CN111437087B - Bifurcated stent - Google Patents
Bifurcated stent Download PDFInfo
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- CN111437087B CN111437087B CN202010256646.1A CN202010256646A CN111437087B CN 111437087 B CN111437087 B CN 111437087B CN 202010256646 A CN202010256646 A CN 202010256646A CN 111437087 B CN111437087 B CN 111437087B
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- 208000007536 Thrombosis Diseases 0.000 abstract description 7
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- 210000004204 blood vessel Anatomy 0.000 description 19
- 238000009940 knitting Methods 0.000 description 17
- 210000003090 iliac artery Anatomy 0.000 description 16
- 210000000702 aorta abdominal Anatomy 0.000 description 9
- 238000000034 method Methods 0.000 description 8
- 238000009954 braiding Methods 0.000 description 7
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- 230000017531 blood circulation Effects 0.000 description 3
- 210000001105 femoral artery Anatomy 0.000 description 3
- 238000002513 implantation Methods 0.000 description 3
- 230000003902 lesion Effects 0.000 description 3
- 230000007704 transition Effects 0.000 description 3
- 208000019553 vascular disease Diseases 0.000 description 3
- 229910000831 Steel Inorganic materials 0.000 description 2
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- 229910000990 Ni alloy Inorganic materials 0.000 description 1
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- 229910045601 alloy Inorganic materials 0.000 description 1
- 239000000956 alloy Substances 0.000 description 1
- 210000001367 artery Anatomy 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 239000007943 implant Substances 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 239000011229 interlayer Substances 0.000 description 1
- 238000003475 lamination Methods 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 229910052751 metal Inorganic materials 0.000 description 1
- 239000002184 metal Substances 0.000 description 1
- 239000007769 metal material Substances 0.000 description 1
- 229910001000 nickel titanium Inorganic materials 0.000 description 1
- 229910052755 nonmetal Inorganic materials 0.000 description 1
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Classifications
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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
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- Prostheses (AREA)
Abstract
The application discloses bifurcation support, including main part, first branch and second branch, first branch with the second branch all is connected to the same end of main part, the main part first branch with the second branch is network structure, bifurcation support still including connect in first branch with bifurcation area between the second branch, bifurcation support is in bifurcation area's net density is greater than the net density in other areas of bifurcation support. Thus, the contact area between the bifurcation area of the bifurcation stent and the vessel wall at the bifurcation position is increased, the bifurcation area can support the vessel wall at the bifurcation position, and the mesh density of the bifurcation area is larger than that of other areas of the bifurcation stent, so that the embolism caused by the falling-off of the wall-attached thrombus at the bifurcation position is prevented.
Description
Technical Field
The present application relates to implantable devices for use in a patient, and in particular to a bifurcated stent.
Background
Along with the improvement of the living standard and the change of the living style of people, the incidence rate of vascular diseases is higher and higher, and if the diseases are not treated in time, the diseases such as vascular blockage, aneurysm and the like can be caused, so that the life safety of people is seriously endangered.
At present, the vascular diseases can be treated by adopting a minimally invasive interventional technique, and the method has small trauma to patients, high safety and high effectiveness, so that operators and patients are affirmed, and the method becomes an important treatment method for the vascular diseases. The interventional treatment method is to implant the stent into the lesion section of the blood vessel of the patient by using a conveying system, the implanted stent can support the blood vessel of the narrow occlusion section or block the interlayer breach of the blood vessel by expanding, the elastic retraction and the reshaping of the blood vessel are reduced, the lumen blood flow is kept smooth, and the stent also has the function of preventing restenosis.
The existing stents for repairing main iliac artery occlusive lesions (including stenotic lesions) are mostly of conventional straight tube type or integrated bifurcation type. In the conventional straight tube type treatment, more than one stent (such as a covered stent or a bare stent) is required to be placed in parallel or placed in a crossed manner, and the stent is implanted in such a way, so that a guide wire cannot enter a contralateral limb vessel after crossing a main iliac artery bifurcation by adopting a mountain-turning technology from a femoral artery, and further the contralateral limb vessel cannot be treated. In addition, after some existing bifurcation stents are implanted at bifurcation positions of the abdominal aorta and the iliac arteries, the wall-attached thrombus at the bifurcation position of the abdominal aorta is easy to fall off at the bifurcation region of the stent and enter the circulatory system along with blood because the mesh of the bifurcation stent at the bifurcation region is sparse.
Disclosure of Invention
In order to solve the foregoing problems, the present application provides a bifurcated stent.
The application provides a bifurcation stent, including main part, first branch and second branch, first branch with the second branch all is connected to the same end of main part, the main part first branch with the second branch is network structure, bifurcation stent still including connect in first branch with bifurcation area between the second branch, bifurcation stent is in bifurcation area's net density is greater than the net density in other areas of bifurcation stent.
