CN117442404B

CN117442404B - Nested stent conveyor and aortic branch vessel repair system

Info

Publication number: CN117442404B
Application number: CN202311787070.1A
Authority: CN
Inventors: 申宝胜; 刘颖; 董永贺
Original assignee: Beijing Huamai Taike Medical Instrument Co ltd
Current assignee: Beijing Huamai Taike Medical Instrument Co ltd
Priority date: 2023-12-25
Filing date: 2023-12-25
Publication date: 2024-03-19
Anticipated expiration: 2043-12-25
Also published as: CN117442404A

Abstract

The invention provides a nested stent conveyor and an aortic branch vessel repair system, which relate to the field of medical appliances and comprise an outer tube, a supporting tube, a main guide wire tube, a branch guide wire tube, a fixed handle, a bending adjusting handle and a bending adjusting wire; the support tube is sleeved outside the main guide wire tube in a sliding manner, the branch guide wire tube is arranged outside the support tube, and the outer tube is sleeved outside the support tube and the branch guide wire tube in a sliding manner; the front end of the bending regulating wire is fixedly connected to the front end of the branch guide wire tube, and the rear end of the bending regulating wire is connected to the bending regulating handle; the rear end of the main guide wire pipe passes through the fixed handle; the rear end of the branch guide wire tube and the rear end of the support tube are fixedly connected to the fixed handle; the bending adjusting handle is connected with the fixed handle in a transmission way, and can pull the front end of the branch guide wire tube backwards, so that the front end of the branch guide wire tube is bent. The invention relieves the technical problems of complex operation, easy failure and great damage to patients in the implantation process when the integrated stent with the branch blood vessel is implanted in the prior art, and improves the accuracy of the release position of the stent.

Description

Nested stent conveyor and aortic branch vessel repair system

Technical Field

The invention relates to the technical field of medical equipment, in particular to a nested stent conveyor and an aortic branch vessel repair system.

Background

In the prior art, the main modes for treating the thoracic aortic branch lesions are divided into two types, namely split type and integrated type.

The split type stent is characterized in that a main body stent placed in an aorta and a branch stent placed in a branch artery are used independently, a fenestration is designed on the main body stent for being matched with the split type stent for use, and the branch stent is released after the main body stent is released. Specifically, the operation mode of combining the main body bracket with the branch bracket of windowing is as follows: firstly, the main body stent is implanted into an aorta, the windowing position is aligned with the opening of a branch vessel, and then the branch stent is implanted through the windowing position, so that a new blood flow passage is established in the aorta and the branch vessel, the real cavity breach of the aorta is blocked, the blood flow of a false cavity is isolated, and the false cavity is gradually tamponade, thereby achieving the aim of treatment.

Such stents have some problems: (1) not easy to implant; when the branch stent is implanted, the branch stent is difficult to position, and particularly, if the branch stent is implanted from a femoral artery implantation path, the branch stent is easy to stay in the main body stent for too long, so that aortic blood flow is blocked; if the branch stent is implanted from the carotid artery or brachial artery access, the skirt edge of the branch stent is easily released in advance and is blocked in the branch vessel, in addition, the access mode also has the risk of over-deep implantation position of the branch stent, thus forming blood flow blocking, and the access is greatly influenced by the size of the branch vessel of a patient, so that the access is not easy for a patient with thinner vessel; (2) The branch stent forms a barrier to aortic blood flow, influences the hydrodynamic property of blood, and has the risk of displacement and occlusion in long term; because the main body stent and the split stent cannot be completely attached after being implanted, part of the branch stent can extend into the main body stent, namely, part of the branch stent is implanted into the aorta, so that the blood flow of the main body stent is influenced, the aortic blood flow is blocked, the hydrodynamic performance of the blood is influenced, and even thrombus is caused; (3) The joint of the main body bracket and the branch bracket is easy to generate internal leakage; in order to ensure that the windowing position on the main body support can be aligned with the branch support and does not shade the blood flow of the branch blood vessel, the windowing size is often designed to be larger than the structure of the opening of the branch blood vessel; when the branch stent is implanted, the branch stent is extruded by a branch vessel, the diameter of the branch stent is basically consistent with the inner diameter of the branch vessel, and a gap between the branch stent and the main body stent is formed; once the skirt edge of the branch stent is poorly attached to the main stent, blood flows from the inside of the main stent to the outside of the branch stent, and if the aortic dissection breach is positioned at the intersection of the aorta and the branch vessel, the effect of plugging the breach cannot be achieved.

