CN109820620A - A kind of anastomosis system of novel blood vessel and intravascular stent - Google Patents

A kind of anastomosis system of novel blood vessel and intravascular stent Download PDF

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Publication number
CN109820620A
CN109820620A CN201910245238.3A CN201910245238A CN109820620A CN 109820620 A CN109820620 A CN 109820620A CN 201910245238 A CN201910245238 A CN 201910245238A CN 109820620 A CN109820620 A CN 109820620A
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blood vessel
artificial blood
branch
main body
ring
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钱希明
何帆
陈怀东
张政
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Abstract

The invention discloses the anastomosis systems of a kind of novel blood vessel and intravascular stent, including branch's artificial blood vessel's group, stent-graft group, exempt from suture ring and identical buckle device, the main body of the branch artificial blood vessel group is the main body artificial blood vessel of tubular structure, and in the fixed main split artificial blood vessel for being communicated with tubular structure in the upper end of main body artificial blood vessel, there are three branch vessels for the fixed connection in the upper end of the main split artificial blood vessel;By using the present invention; simplify operating procedure, reduces operating difficulty, and then greatly shorten external time, operating time, Deep Hypothermia Circulatory Arrest time and brain guard time; operative mortality rate is reduced, while reducing nervous system and the incidence rate of other complication;Previous anastomotic in the present invention is less, and by buckle device and the fastening for exempting from suture ring of coincideing, reduces the probability of bleeding, thereby reduce the death rate, greatly improve the probability of success of operation.

Description

A kind of anastomosis system of novel blood vessel and intravascular stent
Technical field
The present invention relates to artificial blood vessels to be placed in technical field, specially a kind of identical system of novel blood vessel and intravascular stent System.
Background technique
Acute Aortic Dissecting Aneurysm is disease most commonly seen and dangerous in Acute aortic syndromes, although due to Early diagnosis and timely surgery are handled, and clinical prognosis has been obtained greatly improvement, improves, but the death rate of its early stage And long term re-treatm ent rate is still very high.Conventional aortic interlayer is there are two types of more commonly used classifying method: Stanford parting and Debakey parting.For Standford parting, no matter which position interlayer originates from, as long as involving aorta ascendens, person is known as A Type;Interlayer is originating from descending thoracic aorta and does not involve aorta ascendens person is known as Type B.Debakey divides dissecting aneurysm of aorta For three types: I type, dissecting aneurysm of aorta is originating from aorta ascendens and involves abdominal aorta;II type, dissecting aneurysm of aorta It is confined to aorta ascendens;Type III, dissecting aneurysm of aorta originate from descending thoracic aorta, and not involving abdominal aorta downwards, person claims For IIIA, involving abdominal aorta, person is known as IIIB.StanfordA type is equivalent to DebakeyI type and II type, StanfordB type phase When in DebakeyIII type.
And acute Stanford A type dissecting aneurysm of aorta is the acute disease of a life-threatening, in initial 24 of falling ill ~48h, the death rate can increase by 1%~2% per hour.Untreated person, the death rate is about 75% when falling ill 2 weeks, 1 Nian Shike high Up to 91%.Based on this, world wide has been built consensus, and emergency surgery operation is to treat Stanford A type dissection of aorta only One effective method.Although Surgical technique and preoperative, postoperative care make moderate progress, since the state of an illness is critical, operation is complicated, The case fatality rate of Stanford A type dissection of aorta is still higher, up to 10%~25%.If early stage can be to acute Stanford A dissecting aneurysm of aorta is effectively assessed, and sufficient preparation is carried out, then can reduce its death rate.
