CN115462861A - Strutting arrangement is rebuild in anchor area - Google Patents
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- CN115462861A CN115462861A CN202211341516.3A CN202211341516A CN115462861A CN 115462861 A CN115462861 A CN 115462861A CN 202211341516 A CN202211341516 A CN 202211341516A CN 115462861 A CN115462861 A CN 115462861A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12027—Type of occlusion
- A61B17/12031—Type of occlusion complete occlusion
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
- A61B17/12109—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
- A61B17/12109—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
- A61B17/12113—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm
- A61B17/12118—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm for positioning in conjunction with a stent
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
- A61B17/12168—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure
- A61B17/12177—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure comprising additional materials, e.g. thrombogenic, having filaments, having fibers or being coated
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2/07—Stent-grafts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00831—Material properties
- A61B2017/00862—Material properties elastic or resilient
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- Vascular Medicine (AREA)
- Public Health (AREA)
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- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- General Health & Medical Sciences (AREA)
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- Neurosurgery (AREA)
- Gastroenterology & Hepatology (AREA)
- Pulmonology (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Prostheses (AREA)
Abstract
The invention provides an anchoring area reconstruction supporting device, which relates to the technical field of cardiovascular disease medical equipment, and comprises: the elastic support is provided with radial and axial elastic expansion allowance, and the elastic support and the associated support are connected and sealed through the flexible part; under the condition that the elastic stent beats along with the ascending aorta, the flexible part deforms so as to fix the position of the associated stent relative to the distal autologous blood vessel. According to the anchoring area reconstruction supporting device provided by the invention, the elastic support and the associated support do not synchronously move, and the associated support does not move along with the elastic support when the elastic support beats along with the aorta, so that the anchoring area is stable, the vessel wall is not damaged under the condition of meeting the sealing requirement of the anchoring area, and the anchoring area reconstruction supporting device has the technical advantages of abrasion relieving, displacement resistance and internal leakage prevention.
Description
Technical Field
The invention relates to the technical field of cardiovascular disease medical equipment, in particular to an anchoring area reconstruction supporting 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 brain, spinal cord and multi-organ blood supply, has large operation trauma, complicated operation, long time, much blood consumption, and higher complication incidence rate and operation death rate of the operation. It has been a goal pursued by vascular surgeons to reestablish the blood supply to the aorta and its branch arteries in as short a time as possible. A B-type interlayer or aneurysm of a lacerated position on 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, the covered stent is released and fixed, the diseased aneurysm or interlayer is isolated, a blood transport channel is reconstructed, and the treatment purpose is achieved. However, the more dangerous A-type dissections or aneurysms involving the arch are still treated mainly by surgical methods. This is because the aortic vascular stent used in the current intraluminal interventional therapy requires an anchoring region of at least 15mm near the heart, when the existing stent in the market is applied to treat the aortic vascular stent, the branch arterial blood vessels are blocked to different degrees, and when the neck blood vessels are involved in the blockage, a bypass operation is required, the trauma is large, and even the intraluminal technique cannot be used for the treatment.
At present, the problem of arch part blood vessel reconstruction is solved through an arch part stent windowing technology, a chimney technology and the like in clinic, but the physiological structures of 3 branch blood vessels of the aortic arch part of each patient are different, so that the problems of complex operation, difficult positioning, high incidence rate of internal leakage, branch blood vessel occlusion and the like exist in both the windowing technology and the chimney technology, and the clinical popularization is difficult.
For the cumulative aortic arch three-branch blood vessel or the ascending aorta dissection or aneurysm, the ascending aorta is needed to be used as the anchoring area when the treatment is performed by an interventional method. The ascending aorta has larger pulsation compared with the descending aorta at the anchoring area of the conventional TEVAR operation, the pulsation mode of the ascending aorta is radial and axial compound movement, and the complex hemodynamics is added, so that the stent product in the prior art is not suitable for taking the ascending aorta as the anchoring area. The fundamental reasons are that: the ascending aorta has larger pulsation, and the conventional blood vessel stent is difficult to be stably anchored in the ascending aorta area, is easy to loosen and displace and generates endoleak. Even if the anchor is forced, the bracket source-induced breach is easy to generate, and the operation fails due to the complications such as abrasion of the overlapping area of the modular bracket, III-type internal leakage and the like.