The integrated stent is an integrated structure of a main stent placed in an aorta and a branch stent placed in a branch artery, which are connected together in advance, and is usually sewn and connected with a main stent window, and the integrated stent is placed in place once through the same conveying system, specifically, the operation mode of the integrated stent with a section of branch is as follows: the brachial artery puncture is carried into a guide wire and a catheter, the femoral artery puncture is carried out, the guide wire is carried into the thoracic aortic arch, the preset guide wire of the branch part of the integrated stent is pulled to the brachial artery along the brachial artery catheter, the stent is partially released, the branch part is pulled to a branch vessel, and then the stent is thoroughly released. Compare in split type support, the advantage of integral type support includes: the probability of leakage in the lap joint position of the branch bracket and the main body bracket is low, but some problems exist, and the main problems include: the surgical operation is complex and easy to fail, and the requirement on operators is high; during operation, a guide wire is required to be preset at the position of the branch stent, and the traction of the preset guide wire is carried out through the puncture of the carotid artery or the brachial artery; in the operation, the position of the branch stent is required to be adjusted by pulling the guide wire, then the stent is released step by step, the compression volume of the integrated stent structure is large, the caliber of the delivery sheath is large, the release process is complex, the branch guide wire is easy to wind, the release failure is caused, in the operation process, the repeated checking and adjustment are required, and the requirement on an operator is high; (2) during the implantation process, the damage to the body of the patient is large; during operation, a guide wire is required to be preset at the position of the branch stent, and traction of the preset guide wire is carried out by puncturing the carotid artery or the brachial artery, so that the wound of a patient is more, in addition, the integral stent structure has large compression volume, the caliber of the delivery sheath is thick, the delivery sheath is not beneficial to penetrating a tortuous blood vessel, and the blood vessel of the patient is easy to damage; (3) The edge of the branch stent of the integrated stent is integrally stitched with the window of the main stent, the angle adjustment range between the branch stent and the main stent is limited, and the branch stent is easy to block for partial twisted lesions.

Disclosure of Invention

The invention aims to provide a nested stent conveyor and an aortic branch vessel repair system, which are used for alleviating the technical problems in the prior art.

In order to achieve the above purpose, the embodiment of the present invention adopts the following technical scheme:

in a first aspect, an embodiment of the present invention provides a nested stent-graft conveyor, where the nested stent-graft conveyor is used for conveying an integrated branched vascular stent, and specifically, the nested stent-graft conveyor includes an outer tube, a support tube, a main wire tube, a branched wire tube, a fixed handle, a bending handle, and a bending wire;

the support tube is axially sleeved outside the main guide wire tube in a sliding manner, the branch guide wire tube is axially arranged outside the support tube in parallel, and the outer tube is axially sleeved outside the support tube and the branch guide wire tube in a sliding manner; the front end of the main guide wire pipe is provided with a main guide head with an axial through hole, and the front end of the branch guide wire pipe is provided with a branch guide head with an axial through hole;

the front end of the bending regulating wire is fixedly connected to the front end of the branch guide wire tube, and the rear end of the bending regulating wire is connected to the bending regulating handle;

the rear end of the branch guide wire tube and the rear end of the supporting tube are fixedly connected to the front end of the fixed handle; the bending handle is in transmission connection with the fixed handle and is configured to: the bending adjustment handle can pull the bending adjustment wire backwards relative to the fixed handle, so that the front end of the branch guide wire tube is pulled backwards, and the front end of the branch guide wire tube is bent.

The nested support conveyor that this embodiment provided establishes main guide wire pipe, main guide wire head, branch guide wire pipe, branch guide head, transfers curved silk and transfers curved handle, makes the transportation in-process, can introduce main guide wire through main guide wire pipe, guarantees that main support carries in place, introduces branch guide wire through branch guide wire pipe, guarantees that branch support carries in place, and when releasing, releases branch support earlier, releases main support again, guarantees in proper order that the vascular support is accurate to be released to corresponding branch vessel in, reaches best implantation effect. The whole conveying and releasing steps are simple and accurate, errors are not prone to occurring, implantation of the stent can be completed only through femoral artery access, more incisions are not needed to be released under the tension of the guide wire, winding of the guide wire can be avoided, the wound of a patient is less, and operation is convenient and rapid.

In an alternative implementation manner of this embodiment, preferably, a notch is provided on one side of the main guide head, and the branch guide head is located in the notch in a state that the front end of the branch guide wire tube is not bent.

In an optional implementation manner of this embodiment, preferably, a plurality of axial limiting connectors are sleeved outside the branch guide wire tube along an axial spacer of the branch guide wire tube, threading holes are formed in the axial limiting connectors, and the bending wire sequentially passes through the threading holes of the axial limiting connectors.

In an alternative implementation of this embodiment, it is preferable that at least the front end region of the branch guide tube is a cut threaded tube segment.

In an optional implementation manner of this embodiment, preferably, a traction ring is disposed inside the bending adjustment handle, the rear end of the bending adjustment wire is fixedly connected to the traction ring, and the bending adjustment handle can advance or retract relative to the fixed handle so as to bring the traction ring to advance or retract relative to the fixed handle.

Further preferably, the bending adjusting handle is in threaded sleeve connection with the fixed handle;

a bending handle through hole which is axially communicated is formed in the bending handle, and the supporting tube and the branch guide wire tube penetrate through the bending handle through hole;

a traction ring coaxial with the bending handle through hole is arranged in the bending handle through hole, one of the traction ring outer ring surface and the hole wall of the bending handle through hole is provided with a circumferential groove, the other is provided with a bulge, and the bulge is arranged in the circumferential groove;

the rear end of the bending wire is fixedly connected to the traction ring.

