CN118267147A

CN118267147A - Aortic stent

Info

Publication number: CN118267147A
Application number: CN202211708387.7A
Authority: CN
Inventors: 薛松; 刘冀东; 王珂男; 杨焱钦; 王云蕾
Original assignee: Shanghai Weiwei Zhiling Medical Technology Co ltd; Renji Hospital Shanghai Jiaotong University School of Medicine
Current assignee: Shanghai Weiwei Zhiling Medical Technology Co ltd; Renji Hospital Shanghai Jiaotong University School of Medicine
Filing date: 2022-12-29
Publication date: 2024-07-02

Abstract

The invention relates to the technical field of medical equipment, and provides an aortic stent, which comprises: a first stent section, a second stent section and an artificial blood vessel section connected in sequence from the distal end to the proximal end; the second support section is a covered support, and at least one part of the outer wall of the second support section is a hollowed-out area; the aortic stent is configured to: when the aortic stent is implanted into the aorta, the first stent section is positioned in the descending aorta, the second stent section is positioned in the aortic arch, and the artificial blood vessel section is positioned outside the broken ascending aorta and is used for being connected with an artificial blood vessel replaced by the ascending aorta. The aortic stent not only can realize the replacement of the ascending aorta, but also can further carry out synchronous treatment on the aortic arch part and the descending aorta, and not only can fully supply branch blood to the aortic arch part through the arrangement of the hollowed-out area, but also can realize better shaping effect of the long-term true cavity, and eliminate the hidden trouble of further progress of residual lesions of the aortic arch part, the thoracic segment and even the thoracoabdominal segment.

Description

Aortic stent

Technical Field

The invention relates to the technical field of medical equipment, in particular to an aortic stent.

Background

The acute aortic disease is a critical cardiovascular critical disease, wherein the acute A-type aortic dissection is taken as the highest death rate in all aortic dissection types, and the disease has urgent onset, has poor drug treatment effect and can only be treated by surgical operation.

One of the difficulties in aortic dissection surgery of a is focused on the arch treatment. At present, the following surgical formulas are available for aortic lesions involving the arch:

(1) Traditional total arch replacement: the device has the advantages that the device can thoroughly eliminate the ascending aorta and the breach partially positioned at the front part of the arch, and is beneficial to the vacuum cavity remodeling of the descending thoracic aorta. However, the operation has high operation difficulty, needs long-time deep low-temperature stop circulation, has high operation risk, has high incidence rate of early postoperative complications, and is difficult to popularize and develop in general hospitals. The existing intraoperative stent is short, straight and hard, the problems of radial support and true cavity remodeling are not fully considered in design, and the problem of poor repair of a stent section still exists, and even a new fracture can be caused, so that poor prognosis is caused.

(2) Composite total arch displacement: the method has the advantage that corresponding risks caused by deep low-temperature stop circulation can be avoided. But has the problems of limited operation sites, need to master the intra-cavity intervention technology, complex operation, high cost and the like.

(3) The arch treatment is realized by the ascending aorta replacement and intracavitary intervention on-arch branch reconstruction technology, and the method has the advantages of simplifying surgical operation, having extremely high requirements on the operation of an intracavitary intervention part, simultaneously needing to perform certain damage and change on the existing intracavitary product, and having an unclear long-term effect.

(4) Full-cavity interventional therapy: the "parallel bracket" technique, the "windowing" technique, the experimental product, etc. are adopted. However, the original design of the stent aims at B-type lesions, cannot adapt to the characteristics of A-type aortic dissection lesions and the characteristics of high individuation of the arch part, and has no better breakthrough at present.

In addition, the primary breach of most patients with A-type aortic lesion is positioned in the ascending aorta, and the method of only performing the replacement of the ascending aorta through an artificial blood vessel is also a more conventional treatment mode, and the replacement mode is simpler to operate and has high near-medium-term survival rate. However, the method only considers the replacement of the ascending aorta, the untreated aortic arch and the untreated descending aorta, the long-term vacuum cavity is poorly shaped, and the risks of further expanding residual interlayers of chest and abdomen segments and forming aneurysms exist.

Therefore, there is a need for an a-type aortic stent, which is used to simplify the surgical difficulty as much as possible, not only can realize the replacement of the ascending aorta, but also can treat the aortic arch and the descending aorta, has a better long-term vacuum cavity shaping effect, eliminates the hidden trouble of further progress of residual lesions of the arch, the thoracic descending aorta and even the thoracic and abdominal segments, and simplifies the surgical difficulty.

