CN1225565A - 血管连接装置 - Google Patents
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Abstract
为了将第一血管(6)的端部连接到其直径最好大于第一血管(6)的第二血管(8)的侧面上,采用一个其一个端部(12,12′)可扩张成一个圆形端部法兰(15,15′)的套管(11,11′),因此,当第一血管(6)沿向着可扩张端部(12,12′)的方向穿过上述套管(11,11′)并至少折回到套在可扩张端部之后,便可形成一个凸缘(23),该凸缘(23)的两侧封住位于第二血管(8)内的圆形端部法兰(15,15′)并从内部包围第二血管(8)中形成的开口。
Description
本发明总的涉及血管外科手术领域,更具体地说,涉及一种在对冠状动脉进行分路手术时连接血管(尤其是主动脉)的装置。
各冠状动脉中血流阻力的增大可能危及对心肌的供氧。在某些情况下,可通过扩张血管来解决。但是,如果血管中的血流被完全阻塞或者部分地阻塞,那么就只有在阻塞部位设立旁路以防止发生无可挽回的伤害。这种设立旁路的手术通常是在阻塞区的后面连接一条新的血管,并将它与另一条血管(例如主动脉)相连接。这样就可对阻塞区后面的血管供给足够的血流量。
上述的设旁路的手术通常要求使用心-肺机,也就是说,要求心脏暂时不跳动,因为在连接例如相关的两条血管时,设旁路的手术要求心脏不可跳动。由于采用上述的连接技术并使用心-肺机,手术往往相当费时,并且不是没有危险的。
国际专利申请No.PCT/SE97/00804公开了一种分路装置,该装置在颇大程度上有利于将新血管连接到出现狭窄的冠状动脉上。但是,这种分路装置不适用于将新血管连接到例如主动脉上,主要是因为尺寸的差异。
因此,本发明的目的是提出一种将新血管连接到一条血管例如主动脉上的简单而可靠的连接方法,从而通过一条设在阻塞区后面的分路对阻塞的血管提供足够的血流量。所设计的连接方法应当最好可以不使用心-肺机。而且应当最好可以使用内窥镜进行手术。
按照本发明,采用具有本文所附权利要求1所规定的特征的连接装置可以达到上述目的。在相关的权利要求中,规定了本发明连接装置的最佳实施例。
因此,本发明的套管可以在第一血管的端部形成一个凸缘,该凸缘可以环绕第二血管上做出的开口的内部。结果,可在第一血管与第二血管之间的连接区中形成较大的搭接,故可使根血管极为牢固地互相连接起来。
在最佳实施例中,采用了一个用以扩张套管端部以便形成上述凸缘的气球。更确切地说,上述气球带有一根可穿过套管的引入管,故可将气球本身置于与可扩张的端部相邻接的位置上,以便通过充气使气球膨胀,与此同时使第一血管的端部形成一个凸缘。
为了在气球充气过程中固定气球的位置,以便使所产生的压力作用在套管的可扩张的端部上,上述的引入管最好用基本上无弹性的材料制成。
在本发明装置的最佳实施例中,上述气球除了紧靠引入管处具有一个非弹性部分之外,在扩张状态下,它的形状与所需的圆形端部法兰的形状(因此,也与上述凸缘的形状)相对应。这就更加保证了套管的可扩张端部可以以正确的方式形成正确的圆形法兰形状。
按照本发明,最好采用一种锁紧环来固定上述两根血管。所述锁紧环可以套在套管上并沿套管移动至靠近圆形法兰的位置,即靠近第一血管和位于锁环与第一血管之间的第二血管间互相搭接的部分的位置。借助于合适的固定机构(例如带有倒刺的钉,该机构可与锁紧环做成整体,并处于套管的轴向位置),可将第一血管和第二血管的与第一血管互相搭接的部分以简单而可靠的方式环绕第二血管中形成的开口互相连接起来。
整个套管(但最好只是可扩张的端部)用网状柔性材料制成为好,但是,其端部也可以做成在套管的一端开出多个轴向缝隙的形状。
下面参看附图较详细地说明本发明,附图中:
图1是一个心脏的透视图,简单地示出该心脏的两个分别对具有阻塞区的冠状动脉设的旁路;
图2是本发明连接装置的一个实施例及其相关部分最佳实施例的透视图;
图3和4是说明安装图2所示本发明装置的实施例的方法的透视图;
图5是端部扩张成圆形法兰的本发明套管的透视图;
图6a~c简单示出本发明的套管由血管封住时在该套管上形成一个端部法兰的程序;和
图7是图5所示套管的另一个实施例的透视图。
图1所示的心脏1含有两条分别带有狭窄或堵塞状的阻塞区4、5的冠状动脉2和3。图1示意地说明如何通过从患者本身选取两根血管6、7来在上述的阻塞区4、5设立旁路。更具体地说,血管6的一端连接在沿冠状动脉2血流的正常方向看位于阻塞区4的后面,其另一端与主动脉8相连接,这样,就可在阻塞区4之后面将含氧量足够的血供入到已阻塞的冠状动脉2中。同理,冠状动脉3也是这样。
为了将血管6连接到冠状动脉2上,可采用国际专利申请No.PCT/SE97/00804所述的分路装置。
