CN109893193B - Trunk support capable of blocking blood - Google Patents
Trunk support capable of blocking blood Download PDFInfo
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- CN109893193B CN109893193B CN201910055722.XA CN201910055722A CN109893193B CN 109893193 B CN109893193 B CN 109893193B CN 201910055722 A CN201910055722 A CN 201910055722A CN 109893193 B CN109893193 B CN 109893193B
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- 230000000903 blocking effect Effects 0.000 title claims abstract description 80
- 239000008280 blood Substances 0.000 title claims abstract description 75
- 210000004369 blood Anatomy 0.000 title claims abstract description 75
- 230000017531 blood circulation Effects 0.000 claims abstract description 13
- 230000006835 compression Effects 0.000 claims abstract description 6
- 238000007906 compression Methods 0.000 claims abstract description 6
- 230000003902 lesion Effects 0.000 claims abstract description 4
- 239000012528 membrane Substances 0.000 claims description 22
- 239000012781 shape memory material Substances 0.000 claims description 4
- 238000000034 method Methods 0.000 claims 1
- 230000004087 circulation Effects 0.000 abstract description 13
- 230000000694 effects Effects 0.000 abstract description 10
- 208000035965 Postoperative Complications Diseases 0.000 abstract description 4
- 230000009286 beneficial effect Effects 0.000 abstract description 4
- 238000004904 shortening Methods 0.000 abstract description 3
- 210000002376 aorta thoracic Anatomy 0.000 description 14
- 230000003872 anastomosis Effects 0.000 description 6
- 238000001356 surgical procedure Methods 0.000 description 6
- 210000004204 blood vessel Anatomy 0.000 description 5
- 230000006870 function Effects 0.000 description 5
- 230000010412 perfusion Effects 0.000 description 5
- 239000002473 artificial blood Substances 0.000 description 4
- 210000003128 head Anatomy 0.000 description 4
- 230000003788 cerebral perfusion Effects 0.000 description 3
- 238000005516 engineering process Methods 0.000 description 3
- 230000002631 hypothermal effect Effects 0.000 description 3
- 210000001989 nasopharynx Anatomy 0.000 description 3
- 238000007789 sealing Methods 0.000 description 3
- 230000009471 action Effects 0.000 description 2
- 230000001154 acute effect Effects 0.000 description 2
- 210000000709 aorta Anatomy 0.000 description 2
- 230000004888 barrier function Effects 0.000 description 2
- 210000001105 femoral artery Anatomy 0.000 description 2
- 210000004185 liver Anatomy 0.000 description 2
- 210000003141 lower extremity Anatomy 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- 238000011084 recovery Methods 0.000 description 2
- 210000002489 tectorial membrane Anatomy 0.000 description 2
- 210000001835 viscera Anatomy 0.000 description 2
- 208000002251 Dissecting Aneurysm Diseases 0.000 description 1
- VYPSYNLAJGMNEJ-UHFFFAOYSA-N Silicium dioxide Chemical compound O=[Si]=O VYPSYNLAJGMNEJ-UHFFFAOYSA-N 0.000 description 1
- 201000008982 Thoracic Aortic Aneurysm Diseases 0.000 description 1
- 230000002411 adverse Effects 0.000 description 1
- 208000007474 aortic aneurysm Diseases 0.000 description 1
- 206010002895 aortic dissection Diseases 0.000 description 1
- 210000004191 axillary artery Anatomy 0.000 description 1
- 230000008081 blood perfusion Effects 0.000 description 1
- 210000002168 brachiocephalic trunk Anatomy 0.000 description 1
- 230000001684 chronic effect Effects 0.000 description 1
- 230000015271 coagulation Effects 0.000 description 1
- 238000005345 coagulation Methods 0.000 description 1
- 230000006378 damage Effects 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 230000007613 environmental effect Effects 0.000 description 1
- 208000003457 familial thoracic 1 aortic aneurysm Diseases 0.000 description 1
- 210000001035 gastrointestinal tract Anatomy 0.000 description 1
- 210000003734 kidney Anatomy 0.000 description 1
- 230000003907 kidney function Effects 0.000 description 1
- 230000003908 liver function Effects 0.000 description 1
- 230000007774 longterm Effects 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 210000000056 organ Anatomy 0.000 description 1
- 238000002360 preparation method Methods 0.000 description 1
- 229910001285 shape-memory alloy Inorganic materials 0.000 description 1
- 239000000741 silica gel Substances 0.000 description 1
- 229910002027 silica gel Inorganic materials 0.000 description 1
- 210000000278 spinal cord Anatomy 0.000 description 1