Stanford A type Aortic Dissection is complicated, different art formulas should be selected according to lesion, marfan's syndrome is simultaneously Hair active interlayer and dissection of aorta involve aortic root, coronary artery and severe aortic valve incompetence person are caused to use Bentall operation;Dissection of aorta involve aorta petal, sinus portion can the person's of reparation row David operation.The person that involves aorta ascendens merely It need only row aorta ascendens displacement technique.Park etc. points out the acute Stanford A type aorta clamp for involving aortic arch Layer, the full bow displacement technique+bracket elephant trunk technique of row are only correct effective treatment methods.2003, professor Sun Lizhong was first in state Inside start the treatment that interlayer is carried out using Betall art or aorta ascendens displacement+full Aortic arch replacement+bracket " trunk " operation. The characteristics of art formula, is using four bifurcated artificial blood vessels and bracket " trunk " technology.Bend entirely using four bifurcated artificial blood vessel rows and sets It changes, after completion active distal arteries and veins coincide under Deep Hypothermia Circulatory Arrest, selective ascending venography venous, can be inserted through branch artificial blood vessel Enter arterial cannulation and restore lower part of the body blood perfusion, greatly reduces and stop circulation time.The great advantage of bracket " trunk " is selected to exist Have self-expanding characteristic in the artificial blood vessel of belt supporting frame, can not only sealing blood vessels inner membrance cut, make be pressurized true chamber obtain maximum The expansion of limit, while can also squeeze, eliminate false chamber and be attached onto the wall structures torn again, realize vascular wall It rebuilds.
But three branch vessels need to kiss with innominate artery, left common carotid artery, left subclavian artery respectively in Four branches aortic graft It closes, vessel trunk proximal end need to coincide with aorta ascendens notch, need to distally coincide with trunk bracket proximal segment, previous anastomotic is more, can lead It causes:
1. modus operandi is complicated, external time, operating time, Deep Hypothermia Circulatory Arrest time and brain guard time extend, hand The art death rate, nervous system and other complication increased significantly;
2. previous anastomotic is more so that relatively easy bleeding, anthemorrhagic difficulty in art, postoperative hemorrhage amount is big in art, to increase death Rate.
Summary of the invention
The purpose of the present invention is to provide the anastomosis systems of a kind of novel blood vessel and intravascular stent, to solve above-mentioned background It is proposed in technology: a kind of anastomosis system of novel blood vessel and intravascular stent, including branch's artificial blood vessel's group, scaffold artificial's blood Pipe group exempts from suture ring and identical buckle device, and the main body of the branch artificial blood vessel group is the main body artificial blood vessel of tubular structure, and In the fixed main split artificial blood vessel for being communicated with tubular structure in the upper end of main body artificial blood vessel, the main split artificial blood vessel's is upper There are three branch vessels for the fixed connection in end;
The main body of the stent-graft group is the rack body blood vessel of tubular structure, and in rack body blood vessel Wall fixing sleeve is equipped with the intravascular stent of reticular structure, is arranged with inner core in the intravascular stent, the rack body blood vessel it is outer Side ring is laid with the cableties of cyclic structure to being arranged with bracing wire in bracing wire, the outside of the rack body blood vessel and It wears in cableties equipped with wire drawing;
It is arranged in the right end port of the main body artificial blood vessel and exempts from suture ring, the main body for exempting from suture ring is ring junction The ring set of structure, and it is laid in the outer circle of ring set the rollet of annular trough body structure, the main body artificial blood vessel right end The outer sheath of port is equipped with the buckle device that coincide, and the buckle device that coincide fastens with suture ring is exempted from, the main body of the identical buckle device For the fastening ring of ring structure, notch is offered on the wall body for fastening ring, the upper end of the notch and fastening ring Outside is fixed with the upper fixed block of boss structure, and is laid with the locking belt of strip structure, institute in the side of upper fixed block The two sides for stating locking belt are laid with the Elastic buckle of boss structure, the lower end of the notch and fix in the outside for fastening ring Lower fixing sleeve equipped with trough body structure, and locking belt is mutually worn with lower fixing sleeve and is matched.
Preferably, three branch vessels of the fixed connection in upper end of the main split artificial blood vessel are respectively innominate artery Branch artificial blood vessel, left common carotid artery branch artificial blood vessel and left subclavian artery branch artificial blood vessel, the innominate artery point The diameter of branch artificial blood vessel is 12mm, length 10cm, and the diameter of the left common carotid artery branch artificial blood vessel is 10mm, length For 10cm, the diameter of the left subclavian artery branch artificial blood vessel is 8mm, length 10cm.
