CN111249031A

CN111249031A - Femoral artery covered stent with branches

Info

Publication number: CN111249031A
Application number: CN202010053953.XA
Authority: CN
Inventors: 郝迎学; 钟华
Original assignee: First Affiliated Hospital of PLA Military Medical University
Current assignee: First Affiliated Hospital of PLA Military Medical University
Priority date: 2020-01-17
Filing date: 2020-01-17
Publication date: 2020-06-09
Anticipated expiration: 2040-01-17
Also published as: CN111249031B

Abstract

The invention provides a femoral artery covered stent with branches, which comprises a main stent tube, a branch stent tube and a transition tube, wherein one end of the transition tube is connected with the end part of the branch stent tube, the other opposite end of the transition tube is arranged on the outer peripheral surface of the main stent tube and penetrates through the outer peripheral surface of the main stent tube to be communicated with a main stent tube, the axis of the main stent tube and the axis of the branch stent tube are intersected to form an included angle α smaller than or equal to 90 degrees, one side of the transition tube, which is away from the included angle α, is provided with an extension area, and the extension area is used for stretching or contracting along the axis of the branch stent tube when the angle of the included angle α is changed.

Description

Femoral artery covered stent with branches

Technical Field

The invention relates to the field of covered stents, in particular to a femoral artery covered stent with branches.

Background

With the rapid rise in the incidence of hypertension, the incidence of artery-related diseases has risen dramatically, and the high-speed growth is expected to be greater than 40% in the next 5 to 7 years. Among them, acute Stanford a type aortic dissection (AADA) is the most common and most aggressive aortic emergency in the field of cardiovascular surgery. If untreated, the mortality rate of one week after the onset of AADA reaches 50-91%; if only medical conservative treatment is received, the mortality rate at 24 hours can reach 20 percent, and the mortality rate at 48 hours can reach 30 percent. Therefore, once AADA is diagnosed, emergency surgical intervention is necessary without surgical contraindications. However, even under modern medical conditions, perioperative mortality can be as high as 15-35%.

At present, minimally invasive endovascular intervention isolation surgery can be adopted for treating the diseases, and a covered stent is usually adopted to isolate blood flow and aortic dissection. However, when the thoracic aortic aneurysm or aortic dissection involves the aortic arch with openings of the brachiocephalic trunk, the left common carotid artery and the left subclavian artery, the current stent graft on the market has no branch, and when the stent graft is used for treatment, the branch blood vessels can be blocked to different degrees, so that the blood flow of the branch blood vessels is obstructed, and corresponding complications can occur and even can endanger life.

Disclosure of Invention

Aiming at the defects in the prior art, the femoral artery covered stent with the branches ensures the smooth blood flow of the branch blood vessels through the branch stent tube, and is convenient to improve the safety.

The invention provides a femoral artery covered stent with branches, which comprises a main stent tube, a branch stent tube and a transition tube, wherein one end of the transition tube is connected with the end part of the branch stent tube, the other opposite end of the transition tube is arranged on the outer peripheral surface of the main stent tube and penetrates through the outer peripheral surface of the main stent tube to be communicated with the main stent tube, the axis of the main stent tube and the axis of the branch stent tube are intersected to form an included angle α smaller than or equal to 90 degrees, one side of the transition tube, which is away from the included angle α, is provided with an extension area, and the extension area is used for stretching or contracting along the axis of the branch stent tube when the angle of the included angle α changes.

Optionally, the main stent tube includes the elasticity skeleton and the tectorial membrane of tube-shape, open at the middle part of the outer peripheral face of elasticity skeleton has the through-hole, the tectorial membrane parcel is on the outer peripheral face of elasticity skeleton to cover the through-hole, the one end that the transition pipe is kept away from the branch stent tube is provided with joint portion, and this joint portion is used for puncturing the tectorial membrane and penetrates through the through-hole and elasticity skeleton joint.

Optionally, joint portion includes nozzle stub, pulling force ring sum cyclic annular gasbag, the pulling force ring overcoat is on the nozzle stub with slidable mode, cyclic annular gasbag overcoat is on the nozzle stub, and the one end of this cyclic annular gasbag is fixed on the outer peripheral face of nozzle stub, and another looks remote site is fixed on the pulling force ring, the one end that the pulling force ring was installed to the nozzle stub is fixed at the tip of branch stake pipe, and another looks remote site has a plurality of rosette, a plurality of along the articulated a plurality of rosette, a plurality of one side deflection that the one end that the rosette deviates from the nozzle stub is close to the axis mutually forms toper puncture portion, every all be provided with the acting as go-between on the rosette, should act as go-between and keep away from the one end of rosette and fix at the pulling force ring for when the pulling force ring slides.

