CN112569026A - Branch covered stent and branch covered stent implantation device - Google Patents

Branch covered stent and branch covered stent implantation device Download PDF

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Publication number
CN112569026A
CN112569026A CN202011596581.1A CN202011596581A CN112569026A CN 112569026 A CN112569026 A CN 112569026A CN 202011596581 A CN202011596581 A CN 202011596581A CN 112569026 A CN112569026 A CN 112569026A
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China
Prior art keywords
branch
framework
skeleton
stent
stent graft
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CN202011596581.1A
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Chinese (zh)
Inventor
董永贺
刘颖
杜庆庆
霍春青
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Beijing Percutek Therapeutics Co ltd
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Beijing Percutek Therapeutics Co ltd
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Priority to CN202011596581.1A priority Critical patent/CN112569026A/en
Publication of CN112569026A publication Critical patent/CN112569026A/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/82Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/856Single tubular stent with a side portal passage
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/82Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/95Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/954Instruments specially adapted for placement or removal of stents or stent-grafts for placing stents or stent-grafts in a bifurcation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/95Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2002/9505Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument
    • A61F2002/9511Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument the retaining means being filaments or wires

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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)
  • Prostheses (AREA)

Abstract

The invention provides a branch tectorial membrane stent and a branch tectorial membrane stent implantation device, which relate to the field of medical instruments, wherein the branch tectorial membrane stent comprises a branch framework, a supporting framework and a branch framework tectorial membrane; the branch framework and the support framework are elastic frameworks with cylindrical outer contours, one axial end of the branch framework is connected to the radial circumferential surface of the support framework, and the branch framework is connected with and covers the radial outer circumferential surface of the branch framework in a film covering mode. The branch covered stent implantation device is used for implanting the branch covered stent into a branch blood vessel connected with an aorta in which a windowing main covered stent is implanted. The invention solves the problems of more accurate release of the branch covered stent, tighter fit with the main stent after release and long-term stability, and enables the aorta intracavity repair technology to be applied to intracavity treatment involving branch vessels, thereby achieving the effects of small operation trauma and high success rate.

Description

Branch covered stent and branch covered stent implantation device
Technical Field
The invention relates to the field of medical instruments, in particular to a branch covered stent and a branch covered stent implantation device.
Background
The aortic disease is a group of cardiovascular diseases seriously threatening human health, including aortic dissection, aortic aneurysm and the like, mainly caused by hypertension, arteriosclerosis, injury, infection and other reasons, has great threat to the life of a patient, especially has wide range of pathological changes, influences the aortic dissection of blood supply of brain, spinal cord and multiple organs, has large operation wound, complicated operation, long time, much blood consumption, and high complication incidence rate and operation death rate of the operation. The reconstruction of the blood supply of the aorta and its branch arteries in as short a time as possible has always been the goal sought by vascular surgeons. A B-type interlayer or aneurysm of a lacerated position on a descending aorta usually adopts an aorta intracavity repair technology with small wound and high success rate, a conveying system loaded with a covered stent is pushed to a diseased part through an aorta far end such as a human femoral artery incision, and the covered stent is released and fixed, so that the diseased aneurysm or interlayer is isolated, a blood transport channel is reconstructed, and the treatment purpose is achieved.
However, when the dissection involves the aortic arch with openings of the brachiocephalic trunk, the left common carotid artery and the left subclavian artery, the aortic intraluminal repair technique is limited to some extent and cannot be used effectively, so that the current surgical method is mainly adopted for treatment, and the problems of large surgical trauma and low success rate exist.