After the bifurcation stent provided by the application is implanted to the bifurcation position of the abdominal aorta and the iliac arteries, the main body is accommodated in the abdominal aorta, the first branch and the second branch are respectively accommodated in one iliac artery, and the bifurcation area is spanned between the two iliac arteries. The mesh density of the bifurcation area is increased in the bifurcation stent provided by the application, the contact area of the bifurcation area and the vessel wall at the bifurcation position of the iliac arteries is increased on one hand, the risk that the coanda thrombus at the bifurcation position of the abdominal aorta falls off and enters the circulatory system along with blood is reduced, on the other hand, the support force of the bifurcation area to the vessel wall at the bifurcation position of the vessel is increased, and the compression of two branches of the bifurcation stent to two iliac arteries is reduced. In addition, the bifurcated stent provided by the application allows the guide wire to enter the contralateral iliac artery after being bifurcated from the femoral artery by adopting the 'mountain-turning technology' across the main iliac artery, so that an operator can conveniently treat the contralateral limb blood vessel.
Drawings
In order to more clearly illustrate the embodiments of the present application or the technical solutions in the prior art, the drawings that are required in the embodiments or the description of the prior art will be briefly described below, it being obvious that the drawings in the following description are only some embodiments of the present application, and that other drawings may be obtained according to these drawings without inventive effort for a person skilled in the art.
Fig. 1 is a schematic structural view of a bifurcated stent according to a first embodiment of the present application.
Fig. 2 is a schematic view of an application scenario of the bifurcated stent provided in fig. 1.
Fig. 3 is a schematic diagram of the braiding pattern of the bifurcated stent shown in fig. 1.
Fig. 4 is a partial schematic structural view of a support ring of the bifurcated stent shown in fig. 3.
Fig. 5 is a partial schematic structural view of a support ring in an alternative embodiment of the bifurcated stent shown in fig. 3.
Fig. 6 is an enlarged partial schematic view of the bifurcated stent shown in fig. 3.
Fig. 7 is a further enlarged partial schematic view of the bifurcated stent shown in fig. 3.
Fig. 8 is a schematic perspective view of the bifurcated stent shown in fig. 1.
Fig. 9 is an enlarged partial schematic view of the bifurcated stent shown in fig. 1.
Fig. 10 is a schematic view of the bifurcated stent shown in fig. 8 from below.
Fig. 11 is a schematic view showing a bottom view of a bifurcation area of a conventional bifurcation stent without encryption.
Fig. 12 is a schematic structural view of a bifurcated stent according to a second embodiment of the present application.
Fig. 13 is a schematic view of the bifurcated stent shown in fig. 12 from below.
Fig. 14 is a schematic bottom view of a bifurcated stent according to a third embodiment of the present disclosure.
Fig. 15 is an enlarged partial schematic view of the bifurcated stent shown in fig. 14.
Fig. 16 is a schematic structural view of a bifurcated stent according to a fourth embodiment of the present application.
Fig. 17 is a schematic view of the bifurcated stent shown in fig. 16 from below.
Fig. 18 is a schematic structural view of a bifurcated stent according to a fifth embodiment of the present application.
Detailed Description
The following description of the embodiments of the present application will be made clearly and fully with reference to the accompanying drawings, in which it is evident that the embodiments described are only some, but not all, of the embodiments of the present application. All other embodiments, based on the embodiments herein, which would be apparent to one of ordinary skill in the art without undue burden are within the scope of the present application.
The term "proximal" in this application refers to the end that is closer to the heart in the direction of blood flow, and "distal" refers to the end that is farther from the heart in the direction of blood flow; the direction of the rotation center axis of the column, the tube, or the like is defined as the axial direction.
First embodiment
Referring to fig. 1, fig. 1 is a schematic structural diagram of a bifurcated stent according to a first embodiment of the present application.
The present application discloses a bifurcated stent 100, which comprises a main body 10, a first branch 30 and a second branch 50, wherein the first branch 30 and the second branch 50 are all connected to the same end of the main body 10, the first branch 30 and the second branch 50 are all in a net structure, the bifurcated stent 100 further comprises a bifurcation area 70 connected between the first branch 30 and the second branch 50, in fig. 1, for convenience of understanding, parallel oblique lines which are denser relative to other areas are used for representing bifurcation areas 70, but these oblique lines are only used for representing the positions of the areas, and are not used for limiting specific structural forms in the bifurcation area 70, such as a braiding manner of braided wires in the bifurcation area 70, and the like. In this application, the lattice density of bifurcated stent 100 is greater at bifurcation region 70 than at other regions of bifurcated stent 100. Other areas of bifurcated stent 100 are the remaining areas of bifurcated stent 100 excluding bifurcation area 70.
The bifurcated stent 100 provided herein may be used for implantation in a bifurcation-iliac artery location of the abdominal aorta, referring to fig. 1 and 2 in combination, after implantation, the main body 10 is accommodated in the abdominal aorta, the first branch 30 and the second branch 50 are respectively accommodated in an iliac artery, and the bifurcation area 70 spans between the two iliac arteries. According to the bifurcated stent 100 provided by the application, as the grid density of the bifurcated region 70 is greater than that of other regions of the bifurcated stent 100, on one hand, the contact area between the bifurcated region 70 and the vessel wall at the bifurcation position of the iliac artery is increased, the risk that the thrombus on the wall at the bifurcation position of the abdominal aorta enters the circulatory system along with blood after falling off is reduced, and on the other hand, the supporting force of the bifurcated region 70 on the vessel wall at the bifurcation position of the vessel is increased, and the compression of two branches (namely the first branch 30 and the second branch 50) of the bifurcated stent 100 on the two iliac arteries is reduced. In addition, the bifurcated stent 100 provided herein allows the guidewire to be bifurcated from the femoral artery across the abdominal aorta using the "everting technique" and then into the contralateral iliac artery for convenient operator treatment of the contralateral limb vessel. It will be appreciated that the above application scenario is merely exemplary, and is not to be construed as limiting the application, and the bifurcated stent 100 provided in this embodiment can also be used for implantation at any Y-shaped bifurcation formed by a main vessel and a branch vessel. When implanted, the bifurcation area 70 spans between two branch vessels, the first branch 30 and the second branch 50 are respectively accommodated in the two branch vessels, and the main body 10 is accommodated in the main vessel.
