CN115414166A - TIPS stent release retraction structures and methods - Google Patents

Abstract

The embodiment of the invention provides a TIPS stent release withdrawing structure and a TIPS stent release withdrawing method, and relates to the field of TIPS stents. Aims to solve the problem that the stent can not be withdrawn after being released. The TIPS stent release withdrawing structure comprises a stent, an outer layer suture and an inner layer suture; the outer layer suture is wound and connected on the outer part of the stent so as to compress the stent to an initial state; inner layer sutures are passed through the apertures in the stent in a wound fashion, the inner layer sutures being used to simultaneously release the stent during its release, or the inner layer sutures being used to compress the stent from its expanded state to its initial state under tension. The TIPS stent release withdrawing method is implemented by adopting the structure. When the outer layer suture is released, the stent is unfolded due to the self-expanding characteristic, if the release position of the stent needs to be adjusted in the operation, the stent in the release state can be compressed to the initial state through the inner layer suture, if the position of the stent is accurately adjusted, the inner layer suture is released, and the stent is released again.

Description

TIPS stent release retrieval structures and methods

Technical Field

The invention relates to the field of TIPS (stent graft constructs), in particular to a TIPS stent release withdrawing structure and a method.

Background

With the improvement of living standard and the change of life style of people, the incidence rate of peripheral vascular diseases is higher, and the diseases can cause the blockage of blood vessels if not treated in time, thus seriously harming the life safety of human beings. At present, minimally invasive intervention is mainly adopted, and the method has the characteristics of small wound to patients, high safety, high effectiveness and the like, and is confirmed by doctors and patients to become an important treatment method for peripheral vascular diseases. In particular, in TIPS surgery, interventional therapy has become quite common.

The interventional therapy method is to implant an inner support in the pathological change section of the blood vessel, and the implanted inner support can support the blood vessel in the stenotic occlusion section, reduce the elastic retraction and the reshaping of the blood vessel, keep the blood flow of the lumen unobstructed and also have the function of preventing restenosis. The TIPS operation is mainly a bypass operation of intrahepatic portal body vein internal bracket via jugular vein, and the principle is that a special interventional therapy apparatus is adopted, and a manual bypass channel between hepatic vein and main branch of portal vein in liver is established by accessing via jugular vein under the guidance of X-ray fluoroscopy, and the manual bypass channel and the internal metal bracket maintain permanent smoothness. After the portal hypertension is reduced, the esophageal and gastric vein rupture bleeding is controlled and prevented, and the absorption of ascites is promoted. The main indication is esophageal-gastric fundus varices rupture bleeding caused by portal hypertension, and patients with poor effect after conservative treatment adopt the treatment method.

When the minimally invasive stent is placed into an operation, the main tools are the stent and a stent conveying system matched with the stent. Generally, the stent is of a nickel-titanium tube laser cutting or nickel-titanium wire weaving structure, the coating material is ePTFE, the length and the diameter of the vascular stenosis section are judged by a doctor under an imaging device, and the stent with a proper specification is selected. The stent is pre-loaded into a stent conveying system and placed at the far end of a blood vessel stenosis part under the guidance of an image, after the conveying system is withdrawn, the stent is released and self-expands to establish a portal vein shunt, and portal vein pressure is reduced. The key of the operation is that a proper bracket can be quickly and accurately selected according to the operation requirement, and in the bracket releasing process, the bracket releasing device can be accurately positioned. The stent is released at a proper position in the puncture channel, and the effect of reducing portal hypertension can be achieved after the stent is released, otherwise, the stent cannot reduce the high pressure or cause bile leakage due to wrong release position of the stent, the expected operation effect cannot be achieved, even the operation fails or other complications such as hepatic encephalopathy are caused.

The existing stent product cannot be withdrawn again once released, if the position of the stent released by a doctor during an operation is not accurate, secondary adjustment cannot be performed in the operation, the effect of reducing portal vein pressure cannot be achieved, and the operation usually fails.

Disclosure of Invention

Objects of the invention include, for example, providing a TIPS stent release retraction arrangement that ameliorates the problem of stent non-retraction after stent release.