Disclosure of Invention

The invention aims to provide an aortic stent, which not only can realize the replacement of an ascending aorta, but also can treat the aortic arch part and the descending aorta through a three-section structural design, has good long-term vacuum cavity shaping effect, and eliminates hidden trouble of further progress of residual lesions of the aortic arch part, the thoracic descending aorta and even the thoracic and abdominal sections.

The present invention provides an aortic stent comprising: a first stent section, a second stent section and an artificial blood vessel section connected in sequence from the distal end to the proximal end; the first bracket section is a covered bracket; the second support section is a covered support, at least one part of the outer wall of the second support section is a hollowed-out area, and the hollowed-out area enables the inner cavity of the second support section to be communicated with the branch; the aortic stent is configured to: when the aortic stent is implanted into the aorta, the first stent section is positioned in the descending aorta, the second stent section is positioned in the aortic arch, and the artificial blood vessel section is positioned at the ascending aorta and is used for being connected with the blood vessel of the ascending aorta.

So configured, the aortic stent is divided into three parts, wherein the first stent section is positioned in the descending aorta, the second stent section is positioned in the aortic arch, the artificial blood vessel section is positioned outside the severed ascending aorta and is used for being connected with an artificial blood vessel replaced by the ascending aorta, and the aortic stent can be used in cooperation with the replacement of the ascending aorta, so that the existing operation habit can not be changed, and the rapid ascending is facilitated. The aortic stent not only can realize the replacement of the ascending aorta, but also can treat the aortic arch and the descending aorta, has good supporting effect on the aortic arch intima on one hand, ensures that the blood supply of branch vessels of the aortic arch part is sufficient through the arrangement of the hollowed-out area, and also ensures that the long-term vacuum cavity shaping effect is better on the other hand, and eliminates the hidden trouble of further progress of residual lesions of the arch part, the thoracic descending aorta and even the thoracic and abdominal sections.

Optionally, the second bracket section comprises a framework, the framework comprises a plurality of bracket rings arranged along the axial direction, and at least part of the bracket rings has a wavy shape which is curved and undulated along the axial direction; the skeleton is configured to: in the two adjacent bracket rings, the wave crest of one bracket ring and the wave trough of the other bracket ring are oppositely arranged and connected along the axial direction.

Optionally, the second bracket section further includes a covering film, the covering film is attached to an inner wall and/or an outer wall of the framework, and a window is formed on the covering film to form the hollowed-out area on the second bracket section.

Optionally, the windowing is configured to: the fenestration is positioned on the large curved side of the second stent section when the second stent section is curved, and when the aortic stent is implanted into the aorta, the fenestration area faces the aortic branch vessel and faces the aortic branch vessel.

Optionally, the second stent section is adaptively curved when implanted in the aortic arch, the skeleton has a dense region and a sparse region, the wave distribution of the dense region is dense in the wave distribution of the sparse region, the dense region is located on the small curved side when the second stent section is curved, and the sparse region is located on the large curved side when the second stent section is curved.

Optionally, the second support section is implanted the adaptation when in the aortic arch and is crooked form, the skeleton has intensive district and flat district, all support ring is located the position in intensive district is the wave, all support ring is located the position in flat district is flat section, intensive district is located the second support section is the little curved side when crooked form, flat district is located the second support section is the big curved side when crooked form. The support ring is divided into a dense region and a sparse region or a dense region and a flat region, so that the connection strength and the supportability of the large bending side of the second support section are considered, and when the second support section is bent, the sparse region and the flat region are arranged in a sparse wave mode or a wave-free mode, so that the support ring can ensure the circulation of blood with branches, simultaneously reduce the return force caused by the support of the large bending side, effectively improve the bending performance of the small bending side of the second support section, ensure that the second support section can sufficiently conform to the aortic arch shape to bend, and ensure that the aortic arch real cavity is shaped well.

Optionally, two adjacent portions of the bracket ring located on the small curved side are disposed at intervals along the axial direction.

Optionally, a coating is attached to the outer wall of the small curved side of the skeleton.

Optionally, the first bracket section is configured to: the distal end of the first stent section is provided with a reserved connection end which is used for being connected with an artificial blood vessel replaced by the descending aorta.

Optionally, the first stent section is longer than the artificial blood vessel section; and/or, the second stent section is longer than the artificial blood vessel section.

In summary, the aortic stent of the present invention comprises: a first stent section, a second stent section and an artificial blood vessel section connected in sequence from the distal end to the proximal end; the second support section is a covered support, at least one part of the outer wall of the second support section is a hollowed-out area, and the hollowed-out area enables the inner cavity of the second support section to be communicated with the branch; the aortic stent is configured to: when the aortic stent is implanted into the aorta, the first stent section is positioned in the descending aorta, the second stent section is positioned in the aortic arch, and the artificial blood vessel section is positioned outside the broken ascending aorta and is used for being connected with an artificial blood vessel replaced by the ascending aorta.