If the dissected lesion exists, the ascending aorta vessel is often very weak, and if the axial force and the radial force of the stent are larger, a new break (SINE) of the stent origin is easily caused, so that the intima rupture is caused, and more serious complications are caused. If the stent has better adaptability and sets smaller axial and radial forces to enable the stent to beat together with the ascending aorta after being implanted so as to avoid the damage of the stent to the ascending aorta, the stent is also provided with violent axial movement relative to an arch part and descending aorta after being implanted by the arrangement, and is not suitable for being used as an anchoring area of a distal stent to implant the distal stent in the distal stent. Otherwise, the joint stent is easy to shift, and complications such as III-type internal leakage and the like are easy to occur.
Disclosure of Invention
The invention aims to provide an anchoring area reconstruction support device to solve the technical problem that an anchoring area is easy to displace and wear along with the pulsation of an artery.
In a first aspect, the present invention provides an anchoring zone reconstruction support apparatus, comprising: the flexible support comprises an elastic support, an associated support and a flexible part, wherein the elastic support has radial and axial elastic expansion allowance;
the elastic bracket and the associated bracket are connected and sealed through the flexible part;
under the condition that the elastic stent beats along with the ascending aorta, the flexible part deforms so as to fix the position of the associated stent relative to the distal autologous blood vessel.
In combination with the first aspect, the present disclosure provides a first possible implementation manner of the first aspect, wherein the associated stent includes an inner layer anchor, and the elastic stent is connected to the inner layer anchor;
the elastic support is coaxial with the inner layer anchor, and an annular gap exists between the elastic support and the inner layer anchor.
In combination with the first possible implementation manner of the first aspect, the present invention provides a second possible implementation manner of the first aspect, wherein the flexible member is configured as a ring-shaped structure, and the flexible member is connected between the elastic support and the inner layer anchor.
In combination with the second possible embodiment of the first aspect, the present invention provides a third possible embodiment of the first aspect, wherein the flexible member is provided with an annular corrugation around its axis.
With reference to the first possible implementation manner of the first aspect, the present invention provides a fourth possible implementation manner of the first aspect, wherein, in a natural state, an inner diameter of the elastic stent is 10% to 25% larger than an outer diameter of the inner layer anchor.
In combination with the first possible implementation manner of the first aspect, the present invention provides a fifth possible implementation manner of the first aspect, wherein in a natural state, an outer diameter of the elastic stent is 5% to 20% larger than an inner diameter of a target blood vessel, and an outer diameter of the inner layer anchor is less than 5% of the inner diameter of the target blood vessel.
In combination with the first possible implementation manner of the first aspect, the present invention provides a sixth possible implementation manner of the first aspect, wherein the inner layer anchor has a cavity passage that penetrates in an axial direction of the elastic stent.
With reference to the sixth possible implementation manner of the first aspect, the present invention provides a seventh possible implementation manner of the first aspect, wherein one or more chamber channels are provided, and each chamber channel is internally provided with a developing ring.
With reference to the first aspect, the present invention provides an eighth possible implementation manner of the first aspect, wherein the associated stent includes a distal stent, and the distal stent includes: a distal body stent and a distal branch stent;
the far-end main body support is provided with a branch pipeline and/or a side opening window, and the far-end branch support is positioned outside the far-end main body support.
In combination with the eighth possible implementation manner of the first aspect, the present invention provides a ninth possible implementation manner of the first aspect, wherein the flexible member is connected between the elastic support and the distal support.