It is also an object of the present invention to provide a TIPS stent release retrieval method, which is capable of.

Embodiments of the invention may be implemented as follows:

the embodiment of the invention provides a TIPS stent release withdrawing structure, which comprises a stent, an outer layer suture and an inner layer suture;

the outer layer suture is wound and connected on the outer part of the stent so as to compress the stent to an initial state; the outer layer suture is used for releasing the stent from the initial state to a spreading state under a releasing state;

the inner layer suture is wound through the pores on the stent and is used for synchronously relaxing during the releasing process of the stent, or the inner layer suture is used for compressing the stent from the expanding state to the initial state under the condition of tensioning, or the inner layer suture is used for releasing the stent from the initial state to the expanding state under the releasing state.

In addition, the TIPS stent release retraction structure provided by the embodiment of the present invention may also have the following additional technical features:

optionally, the outer layer suture is sewn on the bracket along the length direction of the bracket; the outer layer sutures are used for being sequentially broken under the tension of the stent.

Optionally, the outer layer suture adopts a rice bag type suture mode.

Optionally, the outer layer suture is made of polypropylene or terylene; the thickness range of the outer layer suture is 0.5-1.5mm.

Optionally, the stent comprises a first row of apertures and a second row of apertures which are oppositely arranged and arranged along the length direction of the stent; the inner layer suture is adapted to cross through the first row of apertures and the second row of apertures to compress the stent under tension.

Optionally, the bracket comprises a first end and a second end that are oppositely located;

the inner layer suture comprises a first suture section and a second suture section which are connected with each other; the first suture segment crosses through the first row of apertures and the second row of apertures in a direction from the first end to the second end; the second suture segment crosses through the first row of apertures and the second row of apertures in a direction from the second end to the first end; the first suture section is arranged to intersect with the second suture section.

Optionally, the first row of pores includes a plurality of first pores that are sequentially arranged at intervals along the length direction of the stent, and the second row of pores includes a plurality of second pores that are sequentially arranged at intervals along the length direction of the stent; the plurality of first apertures and the plurality of second apertures are arranged in a one-to-one correspondence.

Optionally, the inner layer suture is made of polypropylene or dacron, and the thickness of the inner layer suture is 2-2.5mm.

Optionally, the inner layer suture is provided with a withdrawing portion and a releasing portion, the withdrawing portion is used for operating and tensioning the inner layer suture, and the releasing portion is used for operating and releasing the inner layer suture.

The embodiment of the invention also provides a TIPS stent release withdrawing method. The method is implemented by adopting a TIPS stent release withdrawing structure, and the TIPS stent release withdrawing method comprises the following steps:

delivering the stent to a lesion site;

releasing the outer layer suture to release the stent;

and if the release position of the stent deviates from the lesion position, tensioning the inner layer suture to compress the stent to the initial state and then moving, and releasing the inner layer suture after moving to the position to release the stent.

The TIPS stent release withdrawal structure and the method of the embodiment of the invention have the beneficial effects that:

a TIPS stent release withdrawal structure comprising a stent, an outer layer of suture and an inner layer of suture; the outer layer suture is wound and connected on the outer part of the stent so as to compress the stent to an initial state; the outer layer suture is used for releasing the stent from an initial state to a spreading state in a releasing state; the inner layer suture is winded through the aperture of the bracket, the inner layer suture is used for synchronously releasing during the releasing process of the bracket, or the inner layer suture is used for compressing the bracket from the expanding state to the initial state under the tensioning condition, or the inner layer suture is used for releasing the bracket from the initial state to the expanding state under the releasing condition.

When the outer layer suture is released, the stent is unfolded and gradually released; when the outer layer suture is released, the inner layer suture is in a relaxed net-shaped state, and if the release position of the stent needs to be adjusted in the operation, the stent can be withdrawn again through the inner layer suture: the inner layer suture is tensioned, the stent in the released state can be compressed to the initial state, and if the position of the stent is accurately adjusted at the moment, the inner layer suture is released, and the stent is released again. If the bracket release position is incorrect or the expected effect of the operation is not achieved, the position of the released bracket can be quickly adjusted through the device, the next operation is continued, and the success rate of the operation is effectively improved.