- 208000020431 spinal cord injury Diseases 0.000 description 1
- 238000009966 trimming Methods 0.000 description 1
- 230000002792 vascular Effects 0.000 description 1
Landscapes
- Surgical Instruments (AREA)
- Prostheses (AREA)
Abstract
The invention discloses a trunk support capable of blocking blood, which comprises a support main body, a main body lining and a film covering pipe, wherein the support main body is sleeved on the main body lining; the stent body is configured to be compressed on the body liner by a covered tube and to be positioned and released at a target lesion position by releasing the compression force of the covered tube; the blood blocking device is arranged in the bracket main body and synchronously compressed and released with the bracket main body, and blood flow in the bracket main body is blocked after the blood blocking device is released. The invention is beneficial to shortening the circulation time of deep low temperature stop, greatly reducing postoperative complications and improving the operation effect.
Description
Technical Field
The invention relates to a medical instrument, in particular to a trunk support capable of blocking blood.
Background
The aortic total arch replacement and stent trunk surgery (Sun's surgery) is widely applied to the treatment of thoracic aortic aneurysm, acute and chronic A-aortic dissection and other diseases, and the curative effect of the near-middle-long-term surgery is accepted by more and more experts at home and abroad. The operation is carried out by adopting a deep low-temperature stop circulation technology, namely, the whole body is required to be cooled in the operation, when the nasopharynx temperature is reduced to 18-20 ℃, single-side selective cerebral perfusion is carried out through an axillary artery or an innominate artery cannula, at the moment, the lower half body stops circulating, namely, organs perfused by the descending aorta, including spinal cord, liver, kidney, alimentary canal and the like, have no blood perfusion, after the stent blood vessel is implanted in the true cavity of the descending aorta, the anastomosis between the proximal end of the descending aorta and the distal end of the bow part is completed by adopting an open anastomosis technology, then the lower half body perfusion is restored, and the stop circulation is ended, wherein the time is generally controlled to be about 20-30 min. However, deep hypothermia can cause a series of unavoidable problems such as internal environmental disturbance, coagulation function damage, acute liver and kidney function insufficiency, gastrointestinal tract function disturbance, spinal cord injury and the like, and cause poor recovery, serious complications and even death of patients after operation. Therefore, how to shorten the circulation time of cryogenic stop has important clinical application value.
Disclosure of Invention
Therefore, the invention aims to provide the trunk stent capable of blocking blood, which is beneficial to shortening the circulation time of deep low temperature stop, greatly reducing postoperative complications and improving the operation effect.
The trunk stent capable of blocking blood comprises a stent main body, a main body lining and a film covering pipe, wherein the stent main body is sleeved on the main body lining, and the film covering pipe is covered on the stent main body; the stent body is configured to be compressed on the body liner by a covered tube and to be positioned and released at a target lesion position by releasing the compression force of the covered tube; the blood blocking device is arranged in the bracket main body and synchronously compressed and released with the bracket main body, and blood flow in the bracket main body is blocked after the blood blocking device is released.
Preferably, the blood blocking device comprises a blood blocking film, wherein the circumferential edge of the blood blocking film is fixedly connected to the bracket main body, and a through hole for the lining of the main body to pass through is formed in the blood blocking film.
Preferably, the blood blocking device further comprises a membrane frame for supporting the blood blocking membrane, the membrane frame comprises a plurality of supporting rods which are distributed radially, one ends of the supporting rods are connected to the support main body, and the other ends of the supporting rods are connected to the main body lining.
Preferably, the struts are sewn to the body liner by stitching.