The embodiment of the invention has the following beneficial effects: the elastic support is provided with radial and axial elastic expansion allowance, the elastic support is connected and sealed with the associated support through the flexible part, the flexible part deforms under the condition that the elastic support beats along with the ascending aorta, so that the associated support is fixed relative to the position of the far-end autologous blood vessel, the associated support is supported inside the aorta wall through the elastic support, the associated support is fixed relative to an anchoring area of the elastic support, the elastic support expands radially and axially along with the beating of the aorta, and the associated support can be prevented from displacing and wearing along with the pulse.
In order to make the aforementioned and other objects, features and advantages of the present invention comprehensible, preferred embodiments accompanied with figures are described in detail below.
Drawings
In order to more clearly illustrate the technical solutions of the embodiments of the present invention or related technologies, the drawings used in the description of the embodiments or related technologies will be briefly introduced 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 cross-sectional view of a first anchor region reconstruction support device according to an embodiment of the present invention;
fig. 2 is a schematic view of a first anchoring zone reconstruction support device and an aortic wall according to an embodiment of the present invention;
FIG. 3 is a schematic view of a first anchoring zone reconstruction support apparatus according to an embodiment of the present invention;
FIG. 4 is a schematic view of a second anchoring zone reconstruction support device according to an embodiment of the present invention during systole;
FIG. 5 is a schematic view of a second anchoring zone reconstruction support apparatus provided in accordance with an embodiment of the present invention during diastole;
FIG. 6 is a schematic view of the distal main body stent and the distal branch stent implanted through the inner layer anchors during installation of the anchor region reconstruction support device according to the embodiment of the present invention.
An icon: 100-a flexible support; 200-an associated scaffold; 201-a chamber channel; 210-inner layer anchors; 220-distal stent; 221-a distal body support; 222-a distal branch stent; 300-a flexible member; 400-aortic wall.
Detailed Description
The technical solutions of the present invention will be described clearly and completely with reference to the accompanying drawings, and it is to be understood that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. 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.
In the description of the present invention, it should be noted that the terms "center", "upper", "lower", "left", "right", "vertical", "horizontal", "inner", "outer", etc., indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings, and are only for convenience of description and simplicity of description, but do not indicate or imply that the device or element being referred to must have a particular orientation, be constructed and operated in a particular orientation, and thus, should not be construed as limiting the present invention. Furthermore, the terms "first," "second," and "third" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance. The term "physical quantity" in the formula, unless otherwise noted, is understood to mean a basic quantity of a basic unit of international system of units, or a derived quantity derived from a basic quantity by a mathematical operation such as multiplication, division, differentiation, or integration.
In the description of the present invention, it should be noted that, unless otherwise explicitly specified or limited, the terms "mounted," "connected," and "connected" are to be construed broadly, e.g., as meaning either a fixed connection, a removable connection, or an integral connection; 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.
As shown in fig. 1, 2, 3, 4, 5 and 6, a first anchor region reconstruction support device provided by an embodiment of the present invention can be used as an ascending aorta stent, and the anchor region reconstruction support device includes: the flexible stent 100, the associated stent 200 and the flexible member 300, wherein the flexible stent 100 has elastic expansion and contraction allowance in the radial direction and the axial direction; the elastic support 100 and the associated support 200 are connected and sealed by a flexible member 300; under the condition that the elastic stent 100 beats with the ascending aorta, the flexible member 300 is deformed to fix the position of the associated stent 200 relative to the distal autologous blood vessel.
Specifically, the elastic stent 100 includes a metal framework and a covering film covering the metal framework, the metal framework can elastically stretch out and draw back along the radial direction and the axial direction, the metal framework has a lower radial supporting force and a lower axial stretching force, and can move along with the ascending aorta pulsation along the radial direction and the axial direction, and the blood vessel is not damaged in the process. When the elastic stent 100 moves along with the pulsation of the aorta, the associated stent 200 is fixed relative to the anchoring area of the elastic stent 100, the associated stent 200 does not damage the ascending aorta, and the overlapped stent does not displace, thereby preventing complications such as internal leakage.