These limitations include: when the interlayer covers the aortic arch with openings of the brachiocephalic trunk, the left common carotid artery and the left subclavian artery, if the aortic intracavity repair technology is adopted, a main tectorial stent with a fenestration is firstly implanted into the aorta, then the branch covered stent is implanted into a branch blood vessel connected with the aorta, and the fenestration tight connection between the branch covered stent and the main covered stent is ensured to avoid internal leakage, however, the branch covered stent in the prior art adopts a straight cylinder type, which easily causes that the part of the branch covered stent extending into the main covered stent is too long when the branch covered stent is released in the window of the main covered stent, and then the problem of blood flow in the main body covered stent is obstructed, and the main body covered stent is connected with the branch covered stent in a line contact manner, the anchoring force of the contact part is small, and the part of the branch covered stent extending into the main body covered stent is too short or has a larger inclination angle and is easy to generate inner leakage.
In summary, if the aortic intraluminal repair technology is applied to the intraluminal treatment of the affected branch vessels, how to make the release of the branch covered stent more accurate, and make the fenestrated fit with the main stent tighter and more stable for a long time after the release is needed, which is a problem that needs to be solved urgently at present.
Disclosure of Invention
The invention aims to provide a branch covered stent and a branch covered stent implantation device, which solve the problems that how to release the branch covered stent more accurately, fit the main stent more tightly after release and ensure long-term stability, and can be used for performing intracavity treatment on the affected branch blood vessel by using an aorta intracavity repair technology, thereby achieving the effects of small operation trauma and high success rate.
In order to achieve the above purpose, the embodiment of the invention adopts the following technical scheme:
in a first aspect, an embodiment of the present invention provides a branch covered stent, including a branch skeleton, a support skeleton and a branch skeleton covering membrane;
the branch skeleton with the support chassis is the elastic framework that the outline is the cylinder, the ascending one end in axial of branch skeleton connect in the radial periphery of support chassis, branch skeleton tectorial membrane connect in and the cladding the radial outer periphery of branch skeleton.
In an alternative embodiment, the branched stent graft further comprises a graft patch; the tectorial membrane patch connect in the outer periphery of support chassis, just the tectorial membrane patch with branch's skeleton tectorial membrane is connected, the tectorial membrane patch is configured into to cover branch's skeleton with the seam that support chassis interconnect position formed.
In an alternative embodiment, the graft patch is a unitary structure with the branch skeleton graft.
In an alternative embodiment, the graft patch and the branched skeleton graft are connected to each other by stitching.
In an alternative embodiment, the branch framework and the support framework are connected through the film covering patch.
In an alternative embodiment, the branch framework is point-connected to the support framework.
In an alternative embodiment, a bare stent is disposed at one end of the branch skeleton far away from the support skeleton.
In an optional embodiment, the bare stent and the branch framework are connected through a covering film, or the bare stent and the branch framework are integrally connected.
In a second aspect, an embodiment of the present invention provides a branch stent graft implantation device for implanting the branch stent graft according to any one of the previous embodiments into a branch vessel connected to an aorta into which a fenestrated main stent graft is implanted, wherein the branch stent graft implantation device includes a guide head, a core tube, a middle tube, an outer tube, a middle tube handle, an outer tube handle, a first pull ring, a second pull ring, a first release wire, a second release wire, a first constraining band, and a second constraining band;
the guide head is sleeved and fixedly connected to the near end of the core tube, the middle tube is sleeved and fixedly connected to the outside of the core tube, the outer tube is sleeved and slidably connected to the outside of the middle tube, the middle tube handle is connected to the far end of the middle tube, the outer tube handle is connected to the far end of the outer tube, the first pull ring and the second pull ring are located on the outside of the outer tube, the first release wire and the second release wire penetrate through the outer tube, the far end of the first release wire is connected to the first pull ring, and the far end of the second release wire is connected to the second pull ring;
in a loading state, the support framework is loaded between the guide head and the intermediate pipe in a mode of being sleeved outside the core pipe, the first constraint belt disc is wound on the outer circumferential surface of the branch framework, the first release wire penetrates through the lantern rings at two ends of the first constraint belt to shrink the branch framework, the second constraint belt disc is wound on the outer circumferential surface of the support framework, the second release wire penetrates through the lantern rings at two ends of the second constraint belt to shrink the support framework, and the near end of the second release wire is inserted into the blind hole in the guide head.
