CN111012409A - Auxiliary tee joint for reconstruction of blood transportation of frontal branch of superficial temporal artery and cerebral artery cortex and use method - Google Patents
Auxiliary tee joint for reconstruction of blood transportation of frontal branch of superficial temporal artery and cerebral artery cortex and use method Download PDFInfo
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- CN111012409A CN111012409A CN201911222882.5A CN201911222882A CN111012409A CN 111012409 A CN111012409 A CN 111012409A CN 201911222882 A CN201911222882 A CN 201911222882A CN 111012409 A CN111012409 A CN 111012409A
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
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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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2576/00—Medical imaging apparatus involving image processing or analysis
- A61B2576/02—Medical imaging apparatus involving image processing or analysis specially adapted for a particular organ or body part
- A61B2576/026—Medical imaging apparatus involving image processing or analysis specially adapted for a particular organ or body part for the brain
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Abstract
The invention discloses an auxiliary tee joint for reconstruction of blood transportation of frontal temporo-superficial artery and cerebral artery cortex and a using method thereof, and mainly relates to the technical field of reconstruction of blood transportation of frontal temporo-superficial artery and cerebral artery cortex. Comprises a tee body; the bottom end of the tee body is a cerebral vessel pipeline, and a slit is arranged at the bottom side of the cerebral vessel pipeline; two ends of the cerebrovascular pipeline are provided with lower tube bulges, and lower suture holes are formed in the lower tube bulges; the three-way body top is that superficial temporal artery is protruding, the protruding below of superficial temporal artery is communicate with the blood vessel of brain pipeline, and its intercommunication department is the intercommunication mouth, the superficial temporal artery is protruding to be equipped with the suture hole on. The tee body is made of a biological mixed type artificial blood vessel material, and the edge of the tee body is chamfered and smoothed. The invention has the beneficial effects that: use this device, the middle cerebral artery cortex bronchus wall cuts off and need not to cut off again in the art, only needs to carry out the side direction incision, and the superficial temporal artery frontal branch also need not to carry out two side incisions again to the operation degree of difficulty has been reduced.
Description
Technical Field
The invention relates to the technical field of reconstruction of blood transport of frontal branches of superficial temporal arteries and cortical branches of middle cerebral arteries, in particular to an auxiliary tee joint for reconstruction of blood transport of frontal branches of superficial temporal arteries and cortical branches of cerebral arteries.
Background
The background analysis is carried out by combining the diagnosis examination and analysis auxiliary diagram of figure 4 in the attached drawings of the specification and the pathology confirmed diagnosis auxiliary diagram of figure 5.
The diagnosis examination profiling auxiliary diagram of figure 4 in the attached drawings of the specification:
visual observation can be carried out from physical examination and skull MRI flat scanning:
post-admission physical primary positive signs: horizontal nystagmus (+), blurred vision to the left, level IV muscle strength of the left limb, hypoesthesia of the left limb, and pathological sign (+) of the left side.
The junction area of the occipital lobe of the right side and the pressing part of the corpus callosum are strengthened in an irregular ring shape, and the back angle of the ventricle on the right side is pressed; the center of the right hemioval shows nodular low signals and no reinforcement; the midline structure is centered.
From physical examination, the head and neck CTA can be visually observed:
multiple atherosclerosis of head and neck, mixed plaques at the beginning of internal carotid arteries on both sides and slightly narrow local lumens, no obvious abnormality of middle cerebral arteries on both sides, light development of the proximal end of the left vertebral artery, and obvious stenosis of the middle section. The anterior cerebral artery walls on both sides are rough and uneven in thickness, and the distal part of the posterior cerebral artery on the right side is obviously slender.
In conclusion, the hemorrhagic cerebral infarction is considered primarily possibly to be large, the treatment is mainly performed by symptomatic treatment such as dehydration, skull pressure reduction, fluid infusion and the like, and meanwhile, relevant examination is perfected to further determine diagnosis.
From the physical examination, the vessel image DSA can be visually observed in the display picture:
a large amount of hyperplastic blood vessels are formed in the blood supply area of the right middle cerebral artery, the vein is developed slightly ahead of time, and a small amount of hyperplastic blood vessels can be seen in the blood vessel A4 section of the right anterior cerebral artery; no obvious abnormality was seen in the left middle cerebral artery and anterior cerebral artery. The vertebral artery angiography can see a large number of hyperplasia vessels of the P3/P4 section of the right posterior cerebral artery, and can see that the drainage vein appears obviously early; no obvious abnormalities were seen in the left posterior cerebral artery. Cranial MRV display: the right side myelinated vein is early shown, and is drained to the venous plexus deep in the annular pool through the vein of the right side choroid plexus, the branches of the right side middle cerebral artery are increased, and the superior sagittal sinus, the inferior sagittal sinus, the right lateral transverse sinus, the right side sigmoid sinus and the sweeping and internal jugular vein do not have obvious filling defects.