Preferably, main body artificial blood vessel, main split artificial blood vessel and people from main split in the branch artificial blood vessel group The material of three branch vessels of work vessel end is polyester material, and main body artificial blood vessel is bend pipe structure.
Preferably, the diameter of the main split artificial blood vessel is 20mm, and the length of main split artificial blood vessel is 2cm.
Preferably, the material of the rack body blood vessel is polyester material, and the intravascular stent is specially W-shaped Nitinol The diameter of metallic support, the rack body blood vessel is identical as the diameter of main body artificial blood vessel.
Preferably, the material of the inner core is plastic material, and the rear end of the inner core is fixedly connected with handle, and in inner core Front end be fixedly connected with the seeker of cone structure.
Preferably, the quantity of the rollet is equal with the quantity of decorative pattern boss, and rollet and decorative pattern boss phase Buckle.
Preferably, the material of the ring set is hardmetal, and the material for fastening ring is elastic metallic.
Compared with prior art, the beneficial effects of the present invention are: structure of the invention setting rationally, functional, have with Lower advantage:
1. simplifying operating procedure by using the present invention, operating difficulty is reduced, and then make external time, operating time, depth Hypothermia circulatory arrest time and brain guard time greatly shorten, and reduce operative mortality rate, at the same reduce nervous system and other The incidence rate of complication;
2. in the present invention, previous anastomotic is less, and by buckle device and the fastening for exempting from suture ring of coincideing, reduces bleeding Probability thereby reduces the death rate, greatly improves the probability of success of operation.
Detailed description of the invention
Fig. 1 is structure of the invention axis side view;
Fig. 2 is the half-sectional structure axis side view of the present invention;
Fig. 3 is partial structurtes enlarged diagram at A in Fig. 2;
Fig. 4 is the half-sectional topology view of stent-graft;
Fig. 5 is partial structurtes enlarged view at B in Fig. 4;
Fig. 6 is that the half-sectional topology view after inner core is removed in stent-graft;
Fig. 7 is partial structurtes enlarged view at C in Fig. 6;
Fig. 8 is the stent-graft release conditions topology view removed after seal wire and bracing wire;
Fig. 9 is to exempt to suture annulate shaft side structure view;
Figure 10 is the buckle device axis side structure view that coincide.
In figure: 1, branch artificial blood vessel group;2, stent-graft group;3, exempt from suture ring;4, coincide buckle device;101, main Body artificial blood vessel;102, main split artificial blood vessel;103, innominate artery branch artificial blood vessel;104, left common carotid artery branch is artificial Blood vessel;105, left subclavian artery branch artificial blood vessel;201, rack body blood vessel;202, intravascular stent;203, inner core;204, Cableties;205, wire drawing;206, handle;207, seeker;208, bracing wire;301, ring set;302, rollet;401, ring is fastened; 402, decorative pattern boss;403, upper fixed block;404, lower fixing sleeve;405, locking belt;406, Elastic buckle.
Specific embodiment
Following will be combined with the drawings in the embodiments of the present invention, and technical solution in the embodiment of the present invention carries out clear, complete Site preparation description, it is clear that described embodiments are only a part of the embodiments of the present invention, instead of all the embodiments.It is based on Embodiment in the present invention, it is obtained by those of ordinary skill in the art without making creative efforts every other Embodiment shall fall within the protection scope of the present invention.