In an alternative implementation manner of this embodiment, preferably, the rear end of the outer tube is further connected with an outer tube handle, and the support tube and the branch guide wire tube pass through an axial through hole provided in the outer tube handle.

In an alternative implementation manner of the present embodiment, preferably, an outer tube wall at the front end of the outer tube is provided with an outer tube developing point; and/or, a branch guide developing point is arranged at the branch guide head.

In a second aspect, an embodiment of the present invention provides an aortic branch vessel repair system comprising an integrated branched vessel stent and a nested stent transporter as described in any of the preceding embodiments.

Wherein:

the integrated branch vascular stent comprises a main body stent, a branch tectorial membrane stent and a branch tectorial membrane stent binding member, wherein the diameter of the branch tectorial membrane stent is far smaller than that of the main body stent; the local area on one side of the port edge at one end of the branch tectorial membrane bracket is in sewed soft connection with the local area on one side of the port edge at one end of the main body bracket; the branch tectorial membrane stent restraint part can peripherally restrain the branch tectorial membrane stent in a releasable way; the integrated branch vessel stent is loaded in the outer tube in the state that:

the branch tectorial membrane support is buckled to from the position of being sewed up the flexible coupling with the main part support, the main part support with the port that the flexible coupling one end was sewed up mutually to the branch tectorial membrane support, just the axis of branch tectorial membrane support passes the inside state of main part support, just the branch tectorial membrane support is located main part support front side the main part support cover is located main silk pipe with outside the branch silk guide pipe, the branch tectorial membrane support cover is located outside the branch silk guide pipe, the front end butt of branch tectorial membrane support in branch direction head rear end the rear end butt of main part support in the front end of stay tube.

In the aortic branch vessel repair system provided in this embodiment, preferably, in the integrated branched vessel stent, a branch stent-graft developing mark is provided at an end of the branched stent-graft, which is far away from the main body stent.

Because the aortic branch vessel repair system provided by the embodiment of the invention comprises the nested stent conveyor provided by the first aspect, the aortic branch vessel repair system provided by the embodiment of the invention can achieve all the beneficial effects which can be achieved by the nested stent conveyor provided by the first aspect.

In addition, when the integrated branch vessel stent with the aortic branch vessel repair system provided by the embodiment is used for conveying, the main body stent and the branch tectorial membrane stent can be directly folded to a state that the central axes of the main body stent and the branch tectorial membrane stent are parallel, and the end faces of the two stents close to one end are mutually crossed or overlapped, and then the main body stent and the branch tectorial membrane stent are radially compressed into the outer tube of the conveyor, so that the whole radial dimension during conveying is smaller, the requirement on the diameter of the outer tube of the conveyor is smaller, the outer tube of the conveyor is allowed to be used for conveying, the conveyor is facilitated to pass through a tortuous narrow vessel, and the damage to the body of a patient is further reduced.

Other advantages that can be achieved by the present embodiment are seen in the detailed description and the explanation of the detailed description section of the present specification.

Drawings

In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings that are needed in the description of the embodiments or the prior art will be briefly described, and it is obvious that the drawings in the description below are some embodiments of the present invention, and other drawings can be obtained according to the drawings without inventive effort for a person skilled in the art.

Fig. 1 is a schematic overall structure of a nested rack conveyor according to an embodiment of the present invention;

FIG. 2 is a cross-sectional view of a drive connection area of a fixed handle and a bend wire adjusting handle in a nested stent conveyor according to an embodiment of the present invention;

FIG. 3 is an enlarged partial view of the structure of FIG. 2;

fig. 4 is a schematic diagram of a connection structure of a bending wire connected to a branch guide wire tube through an axial limiting connector in the nested stent conveyor according to the embodiment of the present invention;

FIG. 5 is an isometric view of a connection structure of a main guide head, a main guide wire tube, a branch guide head, a branch guide wire tube and a front end of a bending wire in a nested stent conveyor according to an embodiment of the present invention;

FIG. 6 is a second perspective view of a connection structure of a main guide head, a main guide wire tube, a branch guide head, a branch guide wire tube, and a bending wire front end in a nested stent conveyor according to an embodiment of the present invention;

fig. 7 is a schematic diagram of the overall structure of an integrated branched vascular stent in the aortic branch vascular repair system according to the embodiment of the invention;

fig. 8 is a schematic diagram of a radial compression state in which an integrated branched vascular stent is axially compressed in an outer tube in an aortic branch vascular repair system according to an embodiment of the present invention;

FIG. 9 is a step diagram of implanting an integrated branched vascular stent into a patient using an aortic branch vascular repair system provided by an embodiment of the present invention;

FIG. 10 is a second step of implanting an integrated branched vascular stent into a patient using the aortic branch vascular repair system provided by the embodiment of the present invention;

FIG. 11 is a third step of implanting an integrated branched vascular stent into a patient using the aortic branch vascular repair system provided by the embodiment of the present invention;

fig. 12 is a final implantation state diagram of an integrated branched vascular stent implanted in a patient using the aortic branch vascular repair system according to the embodiment of the present invention.