The etiology is confirmed by combining the examination results: proliferative vascular disease of the brain (CPA). CPA is an extremely rare ischemic vascular malformation. This is a chronic progressive occlusive cerebrovascular disease of unknown etiology characterized by bilateral or unilateral internal carotid artery end and anterior cerebral or middle cerebral artery proximal stenosis or occlusion, with formation of a cranial base dysplastic vascular network.
Cerebrovascular angiography shows that abnormally-proliferated tiny blood vessels are similar to smoke, the disease rate in China is about 0.43/10 ten thousand, and the disease rate is common in Jiangxi, Henan, Anhui and Shandong. The clinical manifestations are cerebral hemorrhage or cerebral ischemia. If the patient is not treated, the patient is often disabled and killed due to repeated cerebral hemorrhage or ischemia. Currently, the etiology and pathogenesis of the disease are unclear, but the disease can be improved through surgical treatment. Various revascularization procedures can prevent cerebral ischemia and bleeding by increasing cerebral blood perfusion.
The operation mode is direct revascularization, which means that intracranial and extracranial blood vessels are bridged, blood vessels of the scalp are directly anastomosed to blood vessels of the cerebral cortex, and an 'expressway' is established, so that the blood supply of the brain can be directly and rapidly improved. However, because the cerebral vessels are very thin and have a diameter of only 1mm, the requirement on the operation technology is high and the operation difficulty is high.
Firstly, dissociating the frontal branch and the parietal branch of the superficial temporal artery from the scalp, then anastomosing the frontal branch (the diameter is only 2mm) of the superficial temporal artery with the cortical branch (the diameter is only 1mm) of the middle cerebral artery, and displaying unobstructed anastomosis by fluorescence radiography, wherein the blood flow of the frontal branch of the superficial temporal artery directly enters the brain tissue; the superficial temporal artery apical branch is then applied to the surface of the brain to gradually establish a new collateral circulation.
The surgery difficulty of the reconstruction anastomosis of the frontal branch of superficial temporal artery (diameter 2mm) and the cortical branch of cerebral artery (diameter only 1mm) is very high. The existing reconstruction method for blood transportation of frontal branch of superficial temporal artery and cortical branch of middle cerebral artery comprises the following steps: as shown in the attached figure 6 of the specification, after a bilateral incision is made on the wall of a frontal branch vessel of a temporal superficial artery with the diameter of 2mm, and the wall of a branch vessel of a middle cerebral artery cortex with the diameter of only 1mm is cut, the two incisions are respectively sealed with the bilateral incision. The operation mode is a conventional mode for reconstructing blood vessels of small diameter and large diameter, has great difficulty and is easy to seal the position to form thrombus.
Disclosure of Invention
The invention aims to provide an auxiliary tee joint for reconstructing the frontal branch of the superficial temporal artery and the cerebral artery cortex blood vessels.
In order to achieve the purpose, the invention is realized by the following technical scheme:
the auxiliary tee joint for reconstructing the blood transportation of the frontal branch of the superficial temporal artery and the cerebral artery cortex comprises a tee joint body, wherein the tee joint body is made of an artificial blood vessel material; the bottom end of the tee body is a cerebral vessel pipeline, and a slit is arranged at the bottom side of the cerebral vessel pipeline; two ends of the cerebrovascular pipeline are provided with lower tube bulges, and lower suture holes are formed in the lower tube bulges; the three-way body top is that superficial temporal artery is protruding, the protruding below of superficial temporal artery is communicate with the blood vessel of brain pipeline, and its intercommunication department is the intercommunication mouth, the superficial temporal artery is protruding to be equipped with the suture hole on. The tee body is made of a biological mixed type artificial blood vessel material, and the edge of the tee body is chamfered and smoothed.