The setting of first support section not only makes the shaping effect of long-term true chamber better, is provided with reserved link moreover for when long-term needs replacement descending aorta blood vessel, can be located the reserved link position department of first support section in descending aorta department and break away, and sew up the connection with the tectorial membrane of the reserved link department of first support section with the artificial blood vessel that descending aorta was replaced, also open or intracavity intervention headspace for long-term going once more.

In addition, the stent rings of the second stent section are divided into a dense region and a sparse region, and the wave crests and the wave troughs of the adjacent stent rings are oppositely arranged and connected, so that on one hand, the connection strength and the supportability of the large bending side of the second stent section are considered, the blood circulation with branches can be ensured, and the bending performance of the small bending side of the second stent section is effectively improved, thereby ensuring that the second stent section can sufficiently conform to the shape of an aortic arch to bend, and leading the true cavity of the aortic arch to be well shaped.

Drawings

Fig. 1 is a schematic view of an application scenario of an aortic stent according to an embodiment of the invention;

FIG. 2 is a schematic illustration of an aortic stent in accordance with an embodiment of the present invention;

FIG. 3 is a schematic view of an aortic stent in accordance with another embodiment of the present invention;

FIG. 4 is a schematic view of an aortic stent in accordance with another embodiment of the present invention;

Fig. 5 is a schematic structural view of a skeleton of a second bracket section according to an embodiment of the present invention.

Wherein, the reference numerals are as follows:

10-a first stent segment;

20-a second stent section; 201-a hollowed-out area; 21-a stent ring; 211-dense areas; 212-sparse zone; 22-coating; 23-windowing;

30-an artificial blood vessel segment;

41-ascending aorta; 42-aortic arch; 43-descending aorta; 44-aortic branches;

a-separating the fracture; b-reserving a connection terminal.

Detailed Description

The aortic stent according to the present invention will be described in further detail with reference to the accompanying drawings and specific examples. The advantages and features of the present invention will become more apparent from the following description. It should be noted that the drawings are in a very simplified form and are all to a non-precise scale, merely for convenience and clarity in aiding in the description of embodiments of the invention.

In the invention, the outer diameter and the inner diameter correspond to the diameter size for a circular structure, the inner diameter refers to the diameter of an inscribed circle of the circular structure for a non-circular structure, and the outer diameter refers to the diameter of an circumscribed circle of the circular structure; the axial direction corresponds to the direction in which the axis is located for a cylindrical channel, and corresponds to the length direction of the channel for a non-cylindrical channel;

In the present invention, "proximal" and "distal" are relative orientations, relative positions, directions of elements or actions relative to each other from the perspective of an operator using the product, although "proximal" and "distal" are not limiting, "proximal" generally refers to the end of the product that is proximal to the operator during normal operation, i.e., proximal to the aortic blood flow direction, and "distal" generally refers to the end that first enters the patient, i.e., distal to the aortic blood flow direction.

In the present invention, the definition of parallel and vertical should not be interpreted as being in a narrow sense as an absolute vertical or an absolute parallel relationship, and should be interpreted as allowing an error of a set angle, typically ±5°, under the corresponding vertical or parallel precondition, the specific value of the set angle being determined according to the required use conditions;

As used in this disclosure, the singular forms "a," "an," and "the" include plural referents, the term "or" are generally used in the sense of comprising "and/or" and the term "several" are generally used in the sense of comprising "at least one," the term "at least two" are generally used in the sense of comprising "two or more," and the term "first," "second," and "third" are used for descriptive purposes only and are not to be construed as indicating or implying any relative importance or number of features indicated. Thus, a feature defining "a first", "a second", "a third" may include one or at least two such features, either explicitly or implicitly. Furthermore, as used in this disclosure, "mounted," "connected," and "disposed" with respect to another element should be construed broadly to mean generally only that there is a connection, coupling, mating or transmitting relationship between the two elements, and that there may be a direct connection, coupling, mating or transmitting relationship between the two elements or indirectly through intervening elements, and that no spatial relationship between the two elements is to be understood or implied, i.e., that an element may be in any orientation, such as internal, external, above, below, or to one side, of the other element unless the context clearly dictates otherwise. The specific meaning of the above terms in the present invention can be understood by those of ordinary skill in the art according to the specific circumstances. Furthermore, directional terms, such as above, below, upper, lower, upward, downward, left, right, etc., are used with respect to the exemplary embodiments as they are shown in the drawings, upward or upward toward the top of the corresponding drawing, downward or downward toward the bottom of the corresponding drawing.

