustrate a specific embodiment of the invention with reference to the accompanying drawings and examples, but following embodiment is used only in detail It describes the bright present invention in detail, does not limit the scope of the invention in any way.
Embodiment 1: a kind of endovascular stent, referring to figure 2-3, including straight tube shape elastic skeleton 21 and tubulose overlay film 22.
Straight tube shape elastic skeleton 21 is using the tubular bracket with mesh manufactured in tubular metal by laser-induced thermal etching.
Tubulose overlay film 22 can use the film suitable for medical stent, with preferable toughness, such as: PTFE material, Polytetrafluoroethylene material etc..
Tubulose overlay film 22 can by wrapping up in the middle part for the modes such as setting, interweaving and be fixed at straight tube shape elastic skeleton 21, Gu Fixed mode can be bonding, (taeniae telarum's base of a fruit even refers to that a kind of substance is wrapped by another material part or all for taeniae telarum's base of a fruit company The situation wrapped up in) so that the both ends of straight tube shape elastic skeleton 21 form exposed front end anchor portion 211 and rear end anchor portion 212, it is preceding It holds anchor portion 211 and rear end anchor portion 212 is bare bracket, blood flow can be passed through.In this way, the both ends of the bracket are each formed with band There is the anchor portion of open-work, the influence to vascular flow can be reduced when in use.
Referring to fig. 2, in the front end boundary of laser engraving skeleton 21 and tubulose overlay film 22, in front end anchor portion 211 most It is equipped with developing mark point 3 well.
Preferably, the internal diameter of the straight tube shape elastic skeleton 21, which can be set to, common are 8mm, 10mm, 12mm, front end anchor The length for determining portion 211 can be set as 2cm, and the length of rear end anchor portion 212 is set as 2cm, 3cm.
By taking portosystemic shunt in liver (TIPS) operation as an example, front end anchor portion 211 is in portal vein 13, rear end anchor portion 212 in the vena hepatica 14, and intermediate capping film section 22 be in liver parenchyma 11, interlude with overlay film part 22 can prevent tissue to The intracavitary hyperplasia of stand tube, front end anchor portion 211 and rear end anchor portion 212 are fixed on bracket both ends in portal vein and vena hepatica, Vena hepatica and pylic blood flow are not influenced simultaneously.The front end of laser engraving skeleton 21 refers specifically to be located in portal vein 13 one Developing mark point 3 is observed by developing apparatus, it can be determined that laser engraving skeleton 21 and 22 front end boundary of tubulose overlay film exist in end Position in portal vein 13.
Embodiment 2: a kind of endovascular stent, referring to fig. 2-4, including straight tube shape elastic skeleton 21 and tubulose overlay film 22.
The braided fabric made of filiform braiding of straight tube shape elastic skeleton 21, filiform can be endovascular stent Wire, for example, nickel-titanium metal silk.
Referring to fig. 4-6, it is formed with swollen thick changeover portion (corresponding to L24) in the front end of metal wire knitted skeleton, in swollen thick mistake Section is crossed equipped with tubulose overlay film, and one end of tubulose overlay film 22 is preferably disposed at the maximum outside diameter of swollen thick changeover portion.
Referring to fig. 4, in the front end boundary of straight tube shape elastic skeleton 21 and tubulose overlay film 22, in front end anchor portion 211 It is preferably provided with developing mark point 3.
By taking portosystemic shunt in liver (TIPS) operation as an example, rear end anchor portion 212 is in vena hepatica 14 and inferior caval vein 12 Interior, front end anchor portion 211 is in portal vein 13, and intermediate capping film section 22 is in liver parenchyma, and interlude band overlay film part 22 can To prevent tissue from so that bracket both ends is fixed on portal vein to the intracavitary hyperplasia of stand tube, front end anchor portion 211 and rear end anchor portion 212 In vena hepatica, while vena hepatica and pylic blood flow are not influenced.The front end of metal wire knitted skeleton refers specifically to quiet positioned at door One end in arteries and veins 13.
The present invention can be also used for vena iliaca externa compression syndrome in addition to it can be used for portosystemic shunt in liver (TIPS) operation With on the bow of aorta pectoralis endovascular repair points of artery orthotopic fenestration art.
The present invention is described in detail above in conjunction with drawings and examples, still, those of skill in the art Member is it is understood that without departing from the purpose of the present invention, can also carry out each design parameter in above-described embodiment Change, forms multiple specific embodiments, is common variation range of the invention, is no longer described in detail one by one herein.