The use method of the auxiliary tee joint for reconstructing the frontal branch of the superficial temporal artery and the cerebral artery cortex comprises the following steps:
s1, placing the branch vessel of the middle cerebral artery cortex into the lumen of the cerebral vessel through the slit;
s2, suturing the two ends of the cerebral vascular tube with the branch vessels of the middle cerebral artery cortex through the lower suture holes in the operation, and fixing the auxiliary tee joint on the branch vessels of the middle cerebral artery cortex;
s3, cutting off the vessel wall of the branch vessel of the middle cerebral artery cortex at the communication port through the communication port by a scalpel and forceps to form a blood circulation port;
s4, suturing the end of the frontal branch vessel of the superficial temporal artery and the convex tube of the superficial temporal artery through the upper suture hole in the operation, and fixing the auxiliary tee joint at the end of the frontal branch vessel of the superficial temporal artery by the convex suture of the superficial temporal artery.
Compared with the prior art, the invention has the beneficial effects that:
according to the using method of the auxiliary tee joint for reconstructing the frontal branch of the superficial temporal artery and the cerebral artery cortex blood circulation, the device is used, and only one-step resection operation is needed in the operation: the blood circulation port is formed by cutting off the blood vessel wall of the branch vessel of the middle cerebral artery cortex at the communication port. The vessel wall of the cerebral middle artery cortex branch is cut off without cutting off, and the frontal branch of the superficial temporal artery does not need to be subjected to bilateral incision, so that the operation difficulty is reduced.
In addition, in the work of cutting the vessel wall of only the branch vessel of the middle cerebral artery cortex to form a blood transportation port, the two ends of the cerebrovascular pipeline are sewed with the branch vessel of the middle cerebral artery cortex through the lower sewing holes before the cutting operation, so that the auxiliary tee joint is fixed on the branch vessel of the middle cerebral artery cortex; this greatly reduces the difficulty of the vessel wall resection.
Drawings
FIG. 1 is a schematic structural diagram of the present invention.
FIG. 2 is a diagram showing the state of the present invention after suturing with the branch vessels of the middle cerebral artery cortex.
Fig. 3 is a schematic diagram of the present invention used in surgery.
FIG. 4 is a diagnostic check profiling assistance diagram.
Fig. 5 is a diagnostic aid for pathology.
Fig. 6 is a diagram of a method for reconstructing the blood circulation of the frontal branch of the superficial temporal artery and the cortex of the middle cerebral artery in the prior art.
Reference numerals shown in the drawings:
1. a tee body; 2. a cerebrovascular vessel; 3. slotting; 4. a lower tube boss; 5. a lower suture hole; 6. superficial temporal artery convexity; 7. a communication port; 8. sewing holes on the plate; 9. and (4) blood circulation and ventilation.
Detailed Description
The invention will be further illustrated with reference to the following specific examples. It should be understood that these examples are for illustrative purposes only and are not intended to limit the scope of the present invention. Further, it should be understood that various changes or modifications of the present invention may be made by those skilled in the art after reading the teaching of the present invention, and these equivalents also fall within the scope of the present application.
The invention relates to a three-way auxiliary for reconstructing the blood transportation of frontal branches of superficial temporal arteries and cerebral artery cortex, which comprises a three-way body 1 in a main structure, wherein the three-way body 1 is made of a biological mixed type artificial blood vessel material. In order to solve the problem of better adaptability of the artificial blood vessel woven by synthetic materials to biological organisms, a layer of biological material is coated on the surfaces of the high polymer materials, namely the biological mixed type artificial blood vessel. Typical artificial coatings applied include the following: albumin can improve the anticoagulation performance of the artificial blood vessel; fibronectin can promote the formation of intima, so that the occurrence of blood coagulation is inhibited; the collagen can promote the formation of intima, prevent the occurrence of blood coagulation and improve the compliance of the artificial blood vessel; gelatin has the functions of promoting cell adhesion and growth, inducing intima formation after implantation and preventing blood coagulation.
The bottom end of the tee body 1 is a cerebral vessel pipeline 2, and a slit 3 is arranged at the bottom side of the cerebral vessel pipeline 2; two ends of the cerebrovascular pipeline 2 are provided with lower tube protrusions 4, and the lower tube protrusions 4 are provided with lower suture holes 5; the top of the tee body 1 is a superficial temporal artery duct protrusion 6, the lower portion of the superficial temporal artery duct protrusion 6 is communicated with the cerebral vascular pipeline 2, a communication port 7 is arranged at the communication position of the superficial temporal artery duct protrusion 6, and an upper suture hole 8 is arranged on the superficial temporal artery duct protrusion 6. And the edge of the tee body 1 is chamfered and smoothed.
