CN204133644U - Belt supporting frame artificial blood vessel - Google Patents
Belt supporting frame artificial blood vessel Download PDFInfo
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- CN204133644U CN204133644U CN201420462262.5U CN201420462262U CN204133644U CN 204133644 U CN204133644 U CN 204133644U CN 201420462262 U CN201420462262 U CN 201420462262U CN 204133644 U CN204133644 U CN 204133644U
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- blood vessel
- artificial blood
- supporting frame
- belt supporting
- aorta
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Abstract
This utility model provides a kind of belt supporting frame artificial blood vessel, comprise near-end artificial blood vessel and far-end artificial blood vessel, described far-end artificial blood vessel is the extension of near-end artificial blood vessel, and described far-end artificial blood vessel inner surface fixedly has " W " shape Ti-Ni alloy metal rack of some self-expanding functions.This utility model belt supporting frame artificial blood vessel makes 5 anastomotic stoma reduce to 2 anastomotic stoma, reduce aortic arch and rebuild the bleeding problems being difficult to cure that may cause, decrease cardiopulmonary bypass time, reduce operating time, improve success rate of operation, while minimizing blood, decrease the complication because massive transfusion causes.Make this cardiovascular surgery maximum, the most complicated operation becomes a common operation, is conducive to the extensively universal of this operation.
Description
Technical field
This utility model belongs to medical apparatus field, particularly relates to a kind of Novel belt stent-graft that can be used in cardiovascular surgery dissection of aorta clinical treatment.
Background technology
Dissection of aorta refers under the effect of interior external force, cause aortic tunica intima to be torn, and the blood in circulation enters between inner membrance and middle level, makes it to peel off, and forms dissection of aorta, also known as dissecting aneurysm of aorta.Primary disease sickness rate is for every 100,000 populations about 50 ~ 100 are routine every year, and how sharply falling ill, 65% ~ 75% patient died from the cardiovascular complication such as aorta rupture, cardiac tamponade, arrhythmia in 2 weeks.Male's sickness rate comparatively women is high, and the ratio of men and women is 2 ~ 3: 1.The patient of more than 80% dissection of aorta has hypertension, and many patients have aorta cystic medionecrosis.Hypertension not causes the reason of cystic medionecrosis, but can promote that it develops.But its cause of disease is not bright so far.
Involve scope according to cut position and interlayer, have two cover sorting techniques, be respectively DeBakey classification method, be i.e. DeBakey I, II, type III and Stanford classification method, be i.e. Stanford A type and Stanford Type B.The interlayer involving ascending aorta, aortic arch and/or descending aorta is called DeBakey I type, DeBakey I type interlayer onset is anxious, disease progression is violent, fall ill first in 24 hours, death per hour about 1%, as untreated, patient's interior death in 1 week of 50%, dead in the patient 2 weeks of 70%, dead in the patient of 90% 1 year.
Because the criticality of this disease of DeBakey I type dissection of aorta, the aortic rupture risk that may occur at any time, so once diagnosis, must treat timely and effectively.Therefore how to select a kind of safe and effective method to be the study hotspot in cardiovascular surgery field, be also the challenge to cardiovascular surgeon always.Nineteen eighty-three Borst takes the lead in adopting " trunk operation " treatment DeBakeyI type dissection of aorta; In recent years, along with the maturation of stent-graft technology, a kind of " hybridizing method " newly: ascending aorta displacement or Benta11 art+full aortic arch prosthetic vessel replacement+elephant trunk technique, by more employing, improve cure rate, reduce mortality rate.Fig. 1 is prior art stent-graft using state structural representation, part doctor adopts artificial blood vessel to do " soft trunk ", part doctor adopts belt supporting frame artificial blood vessel to do " hard trunk ", but all the artificial blood vessel as trunk is inserted left subclavian artery with in descending aorta far away, and the full aorta artificial vessel replacement of row need use three branch artificial blood vessels, its vascular anastomosis needed more (minimum need 5 anastomotic stoma, as Fig. 1 so).So that art formula is complicated, operating time, cardiopulmonary bypass time, whole body stop circulation and brain guard time long, nervous system and other complication more, especially postoperative hemorrhage is difficult to control sometimes, may cause the serious consequences such as death.Domestic and international lot of documents report adopts said method treatment DeBakey I type dissection of aorta, use the displacement of three branch artificial blood vessel row aorta bow portions, but because anastomotic stoma is more, operation technique is complicated, the complication such as hemorrhage and nervous system are more, not easily grasp, be unfavorable for popularizing, DeBakey I type dissection of aorta can be treated in the domestic cardiovascular diseases center only having minority larger now.Therefore how to improve the artificial blood vessel in operation process, thus simplify operation, being easy to universal, is the problem should considered in novel artificial blood vessel design process.