Claims (3)

  1. The dedicated endovascular stent 1. a kind of TIPS performs the operation, including straight tube shape elastic skeleton, which is characterized in that further include that tubulose covers Film;The tubulose overlay film is fixed at the middle part of the straight tube shape elastic skeleton, so that the two of the straight tube shape elastic skeleton End forms exposed anchor portion, and open-work is equipped in the anchor portion.
  2. 2. endovascular stent as described in claim 1, which is characterized in that the straight tube shape elastic skeleton is laser engraving bone Frame is equipped with developing mark point in the front end boundary of the laser engraving skeleton and the tubulose overlay film in the anchor portion.
  3. 3. endovascular stent as described in claim 1, which is characterized in that the straight tube shape elastic skeleton is metal wire knitted bullet Property skeleton, be formed with swollen thick changeover portion in the front end of the metal wire knitted skeleton, be equipped on the swollen thick changeover portion described Tubulose overlay film.
CN201910037486.9A 2019-01-15 2019-01-15 The dedicated endovascular stent of TIPS operation Pending CN109662804A (en)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111643221A (en) * 2020-06-16 2020-09-11 郑州大学第一附属医院 Intrahepatic portosystemic shunt bracket with diameter capable of being automatically adjusted

Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN2863016Y (en) * 2005-09-09 2007-01-31 深圳市先健科技股份有限公司 Blood vessel tectorial rack with protection function for branch vessel
CN2873140Y (en) * 2006-02-22 2007-02-28 东南大学介入放射学研究所 Anti-bile TIPS coated rack and its placing device
CN201208321Y (en) * 2008-06-06 2009-03-18 北京工业大学 Local tectorial blood vessel internal naked stent
CN202859182U (en) * 2012-09-18 2013-04-10 孙立忠 Membrane-covered stent
CN104758086A (en) * 2015-04-20 2015-07-08 湖南埃普特医疗器械有限公司 Cerebral aneurysm intracavity blood vessel rebuilding device
CN204671319U (en) * 2015-04-21 2015-09-30 中国人民解放军第二军医大学 A kind of conical support graft being applicable to the band distal end bare bracket of dissection of aorta
CN105943198A (en) * 2016-05-24 2016-09-21 李雷 Combined stent used for TIPS operation
WO2018072432A1 (en) * 2016-10-20 2018-04-26 先健科技(深圳)有限公司 Luminal stent
CN108261253A (en) * 2016-12-31 2018-07-10 先健科技(深圳)有限公司 Overlay film frame
CN209847467U (en) * 2019-01-15 2019-12-27 李卫校 Intravascular stent special for TIPS operation

Patent Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN2863016Y (en) * 2005-09-09 2007-01-31 深圳市先健科技股份有限公司 Blood vessel tectorial rack with protection function for branch vessel
CN2873140Y (en) * 2006-02-22 2007-02-28 东南大学介入放射学研究所 Anti-bile TIPS coated rack and its placing device
CN201208321Y (en) * 2008-06-06 2009-03-18 北京工业大学 Local tectorial blood vessel internal naked stent
CN202859182U (en) * 2012-09-18 2013-04-10 孙立忠 Membrane-covered stent
CN104758086A (en) * 2015-04-20 2015-07-08 湖南埃普特医疗器械有限公司 Cerebral aneurysm intracavity blood vessel rebuilding device
CN204671319U (en) * 2015-04-21 2015-09-30 中国人民解放军第二军医大学 A kind of conical support graft being applicable to the band distal end bare bracket of dissection of aorta
CN105943198A (en) * 2016-05-24 2016-09-21 李雷 Combined stent used for TIPS operation
WO2018072432A1 (en) * 2016-10-20 2018-04-26 先健科技(深圳)有限公司 Luminal stent
CN108261253A (en) * 2016-12-31 2018-07-10 先健科技(深圳)有限公司 Overlay film frame
CN209847467U (en) * 2019-01-15 2019-12-27 李卫校 Intravascular stent special for TIPS operation

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111643221A (en) * 2020-06-16 2020-09-11 郑州大学第一附属医院 Intrahepatic portosystemic shunt bracket with diameter capable of being automatically adjusted

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