The method for releasing and withdrawing the stent is implemented by adopting a TIPS stent release withdrawing structure, so that the problem that the stent cannot be withdrawn after being released is solved.

Drawings

In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the drawings needed to be used in the embodiments will be briefly described below, it should be understood that the following drawings only illustrate some embodiments of the present invention and therefore should not be considered as limiting the scope, and for those skilled in the art, other related drawings can be obtained according to the drawings without inventive efforts.

FIG. 1 is a schematic structural view of a TIPS stent release and retraction structure delivered by a delivery device according to an embodiment of the present invention;

FIG. 2 is a schematic structural view of a stent and an inner layer suture provided by an embodiment of the invention;

FIG. 3 is a first stitching pattern for an outer layer of stitching provided in accordance with an embodiment of the present invention;

FIG. 4 is a second type of seam for an outer layer of stitching provided by embodiments of the present invention;

FIG. 5 is a schematic illustration of an embodiment of the present invention providing an inner suture in a relaxed state with a stent released;

FIG. 6 is a schematic view of an inner suture compression stent provided in accordance with an embodiment of the present invention;

fig. 7 is a block diagram of steps of a stent release and withdrawal method according to an embodiment of the present invention.

An icon: releasing the withdrawing structure from the 10-TIPS scaffold; 100-a scaffold; 110-pores; 111-a first end; 112-a second end; 200-outer layer suture; 300-inner layer suture; 310-a first suture segment; 320-a second suture section; 400-a conveying device; 410-a retraction section; 420-release section.

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 obtained by a person skilled in the art without inventive step based on the embodiments of the present invention, are within the scope of protection 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 if the terms "upper", "lower", "inside", "outside", etc. indicate an orientation or a positional relationship based on that shown in the drawings or that the product of the present invention is used as it is, this is only for convenience of description and simplification of the description, and it does not indicate or imply that the device or the element referred to 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 appearances of the terms "first," "second," and the like, if any, are used solely to distinguish one from another and are not to be construed as indicating or implying relative importance.

It should be noted that the features of the embodiments of the present invention may be combined with each other without conflict.

The TIPS stent release retraction structure 10 provided in the present embodiment will be described in detail with reference to fig. 1 to 7.

Referring to fig. 1 to 7, an embodiment of the present invention provides a TIPS stent release and retraction structure 10, including a stent 100, an outer layer suture 200 and an inner layer suture 300; the outer layer suture 200 is wound and connected to the outside of the stent 100 to compress the stent 100 to an initial state; the outer layer suture 200 is used to release the stent 100 from the initial state to the deployed state in the released state; the inner layer suture 300 is twinedly passed through the apertures 110 on the stent 100, the inner layer suture 300 is used for simultaneous releasing during the releasing of the stent 100, or the inner layer suture 300 is used for compressing the stent 100 from the expanded state to the initial state under the tensioning condition, or the inner layer suture 300 is used for releasing the stent 100 from the initial state to the expanded state under the releasing condition.

The "initial state" of the stent 100 is the state in which the stent 100 is compressed, and the "expanded state" of the stent 100 is the released state of the stent 100. The TIPS stent release retrieval structure 10 is delivered to the lesion site by a delivery device 400. A first release is achieved by the outer layer suture 200, a first compression is achieved by the inner layer suture 300, and a second release is achieved.

The outer layer of sutures 200 is placed on the outside of the stent 100 and the inner layer of sutures 300 is placed on the inside of the stent 100. The outer layer suture 200 is wound on the outer side of the stent 100, and the inner layer suture 300 is composed of intertwined coils, passes through the pores 110 of the stent 100, and is sewn on the inner surface of the stent 100.