In the present embodiment, the length of the first branch 30 in the axial direction thereof is longer than the length of the second branch 50 in the axial direction thereof. The length of the second branch 50 along its axial direction is sufficient to facilitate advancement of the guidewire across the bifurcation site and into the contralateral iliac artery using the "mountain-turning technique". It will be appreciated that the length of the first branch 30 in its axial direction is not limited to be greater than the length of the second branch 50 in its axial direction, e.g., the length of the first branch 30 in its axial direction may be equal to or less than the length of the second branch 50 in its axial direction.
In the present embodiment, the bifurcation area 70 extends from the junction of the first branch 30 and the second branch 50, on the side of the first branch 30 near the second branch 50, toward the distal end of the first branch 30; and, a bifurcation area 70 extends distally from the junction of the first leg 30 and the second leg 50, on a side of the second leg 50 adjacent the first leg 30. The distal end of the first branch 30 is the end of the first branch 30 away from the main body 10; the distal end of the second branch 50 is the end of the second branch 50 remote from the main body 10. In one embodiment, the bifurcation area 70 extends from the junction of the first leg 30 and the second leg 50, on the side of the first leg 30 proximal to the second leg 50, near to a location distal to the first leg 30, or to a location distal to the first leg 30. In one embodiment, the bifurcation area 70 extends from the junction of the first leg 30 and the second leg 50, on the side of the second leg 50 proximal to the first leg 30, to a location proximal to the distal end of the second leg 30, or to the distal end of the second leg 50.
It is understood that in alternative embodiments, the shape of the bifurcation area 70 is not limited, for example, the bifurcation area 70 is a linear area connected between the first branch 30 and the second branch 50, or the bifurcation area 70 is a bar-shaped area connected between the first branch 30 and the second branch 50. It will be appreciated that without limiting the extension of the crotch region 70, the crotch region 70 extends distally from the junction of the first branch 30 and the second branch 50, on the side of the first branch 30 adjacent the second branch 50, toward the distal end of the first branch 30; and/or the bifurcation area 70 extends from the junction of the first leg 30 and the second leg 50, on the side of the second leg 50 adjacent the first leg 30, distally of the second leg 50; and/or the bifurcation area 70 extends from the junction of the first branch 30 and the second branch 50 to the main body 10, are all within the scope of the present application.
In the present embodiment, the main body 10, the first branch 30 and the second branch 50 each enclose a cavity, and the cavities of the first branch 30 and the second branch 50 are both communicated with the cavity of the main body 10, wherein a side of the main body 10, the first branch 30 and the second branch 50 facing the respective cavities is an inner side, and a side of the main body 10, the first branch 30 and the second branch 50 facing away from the respective cavities is an outer side.
In the present embodiment, the main body 10, the first branch 30, and the second branch 50 are all cylindrical. It is understood that the main body 10, the first branch 30 and the second branch 50 are not limited to be cylindrical, and the shapes of the main body 10, the first branch 30 and the second branch 50 fitting the inner wall of the blood vessel as much as possible are all within the scope of protection of the present application.
Referring to fig. 1 and 3, the main body 10, the first branch 30 and the second branch 50 each include at least one support ring 61 arranged along the respective axial directions. The support ring 61 is an elastic metal support skeleton or an elastic non-metal support skeleton such as a polymer material, and in this embodiment, the support ring 61 is a nickel alloy support. The support ring 61 includes at least one sub-support ring having a wave shape, and when the number of sub-support rings is plural, the plurality of sub-support rings are arranged around the central axis of the main body 10, the first branch 30, or the second branch 50 in a stacked manner or in an overlapped and interposed manner in the radial direction. The sub-support ring comprises a plurality of sequentially connected waverods 612, two waverods 612 forming peaks 614 at the connection of the proximal ends and two waverods 612 forming valleys 615 at the connection of the distal ends.
A mesh structure knitting method is provided, as follows:
as shown in fig. 3, fig. 3 shows a schematic view of the mesh structure according to the first embodiment of the present application along a bus, in order to distinguish different support rings 61, 3 adjacent support rings are respectively shown as support rings 61A, 61B and 61C in fig. 3, and the support rings 61A, 61B and 61C are sequentially arranged from the proximal end to the distal end, and the support rings 61A, 61B and 61C are located in the main body 10, the first branch 30 or the second branch 50. The bus bar is a line parallel to the respective axial direction on the side of the net structure of the main body 10, the first branch 30 or the second branch 50. The support rings 61A, 61B and 61C may be part of a mesh structure in the body 10, the first branch 30 or the second branch 50. The three support rings 61A, 61B and 61C are woven from one woven wire. In the present embodiment, when knitting is performed, first, the knitting yarn is knitted in a sinusoidal path along the circumferential direction of each of the main body 10, the first branch 30, and the second branch 50 from the start point O1 until the knitting yarn reaches the start point O1 again. Then, the knitting yarn is extended in the direction of the support ring 61B to the boundary between the support ring 61A and the support ring 61B, that is, the knitting yarn reaches the start point O2 of the support ring 61B, and is knitted along the circumferential direction of each of the main body 10, the first branch 30, and the second branch 50 in a sine wave path, thereby completing the knitting of the support ring 61B. And so on, the braiding of the support ring 61C is completed. It will be appreciated that in the present embodiment, the starting point O1 is a peak 614 of the supporting ring 61A, the starting point O2 is a trough 615 of the supporting ring 61A, and the starting point O2 is a peak 614 of the supporting ring 61B.