Icon: 1-an outer tube; 2-supporting the tube; 3-main wire tube; 31-main guide head; 311-notch; 4-branching guide wire tube; 41-branch guide head; 401-axial limit connector; 402-a traction ring; 5-fixing a handle; 6, bending a handle; 7-bending wire adjustment; 8-an outer tube handle; 91-a main body support; 92-branching stent graft; 101-a main guide wire; 102-branch guide wire.

Detailed Description

For the purpose of making the objects, technical solutions and advantages of the embodiments of the present invention more apparent, the technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings in the embodiments of the present invention, and it is apparent that the described embodiments are some embodiments of the present invention, but not all embodiments of the present invention. The components of the 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 invention, as 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 made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.

It should be noted that: like reference numerals and letters designate like items in the drawings, and thus once an item is defined in one drawing, no further definition or explanation thereof is necessary in the subsequent drawings.

In the description of the present invention, it should be noted that, directions or positional relationships indicated by terms such as "front end", "rear end", "inner", "outer", etc., are directions or positional relationships based on those shown in the drawings, or those that are conventionally put in place when the inventive product is used, are merely for convenience of describing the present invention and simplifying the description, and are not indicative or implying that the apparatus or element to be referred to must have a specific direction, be configured and operated in a specific direction, and thus should not be construed as limiting the present invention. Furthermore, the terms "first," "second," and the like, are used merely to distinguish between descriptions and should not be construed as indicating or implying relative importance.

In the description of the present invention, it should also be noted that, unless explicitly specified and limited otherwise, the terms "disposed," "mounted," and "connected" are to be construed broadly, and may be, for example, fixedly connected, detachably connected, or integrally connected; can be directly connected or indirectly connected through an intermediate medium, and can be communication between two elements. The specific meaning of the above terms in the present invention will be understood in specific cases by those of ordinary skill in the art.

Some embodiments of the present invention are described in detail below with reference to the accompanying drawings. The following embodiments and features of the embodiments may be combined with each other without conflict.

Example 1

The present embodiment provides a nested stent-graft for delivering an integrated branched stent-graft, and in particular, referring to fig. 1 to 6, the nested stent-graft includes an outer tube 1, a support tube 2, a main guide wire tube 3, a branched guide wire tube 4, a fixed handle 5, a bending handle 6, and a bending wire 7. Specifically: the support tube 2 is axially sleeved outside the main guide wire tube 3 in a sliding manner, the branch guide wire tube 4 is axially arranged outside the support tube 2 in parallel, and the outer tube 1 is axially sleeved outside the support tube 2 and the branch guide wire tube 4 in a sliding manner; the main guide head 31 having an axial through hole is provided at the front end of the main guide tube 3, and the branch guide head 41 having an axial through hole is provided at the front end of the branch guide tube 4. The front end of the bending regulating wire 7 is fixedly connected with the front end of the branch guide wire tube 4, and the rear end of the bending regulating wire 7 is connected with the bending regulating handle 6. The rear end of the branch guide wire tube 4 and the rear end of the support tube 2 are fixedly connected to a fixed handle 5; the bending handle 6 is in transmission connection with the fixed handle 5 and is configured to: the bending handle 6 can pull the bending wire 7 backwards relative to the fixed handle 5, so that the front end of the branch guide wire tube 4 is pulled backwards, and the front end of the branch guide wire tube 4 is bent.

Taking an integrated vascular stent branching to a thoracic aortic conveyor belt as an example, the usage mode of the nested stent conveyor provided in this embodiment is described as follows:

referring to fig. 8 to 12, in a first step, the branched integrated vascular stent is radially mounted in an outer tube 1, as shown in fig. 8, two ends of a main body stent 91 of the integrated vascular stent are respectively connected to axial distances at connection points with a branched stent-covering stent 92, a shorter end is taken as the front end of the main body stent 91, the branched stent-covering stent 92 of the integrated vascular stent is bent towards the front side of the main body stent 91, the main body stent 91 is arranged in the outer tube 1 and sleeved outside a main wire tube 3 and a branched catheter 4, the branched stent-covering stent 92 is arranged in the outer tube 1 and sleeved outside the branched catheter 4, the rear end of the main body stent 91 is abutted against the front end of a supporting tube 2, and the branched stent-covering stent is circumferentially bound in a releasable manner by using a branched stent-covering stent-binding member (not shown in the figure), a plurality of specific optional structures including but not limited to adopting a compression stent-covering structure with a release wire, the compression stent-covering stent 92 is wound around the branched stent-covering stent 92, and then the release wire is fixed, after the release wire is withdrawn, the release wire is enabled to be correspondingly pressed against the peripheral surface of the branched stent 92, and the compressed stent-covering stent 92 is correspondingly pressed against the peripheral surface of the branched stent 92; or, tying the slipknot with the binding wire directly and winding the branch tectorial membrane bracket 92 in the circumferential direction, withdrawing the binding wire, and opening the branch tectorial membrane bracket 92;

as shown in fig. 9, the main guide wire 101 is threaded from the femoral artery access to the aortic arch;