The outer suture 200 has two states, the first state is wound around the outside of the stent 100 for compressing the stent 100 for delivery into the body; the second state is a released state, where stent 100 is capable of releasing deployment, wherein the released state of outer suture 200 includes a relaxed state or a state disconnected from stent 100. The inner suture 300 has three states, a first state, as shown in fig. 5, in which the inner suture 300 is released with the release of the stent 100 without interfering with the release of the stent 100, mainly in a state where the stent 100 is released with the outer suture 200; a second state, as shown in fig. 6, where the stent 100 after being released and expanded is compressed again by the inner layer suture 300 to return to the original state; in a third state, the compressed stent 100 is released by the inner layer sutures 300, the release of the inner layer sutures 300 including a relaxed state that does not interfere with the release of the stent 100, or a broken state that is disengaged from the stent 100, allowing the stent 100 to be released.

Specifically, when the outer layer suture 200 is released, the stent 100 is expanded due to the self-expanding property of the material, and the state of the stent 100 is as shown in fig. 2, when the outer layer suture 200 is broken and the stent 100 is gradually released; the inner layer suture 300 is sewn on the inner surface of the stent 100, and when the outer layer suture 200 is released, the inner layer suture 300 is in a relaxed net-type state as shown in fig. 2. If the position of the stent 100 released during the operation needs to be adjusted, the withdrawn stent 100 can be compressed again by the inner layer suture 300; once the inner layer suture 300 is tightened, the stent 100 in the released state may be compressed to an initial state, a compressed state. The position of the stent 100 is then adjusted and if the stent 100 position is adjusted correctly at this point, the inner sutures 300 are pulled tight a second time, at which point the inner sutures 300 break and the stent 100 is released again. That is, the inner suture 300 is tightened to compress the stent 100, and releasing the stent 100 is achieved by tightening the inner suture 300.

In the operation, if the release position of the bracket 100 is incorrect or the expected effect of the operation is not achieved, the released bracket 100 can be quickly retracted through the device, the position is adjusted, the bracket can be released again, the next operation is continued, and the success rate of the operation is effectively improved.

The device is used for releasing and withdrawing the covered stent 100, in particular for releasing and withdrawing the covered stent 100 for TIPS operation.

The withdrawing mode of the device can be a drawing mode or a twisting and screwing mode. I.e., release and tensioning of the inner and outer sutures 300, 200 may be of the pull or twist type.

Referring to fig. 3 and 4, in the present embodiment, the outer layer suture 200 is sewn on the stent 100 along the length direction of the stent 100; the outer layer sutures 200 are intended to be sequentially broken under tension of the stent 100. During the process of releasing and unfolding the stent 100, the tension of the stent 100 acts on the outer layer sutures 200, so that the outer layer sutures 200 are sequentially broken, and the release of the stent 100 is completed.

Referring to fig. 3, in the present embodiment, the outer layer suture 200 is formed by a rice-bag type suture. Referring to fig. 4, in other embodiments, the stitching pattern shown in fig. 4 is used. As long as the stent 100 can be sufficiently compressed.

In this embodiment, the outer layer suture 200 is made of polypropylene or terylene; the outer layer suture 200 has a thickness in the range of 0.5-1.5mm. It should be noted that: the outer layer suture 200 material of the present device includes, but is not limited to, polymer such as polypropylene, dacron, etc.

Referring to fig. 2, in the present embodiment, the bracket 100 includes a first row of apertures 110 and a second row of apertures 110 that are oppositely disposed and arranged along the length direction of the bracket 100; inner layer sutures 300 are used to cross through the first and second rows of apertures 110, 110 to compress the stent 100 under tension.

By compressing the stent 100 along opposite sides of the stent 100, the stent 100 can be quickly reduced in diameter from the vessel, thereby allowing the stent 100 to be quickly moved until the position of the stent 100 is properly adjusted. The first row of apertures 110 and the second row of apertures 110 are effective and simple to operate.

Referring to fig. 2, in the present embodiment, the bracket 100 includes a first end 111 and a second end 112 that are oppositely located; the inner layer suture 300 includes a first suture segment 310 and a second suture segment 320 connected to each other; a first suture segment 310 crosses through the first row of apertures 110 and the second row of apertures 110 in a direction from the first end 111 to the second end 112; a second suture segment 320 crosses through the first row of apertures 110 and the second row of apertures 110 in a direction from the second end 112 to the first end 111; the first suture section 310 is arranged to intersect with the second suture section 320.