As shown in fig. 1 and 2, in the embodiment of the present invention, the associated bracket 200 includes an inner anchor 210, and the elastic bracket 100 is coupled to the inner anchor 210.
Specifically, the flexible stent 100 may be supported within the aortic wall 400 of the ascending aorta and the inner anchors 210 may be provided as a skeletal or non-skeletal soft membrane.
Further, the flexible member 300 is configured as a ring structure, and the flexible member 300 is connected between the elastic stent 100 and the inner anchor 210. The resilient support 100 is coaxial with the inner anchor 210, and there is an annular gap between the resilient support 100 and the inner anchor 210.
Further, the flexible member 300 is provided with an annular ripple around the axis thereof, the flexible member 300 can be folded along the annular ripple to achieve expansion and contraction, and when the inner layer anchor 210 moves axially relative to the elastic support 100, the annular ripple ensures that the flexible member 300 expands and contracts smoothly along the axial direction, so as to prevent the flexible member 300 from deflecting and deforming.
In a natural state, the inner diameter of the elastic stent 100 is 10% to 25% larger than the outer diameter of the inner anchor 210. Thereby forming an annular gap between the resilient support 100 and the inner anchor 210.
In a natural state, the outer diameter of the elastic stent 100 is 5% to 20% larger than the inner diameter of the target vessel, and the outer diameter of the inner layer anchor 210 is 5% smaller than the inner diameter of the target vessel. Such that the inner anchor 210 raises the diameter of the main stent inner layer in the implanted state to a diameter still smaller than the diameter of the elastic stent 100 and the target vessel in the compressed state. The inner anchor 210 and the elastic stent 100 may be connected by a flexible member 300, and thus may be arranged such that the inner anchor 210 and the elastic stent 100 may be relatively movable in a partial range in the implanted state.
As shown in fig. 1 and 6, the inner layer anchor 210 has a chamber passage 201 penetrating in the axial direction of the elastic stent 100. One chamber channel 201 may be provided, or a plurality of chamber channels 201 may be provided in parallel, through which chamber channel 201 an associated stent 200 may be inserted. Each chamber channel 201 is internally provided with a developing ring, and the position of the chamber channel 201 can be positioned through the developing ring so as to implant a stent into the chamber channel 201.
In this embodiment, the associated cradle 200 includes a distal cradle 220, and the distal cradle 220 includes: a distal body stent 221 and a distal branch stent 222; the distal body stent 221 is provided with branch lines and/or side-opening windows, and the distal branch stent 222 is located outside the distal body stent 221. Wherein the distal body stent 221 and the distal branch stent 222 are inserted as an assembly through the lumen channel 201, respectively, so that implantation of the associated stent 200 can be achieved.
In another embodiment, the elastic stent 100 is connected with the distal stent 220 as a single structure, the elastic stent 100 can expand and contract with the pulsation of the aorta, the elastic stent 100 at the proximal end of the single structure is used as an ascending aorta stent, the inner layer anchoring elements 210 are connected inside the elastic stent 100, and the distal end of the single structure is configured as a single-layer distal stent 220.
As shown in fig. 1, 4 and 5, in addition to the above embodiments, the flexible member 300 is connected between the elastic stent 100 and the distal stent 220, and the flexible member 300 buffers the motion to slow down the power transmission, so that the elastic stent 100 does not transmit to the distal stent 220 along with the ascending aorta pulsation.
In another embodiment, as shown in fig. 1 and 3, a flexible member 300 is connected between the elastic stent 100 and the distal stent 220, and the elastic stent 100 beats with the ascending aorta to slow down the power transmission through the flexible member 300, thereby stabilizing the inner layer anchor 210 located inside the elastic stent 100.