In a variant embodiment, only one support ring 61A is included in the body 10, the first branch 30 or the second branch 50, and no adjacent support rings 61B and 61C are included.
It will be appreciated that in the course of knitting the knitting lines starting from the starting point O1 and following the respective circumferential directions of the main body 10, the first branch 30 or the second branch 50 in a sine wave path until the knitting lines reach the starting point O1 again, the number of turns of the knitting lines around the central axis of the main body 10, the first branch 30 or the second branch 50 may be one or more, and when the knitting lines around the central axis after more than one turn form a plurality of turns of the first sub-support ring, the second sub-support ring … …, which are sequentially arranged in a radial direction, the one turn of the sub-support ring of the post-knitting covers the sub-support ring of the preceding knitting, and the wavebars of each sub-support ring form a plurality of crossing points with the wavebars inside or outside thereof, as shown in fig. 4. In the adjacent two crossing points, the wave rods of the outer sub-support ring are arranged outside the wave rods of the inner sub-support ring. Specifically, the support ring 61 in fig. 4 includes four sub-support rings formed by braiding around a central axis four times, and in order to distinguish the four sub-support rings, the four sub-support rings in fig. 4 are denoted as Q1, Q2, Q3, Q4, respectively. As described above, the main body 10, the first branch 30, and the second branch 50 are disposed on the inner side of the respective cavities, the side of the main body 10, the first branch 30, and the second branch 50 facing away from the respective cavities is disposed on the outer side, specifically, in fig. 4, the inner side is disposed on the inner side in the direction facing inward in the paper, the outer side is disposed on the outer side in the direction facing outward in the paper, and the sub-support rings Q1, Q2, Q3, and Q4 are sequentially stacked in the radial direction from the inner side to the outer side. Two adjacent crossing points formed by the wave rods of the sub-support ring Q4 and the wave rods of the sub-support rings Q3 and Q2 are X1 and X2, and the sub-support ring Q4 is an outer sub-support ring compared with the sub-support rings Q3 and Q2. In the adjacent intersections X1 and X2, the waverods of the sub-support ring Q4 are both woven outside the waverods of the sub-support rings Q3, Q2. The sub-support rings Q1, Q2, Q3, Q4 may be located in the main body 10, the first branch 30, or the second branch 50.
In the embodiment shown in fig. 5, at least one support ring of the bifurcated stent 100 (the main body 10, the first branch 30 and the second branch 50) includes a first sub-support ring and other sub-support rings, the first sub-support ring and the other sub-support rings are disposed around the axial direction of the main body, the first branch or the second branch in a radially overlapping and penetrating manner, the wave rods of the first sub-support ring and the wave rods of the other sub-support rings form a plurality of crossing points, wherein at least adjacent first crossing points and second crossing points exist, at the first crossing point, the wave rods of the first sub-support ring are disposed at the outer side with respect to the wave rods of the other sub-support rings crossing the first crossing point, and at the second crossing point, the wave rods of the first sub-support ring are disposed at the inner side with respect to the wave rods of the other sub-support rings crossing the first crossing point. At least one of the body 10, the first branch 30 and the second branch 50 comprises a support ring as shown in fig. 5. Specifically, the support ring shown in fig. 5 includes four sub-support rings formed by knitting yarns around a central axis in four turns, the four sub-support rings in fig. 5 are denoted as L1, L2, L3, L4, respectively, in order to distinguish the four sub-support rings, in fig. 5, the sub-support rings L1, L2, L3, L4 are arranged in a radially intersecting stacked manner, with an inner side in a direction inward of the paper surface and an outer side in a direction outward of the paper surface. The sub-supporting rings L1, L2, L3 and L4 comprise a plurality of wave rods, and two adjacent crossing points formed by the wave rods of the sub-supporting ring L4, the wave rods of the sub-supporting ring L3 and the wave rods of the sub-supporting ring L2 are Y1 and Y2. In one of the intersections Y1, the wavebars of the sub-support ring L4 are arranged outside the wavebars of the sub-support ring L2, and in the other intersection Y2, the wavebars of the sub-support ring L4 are arranged inside the wavebars of the sub-support ring L3. The sub-supporting ring L4 is arranged at one intersection point Y1 with other sub-supporting rings, the sub-supporting ring L4 is arranged close to the outer side relative to the sub-supporting ring crossed with the sub-supporting ring L4, and at the other adjacent intersection point Y2, the sub-supporting ring L4 is arranged close to the inner side relative to the sub-supporting ring crossed with the sub-supporting ring L4, so that the radial crossed lamination with other sub-supporting rings is realized, and the whole supporting force and the firmness of the supporting rings are improved. In one embodiment, any one of the support rings is disposed alternately on the inner side and the outer side with respect to the other support rings intersecting with the other support ring at adjacent intersections formed by the other support rings.