本发明的连接装置涉及到血管6、7的另一端9、10与血管例如主动脉8的连接,从而在阻塞区4、5之后面将足够的血流量供入冠状动脉2、3中,以便供给足够的氧。
如图2所示,本发明的连接装置含有一个不会被人体组织排斥的金属或塑料套管11。该套管11的一端12带有多个轴向缝隙13和沿轴向伸出的中间肋14,除了上述端部12外,套管11是相当刚硬的。端部12的中间肋14也具有一定的刚性,但它们可从图2所示的轴向向外弯曲至径向,这一点在图5可清楚地看出。在肋14向外弯曲的状态下,构成一个圆形的径向端部法兰15,这在图5也可清楚地看出。
图7示出一个对图5的套管11的替代方案。它没有图2所示的缝隙13的肋14,它的套管11′至少在其端部12′是由例如张开状的网状柔性材料构成而形成套管11′的法兰15′,该法兰15′的外貌简单示于图7。
上述连接装置还含有一个气球16、一个锁紧环17和一个锁紧套筒18。图2还示出与端部9相邻的一部分第一血管6,更具体地说,图2所示的血管6的形状是这样的:其端部9首先沿向着套管端部12的方向穿过套管11,然后再折回来使其外部包在套管11之外面。
气球16用弹性材料制成,但其引入管19基本上是非弹性的。引入管19可在例如血管6以上述方式置于套管11上之后插入血管6中。气球16在引入管19附近还含有一个基本上是非弹性的部分20,其用途将在下面说明。
锁紧环17基本上是一个平面环圈,它带有多个从其平坦侧面沿相同方向伸出的轴向钉21,每个钉21具有一个或多个倒刺22,这就可保证一旦钉21穿过一种材料(在本实施例中是血管6和端部法兰15)之后可以固定在该材料中,这在下面将更详细地说明。
锁紧套筒18用来将折回并包在套管11上越过端部12的那一部分血管6可靠地固定在套管11上。更具体地说,锁紧套筒18设计成可以打开,并可侧向向内移动到套在折回并包在套管11之外面的那一部分血管6上,然后夹紧,从而将位于一部分血管6上的锁紧套筒18之内侧锁紧在套管11上。另外,锁紧套筒18也可以与锁紧环17做成整体。
下面参看图3和4说明用本发明的装置将血管6连接到主动脉8上的方法。
首先将血管6的端部9穿过套管11,再折回到端部12的上方且稍微超过一点。用锁紧套筒18将血管6的折回的部分固定在套管11上,将气球16的引入管19插入血管6中,再在血管6上从其与气球16相对的一端向内移动锁紧环17。
在主动脉8的壁上做出一个开口之后,将套上锁紧环17并由其锁住且内部带有气球16的带有血管6的套管11插入主动脉8中直到其端部12完全置入主动脉8内。然后通过引入管19使气球16充气,从而使气球16处于使肋14从它们呈轴向向外弯曲到大体为径向的位置。端部12的上述变形是永久性的,从而形成一个端部法兰15。事实上,引入管19是非弹性的,这就使它很容易使气球16以正确的方式将肋14推到其所需要的向外弯曲的位置。另外可通过气球上靠近引入管19的基本上为非弹性的部分20来保证由血管6形成的围绕端部法兰15四周的凸缘23的所需形状,也就是端部法兰15的形状。
当气球16充气时,套管11的形状便从图3所示的形状变成图4(以及图5)所示的形状。
图6a~6c更详细地示出套管形状的变化,图中示出了套管11和第一血管6的纵剖面,但为了简明起见,未示出气球16。
图6a示出初始位置,这时,第一血管6穿过套管11并且向着端部12部分地折回到套管11的端部上,并且锁紧环18夹紧与上述端部相邻接的第一血管的折回部分。
图6b示出套管11之端部12开始扩张后的状态。其中,在套管11内部的第一血管6紧紧地贴靠在端部12之内部,而后套管11外部的第一血管6则大体上在锁紧环18与端部12的自由端之间呈直线伸展,由于上述自由端与第一血管6之间没有固定,故可作相对移动,这是能够在第一血管6不受较大损伤的情况下对其进行扩张所必需的。
图6c示出套管11的端部12扩张后的最终状态。此时,第一血管6也紧靠在端部12之内部,但在套管11的外部,它不进入套管11与扩张后的端部12之间形成的拐角内。血管6与套管11外部靠近扩张端部12的部位之间形成的这种间隙有利于血管6与第二血管8之间必需的密封,因为这样会对第二血管8上形成的开口边缘的内侧施加压力。
为了最后将第一血管6固定在第二血管上,沿套管11之外部向着端部法兰15向下移动锁紧环17,与此同时,钉21至少穿透第二血管8的壁和折回到端部12上并构成凸缘23的一层的那一部分第一血管6的壁。由于钉21上有倒刺22,故可达到所需的锁紧。最好是也使钉21穿透端部法兰15和凸缘23的其他层,并向外与气球16相接触,但是,气球16是有弹性的,故不容易被钉21刺穿。
一旦血管6牢牢地连接到主动脉管8上,便可最后解除气球16中的压力,从而可借助引入管19通过血管6拉出气球16。