Preferably, the distal end of the body liner is provided with a tapered structure of the anchor head.
Preferably, the main body lining comprises an outer cylinder and an inner core, the outer cylinder is coaxially sleeved outside the inner core, and the inner core can move along the axial direction of the outer cylinder; the outer cylinder penetrates through the through hole and is connected with the supporting rod; the distal end of the inner core is provided with a blood blocking plug, and when the distal end of the inner core moves to the position of the blood blocking device, the top surface of the blood blocking plug seals the through hole and the inner cavity of the outer cylinder.
Preferably, one end of the support rod, which is close to the support body, is connected to the support body through a connecting rod, the support rod is elastically connected with the connecting rod, and the support rod is separated from the lining of the body to drive the blood blocking membrane to fold towards the direction of the connecting rod.
Preferably, the support rod and the connecting rod are integrally formed by adopting a shape memory material.
Through the above disclosure, the invention has the following beneficial technical effects:
in the invention, in aortic full arch replacement and stent trunk, when the nasopharynx temperature is reduced to a proper temperature, the lower body circulation is blocked, selective cerebral perfusion is performed, an aortic arch is intersected, after the distal anastomosis of the arch part is rapidly trimmed and prepared, a stent main body in a compressed state is placed into a descending aorta vacuum cavity through an aortic arch incision by guiding of a main body lining, then the stent main body is released by releasing the compression force of a tectorial membrane tube, and at the moment, a blood blocking device is also released and blocks the blood flow in the stent main body to form a blocking, so that the proximal operation is facilitated; thereafter, the femoral artery perfusion tube is opened, the extracorporeal circulation flow is increased, the viscera and lower limb perfusion is restored, and the circulation is stopped. After the anastomosis of the distal end of the four-branch artificial blood vessel and the proximal end of the supporting artificial blood vessel and the aortic arch broken end is completed, the tool is used for stopping the blood blocking device, so that the subsequent operation can be performed.
The blood blocking device is creatively applied to aortic total arch replacement and stent trunk surgery, and is used for blocking the blood flow of the aorta in combination with the trunk stent arranged in the descending aorta, so that deep hypothermia is avoided, the descending aorta and the long-term stop circulation time are obviously shortened, postoperative complications are greatly reduced, and the surgery effect is improved. The invention can greatly improve the safety of the operation and improve the overall curative effect of the operation. Moreover, compared with the blocking mode adopting the balloon body, the blocking effect of the invention is better.
Drawings
FIG. 1 is a schematic view showing the structure of a trunk stand according to the first embodiment;
FIG. 2 is a cross-sectional view A-A of FIG. 1;
FIG. 3 is a schematic view of the structure of a trunk stand according to the second embodiment;
fig. 4 is a schematic structural view of a trunk stand of the third embodiment.
Detailed Description
In order to make the technical scheme of the present invention better understood by those skilled in the art, the present invention will be further described in detail with reference to the accompanying drawings and specific embodiments. It should be noted that the drawings are in a very simplified form and are all to a non-precise scale, merely for convenience and clarity in aiding in the description of embodiments of the invention.
Example 1
As shown in fig. 1 and 2: the trunk stent capable of blocking blood comprises a stent main body 1, a main body lining 2 and a film covering tube 3, wherein the stent main body 1 is sleeved on the main body lining 2, and the film covering tube 3 is covered on the stent main body 1; the stent body 1 is configured to be compressed on the body liner 2 by the graft tube 3, and to position and release the stent body 1 at the target lesion position by releasing the compression force of the graft tube 3. The trunk stent with the structure is well known to the person skilled in the art, and the CRONUS type intraoperative stent system produced by Shanghai medical science and technology (Shanghai) limited company is the structure, and in addition, see Chinese patent CN 106618822B and CN 104622600B; therefore, the specific structure and principle and materials of the bracket main body 1, the main body lining 2 and the covered tube 3 are not repeated.
The trunk stent capable of blocking blood is characterized in that a blood blocking device which is synchronously compressed and released with the trunk stent body 1 is arranged in the trunk stent body 1, and blood flow in the trunk stent body 1 is blocked after the blood blocking device is released.