The present embodiment provides an aortic stent comprising a first stent section 10, a second stent section 20 and an artificial vessel section 30 sequentially connected from the distal end to the proximal end;

The second support section 20 is a covered support, at least a portion of the outer wall of the second support section 20 is a hollowed-out area 201, the hollowed-out area 201 enables the inner cavity of the second support section 20 to be communicated with branches, and the branches here refer to three branches on an arch.

The aortic stent is configured to: when the aortic stent is implanted in the aorta, the first stent section 10 is positioned in the descending aorta 43, the second stent section 20 is positioned in the aortic arch 42, and the artificial blood vessel section 30 is positioned outside the ascending aorta 41 for vascular connection with the ascending aorta.

Referring to fig. 1, fig. 1 is a schematic view of an application scenario of an aortic stent;

Wherein the aorta is comprised of an ascending aorta 41, an aortic arch 42 and a descending aorta 43, wherein the aortic arch 42 is in communication with a plurality of aortic branches 44.

In the process of implanting an aortic stent, firstly connecting an extracorporeal circulation device for surgical open operation, stopping circulation at a deep low temperature, clamping the ascending aorta-aortic arch connection, disconnecting the ascending aorta 41 from the proximal end of the clamp, and forming a disconnection port a on one side of the ascending aorta 41, which is close to the aortic arch 42; the clamp is opened, an aortic stent is placed from the fracture a of the ascending aorta to the descending aorta direction, wherein the first stent section 10 is implanted into the descending aorta 43, the second stent section 20 is implanted into the aortic arch 42, the hollowed-out area 201 corresponds to the aortic branch 44, the artificial blood vessel section 30 is positioned at the fracture a section and is used for being connected with the blood vessel of the ascending aorta, the connection mode is two, one is that the artificial blood vessel section 30 is connected with the artificial blood vessel after the partial replacement of the ascending aorta, at the moment, the artificial blood vessel after the replacement of the ascending aorta is also used as a part of the ascending aorta, and the other is that the ascending aorta of the other section opposite to the fracture a is connected to the artificial blood vessel section 30.

The aortic stent in this embodiment is intended to be used in combination with ascending aortic replacement, so that the existing operating habits can not be changed, and rapid ascending is facilitated. The aortic stent not only can realize the replacement of the ascending aorta, but also can treat the aortic arch and the descending aorta, has good long-term vacuum cavity shaping effect, and eliminates hidden trouble of further progress of residual lesions of the arch part, the chest segment and even the chest and abdomen segment.

In the present embodiment, the materials of the first support section 10 and the second support section 20 are not limited, for example, the materials of the first support section 10 and the second support section 20 include but are not limited to tantalum, nickel-titanium alloy, nickel-titanium-vanadium alloy, stainless steel, titanium, or other alloys or combinations thereof; wherein the first stent section 10 and the second stent section 20 are in a tube-like shape to form a circular channel while also facilitating the maintenance of sufficient support capacity to provide reliable support to the aorta.

In this embodiment, the prosthetic vessel segment 30 may be manufactured using existing products, and the prosthetic vessel is typically formed from biocompatible materials including, but not limited to, polyethylene terephthalate, polytetrafluoroethylene, expanded polytetrafluoroethylene, polyurethane, polycaprolactone, polydioxanone, polysebacic acid glyceride, cellulose, and combinations thereof.

In this embodiment, the lengths and diameters of the first stent section 10, the second stent section 20 and the artificial blood vessel 30 and the actual use requirements are determined, and different lengths and diameters can be set to form various specifications so as to adapt to different use conditions, so that the natural trend of the whole ascending aorta, the aortic arch and the descending aorta can be better complied, and the universality of the aortic stent is improved.

Referring to fig. 2, the second stent section 20 is a bare stent, and the whole section of the second stent section 20 forms a meshed hollow area through the bare stent naturally, and the hollow area is arranged to make the blood supply of the branch vessel of the main artery sufficient.

The bare stent can be formed by braiding medical memory alloy fine wires, and the hollow diamond-shaped braided net-shaped integrated tubular stent can be formed by braiding one wire or a plurality of wires, when the second stent section 20 is installed in an aortic arch, the hollow area corresponds to the aortic branch 44, the second stent section 20 can prop up the inner membrane of the aortic arch, the false cavity is reduced, and meanwhile, the blood flow of the aortic branch vessel is not influenced.