本行业专家会知道,在所附权利要求规定的本发明范围之内,上述连接装置的实施例可以有几种改型,例如,按照图5的端部法兰15的肋14形成的扇形也可以是将端部12的材料翻折成一个扇形而没有缝隙13。
Claims (11)
1.一种用于将第一血管(6)的一端连接到最好是其直径大于上述第一血管(6)的第二血管(8)的侧面上的装置,其特征在于,包括一个套管(11,11′),该套管的一个端部(12,12′)可扩张而形成一个圆形的端部法兰(15,15′),该法兰(15,15′)的两侧由上述第一血管(6)的端部封住而形成一个连接第二血管(8)的凸缘(23)。
2.根据权利要求1的装置,其特征在于,含有一个气球(16),该气球(16)设置在邻近可扩张的端部(12,12′)的位置上,并可在气球充气过程中使该端部扩张,形成上述的凸缘(23)。
3.根据权利要求2的装置,其特征在于,上述的气球(16)具有一个由基本上无弹性的材料制成的引入管(19)。
4.根据权利要求3的装置,其特征在于,上述的气球(16)具有一个基本上是非弹性的部分(20),该部分(20)紧靠着引入管(19),并在扩张状态下具有所需的凸缘(23)的形状。
5.根据权利要求1~4中任一项的装置,其特征在于,上述套管(11,11′)的端部(12,12′)由可永久变形的材料制成。
6.根据权利要求1~5中任一项的装置,其特征在于,含有一个内径大于套管(11,11′)的外径并具有轴向固定机构(21)的锁紧环(17),该锁紧环(17)可将凸缘(23)固定在第二血管(8)的内壁上。
7.根据权利要求6的装置,其特征在于,上述的固定机构(21)含有带倒剌(22)的钉(21)。
8.根据权利要求1~7中任一项的装置,其特征在于,含有一个夹紧装置(18),该夹紧装置(18)用来将第一血管(6)的一部分固定在套管(11,11′)的外部。
9.根据权利要求1~8中任一项的装置,其特征在于,上述套管(11′)的可扩张端部(12′)是用网状材料制成的。
10.根据权利要求9的装置,其特征在于,上述的套管(11,11′)用金属材料或者某种柔性材料制成。
11.根据权利要求1~8中任一项的装置,其特征在于,上述的套管(11,11′)的可扩张端部(12,12′)可向外折弯成扇形。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
SE9602849A SE509389C2 (sv) | 1996-07-24 | 1996-07-24 | Anordning för anslutning av änden av ett första blodkärl till sidan av ett andra blodkärl |
SE96028493 | 1996-07-24 |
Publications (1)
Publication Number | Publication Date |
---|---|
CN1225565A true CN1225565A (zh) | 1999-08-11 |
Family
ID=20403458
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CN97196603A Pending CN1225565A (zh) | 1996-07-24 | 1997-07-23 | 血管连接装置 |
Country Status (10)
Country | Link |
---|---|
US (1) | US6179848B1 (zh) |
EP (1) | EP0914063A1 (zh) |
JP (1) | JP2000515043A (zh) |
KR (1) | KR20000067980A (zh) |
CN (1) | CN1225565A (zh) |
AU (1) | AU3790497A (zh) |
BR (1) | BR9710365A (zh) |
CA (1) | CA2259650A1 (zh) |
SE (1) | SE509389C2 (zh) |
WO (1) | WO1998003118A1 (zh) |
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CN1301084C (zh) * | 2002-01-25 | 2007-02-21 | 爱尔伯电子医疗设备公司 | 用于在空心器官之间产生吻合的装置 |
CN102639067A (zh) * | 2009-07-14 | 2012-08-15 | 厄比电子医学有限责任公司 | 用于建立吻合的装置 |