In aortic total arch replacement and stent trunk surgery, after the nasopharynx temperature is reduced to a proper temperature, the lower body circulation is blocked, selective cerebral perfusion is performed, an aortic arch is transected, a stent main body 1 in a compressed state is placed into a descending aortic vacuum cavity through an aortic arch incision by guiding a main body lining 2 after rapid trimming and preparation of an arch distal anastomosis, then the stent main body 1 is positioned and released by releasing the compression force of a tectorial membrane tube 3, and at the moment, a blood blocking device is also released and blocks blood flow in the stent main body 1 to form a blocking, so that proximal operation is facilitated; thereafter, the femoral artery perfusion tube is opened, the extracorporeal circulation flow is increased, the viscera and lower limb perfusion is restored, and the circulation is stopped. After the anastomosis of the distal end of the four-branch artificial blood vessel and the proximal end of the supporting artificial blood vessel and the aortic arch broken end is completed, the tool is used for stopping the blood blocking device, so that the subsequent operation can be performed.
The trunk stent creatively applies the blood blocking device to aortic total arch replacement and stent trunk operation, and uses the blood blocking device and the trunk stent arranged in the descending aorta to block the blood flow of the aorta, thereby avoiding deep hypothermia, obviously shortening the descending aorta and the circulation time with far stopping, greatly reducing postoperative complications and improving the operation effect. The trunk stent can greatly improve the safety of the operation and the overall curative effect of the operation. Moreover, compared with the blocking mode adopting the balloon body, the blocking effect of the trunk stent is better.
In this embodiment, the blood blocking device includes a blood blocking film 4, the circumferential edge of the blood blocking film 4 is fixedly connected to the bracket main body 1, and a through hole for the main body liner 2 to pass through is provided on the blood blocking film 4. The blood blocking film 4 is a flexible film, and can bear blood flow under a certain pressure and prevent blood circulation. The blood blocking film 4 can shrink or expand along with the bracket main body 1, and the complete blood blocking structure of the blood blocking film needs to be matched with the main body lining 2; namely, in the blood blocking stage, the main body lining 2 passes through and seals the through hole; so that the blood-blocking effect of the blood-blocking device is also eliminated when the body liner 2 is removed.
In this embodiment, the blood blocking device further includes a membrane frame 5 for supporting the blood blocking membrane 4, the membrane frame 5 includes a plurality of radially distributed struts 51, and one end of each strut 51 is connected (rotationally connected) to the support body 1, and the other end is connected to the body liner 2. The membrane frame 5 is beneficial to improving the structural strength of the blood blocking membrane 4 so as to improve the blood blocking effect. The membrane holder 5 is preferably fixed below the blood-blocking membrane 4, or may be fixed above the blood-blocking membrane 4, or may be sandwiched between two blood-blocking membranes 4. The membrane frame 5 and the blood blocking membrane 4 form an umbrella-like structure together; the supporting rods 51 forming the film frame 5 are uniformly distributed, and both ends of the supporting rods 51 can be hinged and fixed on the bracket main body 1 and the main body lining 2, so that the film frame 5 can shrink and deform along with the bracket main body 1; preferably, the struts 51 are sewn to the body liner 2 by stitching, which is only removed when removal of the body liner 2 is desired.
In this embodiment, the distal end of the body liner 2 is provided with a tapered fixing head 21, and the fixing head 21 not only can avoid damaging vascular tissues, but also is more convenient for transportation because the tapered surface is streamline.