Optionally, the clamping portion further includes a limiting ring, the limiting ring is fixed on the outer peripheral surface of the annular air bag at one end far away from the tension ring, a gap is formed between the limiting ring and the annular air bag, and the pull wire penetrates through the gap and is connected with the tension ring.

Optionally, the transition pipe includes a proximal angle half pipe body and an elastic distal angle half pipe body, the proximal angle half pipe body and the distal angle half pipe body are buckled with each other to form a complete tubular body, two ends of the tubular body are respectively connected with the main stent pipe and the sub-stent pipe, and the proximal angle half pipe body is located on one side of the tubular body close to the included angle α.

Optionally, the transition pipe is a corrugated pipe.

Optionally, the blood vessel further comprises an annular and flexible anchoring film, wherein the anchoring film is sleeved on one end of the main stent tube, one end of the anchoring film is fixed on the outer peripheral surface of the main stent tube, and the other opposite end of the anchoring film extends along the direction of blood flow.

According to the technical scheme, the femoral artery covered stent with the branch has the beneficial effects that one end of the transition tube is connected with the end part of the branch stent tube, the other opposite end of the transition tube is installed on the outer peripheral surface of the main stent tube and penetrates through the outer peripheral surface of the main stent tube to be communicated with the main stent tube, the axis of the main stent tube and the axis of the branch stent tube are intersected to form an included angle α smaller than or equal to 90 degrees, and an extension area is arranged on one side of the transition tube, away from the included angle α, and used for stretching or contracting along the axis of the branch stent tube when the angle of the included angle α changes.

Drawings

In order to more clearly illustrate the detailed description of the invention or the technical solutions in the prior art, the drawings that are needed in the detailed description of the invention or the prior art will be briefly described below. Throughout the drawings, like elements or portions are generally identified by like reference numerals. In the drawings, elements or portions are not necessarily drawn to scale.

FIG. 1 is a schematic perspective view of the present invention;

FIG. 2 is a schematic structural view of the present invention;

FIG. 3 is a schematic structural diagram of a T-shaped positioning portion;

FIG. 4 is a schematic structural view of a stop collar;

fig. 5 is an enlarged view of a portion a in fig. 2.

Reference numerals:

1-main stent tube, 2-branch stent tube, 3-transition tube, 4-anchoring film, 11-elastic framework, 12-coating film, 31-clamping part, 32-near angle half tube body, 33-far angle half tube body, 111-through hole, 311-short tube, 312-tension ring, 313-annular air bag, 314-spacing ring, 315-petal body, 316-stay wire and 317-injection hole.

Detailed Description

Embodiments of the present invention will be described in detail below with reference to the accompanying drawings. The following examples are only for illustrating the technical solutions of the present invention more clearly, and therefore are only examples, and the protection scope of the present invention is not limited thereby.

Referring to fig. 1-5, the branched femoral artery covered stent provided in this embodiment includes a main stent tube 1, a branch stent tube 2 and a transition tube 3, wherein one end of the transition tube 3 is connected to an end of the branch stent tube, the other opposite end is mounted on an outer circumferential surface of the main stent tube and is communicated with the main stent tube by penetrating through the outer circumferential surface of the main stent tube, an axis of the main stent tube intersects with an axis of the branch stent tube to form an included angle α smaller than or equal to 90 °, and an extension region is disposed on a side of the transition tube facing away from the included angle α and configured to stretch or contract along the axis of the branch stent tube when an angle of the included angle α changes, the transition tube is a corrugated tube, or the transition tube 3 is formed by splicing a proximal half tube 32 and an elastic distal half tube 33, that is a proximal half tube and a distal half tube that are buckled with each other to form a complete tubular body, both ends of the tubular body are respectively connected to the main stent tube and the branch stent tube, and the proximal half tube is positioned on a side of the tubular body close to the included angle α.

In the process, one side of the transition tube, which is away from the included angle α, is stretched along the axis of the branch frame tube, so that the length of the side of the transition tube, which is away from the included angle α, is greater than that of the side of the transition tube, which is close to the included angle α, so that the transition tube can be better attached to the junction of the branch vessel and the artery vessel, which is convenient for reducing the damage to the vessel, and meanwhile, the stress of one side of the transition tube, which is away from the included angle α, is effectively counteracted, and the problem of the large-angle bending of the branch frame tube is effectively solved, so that the problem of the collapse of the branch frame 2 is solved.