In other words, the inner layer anchor 210 is connected to one of the elastic stent 100 and the distal stent 220 via the flexible member 300, so that the position of the distal stent 220 can be maintained stably when the elastic stent 100 pulsates with the artery. In addition, the branch stent may also adopt a double-layer structure, the outer layer of the double-layer structure is configured as the elastic stent 100, and the associated stent 200 is used as the stent main body; in addition, the main body support may adopt a double-layer structure, the outer layer of the double-layer structure is configured as the elastic support 100, and the associated support 200 is used as a branch support; so set up, elastic support 100 and distal end support 220 can move each other in certain extent, have reduced the wearing and tearing, can regard as bow branch support or abdominal owner and iliac artery branch support to use.
Finally, it should be noted that: the above embodiments are only used to illustrate the technical solution of the present invention, and not to limit the same; while the invention has been described in detail and with reference to the foregoing embodiments, it will be understood by those skilled in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some or all of the technical features may be equivalently replaced; and these modifications or substitutions do not depart from the spirit of the corresponding technical solutions of the embodiments of the present invention.
Claims (10)
1. An anchor reconstruction support apparatus, comprising: the flexible stent comprises an elastic stent (100), an associated stent (200) and a flexible part (300), wherein the elastic stent (100) has radial and axial elastic expansion and contraction margins;
the elastic support (100) and the associated support (200) are connected and sealed through the flexible piece (300);
under the condition that the elastic stent (100) beats along with ascending aorta, the flexible part (300) deforms to fix the position of the associated stent (200) relative to the far end autologous blood vessel.
2. The anchor zone reconstruction support device of claim 1, wherein said associated stent (200) includes an inner anchor (210), said resilient stent (100) being connected to said inner anchor (210);
the elastic support (100) is coaxial with the inner anchor (210), and an annular gap exists between the elastic support (100) and the inner anchor (210).
3. The anchor zone reconstruction support device of claim 2, wherein said flexible member (300) is configured as a loop structure and said flexible member (300) is connected between said resilient support (100) and said inner anchor (210).
4. The anchor reconstruction support device of claim 3, wherein said flexible member (300) is provided with an annular corrugation about its axis.
5. The anchor region reconstruction support device of claim 2, wherein the inner diameter of said elastic stent (100) is 10% to 25% larger than the outer diameter of said inner anchor (210) in a natural state.
6. The anchor region reconstruction support device of claim 2, wherein in a natural state, the outer diameter of said elastic stent (100) is 5% to 20% larger than the inner diameter of a target blood vessel, and the outer diameter of said inner layer anchor (210) is 5% smaller than the inner diameter of said target blood vessel.
7. The anchor zone reconstruction support device of claim 2, wherein said inner anchor (210) has a lumen channel (201) running axially through said elastic stent (100).
8. The anchor zone reconstruction support device of claim 7, wherein said chamber channel (201) is provided with one or more, each of said chamber channels (201) having a developer ring mounted therein.
9. The anchor region reconstruction support device according to any one of claims 1 to 8, wherein said associated stent (200) includes a distal stent (220), said distal stent (220) including: a distal body support (221) and a distal branch support (222);
the distal body stent (221) is provided with a branch line and/or a side opening window, and the distal branch stent (222) is located outside the distal body stent (221).
10. The anchor region reconstruction support device of claim 9, wherein said flexible member (300) is connected between said resilient mount (100) and said distal mount (220).
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CN101015478A (en) * | 2007-02-28 | 2007-08-15 | 许尚栋 | Collateral covered graft-stent and releasing method thereof |
CN101015714A (en) * | 2007-03-07 | 2007-08-15 | 中国人民解放军第二军医大学 | Adjustable artificial aortic arch transplant |
WO2010145703A1 (en) * | 2009-06-18 | 2010-12-23 | Graftcraft I Göteborg Ab | Device and method for treating ruptured aneurysms |
CN205286610U (en) * | 2016-01-08 | 2016-06-08 | 朱建成 | Aorta covered stent |
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