It will be appreciated that the number of sub-support rings is not limited, e.g. the number of sub-support rings is one or more, and when the number of sub-support rings is one, there are no stacked sub-support rings of multiple turns or sub-support rings that overlap.
Referring to fig. 3 and 6 in combination, fig. 6 is an enlarged partial schematic view of the bifurcated stent shown in fig. 1.
In the present embodiment, the peaks 614 and the valleys 615 between the adjacent support rings are provided in correspondence with each other, for example, the peaks 614 of the support ring 61A are provided in correspondence with the valleys (not shown) of the support ring 61B, and the valleys 615 of the support ring 61A are provided in correspondence with the peaks 614 of the support ring 61B.
Taking the main body 10 as an example, in the embodiment where the main body 10 has a plurality of support rings sequentially disposed along the axial direction, the distal support ring is a support ring near one end of the first branch 30 or the second branch 50, and between adjacent support rings in the main body 10, the peak 614 of the distal support ring passes through the trough 615 of the proximal support ring from the inside to the outside, so that the peak 614 of the distal support ring hooks on the trough 615 of the proximal support ring. For example, as shown in fig. 6, when knitting the support ring 61B, the peaks 614 of the support ring 61B are penetrated from the inside of the valleys 615 of the support ring 61A and penetrated from the outside of the valleys 615 of the first support ring 61A, and thus the peaks 614 of the support ring 61B are hooked on the valleys 615 of the support ring 61A. As shown in fig. 7, in knitting the support ring 61C, the peaks 614 of the support ring 61C are penetrated from the inside of the valleys 615 of the support ring 61B and penetrated from the outside of the valleys 615 of the support ring 61B, and thus the peaks 614 of the support ring 61C are hooked on the valleys 615 of the support ring 61B. Wherein the hooking positions between adjacent support rings are shown as circles in fig. 3.
The above description is merely illustrative of the manner in which adjacent support rings in the main body 10 are connected, and in this embodiment, the manner in which adjacent support rings in the first branch 30 and the second branch 50 are connected is similar to the manner in which adjacent support rings in the main body 10 are connected.
In the present embodiment, the connection between the first branch 30 and the main body 10 and the connection between the second branch 50 and the main body 10 are the same as those between the adjacent support rings, that is, as shown in fig. 1, at the connection between the main body 10 and the first branch 30, the peak 614 of the support ring of the first branch 30 near the main body 10 penetrates from the inside of the trough 615 of the support ring of the main body 10 near the first branch 30, and penetrates from the outside of the trough 615 of the support ring of the main body 10, so that the support ring of the first branch 30 is hooked on the support ring of the main body 10. At the junction of the body 10 and the second branch 50, the peaks 614 of the support ring of the second branch 50 near the body 10 penetrate from inside the valleys 615 of the support ring of the body 10 near the second branch 50 and penetrate from outside the valleys 615 of the support ring of the body 10, so that the support ring of the second branch 50 is hooked on the support ring of the body 10, so that the peaks 614 of the support ring of the first branch 30 and/or the second branch 50 are connected with the valleys 615 of the support ring of the body 10. It will be appreciated that when the peaks 614 of the first branch 30 or the second branch 50 pass through the valleys 615 of the body 10 from the inside to the outside, or pass through the valleys 615 of the support ring of the body 10 from the outside to the inside, the braided wire may be wound around the valleys 615 of the support ring of the body 10 a plurality of times to further increase the lattice density of the bifurcated stent 100 at the bifurcation region 70, improving the occlusion effect.
It will be appreciated that in alternative embodiments, the peaks 614 of the distal support ring may extend from the outside to the inside through the valleys 615 of the proximal support ring, either between adjacent support rings of the body 10, the first leg 30, and the second leg 50, or between adjacent support rings at the junction of the body 10 and the first leg 30 or at the junction of the body 10 and the second leg 50. It will be appreciated that the peaks 614 of the distal support ring are not limited to hooking to the valleys 615 of the proximal support ring, e.g., the peaks 614 of the distal support ring may be welded to the valleys 615 of the proximal support ring.
It will be appreciated that the mesh structure provided by the braiding described above is merely exemplary and that the number of support rings is not limited thereto, e.g., the number of support rings may be one or more.
It will be appreciated that the plurality of support rings is not limited to being woven from one woven wire. For example, each support ring may be woven from more than one braided wire.
It is understood that the material of the braided wire is not limited, for example, the braided wire may be made of a metal material such as nickel-titanium alloy wire, cobalt-base alloy wire or stainless steel wire, and the braided wire may be made of a polymer material.
In the present embodiment, the mesh structures of the main body 10, the first branch 30, and the second branch 50 are each woven from one braided wire, i.e., the entire bifurcated stent 100 is made from three wires. It is understood that the entire bifurcated stent 100 is not limited to being made from wire braiding, e.g., the bifurcated stent 100 may be, but is not limited to being, cut with a laser.
In this embodiment, the braided junctions between every two wires are compacted by a steel sheath. It will be appreciated that the braiding node between each two wires is not limited to being compacted by a steel sheath.