As a further improvement to the above technical solution, in a preferred embodiment of the present invention, the main stent tube 1 includes a tubular elastic framework 11 and a covering film 12, a through hole 111 is formed in a middle portion of an outer circumferential surface of the elastic framework 11, the covering film is wrapped on the outer circumferential surface of the elastic framework and covers the through hole, and a clamping portion 31 is disposed at one end of the transition tube 3 away from the partial stent tube, and is used for piercing the covering film to penetrate the through hole and clamping with the elastic framework.

When the stent is used, the main stent tube 1 is placed in an arterial blood vessel, the through hole 111 is opposite to the inlet of a branch blood vessel, then the branch stent tube 2 is placed in the branch blood vessel, the clamping part 31 is opposite to the through hole 111, the clamping part 31 is used for puncturing the coating film, and the clamping part 31 penetrates into the through hole to be clamped with the elastic framework. Preferably, the puncture needle can be used for puncturing the membrane along the branch blood vessel, then the branch stent tube 2 is placed into the branch blood vessel, and the clamping part 31 is inserted into the through hole to be clamped with the elastic framework. In this embodiment, the main stent tube 1 and the sub-stent tube 2 are in a separated state in an initial state, so that the main stent tube and the sub-stent tube can be conveniently placed. Meanwhile, the elastic framework 11 is not arranged at the through hole 111, so that the puncture is facilitated.

As a further improvement to the above technical solution, the clamping portion 31 includes a short tube 311, a tension ring 312 and an annular air bag 313, the tension ring is slidably sleeved on the short tube, a plurality of injection holes 317 distributed along the circumferential direction are formed on the inner circumferential surface of the short tube 311, and the injection holes 317 penetrate through the short tube along the radial direction of the short tube 311. The annular air bag is sleeved on the short pipe to cover the injection hole 317, one end of the annular air bag is fixed on the outer peripheral surface of the short pipe, the other opposite end of the annular air bag is fixed on the tension ring, one end of the short pipe 311 provided with the tension ring is fixed at the end part of the branch support pipe, the other opposite end of the short pipe is hinged with a plurality of rosettes 315 along the circumferential direction, one ends of the rosettes departing from the short pipe are deflected close to one side of the axis of the short pipe to form a conical puncture part, each rosettes 315 is provided with a stay wire 316, one end of the stay wire, far away from the rosettes, is fixed on the tension ring, and when the tension ring slides, the rosettes are pulled to.

In an initial state, one end of each petal-shaped body, which is far away from the short pipe, deflects to form a conical puncture part, so that the short pipe can be conveniently inserted into the through hole 111, and the short pipe is prevented from interfering with the elastic framework 11. After the short tube is inserted into the through hole 111, a puncture needle pierces the annular air bag 313 along one of the injection holes, medicine is injected into the annular air bag 313, the annular air bag 313 expands along the axial direction of the short tube, the annular air bag 313 pushes the tension ring 312 to slide towards one side far away from the rosette 315, the tension ring 312 pulls the rosette 315 through the pull wire 316, the rosette 315 rotates and deviates towards one side far away from the axis of the short tube to form a T-shaped positioning part, and the rosette 315 abuts against the inner side wall of the main stent tube 1. At this time, one end of the short pipe inserted into the through hole 111 is shaped like a T, so that the short pipe is fixed in the main bracket pipe 1, preventing the main bracket pipe 1 from being separated from the short pipe. Meanwhile, the short pipe can be better attached to the edge shape of the through hole 111, so that the tightness between the main support pipe 1 and the branch support pipe 2 is ensured, and the condition of blood internal leakage is prevented.

It can be understood that the clamping portion 31 may further include a limiting ring 314 fixed on an end of the outer circumferential surface of the annular air bag, which is far away from the tension ring, and a gap is formed between the limiting ring and the annular air bag, and the pull wire passes through the gap and is connected with the tension ring. The position of the stay wire is convenient to limit, a triangle is prevented from being generated among the stay wire, the petal-shaped body and the annular air bag in the pulling process, and the interference between the stay wire and the main bracket tube 1 is convenient to prevent.