second, as shown in fig. 10, the main guide wire 101 is threaded from the main guide wire 3; feeding the conveyor along the main guide wire 101 to the aortic arch until the main guide head 31 and the branch guide head 41 reach the junction of the branch vessel and the aorta; in this step, the outer conveyor tube 1 is guided by the main guide wire 101 to bend along the aorta;

thirdly, as shown in fig. 11, the branch guide head 41 is aligned to the opening of the branch vessel, the fixed handle 5 of the conveyer is kept motionless, the outer tube 1 is pulled backwards, the front end of the branch covered stent 92 of the integrated vessel stent which is circumferentially restrained by the branch covered stent restraint is exposed, the corresponding part of the branch guide wire 4 is not restrained by the outer tube 1 any more, the bending handle 6 is operated, the bending wire 7 is pulled backwards relative to the fixed handle 5, so that the front end of the branch guide wire 4 is pulled backwards, and the front end of the branch guide wire 4 is bent, and the branch covered stent 92 is bent along with the front end of the branch guide wire; then the branch guide wire 102 is sent into the branch blood vessel along the branch guide wire pipe 4; the whole conveyor is pushed forward continuously along the branch guide wire 102, the bending handle 6 is operated continuously to push the front end of the branch guide wire tube 4 until the branch covered stent 92 completely enters the branch vessel, the outer tube 1 is retracted until the branch covered stent 92 which is circumferentially restrained by the branch covered stent restraint is completely released, the branch covered stent restraint is opened to completely release the corresponding branch covered stent 92 in the branch vessel, and the branch covered stent 92 self-elastically compresses to the inner wall of the branch vessel, so that the effect that the branch covered stent 92 is self-adaptive to the branch vessel of a patient is achieved;

in this step, the branch guide wire 102 guides the branch guide wire tube 4 of the conveyor to bend into the branch vessel so as to precisely release the branch stent-graft 92;

fourth, the fixed handle 5 is kept still, the outer tube 1 is withdrawn, the main stent 91 is released into the aortic vessel, and then the whole of the main stent is withdrawn from the conveyor, and the final implantation state of the integrated vascular stent can be referred to as fig. 12.

In particular, when the axial distance from the front end of the main body stent 91 to the connection point with the branch stent graft 92 is greater than 0, it is also necessary to bind the front end of the main body stent 91 to the connection point with the branch stent graft 92 with a binding band or other releasable binding member in the first step; at the end of the fourth step, the tie is contacted. This special step is not required when the axial distance from the front end of the main body stent 91 to the point of connection with the branched stent graft 92 is 0, i.e., the integrated stent graft is of the construction shown in fig. 7.

The nested support conveyor provided by the embodiment is provided with the main guide wire pipe 3, the main guide wire head 31, the branch guide wire pipe 4, the branch guide head 41, the bending wire 7 and the bending handle 6, so that the main guide wire 101 can be introduced through the main guide wire pipe 3 in the conveying process, the main support 91 is ensured to be conveyed in place, the branch guide wire 102 is introduced through the branch guide wire pipe 4, and the branch tectorial membrane support 92 is ensured to be conveyed in place; during release, the branch tectorial membrane bracket 92 is released firstly, then the main body bracket 91 is released, so that the vascular bracket is ensured to be accurately released into the corresponding branch blood vessel, and the optimal implantation effect is achieved. The whole conveying and releasing steps are simple and accurate, errors are not prone to occurring, implantation of the stent can be completed only through femoral artery access, more incisions are not needed to be released under the tension of the guide wire, winding of the guide wire can be avoided, the wound of a patient is less, and operation is convenient and rapid.

When the abdominal aorta of the patient is diseased and the renal artery is involved, the nested stent conveyor provided by the embodiment can be accurately implanted into the renal artery similar to the delivery of the integrated vascular stent to the thoracic aorta, and can be applied to other treatments involving aortic stenosis and branch vascular lesions.

With continued reference to fig. 1-6, in an alternative implementation of the present embodiment, it is preferable that at least the front end region of the branch guide wire 4 is a cut threaded pipe section, and bending deformation can occur more easily under the pulling of the bending wire 7 due to the higher flexibility of the cut threaded pipe section.

In an alternative implementation manner of this embodiment, preferably, a plurality of axial limiting connectors 401 are sleeved outside the branch guide wire tube 4 along the axial spacing of the branch guide wire tube 4, threading holes are formed in the axial limiting connectors 401, and the bending wire 7 sequentially passes through the threading holes of the axial limiting connectors 401.

Referring to fig. 5 and 6, in an alternative implementation manner of the present embodiment, it is preferable that a notch 311 is provided on one side of the main guide head 31, and the branch guide head 41 is located in the notch 311 in a state that the front end of the branch guide wire 4 is not bent, so as to avoid interference between the main guide head 31 and the branch guide head 41 in the conveying process of the conveyor before the front end of the branch guide wire 4 is not bent, and reduce damage to a blood vessel of a patient; when the front end of the branch guide wire 4 is bent, the branch guide head 41 is tilted from the notch 311 to be separated from the main guide head 31.