Referring to fig. 1 and 8 in combination, fig. 8 is a schematic perspective view of the bifurcated stent shown in fig. 1. It should be noted that fig. 8 shows only a partial area of the mesh structure by way of example, and other areas of the mesh structure are not shown.
In the present embodiment, each of the first and second branches 30 and 50 includes a connecting portion 63 and a main body portion 65 integrally connected, the main body portion 65 is substantially cylindrical, and at least a portion of the connecting portion 63 is funnel-shaped and is connected between the main body portion 65 and the main body 10. The crotch region 70 is at least partially disposed on the connection portion 63.
In the present embodiment, the first branch 30 is exemplified, the first branch 30 is close to a supporting ring of the main body 10 to form a connecting portion 63, at least part of the connecting portion 63 is funnel-shaped, that is, the outer diameter of the funnel-shaped portion in the connecting portion 63 is gradually reduced along the direction of the main body 10 toward the first branch 30, and the connecting portion 63 serves as a transition between the main body 10 and the first branch 30. The main body 65 is substantially cylindrical and supports the inner wall of the branched blood vessel. In the application scenario, the main body 10 is used for being implanted into a main blood vessel, the first branch 30 or the second branch 50 is used for being implanted into a branch blood vessel, wherein the inner diameter of the branch blood vessel is narrower than that of the main blood vessel, and therefore, at the transition position of the branch blood vessel and the main blood vessel, the main blood vessel tends to have a section of blood vessel with the inner diameter gradually narrowing towards the direction of the branch blood vessel. In the present application, the connecting portion 63 is provided, so that the connecting portion 63 can be attached to the inner wall of the blood vessel at the transition position between the branch blood vessel and the main blood vessel.
It will be appreciated that when the number of support rings of the first branch 30 or the second branch 50 is one, the portion of the support ring close to the main body 10 is the connection portion 63 and is at least partially funnel-shaped, and the portion of the support ring away from the main body 10 is the body portion 65 and is cylindrical.
In the present embodiment, the mesh structures of the first branch 30 and the second branch 50 are woven from the distal end to the proximal end, and when the mesh structure is woven to the last turn of the support ring of the first branch 30 or the second branch 50, that is, to the connecting portion 63, the peak 614 of the first branch 30 or the second branch 50 passes through the trough 615 of the main body 10 from the inside to the outside, that is, at the junction between the connecting portion 63 and the main body 10, the peak 614 of the first branch 30 or the second branch 50 is hooked to the trough 615 of the main body 10. It will be appreciated that the first branch 30 and/or the second branch 50 may also be braided from the proximal end to the distal end.
It is understood that the first branch 30 and/or the second branch 50 include the connecting portion 63 within the scope of the present application.
Referring to fig. 8, 9 and 10, fig. 9 is an enlarged partial view of the bifurcation area of the bifurcated stent shown in fig. 1. Fig. 10 is a schematic view of the bifurcated stent shown in fig. 8 from below.
It is noted that the mesh structure of the first branch 30 at the bifurcation area 70 intertwines with the mesh structure of the second branch 50 at the bifurcation area 70. More specifically, in the branching region 70, the wave rod 612 on the side of the connection portion 63 of the first branch 30 near the second branch 50 and the wave rod 612 on the side of the connection portion 63 of the second branch 50 near the first branch 30 are intertwined. In the present embodiment, in the bifurcation area 70, the wave rod 612 of the second branch 50 penetrates from the inner side of the wave rod 612 of the first branch 30 and penetrates from the outer side of the wave rod 612 of the first branch 30, so that the wave rods 612 of the first branch 30 and the wave rods 612 of the second branch 50 are intertwined with each other, so as to draw the distance between the two wave rods 612 of the first branch 30 and the second branch 50 located in the bifurcation area 70, and the mesh density of the bifurcation stent 100 in the bifurcation area 70 is greater than that in other areas of the bifurcation stent 100. Thus, compared to the case where the bifurcation area between the first branch 30a and the second branch 50a is formed without the braid coverage to form a hollow area in the conventional bifurcation stent as shown in fig. 11, the bifurcation stent 100 (as shown in fig. 10) provided herein has the hollow area of the bifurcation area 70 blocked by the intertwined waverods 612, so that the coanda thrombus at the location of the bifurcation area 70 is not easily detached from the bifurcation area 70 and flows to other locations along with blood, and the contact area between the bifurcation area 70 of the bifurcation stent 100 and the vessel wall at the bifurcation location is increased, so that the intertwined waverods 612 provide support for the vessel wall at the bifurcation location.
It is understood that the number of intertwined waverods 612 is not limited to two, and the number of intertwined waverods 612 may be, but is not limited to, a plurality, for example, in a modified embodiment, a plurality of waverods 612 may be intertwined.
Second embodiment
Referring to fig. 12 and 13 together, fig. 12 is a schematic structural view of a bifurcated stent according to a second embodiment of the present disclosure, and fig. 13 is a schematic structural view of the bifurcated stent shown in fig. 12 in a bottom view.
The bifurcated stent 300 provided in this embodiment is mainly different from the bifurcated stent 100 provided in the first embodiment in that: the bifurcated stent 300 provided in this embodiment further includes a connector 390, wherein the connector 390 is connected between the mesh structures of the first branch 330 and the second branch 350, such that the bifurcated stent 300 has a mesh density in the bifurcation area 370 that is greater than that in other areas of the bifurcated stent 300.