As a further improvement to the above technical solution, the blood vessel further comprises an annular and flexible anchoring film 4, the anchoring film is sleeved on one end of the main stent tube, one end of the anchoring film is fixed on the outer circumferential surface of the main stent tube, and the other opposite end extends along the direction of blood flow. An anchoring film 4 is also arranged at one end of the sub-stent tube 2 far away from the main stent tube 1, and the anchoring film 4 also extends along the direction of blood flow. Taking fig. 2 as an example, the direction of blood flow in fig. 2 is from left to right, and in the initial state, the left side of the anchoring membrane 4 is fixed and the right side is in an extended state. If the main stent tube slides to the right side along with the movement of blood, at the moment, the fixed film 4 can be relatively contracted to the left side of the main stent tube, so that the diameter of the outer peripheral surface of the left side of the main stent tube is enlarged, the main stent tube is fixed in a blood vessel, and the main stent tube is prevented from sliding in the blood vessel.

Finally, it should be noted that: the above embodiments are only used to illustrate the technical solution of the present invention, and not to limit the same; while the invention has been described in detail and with reference to the foregoing embodiments, it will be understood by those skilled in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some or all of the technical features may be equivalently replaced; such modifications and substitutions do not depart from the spirit and scope of the present invention, and they should be construed as being included in the following claims and description.

Claims

1. The femoral artery covered stent with the branches is characterized by comprising a main stent tube (1), a branch stent tube (2) and a transition tube (3), wherein one end of the transition tube (3) is connected with the end part of the branch stent tube, the other opposite end of the transition tube is installed on the outer peripheral surface of the main stent tube and penetrates through the outer peripheral surface of the main stent tube to be communicated with the main stent tube, the axis of the main stent tube and the axis of the branch stent tube are intersected to form an included angle α smaller than or equal to 90 degrees, and one side of the transition tube, which is away from the included angle α, is provided with an extension area which is used for stretching or contracting along the axis of the branch stent tube when the angle of the included angle α changes.

2. The branched femoral artery stent graft of claim 1, wherein: the main support pipe (1) comprises a cylindrical elastic framework (11) and a film (12), a through hole (111) is formed in the middle of the outer peripheral surface of the elastic framework (11), the film is wrapped on the outer peripheral surface of the elastic framework and covers the through hole, a clamping portion (31) is arranged at one end, far away from the support pipe, of the transition pipe (3), and the clamping portion is used for puncturing the film and penetrating the through hole to be clamped with the elastic framework.

3. The branched femoral artery stent graft of claim 2, wherein: the clamping part (31) comprises a short pipe (311), a tension ring (312) and an annular air bag (313), the tension ring is sleeved on the short pipe in a sliding way, the annular air bag is sleeved on the short pipe, one end of the annular air bag is fixed on the outer peripheral surface of the short pipe, the other opposite end is fixed on the tension ring, one end of the short pipe (311) provided with the tension ring is fixed at the end part of the branch bracket pipe, the other opposite end is hinged with a plurality of rosettes (315) along the circumferential direction, one ends of the rosettes departing from the short pipe deflect close to one side of the axis of the short pipe to form a conical puncture part, each rosette (315) is provided with a stay wire (316), one end of the stay wire, which is far away from the rosette body, is fixed on the tension ring, so that when the tension ring slides, the rosette body is pulled to deflect to one side far away from the axis of the short pipe, and a T-shaped positioning part is formed.

4. The branched femoral artery stent graft of claim 3, wherein: the clamping portion (31) further comprises a limiting ring (314), the limiting ring is fixed at one end, far away from the tension ring, of the outer peripheral surface of the annular air bag, a gap is formed between the limiting ring and the annular air bag, and the pull wire penetrates through the gap and is connected with the tension ring.

5. The branched femoral artery covered stent according to claim 1, wherein the transition tube (3) comprises a proximal angle half tube body (32) and a distal angle half tube body (33) with elasticity, the proximal angle half tube body and the distal angle half tube body are mutually buckled to form a complete tubular body, two ends of the tubular body are respectively connected with the main stent tube and the branch stent tube, and the proximal angle half tube body is positioned on one side of the tubular body close to the included angle α.

6. The branched femoral artery stent graft of claim 1, wherein: the transition pipe is a corrugated pipe.

7. The branched femoral artery stent graft of any one of claims 1-6, wherein: the blood vessel stent further comprises an annular and flexible anchoring film (4), wherein the anchoring film is sleeved at one end of the main stent tube, one end of the anchoring film is fixed on the outer peripheral surface of the main stent tube, and the other opposite end of the anchoring film extends along the direction of blood flow.