In a third aspect, an embodiment of the present invention further provides another branch stent graft implanting device, configured to implant the branch stent graft according to any one of the previous embodiments into a branch vessel connected to an aorta in which a fenestrated main stent graft is implanted, wherein the branch stent graft implanting device includes a guide head, a middle tube, an outer tube, a middle tube handle, an outer tube handle, and a core wire;
the outer tube is sleeved outside the middle tube, the middle tube handle is connected to the far end of the middle tube, the outer tube handle is connected to the far end of the outer tube, the core wire penetrates through and is fixedly connected to the middle tube, and the guide head is connected to the near end of the core wire; a wire guide hole penetrating through the guide head is formed in the guide head;
in a loading state, the branch covered stent is loaded inside the outer tube in a mode that the branch framework is axially compressed and the support framework is radially compressed, and the support framework is positioned at the proximal end of the branch framework; the core wire penetrates through the branch framework and the supporting framework.
The embodiment of the invention can realize the following beneficial effects:
in a first aspect, embodiments of the present invention provide a branched stent-graft, which includes a branched skeleton, a supporting skeleton, and a branched skeleton-graft; the branch framework and the support framework are elastic frameworks with cylindrical outer contours, one axial end of the branch framework is connected to the radial circumferential surface of the support framework, and the branch framework is connected with and covers the radial outer circumferential surface of the branch framework in a film covering mode.
Taking an example of an operation of applying the branch covered stent provided by the embodiment of the invention to treat aortic dissection as an example, during the operation, the fenestration main covered stent is implanted into an aorta, and the branch covered stent is implanted into a branch blood vessel by using the covered stent implantation device in a manner that the supporting framework is positioned inside the fenestration main covered stent and the branch framework extends into the branch blood vessel. Compared with the straight-tube type branch covered stent in the prior art, the branch covered stent provided by the embodiment of the invention comprises the branch framework and the support framework, so that under the supporting and positioning effects of the support framework, the branch framework can be prevented from excessively extending into the windowing main covered stent or excessively short and leaking inwards during release, the branch covered stent is more accurate in release, the interference of the branch covered stent implantation on the blood flow in the aorta cavity is reduced, the windowing fit with the main stent is tighter and more stable for a long time after release, the aorta intracavity repair technology can be applied to intracavity treatment involving the branch vessels, and the effects of small surgical trauma and high success rate are achieved.
The second and third aspects of the embodiments of the present invention also provide a branch stent graft implanting device for implanting the branch stent graft into a branch vessel connected to an aorta into which the fenestrated main stent graft is implanted, respectively. The branch covered stent implanting device provided by the second and third aspects is simple to operate and convenient to use, is beneficial to shortening the operation time when the aorta intracavity repair technology is applied to the intracavity treatment of the affected branch blood vessel, and improves the operation success rate.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly described below, and it is obvious that the drawings in the following description are some embodiments of the present invention, and other drawings can be obtained by those skilled in the art without creative efforts.
FIG. 1 is a schematic view of a fenestrated main stent graft built into the aorta;
FIG. 2 is a schematic view of a connection structure of a branch stent graft and a fenestrated main stent graft in the prior art;
FIG. 3 is a schematic overall structural view of an alternative embodiment of a branched stent graft provided in accordance with an embodiment of the present invention;
FIG. 4 is a schematic overall structural view of an alternative embodiment of a branched stent graft provided in accordance with an embodiment of the present invention;
FIG. 5 is a schematic structural view of a branched stent graft implanted in a lesion site according to an embodiment of the present invention;
FIG. 6 is a schematic distal end structure view of a branched stent graft implantation device according to a second embodiment of the present invention;
FIG. 7 is a schematic view of the proximal end structure of a branched stent graft implantation device according to a second embodiment of the present invention;
FIG. 8 is a schematic view of the distal end of a branched stent graft implantation device according to a third embodiment of the present invention;
FIG. 9 is a schematic view of the proximal end structure of a branched stent graft implantation device according to a third embodiment of the present invention;
FIG. 10 is a schematic view of a compressed process at a front view angle of a branch stent graft when the branch stent graft implantation device provided by the third embodiment of the invention is implanted into the branch stent graft;
FIG. 11 is a schematic view of a side view of a branch stent graft being compressed when the branch stent graft implantation device according to the third embodiment of the present invention is used to implant a branch stent graft;
FIG. 12 is a schematic view illustrating a step of implanting a guide wire when a branch stent graft is implanted by using the branch stent graft implanting device according to the third embodiment of the present invention;
FIG. 13 is a schematic view illustrating a branch stent graft implantation step when the branch stent graft implantation device according to the third embodiment of the present invention is used to implant a branch stent graft.