In this embodiment, the bending handle 6 is drivingly connected to the fixed handle 5 and configured to: the bending handle 6 can pull the bending wire 7 backwards relative to the fixed handle 5, so as to pull the front end of the branch guide wire 4 backwards, and further bend the front end of the branch guide wire 4, and in a structure, specific connection modes of the bending handle 6 in transmission connection with the fixed handle 5 are various, for example, but not limited to, the bending handle 6 comprises a rotating knob and a winding rod connected with the rotating knob, the rear end of the bending wire 7 is wound on the rotating knob, when the rotating knob is rotated relative to the fixed handle 5, the rear end of the bending wire 7 can be wound on the winding rod, so that the function of pulling the bending wire 7 backwards is achieved, or the bending handle 6 is slidably mounted on the fixed handle 5 forwards and backwards, and a locking component is additionally arranged, when the bending handle 6 is pulled backwards relative to the fixed handle 5, the relative position of the bending handle 6 relative to the fixed handle 5 is locked when the bending handle 6 is pulled backwards.

However, in view of both the ease of assembly and ease of operation, referring to fig. 2 and 3, in a plurality of alternative implementations of the present embodiment, it is preferable that a traction ring 402 is provided inside the bending handle 6, and the rear end of the bending wire 7 is fixedly connected to the traction ring 402, so that the bending handle 6 can be advanced or retracted relative to the fixed handle 5 to advance or retract relative to the fixed handle 5 with the traction ring 402. Further preferably, the bending handle 6 is in threaded sleeve connection with the fixed handle 5; a bending handle through hole which is axially communicated is arranged in the bending handle 6, so that the support tube 2 and the branch guide wire tube 4 both pass through the bending handle through hole; a traction ring 402 coaxial with the bending handle through hole is arranged in the bending handle through hole, one of the outer ring surface of the traction ring 402 and the hole wall of the bending handle through hole is provided with a circumferential groove, the other is provided with a bulge, and the bulge is arranged in the circumferential groove; the rear end of the bending wire 7 is fixedly connected to the traction ring 402, wherein, optionally, an axial through fixing hole is arranged on the traction ring 402, and the rear end of the bending wire 7 passes through and is tied to the fixing hole. When the bending handle 6 rotates relative to the fixed handle 5, the bending handle 5 can advance or retreat relative to the fixed handle 5, and the traction ring 402 is connected to the bending handle 6 through the circumferential groove and the bulge, so that the traction ring 402 does not rotate along with the bending handle 6, but can advance or retreat along with the bending handle 6, so that the bending wire 7 is pulled or released backwards, and the bending degree of the front end of the branch guide wire tube 4 is adjusted.

In addition, as shown in fig. 1, in an alternative implementation manner of the present embodiment, preferably, an outer tube handle 8 is further connected to the rear end of the outer tube 1, and both the support tube 2 and the branch guide wire tube 4 pass through axial through holes provided in the outer tube handle 8, so that the outer tube 1 is retracted by operating the outer tube handle 8, and the operation is more convenient.

In an alternative implementation of this embodiment, it is preferable that the outer tube wall at the front end of the outer tube 1 is provided with an outer tube developing point to help define the position where the front end of the branched stent graft 92 is delivered before the outer tube 1 is withdrawn; and/or, a branch guide developing point is provided at the branch guide head 41 to help define the front end position and the bending state of the branch stent graft 92, but not limited thereto, and can also be realized by the design assistance of the skeleton of the loaded stent graft itself or the developing point.

Example two

The present embodiment provides an aortic branch vessel repair system, which includes an integrated branched vessel stent and a nested stent-graft provided in any one of the optional embodiments of the first embodiment.

Wherein: referring to fig. 7 and 8, in combination with fig. 9 to 12, the integrated branched vascular stent includes a main body stent 91, a branched stent-graft 92, and a branched stent-graft tether (not shown), the branched stent-graft 92 having a diameter substantially smaller than that of the main body stent 91; the local area on the side of the port edge at one end of the branch tectorial membrane bracket 92 is in sewed soft connection with the local area on the side of the port edge at one end of the main body bracket 91; the above-mentioned branch tectorial membrane support tie-down circumferentially ties the branch tectorial membrane support 92 in a releasable way, the specific optional structure of this branch tectorial membrane support tie-down is multiple, including but not limited to adopting the compression film cover structure with release wire, this compression film cover is fixed by the release wire after wrapping up the branch tectorial membrane support 92 by the film structure for a week, withdraw the release wire, can make the compression film cover open, in order to release the corresponding branch tectorial membrane support 92, the compression film cover point is connected to the corresponding branch tectorial membrane support 92, after the compression film cover is opened, the compression film cover is pressed and connected between the outer peripheral surface of the branch tectorial membrane support 92 and the implanted branch vessel inner wall of butt joint by the branch tectorial membrane support 92; alternatively, the tie wire is directly used to tie the slip knot circumferentially around the branch stent graft 92, the tie wire is withdrawn, and the branch stent graft 92 is opened.