Please refer to Fig. 1 to Figure 10, the present invention provides a kind of technical solution: a kind of novel blood vessel and intravascular stent coincide System, including branch artificial blood vessel organize 1, stent-graft group 2, exempt from suture ring 3 and identical buckle device 4, branch artificial blood vessel The main body of group 1 is the main body artificial blood vessel 101 of tubular structure, and fixation is communicated with tubulose in the upper end of main body artificial blood vessel 101 The main split artificial blood vessel 102 of structure, there are three branch vessels for the fixed connection in the upper end of main split artificial blood vessel 102, wherein leading The diameter range of body artificial blood vessel 101 is between 26mm-32mm, specially tetra- kinds of specifications of 26mm, 28mm, 30mm and 32mm, because Within this range for Most patients aorta diameter, the length of main body artificial blood vessel 101 is 15cm;
The main body of stent-graft group 2 is the rack body blood vessel 201 of tubular structure, and in rack body blood vessel 201 Inner wall fixing sleeve be equipped with the intravascular stent 202 of reticular structure, be arranged with inner core 203, rack body blood vessel in intravascular stent 202 201 outside circumferential direction is arranged with bracing wire 208, and the cableties 204 of cyclic structure, rack body blood are laid in bracing wire 208 It the outside of pipe 201 and wears in cableties 204 equipped with wire drawing 205;
It is arranged in the right end port of main body artificial blood vessel 101 and exempts from suture ring 3, the main body for exempting from suture ring 3 is ring structure Ring set 301, and be laid in the outer circle of ring set 301 rollet 302 of annular trough body structure, main body artificial blood vessel The outer sheath of 101 right end ports is equipped with the buckle device 4 that coincide, and the buckle device 4 that coincide fastens with suture ring 3 is exempted from, and coincide buckle device 4 Main body be ring structure fastening ring 401, fasten and offer notch on the wall body of ring 401, the upper end of notch and fastening The outside of ring 401 is fixed with the upper fixed block 403 of boss structure, and is laid with strip knot in the side of upper fixed block 403 The locking belt 405 of structure, the two sides of locking belt 405 are laid with the Elastic buckle 406 of boss structure, the lower end of notch and are detaining The outside of cyclization 401 is fixed with the lower fixing sleeve 404 of trough body structure, and locking belt 405 is worn with lower 404 phase of fixing sleeve and matched, when After decorative pattern boss 402 is buckled with 302 phase of rollet, the length adjustment by shrinking lower 404 internal locking band 405 of fixing sleeve is coincide Buckle device 4 and the clamping level for exempting from suture ring 3.
Further, three branch vessels of the fixed connection in the upper end of main split artificial blood vessel 102 are respectively unknown dynamic Arteries and veins branch artificial blood vessel 103, left common carotid artery branch artificial blood vessel 104 and left subclavian artery branch artificial blood vessel 105, it is unknown The diameter of arterial branch artificial blood vessel 103 is 12mm, length 10cm, and the diameter of left common carotid artery branch artificial blood vessel 104 is 10mm, length 10cm, the diameter of left subclavian artery branch artificial blood vessel 105 is 8mm, length 10cm.
Further, the main body artificial blood vessel 101 in branch artificial blood vessel group 1, main split artificial blood vessel 102 and main point The material of three branch vessels of 102 end of branch artificial blood vessel is polyester material, and main body artificial blood vessel 101 is bend pipe knot Structure, this makes entire branch artificial blood vessel group 1 have good elasticity.
Further, the diameter of main split artificial blood vessel 102 is 20mm, and the length of main split artificial blood vessel 102 is 2cm, it is too short in this way convenient for providing sufficient space for blocking artificial blood vessel, it is not easy clamp, it is too long to be then easy bending.
Further, the material of rack body blood vessel 201 is polyester material, has rack body blood vessel 201 good Elasticity, intravascular stent 202 be specially W-shaped Nitinol metallic support, when wire drawing 205 along rack body blood vessel 201 outer wall from After pulling out in cableties 204, the bracing wire around rack body blood vessel 201 is unclamped rapidly, and bound intravascular stent 202 obtains at this time Rack body blood vessel 201 can be propped up automatically after release, the diameter of rack body blood vessel 201 is straight with main body artificial blood vessel's 101 Diameter is identical.
Further, the material of inner core 203 is plastic material, and the rear end of inner core 203 is fixedly connected with handle 206, and The front end of inner core 203 is fixedly connected with the seeker 207 of cone structure, and the front end that this structure is conducive to inner core 203 is imported into In descending aorta.