Icon: 100-branch covered stent; 200-windowing a main film coating bracket; 1-a branched backbone; 11-a bare stent; 2-supporting the framework; 3-branch framework film covering; 4-laminating a patch; 5-a guide head; 51-wire guide holes; 510-a guide wire; 6-core tube; 61-core filament; 7-an intermediate pipe; 71-intermediate tube handle; 8-outer tube; 81-outer tube handle; 91-a first tab; 92-a second tab; 93-a first release wire; 94-second release wire; 101-a first constraining band; 102-second constraining band.
Detailed Description
In order to make the objects, technical solutions and advantages of the embodiments of the present invention clearer, the technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are some, but not all, embodiments of the present invention. The components of embodiments of the present invention generally described and illustrated in the figures herein may be arranged and designed in a wide variety of different configurations.
Thus, the following detailed description of the embodiments of the present invention, presented in the figures, is not intended to limit the scope of the invention, as claimed, but is merely representative of selected embodiments of the invention. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
It should be noted that: like reference numbers and letters refer to like items in the following figures, and thus, once an item is defined in one figure, it need not be further defined and explained in subsequent figures.
In the description of the present invention, it should be noted that the terms "upper", "lower", "vertical", "horizontal", "inner", "outer", and the like indicate orientations or positional relationships based on orientations or positional relationships shown in the drawings or orientations or positional relationships conventionally laid out when products of the present invention are used, and are only for convenience of description and simplicity of description, and do not indicate or imply that the referred devices or elements must have a specific orientation, be constructed in a specific orientation, and be operated, and thus, should not be construed as limiting the present invention. Furthermore, the terms "first," "second," "third," and the like are used solely to distinguish one from another and are not to be construed as indicating or implying relative importance.
Furthermore, the term "proximal" refers to the end of the instrument that is closer to the body during surgery, and "distal" refers to the end of the instrument that is further from the body during surgery.
In the description of the present invention, it should also be noted that, unless otherwise explicitly specified or limited, the terms "disposed," "mounted," and "connected" are to be construed broadly, e.g., as meaning fixedly connected, detachably connected, or integrally connected; can be mechanically or electrically connected; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements. The specific meanings of the above terms in the present invention can be understood in specific cases to those skilled in the art.
Some embodiments of the invention are described in detail below with reference to the accompanying drawings. The embodiments described below and the features of the embodiments can be combined with each other without conflict.
Example one
Referring to fig. 3, the branched stent graft 100 includes a branched skeleton 1, a supporting skeleton 2, and a branched skeleton membrane 3; the branch framework 1 and the support framework 2 are elastic frameworks with cylindrical outer contours, one axial end of the branch framework 1 is connected to the radial circumferential surface of the support framework 2, and the branch framework film 3 is connected to and covers the radial outer circumferential surface of the branch framework 1.