The inner layer suture 300 may include a first suture segment 310, or a second suture segment 320, or a first suture segment 310 and a second suture segment 320. Can compress the stent 100 out of the vessel in a taut condition to facilitate adjustment of the position of the stent 100.

Referring to fig. 2, in the present embodiment, the first row of apertures 110 includes a plurality of first apertures 110 sequentially spaced along the length direction of the stent 100, and the second row of apertures 110 includes a plurality of second apertures 110 sequentially spaced along the length direction of the stent 100; the plurality of first apertures 110 and the plurality of second apertures 110 are disposed in one-to-one correspondence.

Referring to fig. 2, the plurality of first apertures 110 and the plurality of second apertures 110 are arranged in a one-to-one correspondence manner, so that the first suture section 310 and the second suture section 320 are symmetrically wound, thereby achieving uniform compression of the stent 100, and simultaneously, the winding manner is simple, effective and simple.

In this embodiment, the inner layer thread 300 is made of polypropylene or terylene, and the thickness of the inner layer thread 300 is 2-2.5mm. It should be noted that the inner layer suture 300 material in the present device includes, but is not limited to, high molecular polymer such as polypropylene, dacron, etc.

In this embodiment, the inner layer suture 300 is provided with a withdrawing portion 410 and a releasing portion 420, wherein the withdrawing portion 410 is used for operating the tightening of the inner layer suture 300, and the releasing portion 420 is used for operating the releasing of the inner layer suture 300.

The withdrawing part 410 and the releasing part 420 can be regarded as 2 marking points for positioning the position of pulling the inner layer suture 300 twice to realize the withdrawing and releasing functions of the stent 100. Specifically, when the withdrawing part 410 is pulled, the inner layer suture 300 is tightened, and the compression stent 100 is tightened by the inner layer suture 300. Pulling the release portion 420 will break the inner layer suture 300, and the stent 100 will be released without the constraint of the inner layer suture 300.

According to the TIPS stent release and retraction structure 10 provided by the embodiment, the working principle of the TIPS stent release and retraction structure 10 is as follows: the outer layer suture 200 is spirally sewed on the outer side of the stent 100, and the inner layer suture 300 is formed by winding coils which are mutually intertwined and sewed on the inner surface of the stent 100. Two marker points are coated on the inner layer suture 300, which are the primary and secondary release indication positions respectively. The outer layer suture 200 is sewed on the outer surface of the stent 100, and when the outer layer suture 200 is released, the stent 100 is unfolded due to the self-expanding property of the material, and the state of the stent 100 is as shown in fig. 2. The specific sewing method of the outer layer sewing thread 200 is as shown in fig. 3 or fig. 4. When force is applied, the outer layer suture 200 is continuously broken and the stent 100 is gradually released. The inner suture 300, which is composed of intertwined coils, is sutured to the inner surface of the stent 100, and when the outer suture is released, the inner suture is in a relaxed mesh-type state as shown in fig. 2, and if the release position of the stent 100 needs to be adjusted during the operation, the stent 100 can be withdrawn again by the inner suture 300. The inner suture 300 is pulled tight for the first time, and depending on the number of pulls or the position of the withdrawal portion 410, the stent 100 in the released state may be compressed to the original unreleased state, as shown in fig. 2. If the stent 100 position adjustment is correct at this point, the inner suture 300 is pulled tight a second time, depending on the number of pulls or the position of the release portion 420, at which time the inner suture 300 breaks and the stent 100 is released again.

The TIPS stent release retraction mechanism 10 provided in this embodiment has at least the following advantages:

if the release position of the bracket 100 is incorrect or the expected effect of the operation is not achieved, the released bracket 100 can be quickly withdrawn through the device, the position is adjusted, the bracket can be released again, the next operation is continued, and the success rate of the operation is effectively improved.

The embodiment of the invention also provides a TIPS stent release withdrawing method. The implementation is carried out by using a TIPS stent release and retraction structure 10, and the TIPS stent release and retraction method comprises the following steps: step S1, conveying a stent 100 to a lesion position; s2, releasing the outer layer suture 200 to release the stent 100; and S3, if the release position of the stent 100 deviates from the lesion position, tensioning the inner layer suture 300 to compress the stent 100 to the initial state, moving, and releasing the inner layer suture 300 after moving to the position to release the stent 100. Improving the problem that the stent 100 cannot be withdrawn after being released.