Further, the quantity of rollet 302 is equal with the quantity of decorative pattern boss 402, and rollet 302 and decorative pattern 402 phase of boss buckle, by the fastening of rollet 302 and decorative pattern boss 402 so that exempting from suture ring 3 and identical buckle device 4 tightly Tight is fixed together.
Further, the material of ring set 301 is hardmetal, and the material for fastening ring 401 is elastic metallic, and this structure makes Must exempt from suture ring 3 and identical buckle device 4 all has stronger support strength.
Inner core 203: first importeding into the lumen of stent-graft group 2 by working principle, and bracing wire 208 is looped around branch The outside of frame body blood vessel 201 tightens rack body blood vessel 201, then uses wire drawing 205 through the cableties in bracing wire 208 204, adjusting bracket artificial blood vessel group 2 is in trunk shape, this process is completed by producer;
In the course of surgery, the aorta ascendens for cutting off lesion leads the seeker 207 of the front end of stent-graft group 2 Enter to after descending aorta, pull out wire drawing 205, and then open the release of intravascular stent 202, inner core 203 is then extracted out, with identical button Device 4 fastens active distal arteries and veins on exempting from suture ring 3, according to the elasticity of aorta size adjusting fitting buckle device 4, in turn Complete the installation of stent-graft group 2;
Then innominate artery branch artificial blood vessel 103 and left common carotid artery branch artificial blood vessel 104 are fit to nothing respectively On name artery and left common carotid artery, left subclavian artery branch artificial blood vessel 105 coincide at left subclavian artery as needed, Block main split artificial blood vessel 102, left common carotid artery branch artificial blood vessel 104 and left subclavian artery branch artificial blood vessel 105 Respectively by 103 blood supply of innominate artery branch artificial blood vessel, to increase the time that bilateral cerebral is perfused in art, nerveous system in art is reduced System damage, while also correspondingly reducing operating time;
Finally 101 proximal end of main body artificial blood vessel and active proximal arteries and veins root are sutured, open exhaust, after listening circulation, hemostasis Terminate operation.
Row bends the patient of displacement full when for acute type A aortic dissection, can effectively be simplified by using the present invention Operation shortens operating time and Deep Hypothermia Circulatory Arrest time, improves the perfusion of art midbrain, reduces previous anastomotic quantity in art, to drop The low incidence of Anastomotic bleeding event, postoperative nerve system and cardiovascular complications.
It although an embodiment of the present invention has been shown and described, for the ordinary skill in the art, can be with A variety of variations, modification, replacement can be carried out to these embodiments without departing from the principles and spirit of the present invention by understanding And modification, the scope of the present invention is defined by the appended.

Claims (8)

1. a kind of anastomosis system of novel blood vessel and intravascular stent, including branch's artificial blood vessel's group (1), stent-graft group (2), exempt from suture ring (3) and identical buckle device (4), it is characterised in that: the main body of the branch artificial blood vessel group (1) is tubulose knot The main body artificial blood vessel (101) of structure, and in the fixed main split people for being communicated with tubular structure in the upper end of main body artificial blood vessel (101) Work blood vessel (102), there are three branch vessels for the fixed connection in the upper end of the main split artificial blood vessel (102);
The main body of the stent-graft group (2) is the rack body blood vessel (201) of tubular structure, and in rack body blood vessel (201) inner wall fixing sleeve is equipped with the intravascular stent (202) of reticular structure, is arranged with inner core in the intravascular stent (202) (203), the outside circumferential direction of the rack body blood vessel (201) is arranged with bracing wire (208), and is laid on bracing wire (208) The cableties (204) of cyclic structure, the outside of the rack body blood vessel (201) and wear equipped with wire drawing in the cableties (204) (205);
It is arranged with and exempts from suture ring (3) in the right end port of the main body artificial blood vessel (101), the main body for exempting from suture ring (3) For the ring set (301) of ring structure, and it is laid in the outer circle of ring set (301) rollet of annular trough body structure (302), the outer sheath of main body artificial blood vessel (101) the right end port, which is equipped with, coincide buckle device (4), and coincide buckle device (4) It fastens with suture ring (3) is exempted from, the main body of the identical buckle device (4) is the fastening ring (401) of ring structure, the fastening ring (401) it offers notch on wall body, the upper end of the notch and is fixed with boss structure on the outside of ring (401) fastening Upper fixed block (403), and be laid with the locking belt (405) of strip structure, the locking in the side of upper fixed block (403) The two sides of band (405) are laid with the Elastic buckle (406) of boss structure, the lower end of the notch and are fastening ring (401) Outside be fixed with the lower fixing sleeve (404) of trough body structure, and locking belt (405) is mutually worn with lower fixing sleeve (404) and is matched.