Taking an example of an operation of applying the branch stent graft 100 provided in this embodiment to treat aortic dissection as shown in fig. 1, a, b, c, and d sequentially represent an aorta, a left vertebral artery, a left subclavian artery, and an aortic dissection, a fenestrated main stent graft 200 is implanted in the aorta, and its fenestration is directly opposite to a branch blood vessel, namely the left subclavian artery, to which the branch stent graft 100 is to be implanted; in operation, referring to fig. 5, the branch stent graft 100 is implanted into a branch vessel using a stent graft implantation device such that the supporting scaffold 2 is positioned inside the fenestrated main stent graft 200 and the branch scaffold extends into the branch vessel, i.e., the left subclavian artery. Compared with the straight-tube-type branch covered stent 100 in the prior art shown in fig. 2, the branch covered stent 100 provided by the embodiment comprises the branch framework 1 and the support framework 2, so that under the supporting and positioning effects of the support framework 2, when release can be avoided, the branch framework 1 excessively extends into the windowing main covered stent 200 or leaks in an excessively short way, so that the branch covered stent is more accurate in release, the interference of the branch covered stent 100 implanted into the blood flow in the aortic cavity is reduced, the windowing fit with the main stent is tighter and stable for a long time after release, the aortic intracavity repair technology can be applied to intracavity treatment on the affected branch blood vessel, and the effects of small surgical trauma and high success rate are achieved.
In this embodiment, the length of the branch skeleton coating 3 may be, but is not limited to, any length between 15mm or 30mm or 15mm to 30mm, and the branch skeleton 1 and the support skeleton 2 are preferably made of metal mesh structures.
Referring to fig. 4, in another alternative embodiment of this embodiment, the branched stent graft 100 further comprises a graft patch 4; the film-covered patch 4 is connected to the outer circumferential surface of the supporting framework 2, the film-covered patch 4 is connected with the branch framework film 3, the film-covered patch 4 is configured to cover a seam formed by the connecting part of the branch framework 1 and the supporting framework 2, and by the structure, the film-covered patch 4 can be tightly attached to the windowing main film-covered bracket 200 under the action of the radial supporting force of the supporting framework 2 to make up the gap between the windowing parts of the branch film-covered bracket 100 and the windowing main film-covered bracket 200, so that the connecting part between the branch film-covered bracket 100 and the windowing main film-covered bracket 200 is in surface contact, and compared with the line contact in the prior art, the good effect of preventing internal leakage can be achieved. The film patch 4 and the branch skeleton film 3 are integrated, and the film patch 4 and the branch skeleton film 3 may be connected by sewing.
In this optional embodiment, in order to adapt the angle between the branch framework 1 and the support framework 2 to various angles of the human body branch blood vessel, it is preferable that the stent portion of the branch framework 1 and the stent portion of the support framework 2 are not connected to each other, but the branch framework 1 and the support framework 2 are connected only through the film-covered patch 4, so as to adjust the angle between the branch framework 1 and the support framework 2 more flexibly. Of course, in other alternative embodiments of this embodiment, the purpose of adjusting the angle between the branch framework 1 and the support framework 2 more flexibly may also be achieved by a point connection between the branch framework 1 and the support framework 2, where the point connection includes, but is not limited to, a spot welding connection and the like.
In addition, with reference to fig. 4, in an optional implementation manner of this embodiment, it is preferable that a bare stent 11 is disposed at an end of the branch framework 1 away from the support framework 2, and the bare stent 11 may be connected with the branch framework 1 through a coating, or the bare stent 11 is integrally connected with the branch framework 1, or the bare stent 11 and the branch framework 1 are two stent bodies and are formed by post-processing connection, and the like; in this embodiment, by providing the bare stent 11, the bifurcation of the branch covered stent distal end to block the branch blood vessel can be prevented, and the stability of the branch covered stent 100 can be increased, for example, as shown in fig. 5, when the branch covered stent 100 is implanted into the left subclavian artery, the bare stent 11 at the branch blood vessel distal end can not only prevent the left vertebral artery from being blocked, but also increase the stability of the branch covered stent 100, and avoid the branch covered stent 100 moving after implantation.
Example two
The present embodiment provides a branch stent graft implantation device for implanting the branch stent graft 100 provided in any one of the alternative embodiments of the present embodiment into a branch vessel connected to an aorta into which the fenestrated main stent graft 200 is implanted.