Wherein the first stent section 10 is a stent graft. The covered stent is a closed circular channel formed by adhering a covered film on the basis of a bare stent or a framework, wherein a single-layer covered film can be adhered to the outer peripheral surface of the framework, a single-layer covered film can be adhered to the inner peripheral surface of the framework, or a double-layer covered film can be formed by adhering the covered film on the inner peripheral surface and the outer peripheral surface of the framework at the same time. In this embodiment, the covering structure of the first stent section 10 can refer to the covering structure of the second stent section 20 in fig. 3 or fig. 4, wherein the covering structure of the second stent section 20 is described in detail below. The first stent section 10 is arranged as a covered stent, so that on one hand, the supporting performance of the descending aorta is improved, the wound on the inner wall of the descending aorta can be covered, the false cavity is reduced, and meanwhile, a space is reserved for long-term reopening or intra-cavity intervention.

The first carrier section 10 is configured to: the distal end of the first stent section 10 is provided with a reserved connection end for connection with an artificial blood vessel replaced by the descending aorta. If the first stent segment 10 is a stent graft, the distal end of the first stent segment 10 may be used as the reserved connection end b for suture connection with the artificial blood vessel replaced by the descending aorta; or the distal end of the first support section 10 may also be adaptively modified to form the reserved connection end b, for example, a small-section covered stent may be disposed at the distal end of the first support section 10 as the reserved connection end, and the reserved connection end may also be formed by disposing an artificial blood vessel section, which is not described in detail herein. Thus, when a replacement of the descending aortic blood vessel is required for a long period, the vessel can be disconnected at the position of the reserved connection end b of the first stent section 10 at the descending aorta, and the artificial blood vessel replaced by the descending aorta can be connected with the tectorial membrane at the reserved connection end b of the first stent section 10 by stitching. Wherein the first stent section 10 is longer than the artificial blood vessel section 30 and/or the second stent section 20 is longer than the artificial blood vessel section 30. The support range of the descending aorta is increased by the longer first stent section 10, the second stent section 20 is adapted to the length of the aortic arch 42, and the artificial blood vessel section 30 is shorter, which is beneficial to better spatial arrangement of the aortic stent, so that the artificial blood vessel section 30 is smoothly connected with the artificial blood vessel replaced by the ascending aorta.

Referring to fig. 3, which is another embodiment of the second bracket section 20, fig. 3 is different from fig. 1in the hollowed-out area,

The second bracket section 20 comprises a framework and a covering film 22, the framework comprises a plurality of bracket rings 21, each bracket ring 21 is arranged at intervals along the axial direction, at least part of the bracket rings 21 has a wavy shape which is curved and undulated along the axial direction, the covering film 22 is attached to the outer wall and/or the outer wall of the framework, and the covering film 22 is provided with a window 23 to form the hollowed-out area 201 on the second bracket section 20.

The coating 22 may be attached to the inner wall or the outer wall of the stent ring 21, or may be attached to both the inner wall and the outer wall thereof to form a double-layered film, for example, one layer of coating is disposed on the entire outer circumferential surface of the stent, the other layer of coating is disposed on the entire inner circumferential surface of the stent, and two layers of coating are bonded to each other, at this time, the two layers of coating completely comprise the stent, or the two layers of coating and the stent are bonded to each other two by two to form a complete double-layered stent. In this embodiment, the covering film 22 is preferably attached to the outer wall of the support ring 21, and covers the gap area between the adjacent support rings, and the window 23 exposes a part of the gap to form the hollowed-out area 201.

In this embodiment, all the covering films are made of flexible film materials, and the covering films should have a certain ductility, so that when the bracket is bent, the covering films on the large bending side are adaptively expanded, the covering films on the small bending side are adaptively contracted, the covering films are preferably made of materials which are not absorbable by human bodies, the film materials include but are not limited to PET, EPTFE or a combination thereof, the covering films are of the prior art, and the covering films can also be directly made of the prior products meeting the use requirements; the cover 22 may be attached to the stent ring 21 by sewing, heat-sealing, adhesive bonding, or the like.

The position and shape of the fenestration are not limited in this embodiment, and when the second stent section 20 is implanted in the aortic arch, the fenestration corresponds to each aortic branch 44, and the fenestration 23 ensures the patency of the aortic arch 42 and the aortic branch 44; the arrangement mode of the partial covering film of the second bracket section 20 ensures that the second bracket section 20 has better integrity, not only has the supporting performance on the aortic arch 42, but also can effectively prevent the framework from damaging the aortic intima, and simultaneously has the advantages of smooth blood flow between the aortic arch 42 and the aortic branch 44.