The integrated branched stent is loaded in the outer tube 1: the branch tectorial membrane support 92 is buckled from the part of sewing up soft connection with main part support 91 to, and main part support 91 and branch tectorial membrane support 92 are mutually linked together to sew up the port of soft connection one end mutually, and the axis of branch tectorial membrane support 92 passes the inside state of main part support 91 to, and branch tectorial membrane support 92 is located main part support 91 front side, main part support 91 cover locates outside main guide pipe 3 and branch guide pipe 4, branch tectorial membrane support 92 cover locates outside branch guide pipe 4, the front end butt of branch tectorial membrane support 92 is in branch guide head 41 rear end, the rear end butt of main part support 91 is in the front end of stay tube 2.

The manner of use is referred to in embodiment one.

Since the aortic branch vessel repair system provided in this embodiment includes the nested stent conveyor described in embodiment one, the aortic branch vessel repair system provided in this embodiment can achieve all the beneficial effects achieved by the nested stent conveyor in embodiment one, and the specific structure and the effects that can be achieved can be obtained by referring to the optional or preferred embodiments in embodiment one.

In addition, when the aortic branch vessel repair system provided in this embodiment includes the integrated branch vessel stent delivery, the aortic branch vessel repair system may be directly folded to a state in which the central axes of the main body stent 91 and the branch stent-graft 92 are parallel to each other, and the end surfaces of the two stents close to each other are intersected or overlapped with each other, and then radially compressed into the outer tube 1 of the delivery device to form the state shown in fig. 8, so that the overall radial dimension during delivery is smaller, and thus the diameter requirement on the outer tube 1 of the delivery device is smaller, the delivery by using the outer tube 1 of the delivery device with a small diameter is allowed, the delivery device is facilitated to pass through the tortuous narrow vessel, and the damage to the body of the patient is further reduced.

In the integrated branch-carrying vascular stent provided by the system, the branch stent-graft 92 and the main body stent 91 are in soft suture connection, and instead of all the port peripheral surfaces at one end of the branch stent-graft 92 being sutured on the window at the side surface of the main body stent 91, the local area at one side of the port edge at one end of the branch stent-graft 92 is in soft suture connection with the local area at one side of the port edge at one end of the main body stent 91, so that the adjustable angle range between the branch stent-graft 92 and the main body stent 91 is very large, the branch vascular shape of different angles of patients can be adapted, branch occlusion is not easy to occur, and the vascular new rupture caused by the inadaptation of the stent angle is not adapted. Preferably, the skeleton of the main body stent 91 is a wire wound stent, and the skeleton of the branch stent graft 92 is a wire wound stent or a grid stent, so as to further ensure the elasticity of the main body stent 91 and the branch stent graft 92, further improve the self-adaptability of the main body stent 91 to the aortic vessel of the patient and the branch stent graft 92 to the branch vessel of the patient after the release, and improve the bonding tightness between the outer peripheral surface of the stent and the vessel wall of the patient after the release. Alternatively, the main body stent 91 is a bare stent, or the main body stent 91 is an integral stent graft, or the main body stent 91 is a partial stent graft; specifically, when the dissection breach is located in the patient's aorta, the dissection breach may be a whole-covered stent or a partial-covered stent, where when the dissection breach is located in the patient's aorta and the breach is smaller and the number is smaller, the main body stent 91 is preferably a partial-covered stent, and the covered membrane partially or semi-surrounds the framework of the main body stent 91, so that the compression volume of the main body stent 91 is reduced on the premise that the sealing effect between the branch covered stent 92 and the main body stent 91 is not reduced; when the dissection site is located on the wall of a branch vessel of a patient, the main body stent 91 is preferably a bare stent, and the compressed volume of the main body stent 91 can be reduced in the same way, and at the same time, the structure can also reduce the blockage of the main body stent 91 to the branch blood flow, so that the dissection site can be used for treating the brachiocephalic trunk or left common carotid artery branch vessel lesions in the aortic arch region.

In addition, in the aortic branch vessel repair system provided in this embodiment, preferably, in the integrated branch vessel stent with branch, a branch stent developing mark is provided at one end of the branch stent graft 92 far away from the main body stent 91, so that an operator can be helped to observe whether the front end of the branch stent graft 92 is conveyed in place or not in a compressed loading state, observe a bending state of the branch stent graft, and not be provided with the branch stent developing mark, but a developing point is provided at the branch guide head 41 of the conveyor to help the operator judge.

Finally, it should be noted that:

1. in the present specification, "and/or" means "and/or" the structure described before "and/or" the structure described after "are provided simultaneously or alternatively;

2. in the present specification, each embodiment is described in a progressive manner, and each embodiment is mainly described by differences from other embodiments, and identical and similar parts between the embodiments are only required to be seen with each other; the above embodiments in the present specification are only for illustrating the technical solution of the present invention, and are not limiting; although the invention has been described in detail with reference to the foregoing embodiments, it will be understood by those of ordinary skill in the art that: the technical scheme described in the foregoing embodiments can be modified or some or all of the technical features thereof can be replaced by equivalents; such modifications and substitutions do not depart from the spirit of the invention.