Specifically, referring to fig. 6 and 7, the branched stent graft implantation device provided by the present embodiment includes a guide head 5, a core tube 6, an intermediate tube 7, an outer tube 8, an intermediate tube handle 71, an outer tube handle 81, a first pull ring 91, a second pull ring 92, a first release wire 93, a second release wire 94, a first restraint band 101, and a second restraint band 102.
The guiding head 5 is sleeved and fixedly connected to the proximal end of the core tube 6, the middle tube 7 is sleeved and fixedly connected to the outside of the core tube 6, the outer tube 8 is sleeved and slidably connected to the outside of the middle tube 7, the middle tube handle 71 is connected to the distal end of the middle tube 7, the outer tube handle 81 is connected to the distal end of the outer tube 8, the first pull ring 91 and the second pull ring 92 are located outside the outer tube 8, the first releasing wire 93 and the second releasing wire 94 both penetrate through the outer tube 8, the distal end of the first releasing wire 93 is connected to the first pull ring 91, and the distal end of the second releasing wire 94 is connected to the second pull ring 92. In a loading state, the support framework 2 is loaded between the guide head 5 and the middle tube 7 in a mode of being sleeved outside the core tube 6, the first restraint strap 101 is wound on the outer circumferential surface of the branch framework 1, the first release wire 93 penetrates through the lantern rings at two ends of the first restraint strap 101 to shrink the branch framework 1, the second restraint strap 102 is wound on the outer circumferential surface of the support framework 2, the second release wire 94 penetrates through the lantern rings at two ends of the second restraint strap 102 to shrink the support framework 2, and the near end of the second release wire 94 is inserted into the blind hole in the guide head 5.
In more detail, in the present embodiment, the first releasing wire 93 and the second releasing wire 94 may pass through the outer tube 8 in various manners, such as, but not limited to, the first releasing wire 93 and the second releasing wire 94 may pass through a gap between an outer wall of the middle tube 7 and an inner wall of the outer tube 8, or a threading lumen spaced from the core lumen may be separately provided inside the middle tube 7, the first releasing wire 93 and the second releasing wire 94 may pass through the middle tube 7 in a manner of passing through the threading lumen for the purpose of passing through the outer tube 8, or the first releasing wire 93 and the second releasing wire 94 may pass through the outer tube 8 in other manners.
When implanting the branch stent graft 100 into a branch vessel connected to an aorta into which the fenestrated main stent graft 200 is implanted, the branch stent graft 100 is loaded into the branch stent graft device in the above-described loading manner, then the proximal end of the first release wire 93 is inserted into the aorta and is pulled out of the body through the branch vessel, then the branch stent graft device is pushed from the aorta to the position of the branch vessel under the guidance of a guide wire passing through the core tube 6, and then the middle tube handle 71 is fixed while the outer tube 8 is withdrawn through the outer tube handle 81, so that the branch frame 1 and the support frame 2 are half-released (first-stage release) as shown in fig. 7, and further, the branch frame 1 is introduced into the branch vessel by pulling the proximal end of the first release wire 93; further, the first pull ring 91 and the second pull ring 92 are sequentially pulled, so that the first release wire 93 releases the first restraint strap 101, the second release wire 94 releases the second restraint strap 102, the branch framework 1 and the support framework 2 are completely released (secondary release), and finally the branch covered stent implantation device is withdrawn through the outer tube handle 81 and the middle tube handle 71.
In this embodiment, the specific materials or winding manners of the first constraining band 101 and the second constraining band 102 are various, and the first constraining band 101 and the second constraining band 102 are arranged, so that the diameters of the branch framework 1 and the support framework 2 can be reduced in the implantation process, and the position of the branch stent graft 100 can be accurately adjusted before implantation into a branch blood vessel and release.
EXAMPLE III
The present example provides another branch stent graft implantation device for implanting the branch stent graft 100 provided in any one of the alternative embodiments of the present example into a branch vessel connected to an aorta into which the fenestrated main stent graft 200 is implanted.