The second stent section 20 can provide continuous real cavity radial expansion adhesion with time progression no matter the metal bare stent or semi-covered stent design is adopted, so as to achieve better expansion support and false cavity elimination effects.

Further, the fenestration 23 is configured to: the fenestration 23 is located on the side of the greater curvature of the second stent section 20 when the aortic stent is curved, and the fenestration 23 is directed toward and against the aortic branch vessel when the aortic stent is implanted in the aorta. At this time, the fenestration 23 is only formed on one radial side of the second support section 20, but not circumferentially surrounds and penetrates around the second support section 20, so that on one hand, the covering film is axially continuous on the small-bending side of the second support section 20, thereby being beneficial to improving the supportability of the second support section 20, and on the other hand, being beneficial to ensuring a larger covering area of the covering film, and being capable of effectively preventing the framework from damaging the aortic intima; and the fenestration positions correspond to the aortic branches 44, the fenestration 23 positions ensuring the patency of the aortic arch 42 and the aortic branches 44.

Further, the fenestration 23 area ensures that at least a portion of one of the stent rings 21 is uncovered, such that when the aortic stent is implanted in the aorta, at least one of the stent rings 21 is supported within the aortic arch at the location of the aortic branch 44. Referring to fig. 3, since the cover film 22 is attached to the outer wall of the bracket ring 21, the fenestration exposes a portion of at least one bracket ring 21. The scope of the fenestration 23 needs to cover the aortic branch 44, so the scope of the fenestration 23 is relatively large, if no stent ring 21 is exposed in the scope of the fenestration 23, the second stent section 20 has poor support property at the position of the fenestration 23, so the fenestration 23 should have stent rings 21, for example, six stent rings 21 are exposed at the position of the fenestration 23 in fig. 3, and the number of the specific exposed stent rings 21 can be adjusted according to practical situations. In addition, on the one hand, in view of the supportive nature of the second stent section 20 at the junction of the aortic arch 42 and the aortic branch 44 and in view of preventing the stent rings 21 from affecting the blood flow of the aortic branch 44, a proper number of stent rings 21 should be left bare, preferably one stent ring 21 is ensured between the adjacent aortic branches 44 in the bare stent rings 21 in the axial direction, so as to compromise the supportive nature and the stent rings 21 do not directly block the aortic branch 44.

Referring to fig. 4 and 5, another embodiment of the second bracket section 20 is shown, wherein fig. 5 is a schematic structural diagram of the skeleton in fig. 4; fig. 4 differs from fig. 3 in the connection manner of the bracket rings 21, and in the bracket rings 21 corresponding to fig. 4, the peaks of one bracket ring 21 and the valleys of the other bracket ring are disposed opposite to each other in the axial direction and connected.

The second carrier section 20 is formed by a plurality of support units connected in the axial direction; the adjacent stent rings 21 may be attached by, but not limited to, stitching, snap-fit, welding, or adhesive. Referring to fig. 4, when the peaks and valleys of adjacent stent rings 21 are connected, the large diameter side of the second stent section 20 is smoother without protrusions when the second stent section 20 is bent in compliance with the aortic arch 42, thereby eliminating the potential safety hazard of the second stent section 20 to the vessel wall. In order to further improve the potential safety hazard of the stent ring 21 to the inner wall of the blood vessel, the peaks and the troughs of the stent ring 21 are arc-shaped so as to further prevent the stent ring 21 from damaging the inner wall of the blood vessel.

As shown in fig. 4 and 5, the second stent section 20 is adaptively curved when implanted in the aortic arch, the skeleton of the second stent section 20 has dense regions 211 and sparse regions 212, the wave distribution of the dense regions 211 is dense to the wave distribution of the sparse regions 212, the dense regions 211 are located on the small curved side of the second stent section 20 when the second stent section 20 is curved, and the sparse regions 212 are located on the large curved side of the second stent section 20 when the second stent section is curved. It should be noted that, when the second stent section 20 is implanted in the aortic arch, the second stent section 20 is in a curved state, the implanted second stent section 20 is denser on the small curved side, the curved performance is ensured, and is sparser on the large curved side, so that the blood circulation with the branches is ensured. Thus, as shown in fig. 4 and 5, the scaffold of the second stent section 20 has dense regions 211 and sparse regions 212 to ensure dense and sparse sides of the small and large bends of the second stent section 20 after implantation.

The dense region 211 and the sparse region 212 are relative concepts, and the wave distribution density in the specific sparse region 212 and the wave distribution density of the sparse region 212 are determined according to actual use requirements, and fewer waves are set in the sparse region 212; the dense region 211 and the sparse region 212 on the second stent section 20 are opposed in the radial direction, the dense region 211 and the sparse region 212 each occupying an area of about 180 ° of the central angle of the framework of the second stent section 20.