The above description is only for the specific embodiment of the present invention, but the scope of the present invention is not limited thereto, and any changes or substitutions that can be easily conceived by those skilled in the art within the technical scope of the present invention are included in the scope of the present invention. Therefore, the protection scope of the present invention shall be subject to the protection scope of the appended claims.

Claims (10)

1. A TIPS stent release retrieval structure, comprising:

a stent (100), an outer layer suture (200) and an inner layer suture (300);

the outer layer suture (200) is wound and connected at the outer part of the stent (100) so as to compress the stent (100) to an initial state; the outer layer suture (200) is used for releasing the stent (100) from the initial state to a spreading state under a releasing state;

the inner layer suture (300) is wound through the pores (110) on the stent (100), the inner layer suture (300) is used for synchronously loosening during the releasing process of the stent (100), or the inner layer suture (300) is used for compressing the stent (100) from the expanding state to the initial state under the condition of tensioning, or the inner layer suture (300) is used for releasing the stent (100) from the initial state to the expanding state under the condition of releasing.

2. The TIPS stent release retrieval structure of claim 1, wherein:

the outer layer suture (200) is sewed on the bracket (100) along the length direction of the bracket (100); the outer layer suture (200) is used for being broken in sequence under the tension of the bracket (100).

3. A TIPS stent release retraction structure according to claim 2, wherein:

the outer layer suture (200) adopts a rice bag type suture mode.

4. The TIPS stent release retrieval structure of claim 3, wherein:

the outer layer suture (200) is made of polypropylene or terylene; the thickness range of the outer layer suture (200) is 0.5-1.5mm.

5. A TIPS stent release retraction structure according to any of claims 1-4, wherein:

the bracket (100) comprises a first row of pores (110) and a second row of pores (110) which are opposite in position and arranged along the length direction of the bracket (100); the inner layer suture (300) is adapted to cross through the first row of apertures (110) and the second row of apertures (110) to compress the stent (100) under tension.

6. A TIPS stent release retraction structure according to claim 5, wherein:

the bracket (100) comprises a first end (111) and a second end (112) which are opposite in position;

the inner layer suture (300) comprises a first suture section (310) and a second suture section (320) which are connected with each other; the first suture segment (310) crosses through the first row of apertures (110) and the second row of apertures (110) in a direction from the first end (111) to the second end (112); the second suture segment (320) crossing the first row of apertures (110) and the second row of apertures (110) in a direction from the second end (112) to the first end (111); the first suture section (310) is arranged to intersect the second suture section (320).

7. A TIPS stent release retraction structure according to claim 6, wherein:

the first row of pores (110) comprises a plurality of first pores (110) which are sequentially arranged at intervals along the length direction of the support (100), and the second row of pores (110) comprises a plurality of second pores (110) which are sequentially arranged at intervals along the length direction of the support (100); the plurality of first apertures (110) and the plurality of second apertures (110) are arranged in a one-to-one correspondence.

8. The TIPS stent release retrieval structure of claim 7, wherein:

the inner layer suture (300) is made of polypropylene or terylene, and the thickness of the inner layer suture (300) is 2-2.5mm.

9. A TIPS stent release retraction structure according to any of claims 1-4, wherein:

the inner layer suture (300) is provided with a withdrawing part (410) and a releasing part (420), wherein the withdrawing part (410) is used for operating and tensioning the inner layer suture (300), and the releasing part (420) is used for operating and releasing the inner layer suture (300).

10. A TIPS stent release retrieval method implemented using the TIPS stent release retrieval structure of any one of claims 1 to 9, wherein the TIPS stent release retrieval method comprises the steps of:

delivering the stent (100) to a lesion site;

releasing the outer layer suture (200) to release the stent (100);

if the release position of the stent (100) deviates from the lesion position, the inner layer suture (300) is tensioned to compress the stent (100) to the initial state and then moved, and the inner layer suture (300) is released after moving to the position, so that the stent (100) is released.

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