Specifically, referring to fig. 8 to 13, the present embodiment provides a branched stent graft implantation device comprising a guide head 5, an intermediate tube 7, an outer tube 8, an intermediate tube handle 71, an outer tube handle 81, and a core wire 61. Wherein, the outer tube 8 is sleeved outside the middle tube 7, the middle tube handle 71 is connected to the distal end of the middle tube 7, the outer tube handle 81 is connected to the distal end of the outer tube 8, the core wire 61 passes through and is fixed on the middle tube 7, and the guide head 5 is connected to the proximal end of the core wire 61; the guide head 5 is provided with a guide wire hole 51 penetrating the guide head 5. Referring to fig. 9, in the loaded state, the branched stent graft 100 is loaded inside the outer tube 8 in such a manner that the branched scaffold 1 is axially compressed and the supporting scaffold 2 is radially compressed as shown in fig. 10 and 11, and the supporting scaffold 2 is located at the proximal end of the branched scaffold 1; the core wire 61 passes through the branch bobbin 1 and the support bobbin 2.
When implanting the branch stent graft 100 into the branch vessel connected to the aorta into which the fenestration main stent graft 200 is implanted, the branch stent graft 100 is first loaded into the branch stent graft device in the above-described loading manner, and then as shown in fig. 12, a guide wire 510 is inserted into the branch vessel, the guide wire 510 is passed through the fenestration main stent graft 200 and then the proximal end is floated toward the proximal end of the aorta, the branch stent graft implant device is pushed from the branch vessel to a desired release position under the guidance of the guide wire 510, as shown in fig. 13, the guide wire 510 is withdrawn, the middle tube handle 71 is fixed, and at the same time, the outer tube handle 81 is withdrawn, so that the supporting frame 2 and the branch frame 1 are sequentially released.
Finally, it should be noted that: the embodiments in the present description are all described in a progressive manner, each embodiment focuses on the differences from the other embodiments, and the same and similar parts among the embodiments can be referred to each other; the above embodiments in the present specification are only used for illustrating the technical solutions of the present invention, and not for limiting 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; and the modifications or the substitutions do not make the essence of the corresponding technical solutions depart from the scope of the technical solutions of the embodiments of the present invention.

Claims (10)

1. A branch covered stent (100) is characterized by comprising a branch skeleton (1), a supporting skeleton (2) and a branch skeleton covered membrane (3);
branch skeleton (1) with support skeleton (2) are the elastic skeleton that the outline is the cylinder, the ascending one end in axial of branch skeleton (1) connect in the radial periphery of support skeleton (2), branch skeleton tectorial membrane (3) connect in and the cladding the radial outer periphery of branch skeleton (1).
2. The branched stent graft (100) of claim 1, wherein the branched stent graft (100) further comprises a graft patch (4); tectorial membrane patch (4) connect in the outer periphery of support chassis (2), just tectorial membrane patch (4) with branch skeleton tectorial membrane (3) are connected, tectorial membrane patch (4) configure into the cover branch skeleton (1) with the seam that support chassis (2) interconnect position formed.
3. The branched stent graft (100) of claim 2, wherein the graft patch (4) is of unitary construction with the branched scaffolding stent graft (3).
4. The branched stent graft (100) of claim 2, wherein the graft patch (4) and the branched skeleton graft (3) are sutured to each other.
5. The branched stent graft (100) of any one of claims 2 to 4, wherein the branched skeleton (1) and the supporting skeleton (2) are connected by the graft patch (4).
6. The branched stent graft (100) of any one of claims 1 to 4, wherein the branched skeleton (1) is connected to the support skeleton (2) at points.
7. The branched stent graft (100) according to any one of claims 1 to 4, wherein one end of the branched skeleton (1) away from the supporting skeleton (2) is provided with a bare stent (11).
8. The branch stent graft (100) of claim 7, wherein the bare stent (11) is connected with the branch framework (1) through a membrane, or the bare stent (11) is integrally connected with the branch framework (1).