Utility model content
The purpose of this utility model is the defect solving the existence of above-mentioned prior art, provides one to simplify treatment, reduces the Novel belt stent-graft of operation risk.
A kind of belt supporting frame artificial blood vessel, comprise near-end artificial blood vessel and far-end artificial blood vessel, described far-end artificial blood vessel is the extension of near-end artificial blood vessel, and described far-end artificial blood vessel inner surface fixedly has " W " shape Ti-Ni alloy metal rack of some self-expanding functions.
Further, belt supporting frame artificial blood vessel as above, described " W " shape Ti-Ni alloy metal rack spacing is between any two 5mm.
Further, belt supporting frame artificial blood vessel as above, described near-end artificial blood vessel is artificial terylene blood vessel.
Further, belt supporting frame artificial blood vessel as above, described near-end artificial blood vessel partial-length is 5-10cm.
Further, belt supporting frame artificial blood vessel as above, described near-end artificial blood vessel partial-length is 5cm or 6cm or 7cm or 8cm or 9cm or 10cm.
Further, belt supporting frame artificial blood vessel as above, the length of described far-end artificial blood vessel is 10cm.
Further, belt supporting frame artificial blood vessel as above, the diameter of stent-graft is 24-30mm.
Further, belt supporting frame artificial blood vessel as above, the diameter of stent-graft is 24mm, 25mm, 26mm, 27mm, 28mm, 29mm, 30mm.
The belt supporting frame artificial blood vessel that this utility model provides, red at the therapeutic process of clinical DeBakey I type dissection of aorta, apply it and obviously can simplify traditional aortic arch reconstruction operations, do not need to rebuild aortic arch 3 branch vessel, 5 anastomotic stoma are made to reduce to 2 anastomotic stoma, reduce aortic arch and rebuild the bleeding problems being difficult to cure that may cause, decrease cardiopulmonary bypass time, reduce operating time, improve success rate of operation, while minimizing blood, decrease the complication because massive transfusion causes.Make this cardiovascular surgery maximum, the most complicated operation becomes a common operation, is conducive to the extensively universal of this operation.
Accompanying drawing explanation
Fig. 1 is prior art stent-graft using state structural representation;
Fig. 2 is this utility model belt supporting frame artificial blood vessel structure view;
Fig. 3 is this utility model belt supporting frame artificial blood vessel using state structural representation.
Detailed description of the invention
For making the purpose of this utility model, technical scheme and advantage clearly, below technical scheme in this utility model be clearly and completely described, obviously, described embodiment is this utility model part embodiment, instead of whole embodiments.Based on the embodiment in this utility model, those of ordinary skill in the art are not making the every other embodiment obtained under creative work prerequisite, all belong to the scope of this utility model protection.
Fig. 2 is this utility model belt supporting frame artificial blood vessel structure view, as shown in Figure 2, Novel belt stent-graft of the present utility model, comprise near-end artificial blood vessel 2 and far-end artificial blood vessel 1, described far-end artificial blood vessel 1 is the extension of near-end artificial blood vessel 2, and described far-end artificial blood vessel 1 inner surface fixedly has " W " shape Ti-Ni alloy metal rack 3 of some self-expanding functions.
Described near-end artificial blood vessel is artificial terylene blood vessel composition, and according to different needs, length can be 5cm, 6cm, 7cm, 8cm, 9cm, 10cm.
Particularly, because aortic arch three component length is between 5-10cm, this part aortic arch is covered as far as possible for making near-end artificial blood vessel, its length should be just passable more than three component aortic arch, and exceed and waste to some extent too much, so the artificial length of vessel design of this part is at 5-10cm.
Described its length 10cm of far-end artificial blood vessel, fixedly have multilamellar " W " the shape Ti-Ni alloy metal rack of self-expanding function at artificial blood vessel's inner surface, every layer of metal rack width is 7mm, and every two layers of metal rack distance A are 5mm (as shown in Figure 3).The length of far-end artificial blood vessel is 10cm, and this length is easy to operation, can reach good therapeutic effect.Long being unfavorable for inserts descending aorta, and covers too much intercostal arteries opening, easily occurs the complication such as bone marrow ischemia; The too short intimal tear being unfavorable for covering interlayer, supporting role is also less, is unfavorable for the expansion in the true chamber of interlayer.
The diameter of the Novel belt stent-graft that this utility model provides can need to be designed to 24mm or 25mm or 26mm or 27mm or 28mm or 29mm or 30mm according to difference.
Particularly, most patient's Ad, all within the scope of this, selects the belt supporting frame artificial blood vessel of different-diameter according to different patient's Ad in art.Diameter is too small, does not have supporting role, and artificial blood vessel and aortic tunica intima are fitted defective tightness, easily occur internal fistula; Diameter is excessive, may cause aorta overdistension, and interior film rupture forms new interlayer or aortic rupture.