Example two
As shown in fig. 3, in this embodiment, unlike the first embodiment, the structure of the body liner 2 may be further optimized, where the body liner 2 includes an outer cylinder 2a and an inner core 2b, the outer cylinder 2a is coaxially sleeved outside the inner core 2b, and the inner core 2b may move along the axial direction of the outer cylinder 2 a; the outer cylinder 2a passes through the through hole and is connected with the supporting rod 51; the distal end of the inner core 2b is provided with a blood blocking plug 22, and when the distal end of the inner core 2b moves to the blood blocking device position, the top surface of the blood blocking plug 22 seals the through hole and the inner cavity of the outer cylinder 2 a. By pulling the inner core 2b, the movement of the inner core 2b along the outer cylinder 2a can be controlled; the blood blocking plug 22 may have a structure similar to the fixing head 21, and may perform a similar function at this time, but the blood blocking plug 22 is characterized in that an end surface of the blood blocking plug 22 near the blood blocking device is a sealing surface structure capable of performing a sealing function (for example, the whole blood blocking plug 22 is made of a silica gel material, and an end surface near the blood blocking device is a planar structure), and when the distal end of the inner core 2b moves to the position of the blood blocking device, the sealing surface seals a gap between the membrane frame 5 and the outer cylinder 2a and a gap between the outer cylinder 2a and the inner core 2b, so as to further ensure the realization of the blood blocking function, and make up for the natural defects of the blood blocking membrane 4 and the membrane frame 5.
Example III
As shown in fig. 4, in this embodiment, on the basis of the trunk support structure of the first embodiment or the second embodiment, the trunk support may be further optimized, that is, one end of the strut 51, which is close to the support body 1, is connected to the support body 1 through the connecting rod 52, the strut 51 and the connecting rod 52 are elastically connected, and the strut 51 is separated from the body liner 2 to drive the blood-blocking film 4 to fold toward the connecting rod 52. The connecting rod 52 may be integrally fixed to the bracket body 1, but cannot affect the shrinkage deformation of the bracket body 1; the strut 51, the connecting rod 52 are preferably located below the blood barrier 4 to support the fixed blood barrier 4; when the bracket main body 1 is released and unfolded, the blood blocking film 4 is released and drives the supporting rod 51 to be unfolded so as to realize blood blocking; the struts 51 and the connecting rods 52 are preferably integrally formed of a shape memory material (e.g., a shape memory alloy), and when the struts 51 are separated from the body liner 2 (e.g., the suture is removed), the struts 51 which are radially distributed are folded (e.g., can be deformed from a vertical L-shaped structure to a parallel II-shaped structure) towards the stent body 1 under the self-recovery action of the shape memory material, and drive the blood-blocking film 4 to fold, so that the blood-blocking film 4 is finally formed into a tubular film and attached to the inner wall of the stent body 1, thereby eliminating the blood-blocking action and preventing the adverse effect of the film frame 5 on normal blood flow.
Finally, it is pointed out that the principles and embodiments of the invention have been described herein with reference to specific examples, which are intended to be merely illustrative of the core idea of the invention, and that several improvements and modifications can be made to the invention without departing from the principles of the invention, which also fall within the scope of protection of the invention.
Claims (6)
1. The trunk support comprises a support body, a main body lining and a film covering pipe, wherein the support body is sleeved on the main body lining, and the film covering pipe is covered on the support body; the stent body is configured to be compressed on the body liner by a covered tube and to be positioned and released at a target lesion position by releasing the compression force of the covered tube; the method is characterized in that: the blood blocking device which is synchronously compressed and released with the blood blocking device is arranged in the bracket main body, and the blood flow in the bracket main body is blocked after the blood blocking device is released;
the blood blocking device comprises a blood blocking film, wherein the circumferential edge of the blood blocking film is fixedly connected to the bracket main body, and a through hole for the lining of the main body to pass through is formed in the blood blocking film; the blood blocking device further comprises a membrane frame for supporting the blood blocking membrane, wherein the membrane frame comprises a plurality of supporting rods which are radially distributed, one ends of the supporting rods are connected with the bracket main body, and the other ends of the supporting rods are connected with the main body lining; the blood blocking film is a flexible film, can bear blood flow with certain pressure and can prevent blood circulation.
2. The blood-lockable trunk stent of claim 1, wherein: the support rod is sewn on the main body lining through a suture.
3. The blood-lockable trunk stent of claim 1 or 2, wherein: the distal end of the body liner is provided with a fixed head with a conical structure.