9. A branch stent graft implantation device for implanting the branch stent graft (100) of any one of claims 1 to 8 into a branch vessel connected to an aorta in which a fenestrated main stent graft (200) is implanted, the branch stent graft implantation device comprising a guide head (5), a core tube (6), a middle tube (7), an outer tube (8), a middle tube handle (71), an outer tube handle (81), a first pull ring (91), a second pull ring (92), a first release wire (93), a second release wire (94), a first constraining band (101), and a second constraining band (102);
the guiding head (5) is sleeved and fixedly connected to the proximal end of the core tube (6), the intermediate tube (7) is sleeved and fixedly connected to the outside of the core tube (6), the outer tube (8) is sleeved and slidably connected to the outside of the intermediate tube (7), the intermediate tube handle (71) is connected to the distal end of the intermediate tube (7), the outer tube handle (81) is connected to the distal end of the outer tube (8), the first pull ring (91) and the second pull ring (92) are located outside the outer tube (8), the first release wire (93) and the second release wire (94) both pass through the outer tube (8), the distal end of the first release wire (93) is connected to the first pull ring (91), and the distal end of the second release wire (94) is connected to the second pull ring (92);
in a loading state, the support framework (2) is loaded between the guide head (5) and the intermediate pipe (7) in a mode of being sleeved outside the core pipe (6), the first restraint band (101) is wound on the outer circumferential surface of the branch framework (1), the first release wire (93) penetrates through the lantern rings at two ends of the first restraint band (101) to shrink the branch framework (1), the second restraint band (102) is wound on the outer circumferential surface of the support framework (2), the second release wire (94) penetrates through the lantern rings at two ends of the second restraint band (102) to shrink the support framework (2), and the near end of the second release wire (94) is inserted into the blind hole in the guide head (5).
10. A branch stent graft implantation device for implanting a branch stent graft (100) according to any one of claims 1 to 8 into a branch vessel connected to an aorta in which a fenestrated main stent graft (200) is implanted, the branch stent graft implantation device comprising a guide head (5), a middle tube (7), an outer tube (8), a middle tube handle (71), an outer tube handle (81), and a core wire (61);
the outer tube (8) is sleeved outside the middle tube (7), the middle tube handle (71) is connected to the distal end of the middle tube (7), the outer tube handle (81) is connected to the distal end of the outer tube (8), the core wire (61) penetrates through and is fixedly connected to the middle tube (7), and the guide head (5) is connected to the proximal end of the core wire (61); a wire guide hole (51) penetrating through the guide head (5) is formed in the guide head (5);
in a loading state, the branch covered stent (100) is loaded inside the outer tube (8) in a mode that the branch framework (1) is axially compressed and the support framework (2) is radially compressed, and the support framework (2) is positioned at the proximal end of the branch framework (1); the core wire (61) passes through the branch framework (1) and the support framework (2).
CN202011596581.1A 2020-12-29 2020-12-29 Branch covered stent and branch covered stent implantation device Pending CN112569026A (en)

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN113558709A (en) * 2021-09-22 2021-10-29 北京华脉泰科医疗器械股份有限公司 Support anchoring area moves device down
CN117442404A (en) * 2023-12-25 2024-01-26 北京华脉泰科医疗器械股份有限公司 Nested stent conveyor and aortic branch vessel repair system

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN113558709A (en) * 2021-09-22 2021-10-29 北京华脉泰科医疗器械股份有限公司 Support anchoring area moves device down
CN113558709B (en) * 2021-09-22 2021-12-28 北京华脉泰科医疗器械股份有限公司 Support anchoring area moves device down
CN117442404A (en) * 2023-12-25 2024-01-26 北京华脉泰科医疗器械股份有限公司 Nested stent conveyor and aortic branch vessel repair system
CN117442404B (en) * 2023-12-25 2024-03-19 北京华脉泰科医疗器械股份有限公司 Nested stent conveyor and aortic branch vessel repair system

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