It is understood that the connection 390 is not limited to being connected between the mesh structures of the first branch 330 and the second branch 350, for example, the connection 390 may also be connected between the first branch 330 and the main body 310, or the connection 390 may also be connected between the second branch 350 and the main body 310, the connection 390 may also be disposed in the bifurcation area 370, the mesh density of the connection 390 in the bifurcation area 370 may be greater than that of other areas of the bifurcation stent, and if the connection 390 further includes an area disposed outside the bifurcation area 370, the mesh density of the connection 390 in the bifurcation area 370 may be greater than that of the portion disposed outside the bifurcation area 370, such that the mesh density of the bifurcation stent 300 in the bifurcation area 370 is greater than that of the other areas of the bifurcation stent 300.
In this embodiment, the connectors 390 are mesh structures disposed in the bifurcation area 370, with the mesh density of the connectors 390 being greater than the mesh density of other areas of the bifurcated stent 300. It will be appreciated that the mesh density is not limited to being the same throughout the connector 390, for example, a greater mesh density may be provided at portions of the connector 390 located at the bifurcation area 370 and a lesser mesh density may be provided at portions of the connector 390 located outside the bifurcation area 370.
In this embodiment, the connector 390 is integrally woven with the first and second branches 330, 350.
It is understood that the connecting member 390 is not limited to being integrally woven with the first and second branches 330 and 350, for example, the connecting member 390 may be, but not limited to, a pre-woven mesh patch, which is connected between the mesh structures of the first and second branches 330 and 350 by stitching or wire fastening, or the like.
Third embodiment
Referring to fig. 14 and 15 in combination, fig. 14 is a schematic bottom structural view of a bifurcated stent according to a third embodiment of the present disclosure; fig. 15 is an enlarged partial schematic view of the bifurcated stent shown in fig. 14.
The bifurcated stent 400 provided in this embodiment is mainly different from the bifurcated stent 300 provided in the second embodiment in that: the connector 490 of the bifurcated stent 400 is a wire wrap for connection between the mesh structures of the first and second branches 430, 450. Specifically, the wire wrap is fixedly connected between the two poles 4612 located in the first branch 430 and the second branch 450.
It will be appreciated that the number of windings is not limited. For example, the number of windings may be, but is not limited to being, a plurality. It will be appreciated that when the number of windings is plural, the windings are used to connect between the mesh of the first branch 430 and one winding, the mesh of the second branch 450 and one winding, or both windings.
Fourth embodiment
Referring to fig. 16 and 17 in combination, fig. 16 is a schematic structural view of a bifurcated stent according to a fourth embodiment of the present disclosure; fig. 17 is a schematic view of the bifurcated stent shown in fig. 16 from below.
The bifurcated stent 500 provided in this embodiment is mainly different from the bifurcated stent 100 provided in the first embodiment in that: the bifurcation region 570 also extends from the junction of the first branch 530 and the second branch 550 to the body 510. The bifurcated stent 500 includes a first cover film 110 covering the bifurcation area 570, the first cover film 110 having a mesh density greater than that of other areas of the bifurcated stent 500, such that the coaptation thrombus at the bifurcation site of the vessel is less prone to falling out of the bifurcation area 570 covered by the first cover film 110.
The first cover film 110 may be made of polyester cloth, PTFE, PET, or other high polymer materials.
In the present embodiment, the first coating 110 is sewn between the wave rod 5612 of the first branch 530 and the wave rod 5612 of the second branch 550 to seal off the bifurcation area 570.
It is to be appreciated that the first cover film 110 is not limited to being sutured to the bifurcation area 570, for example, the first cover film 110 may be, but is not limited to being, secured to the bifurcation area 570 by bonding.
Fifth embodiment
As shown in fig. 18, the bifurcated stent 600 provided in the present embodiment is mainly different from the bifurcated stent 500 provided in the fourth embodiment in that: the bifurcated stent 600 further includes a second coating 120, the second coating 120 being disposed at the interface of the main body 610 and the first branch 630 shown in fig. 18, wherein the mesh density of the first coating 110 is greater than that of the second coating 120, such that the coanda thrombus is not easily detached from the area covered by the second coating 120. The second cover film 120 may be made of polyester cloth, PTFE, PET, or other polymer materials.
It is understood that, without limiting the placement position of the second covering film 120, it is within the scope of the present application that the bifurcated stent 600 is further provided with the second covering film 120 outside the bifurcation area 670.
Within the technical principle of the present application, the specific technical solutions in the foregoing embodiments may be mutually applicable, which is not described herein in detail.
The foregoing disclosure is merely illustrative of the preferred embodiments of the present application and is not intended to limit the scope of the claims herein, as such equivalent variations are contemplated by the present application.