In another alternative embodiment, the second stent section 20 is adaptively curved when implanted in the aortic arch, the skeleton of the second stent section 20 has dense areas 211 and flat areas, all the portions of the stent rings 21 located in the dense areas 211 are in the wave shape, all the portions of the stent rings 21 located in the flat areas are in the flat sections, the dense areas 211 are located on the small curved side when the second stent section 20 is in the curved shape, and the flat areas are located on the large curved side when the second stent section 20 is in the curved shape.

The straight section here means practically a wave structure which maintains the circular arc structure of the ring itself without undulation in the axial direction, and when the straight section is not provided with waves, the straight section of the holder ring 21 is substantially circular arc-shaped.

The framework of the second support section 20 is divided into a dense region 211 and a sparse region 212 or the dense region 211 and a flat region, on one hand, the connection strength and the supportability of the large bending side of the second support section 20 are considered, and when the second support section 20 is bent, the sparse region 212 and the flat region are arranged in a sparse wave mode or a wave-free mode, so that the second support section 20 is ensured to circulate with branched blood, simultaneously, the straightening force caused by the support of the support ring 21 on the large bending side can be reduced, the bending performance of the small bending side of the second support section 20 is effectively improved, and therefore, the second support section 20 can be fully compliant with the aortic arch shape to bend, and the aortic arch true cavity is well shaped.

The second stent section 20 is pre-curved such that the small and large curved sides of the second stent section 20 have folds that fit within the aortic arch to accommodate the fine-tuned curvature of the aortic arch. In another alternative embodiment of the second stent section 20, the difference from FIG. 5 is in the manner in which the dense areas 211 of adjacent stent rings are connected, wherein the dense areas 211 of adjacent stent rings are connected to each other in FIG. 5. In this embodiment, the bracket ring 21 is further configured to: in the two adjacent stent rings 21, the peak of one stent ring on the large curved side (i.e. the portion of the stent ring 21 on the sparse zone 212 or the flat zone) and the trough of the other stent ring on the large curved side (i.e. the portion of the stent ring 21 on the sparse zone 212 or the flat zone) are oppositely arranged and connected along the axial direction, the small curved sides (i.e. the dense zone 211) of the two adjacent stent rings 21 are arranged at intervals along the axial direction, and the small curved sides of the stent rings 21 are connected through a coating.

The sparse regions 212 or the flat regions of the adjacent two stent rings are connected, the dense regions 211 are not directly connected in the axial direction, so that the second stent section 20 has good plasticity, when the second stent section 20 is bent, the small bending side of the second stent section 20 is contracted, so that the adjacent annular stents 21 are mutually close in the dense regions 211, and as the annular stents 21 are arranged at intervals along the axial direction in the dense regions 211 and do not have a direct connection relationship, the annular stents 21 are not blocked in the process of mutually approaching the dense regions 211, can be mutually close, can maintain the bending state of the annular stents 21, ensure the plasticity of the annular stents 21 in the bending process, and can reduce the straightening force of the second stent section 20 in the bending process. The second support section 20 of this structure makes on the one hand in the big curved side of second support section 20, interconnect between the adjacent support ring, improves joint strength, and the bending deformation performance of the little curved side of the improvement second support section 20 of maximize simultaneously improves the adaptability of second support section 20.

On the basis of the above-mentioned connection structure, preferably, a coating film is attached to at least the outer wall of the small-bend side of the skeleton. Because the annular supports 21 on the small curved side are not connected, on one hand, the annular supports 21 are connected into a whole through the covering film, the overall consistency of the second support section 20 is improved, on the other hand, the covering film covers the outer wall on the small curved side, when the second support section 20 is positioned in the aortic arch 42, the annular supports 21 on the small curved side are mutually close, and at the moment, the covering film is isolated between the annular supports 21 and the aortic intima, so that the damage of the annular supports 21 to the aortic intima can be prevented.

In this embodiment, the first support section 10 and the second support section 20 may share an integral skeleton, or the first support section 10 and the second support section 20 are respectively provided with skeletons, and the two skeletons are in a split structure and are integrally connected by bonding, welding or the like, when the second support section 10 has a film, the first support section 10 and the second support section 20 may share an integral complete film. The artificial blood vessel segment 30 may be fixedly connected to the framework of the second support segment 20 by means of bonding, hot melting, etc., and the first support segment 10, the second support segment 20 and the artificial blood vessel segment 30 are of the prior art, and will not be described herein.