The use method of the auxiliary tee joint for reconstructing the frontal branch of the superficial temporal artery and the cerebral artery cortex comprises the following steps:
s1, placing the cerebral artery cortex branch vessel into the lumen of the cerebral vessel 2 through the slit 3;
s2, suturing the two ends of the cerebral vascular pipeline 2 with the cerebral middle artery cortex branch vessels through the lower suture holes 5 in an operation, and fixing the auxiliary tee joint on the cerebral middle artery cortex branch vessels in a suture manner;
s3, cutting off the blood vessel wall of the branch vessel of the middle cerebral artery cortex at the position of the communication opening 7 through the communication opening 7 by a scalpel and forceps to form a blood circulation opening 9;
s4, suturing the end of the frontal branch vessel of the superficial temporal artery and the convex temporal artery 6 through the upper suture hole 8, and enabling the auxiliary tee joint to be the convex temporal artery 6 and be fixed at the end of the frontal branch vessel of the superficial temporal artery.
The method for using the auxiliary tee joint for reconstructing the blood transportation of the frontal branch of the superficial temporal artery and the cerebral artery cortex is used for performing the blood transportation reconstruction operation at the position A in the attached figure 3 of the specification. By applying the device to use the method, only one-step resection operation is needed in the operation: the blood circulation port 9 is formed by cutting the blood vessel wall of the branch vessel of the middle cerebral artery cortex at the communication port 7. The vessel wall of the cerebral middle artery cortex branch is cut off without cutting off, and the frontal branch of the superficial temporal artery does not need to be subjected to bilateral incision, so that the operation difficulty is reduced.
In addition, in the work of cutting the vessel wall of only the branch vessel of the middle cerebral artery cortex to form a blood circulation opening 9, the two ends of the cerebral vessel pipeline 2 are sutured with the branch vessel of the middle cerebral artery cortex through the lower suture hole 5 before the cutting operation, so that the auxiliary tee joint is sutured and fixed on the branch vessel of the middle cerebral artery cortex; this greatly reduces the difficulty of the vessel wall resection.
Claims (4)
1. Supplementary tee bend is rebuild with cerebral artery cortex blood transport to superficial temporal artery frontal branch, its characterized in that: the blood circulation promoting blood;
the bottom end of the tee body (1) is provided with a cerebral vessel pipeline (2), and the bottom side of the cerebral vessel pipeline (2) is provided with a slot (3); lower pipe bulges (4) are arranged at two ends of the cerebrovascular pipeline (2), and lower suture holes (5) are arranged on the lower pipe bulges (4);
the three-way body (1) top is the superficial temporal artery pipe protruding (6), the superficial temporal artery pipe protruding (6) below communicates with cerebral vessel pipeline (2), and its intercommunication department is intercommunication mouth (7), be equipped with on the superficial temporal artery pipe protruding (6) and sew up hole (8).
2. The auxiliary tee joint for reconstruction of frontal temporo-superficial artery and cerebral arterial cortex blood transportation according to claim 1, wherein: the tee body (1) is made of biological mixed type artificial blood vessel materials.
3. The auxiliary tee joint for reconstruction of frontal temporo-superficial artery and cerebral arterial cortex blood transportation according to claim 1, wherein: the edge of the tee body (1) is chamfered and smoothed.
4. The use of the auxiliary tee for reconstruction of frontal branch of superficial temporal artery and cerebral arterial cortex as claimed in claims 1-3, wherein:
the method comprises the following steps:
s1, placing the cerebral artery cortex branch vessel into the lumen of the cerebral vessel (2) through the slit (3);
s2, suturing the two ends of the cerebral vascular pipeline (2) with the cerebral middle artery cortical branch blood vessels through the lower suture holes (5) in an operation, and fixing the auxiliary tee joint on the cerebral middle artery cortical branch blood vessels;
s3, cutting off the blood vessel wall of the cerebral middle artery cortical branch vessel at the position of the communication opening (7) through the communication opening (7) by a scalpel and a pair of forceps to form a blood circulation opening (9);
s4, suturing the end of the frontal branch vessel of the superficial temporal artery and the convex tube (6) of the superficial temporal artery through the upper suture hole (8) in the operation, and enabling the auxiliary tee joint to be the convex tube (6) of the superficial temporal artery and to be fixed at the end of the frontal branch vessel of the superficial temporal artery in a suture mode.
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201911222882.5A CN111012409A (en) | 2019-12-03 | 2019-12-03 | Auxiliary tee joint for reconstruction of blood transportation of frontal branch of superficial temporal artery and cerebral artery cortex and use method |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201911222882.5A CN111012409A (en) | 2019-12-03 | 2019-12-03 | Auxiliary tee joint for reconstruction of blood transportation of frontal branch of superficial temporal artery and cerebral artery cortex and use method |
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| CN111012409A true CN111012409A (en) | 2020-04-17 |
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