Claims (10)
1. A bifurcated stent comprising a main body, a first branch and a second branch, wherein the first branch and the second branch are connected to the same end of the main body, the first branch and the second branch are all net structures, the bifurcated stent further comprises a bifurcation area connected between the first branch and the second branch, and the bifurcation area has a greater lattice density than other areas of the bifurcated stent;
the bifurcation area extends from the connection of the first branch and the second branch to the distal end of the first branch on the side of the first branch near the second branch; and/or
The bifurcation area extends from the connection of the first branch and the second branch to the distal end of the second branch on the side of the second branch near the first branch;
the first branch and/or the second branch comprises a connecting part arranged at the proximal end, at least part of the connecting part is funnel-shaped and is connected with the distal end of the main body, and the bifurcation area is at least partially arranged on the connecting part;
the main body, the first branch and the second branch are all of a net structure comprising at least one supporting ring which is arranged along the respective axial direction, each supporting ring comprises at least one sub supporting ring, each sub supporting ring comprises a plurality of wave rods which are connected in sequence, the wave rods form wave crests at the connection positions of the proximal ends, and the wave rods form wave troughs at the connection positions of the distal ends;
in the bifurcation area, the wave rods on one side of the connecting part of the first branch, which is close to the second branch, and the wave rods on one side of the connecting part of the second branch, which is close to the first branch, are mutually wound so as to shorten the distance between the two wave rods of the first branch and the second branch, which are positioned in the bifurcation area, so that the grid density of the bifurcation stent in the bifurcation area is greater than the grid density of other areas of the bifurcation stent.
2. The bifurcated stent of claim 1, wherein the bifurcation region extends from a junction of the first branch and the second branch to the main body.
3. The bifurcated stent of claim 1 or 2, further comprising a connector disposed in the bifurcation region, the connector being connected between the networks of the first branch and the second branch such that the bifurcated stent has a greater lattice density in the bifurcation region than in other regions of the bifurcated stent.
4. The bifurcated stent of claim 3 wherein,
the connecting pieces are of a net structure, and the grid density of the connecting pieces is greater than that of other areas of the bifurcation stent; or,
the connector comprises at least one wire winding, each wire winding being adapted to be connected between the first branch and the mesh of the second branch, between the mesh of the first branch and one of the wire windings, between the mesh of the second branch and one of the wire windings or between two of the wire windings.
5. The bifurcated stent of claim 1 or 2, further comprising a first cover covering the bifurcation region, the first cover having a mesh density greater than that of other regions of the bifurcated stent.
6. The bifurcated stent of claim 5, further comprising a second cover outside the bifurcation region, the first cover having a greater lattice density than the second cover.
7. The bifurcated stent of claim 1 or 2, wherein the support rings are undulating and form peaks and valleys, the peaks of the support rings of the first and/or second branches being connected with the valleys of the support rings of the main body.
8. The bifurcated stent of claim 7, wherein each of the main body, the first branch and the second branch defines a cavity, and the cavities of the first branch and the second branch are in communication with the cavities of the main body, the side of the main body, the first branch and the second branch facing the respective cavities being the inside, the side of the main body, the first branch and the second branch facing away from the respective cavities being the outside;
at the connection of the main body with the first branch and the second branch, the wave crest of the supporting ring of the first branch and/or the second branch passes through the wave trough of the supporting ring of the main body from the inner side to the outer side or passes through the wave trough of the supporting ring of the main body from the outer side to the inner side; and/or
Between adjacent support rings of the main body, the wave crest of the distal support ring passes through the wave trough of the proximal support ring from the inner side to the outer side or passes through the wave trough of the proximal support ring from the outer side to the inner side; and/or
Between adjacent support rings of the first branch and/or the second branch, the wave crest of the support ring at the far end passes through the wave trough of the support ring at the near end from the inner side to the outer side or passes through the wave trough of the support ring at the near end from the outer side to the inner side.
9. The bifurcated stent of claim 8, wherein at least one of the support rings in the bifurcated stent comprises a first sub-support ring and a second sub-support ring, the first sub-support ring and the second sub-support ring being radially stacked in sequence around an axial direction of the main body, the first branch, or the second branch.
10. The bifurcated stent of claim 8, wherein at least one of the support rings in the bifurcated stent comprises a first sub-support ring and other sub-support rings, the first sub-support ring and the other sub-support rings being disposed radially overlapping and interspersed around the axial direction of the main body, the first branch or the second branch, the wave bars of the first sub-support ring and the wave bars of the other sub-support rings forming a plurality of intersecting points, wherein there are at least adjacent first intersecting points at which the wave bars of the first sub-support ring are disposed outside with respect to the wave bars of the other sub-support rings intersecting therewith, and second intersecting points at which the wave bars of the first sub-support ring are disposed inside with respect to the wave bars of the other sub-support rings intersecting therewith.
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| CN202010256646.1A CN111437087B (en) | 2020-04-02 | 2020-04-02 | Bifurcated stent |
| PCT/CN2021/084879 WO2021197408A1 (en) | 2020-04-02 | 2021-04-01 | Bifurcated stent |
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| CN202010256646.1A CN111437087B (en) | 2020-04-02 | 2020-04-02 | Bifurcated stent |
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| WO2021197408A1 (en) * | 2020-04-02 | 2021-10-07 | 杭州唯强医疗科技有限公司 | Bifurcated stent |
| CN114432001A (en) * | 2021-12-08 | 2022-05-06 | 上海微创心脉医疗科技(集团)股份有限公司 | Covered stent |
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| US7169177B2 (en) * | 2003-01-15 | 2007-01-30 | Boston Scientific Scimed, Inc. | Bifurcated stent |
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| CN105662666A (en) * | 2015-12-30 | 2016-06-15 | 先健科技(深圳)有限公司 | Lumen stent |
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