In summary, the aortic stent of the present invention comprises: a first stent section, a second stent section and an artificial blood vessel section connected in sequence from the distal end to the proximal end; at least one part of the outer wall of the second bracket section is a hollowed-out area, the hollowed-out area enables the inner cavity of the second bracket section to be communicated with branches, and the branches refer to three branches on an arch; the aortic stent is configured to: when the aortic stent is implanted into the aorta, the first stent section is positioned in the descending aorta, the second stent section is positioned in the aortic arch, and the artificial blood vessel section is positioned outside the broken ascending aorta and is used for being connected with an artificial blood vessel replaced by the ascending aorta.

So configured, the aortic stent is divided into three parts, wherein the first stent section is positioned in the descending aorta, the second stent section is positioned in the aortic arch, the artificial blood vessel section is positioned outside the severed ascending aorta and is used for being connected with an artificial blood vessel replaced by the ascending aorta, and the aortic stent can be used in cooperation with the replacement of the ascending aorta, so that the existing operation habit can not be changed, and the rapid ascending is facilitated. The aortic stent not only can realize the replacement of the ascending aorta, but also can treat the aortic arch and the descending aorta, has good supporting effect on the aortic arch, ensures that the blood supply of the branch vessels of the main artery is sufficient through the arrangement of the hollowed-out area, and has good shaping effect of the long-term true cavity on the other hand, and eliminates the hidden trouble of further expansion of residual interlayers of chest segments and even chest and abdomen segments.

In the present specification, each embodiment is described in a progressive manner, and each embodiment is mainly described in a different point from other embodiments, and identical and similar parts between the embodiments are all enough to refer to each other.

The above description is only illustrative of the preferred embodiments of the present invention and is not intended to limit the scope of the present invention, and any alterations and modifications made by those skilled in the art based on the above disclosure shall fall within the scope of the appended claims.

Claims

1. An aortic stent, comprising: a first stent section, a second stent section and an artificial blood vessel section connected in sequence from the distal end to the proximal end;

the first bracket section is a covered bracket;

The second support section is a covered support, at least one part of the outer wall of the second support section is a hollowed-out area, and the hollowed-out area enables the inner cavity of the second support section to be communicated with the branch;

the aortic stent is configured to: when the aortic stent is implanted into the aorta, the first stent section is positioned in the descending aorta, the second stent section is positioned in the aortic arch, and the artificial blood vessel section is positioned at the ascending aorta and is used for being connected with the blood vessel of the ascending aorta.

2. The aortic stent as claimed in claim 1, wherein the second stent section comprises a framework comprising a plurality of stent rings arranged in an axial direction, at least part of the stent rings having a wavy shape that undulates in the axial direction; the skeleton is configured to: in the two adjacent bracket rings, the wave crest of one bracket ring and the wave trough of the other bracket ring are oppositely arranged and connected along the axial direction.

3. The aortic stent as claimed in claim 2, wherein the second stent section further comprises a cover attached to an inner wall and/or an outer wall of the framework, the cover having a fenestration thereon to form the hollowed out area on the second stent section.

4. The aortic stent as claimed in claim 3, wherein the fenestration is configured to: the fenestration is located on a large curved side of the second bracket section when the second bracket section is curved.

5. The aortic stent as claimed in claim 2, wherein the second stent section is adapted to assume a curved shape when implanted in the aortic arch, the framework having dense and sparse regions, the dense region having a dense undulating distribution that is dense to the sparse region, the dense region being located on a lesser curved side of the second stent section when in the curved shape, and the sparse region being located on a greater curved side of the second stent section when in the curved shape.

6. The aortic stent as claimed in claim 2, wherein the second stent section is adapted to assume a curved shape when implanted in the aortic arch, the framework having a dense region and a flat region, all of the stent rings being in the waved shape at the dense region and all of the stent rings being in the flat region, the dense region being on the lesser curved side of the second stent section assuming the curved shape, and the flat region being on the greater curved side of the second stent section assuming the curved shape.

7. The aortic stent as claimed in claim 5 or 6, wherein two adjacent portions of the stent rings on the lesser curvature side are axially spaced apart.

8. The aortic stent as claimed in claim 7, wherein a coating is attached to an outer wall of the lesser curvature side of the framework.

9. The aortic stent as claimed in claim 1, wherein the first stent section is configured to: the distal end of the first stent section is provided with a reserved connection end which is used for being connected with an artificial blood vessel replaced by the descending aorta.

10. The aortic stent as claimed in claim 1, wherein the first stent section is longer than the artificial vessel section; and/or, the second stent section is longer than the artificial blood vessel section.