CN102958467A (zh) * | 2010-06-25 | 2013-03-06 | 安东尼奥·桑布塞蒂 | 原位人造膀胱假体 |
CN104257441A (zh) * | 2014-10-17 | 2015-01-07 | 王洛 | 用于血管、肠管应急重建的套接组件 |
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-
1996
- 1996-07-24 SE SE9602849A patent/SE509389C2/sv not_active IP Right Cessation
-
1997
- 1997-07-23 CA CA002259650A patent/CA2259650A1/en not_active Abandoned
- 1997-07-23 CN CN97196603A patent/CN1225565A/zh active Pending
- 1997-07-23 JP JP10506868A patent/JP2000515043A/ja active Pending
- 1997-07-23 BR BR9710365A patent/BR9710365A/pt not_active IP Right Cessation
- 1997-07-23 AU AU37904/97A patent/AU3790497A/en not_active Abandoned
- 1997-07-23 EP EP97934831A patent/EP0914063A1/en not_active Withdrawn
- 1997-07-23 KR KR1019997000495A patent/KR20000067980A/ko not_active Application Discontinuation
- 1997-07-23 WO PCT/SE1997/001309 patent/WO1998003118A1/en not_active Application Discontinuation
-
1999
- 1999-01-12 US US09/228,749 patent/US6179848B1/en not_active Expired - Fee Related
Cited By (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN1301084C (zh) * | 2002-01-25 | 2007-02-21 | 爱尔伯电子医疗设备公司 | 用于在空心器官之间产生吻合的装置 |
CN102639067A (zh) * | 2009-07-14 | 2012-08-15 | 厄比电子医学有限责任公司 | 用于建立吻合的装置 |
CN102639067B (zh) * | 2009-07-14 | 2014-12-10 | 厄比电子医学有限责任公司 | 用于建立吻合的装置 |
CN102958467A (zh) * | 2010-06-25 | 2013-03-06 | 安东尼奥·桑布塞蒂 | 原位人造膀胱假体 |
CN102958467B (zh) * | 2010-06-25 | 2015-12-02 | 安东尼奥·桑布塞蒂 | 原位人造膀胱假体 |
CN104257441A (zh) * | 2014-10-17 | 2015-01-07 | 王洛 | 用于血管、肠管应急重建的套接组件 |
CN104257441B (zh) * | 2014-10-17 | 2016-03-23 | 王洛 | 用于血管、肠管应急重建的套接组件 |
Also Published As
Publication number | Publication date |
---|---|
US6179848B1 (en) | 2001-01-30 |
BR9710365A (pt) | 1999-08-17 |
KR20000067980A (ko) | 2000-11-25 |
SE509389C2 (sv) | 1999-01-18 |
WO1998003118A1 (en) | 1998-01-29 |
AU3790497A (en) | 1998-02-10 |
EP0914063A1 (en) | 1999-05-12 |
SE9602849L (sv) | 1998-01-25 |
SE9602849D0 (sv) | 1996-07-24 |
JP2000515043A (ja) | 2000-11-14 |
CA2259650A1 (en) | 1998-01-29 |
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