2. the anastomosis system of one kind according to claim 1 novel blood vessel and intravascular stent, it is characterised in that: the master Three branch vessels of the fixed connection in upper end of branch artificial blood vessel (102) are respectively innominate artery branch artificial blood vessel (103), left common carotid artery branch artificial blood vessel (104) and left subclavian artery branch artificial blood vessel (105), the innominate artery The diameter of branch artificial blood vessel (103) is 12mm, length 10cm, the left common carotid artery branch artificial blood vessel (104) it is straight Diameter is 10mm, length 10cm, and the diameter of the left subclavian artery branch artificial blood vessel (105) is 8mm, length 10cm.
3. the anastomosis system of one kind according to claim 1 novel blood vessel and intravascular stent, it is characterised in that: described point Main body artificial blood vessel (101), main split artificial blood vessel (102) and main split artificial blood vessel in branch artificial blood vessel group (1) (102) material of three branch vessels of end is polyester material, and main body artificial blood vessel (101) is bend pipe structure.
4. the anastomosis system of one kind according to claim 1 novel blood vessel and intravascular stent, it is characterised in that: the master The diameter of branch artificial blood vessel (102) is 20mm, and the length of main split artificial blood vessel (102) is 2cm.
5. the anastomosis system of one kind according to claim 1 novel blood vessel and intravascular stent, it is characterised in that: the branch The material of frame body blood vessel (201) is polyester material, and the intravascular stent (202) is specially W-shaped Nitinol metallic support, institute The diameter for stating rack body blood vessel (201) is identical as the diameter of main body artificial blood vessel (101).
6. the anastomosis system of one kind according to claim 1 novel blood vessel and intravascular stent, it is characterised in that: in described The material of core (203) is plastic material, and the rear end of the inner core (203) is fixedly connected with handle (206), and in inner core (203) Front end be fixedly connected with the seeker (207) of cone structure.
7. the anastomosis system of one kind according to claim 1 novel blood vessel and intravascular stent, it is characterised in that: the flower The quantity of line groove (302) is equal with the quantity of decorative pattern boss (402), and rollet (302) mutually blocks with decorative pattern boss (402) Button.
8. the anastomosis system of one kind according to claim 1 novel blood vessel and intravascular stent, it is characterised in that: the ring The material for covering (301) is hardmetal, and the material for fastening ring (401) is elastic metallic.
CN201910245238.3A 2019-03-28 2019-03-28 A kind of anastomosis system of novel blood vessel and intravascular stent Pending CN109820620A (en)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN115317209A (en) * 2021-04-22 2022-11-11 血管移植解决方案有限公司 Asymmetric external stent for stabilizing vein graft used in coronary artery bypass graft surgery and application thereof

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Publication number Priority date Publication date Assignee Title
CN115317209A (en) * 2021-04-22 2022-11-11 血管移植解决方案有限公司 Asymmetric external stent for stabilizing vein graft used in coronary artery bypass graft surgery and application thereof
CN115317209B (en) * 2021-04-22 2024-02-02 血管移植解决方案有限公司 Asymmetric external stent for stabilizing vein grafts for coronary bypass grafting and uses thereof
CN115317209B8 (en) * 2021-04-22 2024-03-22 血管移植解决方案有限公司 Asymmetric external stent for stabilizing vein grafts for coronary bypass grafting and uses thereof

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