Claims

1. The utility model provides a nested formula support conveyer for carry integral type area branch vessel support, its characterized in that: the nested support conveyor comprises an outer tube (1), a support tube (2), a main guide wire tube (3), a branch guide wire tube (4), a fixed handle (5), a bending adjustment handle (6) and a bending adjustment wire (7);

the support tube (2) is axially sleeved outside the main guide wire tube (3) in a sliding manner, the branch guide wire tube (4) is axially arranged outside the support tube (2) in parallel, and the outer tube (1) is axially sleeved outside the support tube (2) and the branch guide wire tube (4) in a sliding manner; a main guide head (31) with an axial through hole is arranged at the front end of the main guide tube (3), and a branch guide head (41) with an axial through hole is arranged at the front end of the branch guide tube (4);

at least the front end area of the branch wire guide tube (4) is a cutting thread tube section, the front end of the bending regulating wire (7) is fixedly connected to the front end of the branch wire guide tube (4), and the rear end of the bending regulating wire (7) is connected to the bending regulating handle (6);

the rear end of the branch guide wire tube (4) and the rear end of the supporting tube (2) are fixedly connected to the fixed handle (5); the bending handle (6) is connected with the fixed handle (5) in a transmission way and is configured to: the bending adjusting handle (6) can pull the bending adjusting wire (7) backwards relative to the fixed handle (5), so that the front end of the branch guide wire tube (4) is pulled backwards, and the front end of the branch guide wire tube (4) is bent.

2. The nested stent conveyor of claim 1, wherein: a notch (311) is arranged on one side of the main guide head (31), and the branch guide head (41) is positioned in the notch (311) when the front end of the branch guide wire tube (4) is not bent.

3. The nested stent conveyor of claim 1, wherein: outside branch wire guide tube (4), follow the axial spacer sleeve of branch wire guide tube (4) is equipped with a plurality of axial spacing connecting pieces (401), be equipped with the through wires hole on axial spacing connecting piece (401), turn wire (7) of adjusting pass in proper order the through wires hole of a plurality of axial spacing connecting pieces (401).

4. The nested stent conveyor of claim 1, wherein: the bending handle (6) is internally provided with a traction ring (402), the rear end of the bending wire (7) is fixedly connected with the traction ring (402), and the bending handle (6) can move forwards or backwards relative to the fixed handle (5) so as to drive the traction ring (402) to move forwards or backwards relative to the fixed handle (5).

5. The nested stent conveyor of claim 4, wherein: the bending adjusting handle (6) is in threaded sleeve connection with the fixed handle (5);

a bending handle through hole which is axially communicated is formed in the bending handle (6), and the supporting tube (2) and the branch guide wire tube (4) penetrate through the bending handle through hole;

a traction ring (402) coaxial with the bending handle through hole is arranged in the bending handle through hole, one of the outer ring surface of the traction ring (402) and the hole wall of the bending handle through hole is provided with a circumferential groove, the other is provided with a bulge, and the bulge is arranged in the circumferential groove;

the rear end of the bending wire (7) is fixedly connected to the traction ring (402).

6. The nested stent conveyor of claim 1, wherein: the rear end of the outer tube (1) is also connected with an outer tube handle (8), and the support tube (2) and the branch guide wire tube (4) penetrate through an axial through hole formed in the outer tube handle (8).

7. The nested stent conveyor of claim 1, wherein: an outer tube development point is arranged on the outer tube wall at the front end of the outer tube (1); and/or, a branch guide developing point is provided at the branch guide head (41).

8. An aortic branch vessel repair system, characterized by: comprising an integrated branched vascular stent and a nested stent delivery device according to any one of claims 1 to 7; wherein,

the integrated branch-carrying vascular stent comprises a main body stent (91), a branch covered stent (92) and a branch covered stent binding member, wherein the diameter of the branch covered stent (92) is far smaller than that of the main body stent (91); the local area on one side of the port edge at one end of the branch tectorial membrane bracket (92) is in sewed soft connection with the local area on one side of the port edge at one end of the main body bracket (91); the branch stent graft tie releasably circumferentially ties the branch stent graft (92); the integrated branch vessel stent is loaded in the outer tube (1) in the state that:

the branch tectorial membrane support (92) is bent to from the part of being sewed up the flexible connection with main part support (91), main part support (91) with the port of flexible connection one end is sewed up each other to branch tectorial membrane support (92) communicates each other, just the axis of branch tectorial membrane support (92) passes the inside state of main part support (91), just branch tectorial membrane support (92) are located main part support (91) front side main part support (91) cover is located main silk pipe (3) with branch silk pipe (4) outside, branch tectorial membrane support (92) cover is located branch silk pipe (4) outside, the front end butt of branch tectorial membrane support (92) in branch direction head (41) rear end, the rear end butt of main part support (91) in the front end of stay tube (2).

9. The aortic branch vessel repair system of claim 8, wherein: in the integrated stent with branch blood vessel, a branch stent developing mark is arranged at one end of the branch stent (92) far away from the main body stent (91).