4. The blood-lockable trunk stent of claim 1, wherein: the main body lining comprises an outer cylinder and an inner core, the outer cylinder is coaxially sleeved outside the inner core, and the inner core can move along the axial direction of the outer cylinder; the outer cylinder penetrates through the through hole and is connected with the supporting rod; the distal end of the inner core is provided with a blood blocking plug, and when the distal end of the inner core moves to the position of the blood blocking device, the top surface of the blood blocking plug seals the through hole and the inner cavity of the outer cylinder.
5. The blood-snapable trunk stent of claim 1, 2 or 4 wherein: the one end that branch is close to the support main part is passed through the connecting rod and is connected in the support main part, branch and connecting rod elasticity link to each other, just it is folding towards the connecting rod direction to drive the blood blocking membrane after the branch breaks away from the main part inside lining.
6. The blood-lockable trunk stent of claim 5, wherein: the support rod and the connecting rod are integrally formed by adopting a shape memory material.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201910055722.XA CN109893193B (en) | 2019-01-22 | 2019-01-22 | Trunk support capable of blocking blood |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201910055722.XA CN109893193B (en) | 2019-01-22 | 2019-01-22 | Trunk support capable of blocking blood |
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| Publication Number | Publication Date |
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| CN109893193A CN109893193A (en) | 2019-06-18 |
| CN109893193B true CN109893193B (en) | 2024-01-02 |
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| CN201910055722.XA Active CN109893193B (en) | 2019-01-22 | 2019-01-22 | Trunk support capable of blocking blood |
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Families Citing this family (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| AU2019458212B2 (en) * | 2019-07-25 | 2021-06-03 | Clearstream Technologies Limited | Embolisation device for promoting blood clot formation and a method of retrieving the same from a bodily lumen |
| CN113616376A (en) * | 2021-07-29 | 2021-11-09 | 汕头大学医学院第一附属医院 | Coronary fistula covered stent and conveying system |
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| US6482228B1 (en) * | 2000-11-14 | 2002-11-19 | Troy R. Norred | Percutaneous aortic valve replacement |
| CN201617974U (en) * | 2009-11-09 | 2010-11-03 | 于存涛 | Integrated artificial four-branch trunk blood vessel with bracket and delivery device thereof |
| CN104622600A (en) * | 2013-11-15 | 2015-05-20 | 微创心脉医疗科技（上海）有限公司 | Intra-operative stent system |
| CN106618822A (en) * | 2016-12-26 | 2017-05-10 | 微创心脉医疗科技（上海）有限公司 | Intraoperative support conveying system and intraoperative support system |
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| WO2018042439A1 (en) * | 2016-08-31 | 2018-03-08 | Corassist Cardiovascular Ltd. | Transcatheter mechanical aortic valve prosthesis |
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| CN210019818U (en) * | 2019-01-22 | 2020-02-07 | 中国医学科学院阜外医院 | Support system for blood blocking type operation |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| AUPR748801A0 (en) * | 2001-09-04 | 2001-09-27 | Stentco Llc | A stent |
| US7771448B2 (en) * | 2004-06-21 | 2010-08-10 | Arvik Enterprises, Llc | Catheter device and method for selective occlusion of arteries of the descending aorta |
| US8057503B2 (en) * | 2007-01-25 | 2011-11-15 | Trinity Health-Michigan | Blood vessel occluder and method of use |
| CN103598929B (en) * | 2013-11-28 | 2016-04-20 | 先健科技(深圳)有限公司 | Thoracic aorta covered bracket |
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- 2019-01-22 CN CN201910055722.XA patent/CN109893193B/en active Active
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6482228B1 (en) * | 2000-11-14 | 2002-11-19 | Troy R. Norred | Percutaneous aortic valve replacement |
| CN201617974U (en) * | 2009-11-09 | 2010-11-03 | 于存涛 | Integrated artificial four-branch trunk blood vessel with bracket and delivery device thereof |
| CN104622600A (en) * | 2013-11-15 | 2015-05-20 | 微创心脉医疗科技（上海）有限公司 | Intra-operative stent system |
| WO2018042439A1 (en) * | 2016-08-31 | 2018-03-08 | Corassist Cardiovascular Ltd. | Transcatheter mechanical aortic valve prosthesis |
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