When this utility model Novel belt stent-graft does not use, silk thread when namely not discharging, is adopted to be bundled in guiding steel wire and arc guide bracket; Extract silk thread out by guiding steel wire during use and can discharge self-expanding functional bands stent-graft.Multilamellar " W " the shape Ti-Ni alloy metal rack with self-expanding function can increase the supporting role of artificial blood vessel, increases the true chamber of aorta, reduces false chamber, promotes the healing of interlayer.Two layers of metal rack 5mm can make artificial blood vessel's compliance of this belt supporting frame better without holder part artificial blood vessel, more adapt to the aortal traveling of different patient, curvature and official jargon size.
The feature of Novel belt stent-graft is that when being not discharge, its far-end can be inserted since the true intracavity of DeBakey I type dissection of aorta patient descending aorta with self-expanding function metal base portion, after release, its support fully launches, utilize with the far-end artificial blood vessel of metal rack as trunk, expand true chamber, reduce false chamber; Near-end artificial blood vessel can be covered in aortic arch inwall after launching.Wipe out part artificial blood vessel by wedge shape and expose bow portion three bifurcated artery (left subclavian artery, left common carotid artery, innominate artery) opening, bow portion aorta inwall can be made to remove outside three bifurcated artery opening portions all covered by artificial blood vessel, be equivalent to the aortic arch displacement that island three branch vessel is built again.The branch that the treatment adopting this Novel belt stent-graft to carry out DeBakey I type dissection of aorta does not need to carry out aortic arch replaces the effect that just can reach full Aortic arch replacement, operation technique can be simplified, be easy to grasp, there is important clinical value.
Red at the therapeutic process of clinical DeBakey I type dissection of aorta, application Novel belt stent-graft obviously can simplify traditional aortic arch reconstruction operations, do not need to rebuild aortic arch 3 branch vessel, 5 anastomotic stoma are made to reduce to 2 anastomotic stoma, reduce aortic arch and rebuild the bleeding problems being difficult to cure that may cause, decrease cardiopulmonary bypass time, reduce operating time, improve success rate of operation, while minimizing blood, decrease the complication because massive transfusion causes.Make this cardiovascular surgery maximum, the most complicated operation becomes a common operation, is conducive to the extensively universal of this operation.
Embodiment 1
Patient's high ××, man, 40 years old, the emergency treatment in 4 hours of discontinuity abdominal part distending pain was admitted to hospital.Clinical diagnosis: Aortic Dissection (DeBakey I type), hypertension 3 grades (high dangerous group).Using modified type belt supporting frame artificial blood vessel row ascending aorta replacement+improvement aortic arch replacement+modified form belt supporting frame artificial blood vessel implantation under general anesthesia extracorporeal circulation after Preoperative Method.General anesthesia metasternum median incision in art, femoral artery and superior and inferior vena cava intubate, set up extracorporeal circulation and make a connection, and be separated tremulous pulse under aortic arch and innominate artery, left common carotid, left collarbone, cuff is for subsequent use.Left heart drainage-tube is inserted through right superior pulmonary vein.Cooling, clamping of aorta, cut ascending aorta through left and right coronary ostium perfusion myocardium protecting liquid, cardiac arrest, heart surface puts ice bits, prunes proximal part, and row " sandwich " reinforces near-end ascending aorta tube wall.Stop circulation during anus temperature drop to 25 DEG C, at the cross-section ascending aorta of the near-end of innominate artery, adopt bilateral selective cerebral perfusion to carry out brain protection by innominate artery and left common carotid.By cross-section ascending aorta, modified form belt supporting frame artificial blood vessel (diameter 28mm, distally holder part length 10cm, near-end artificial blood vessel length 9cm) inserted from the true intracavity of interlayer and discharges, support fully being launched, as trunk.The artificial blood vessel of belt supporting frame artificial blood vessel proximal part part (length 9cm) is launched to aortic arch side, wedge shape wipes out the artificial blood vessel of aortic arch three bifurcated artery (left subclavian artery, left common carotid artery, innominate artery) opening part, exposes left subclavian artery opening, left common carotid artery opening, innominate artery opening.Belt supporting frame proximal part artificial blood vessel wedge shape wipes out edge and above-mentioned brachiocephalic trunk blood vessel periphery aorta is sewed up, and artificial blood vessel's proximal part and the aorta broken ends of fractured bone " sandwich " are reinforced and sewed up.Such bow portion aorta inwall removing aorta brachiocephalic trunk openings in blood vessels part is almost all covered by artificial blood vessel, is equivalent to the aortic arch displacement that island three branch vessel is built again.Then ascending aorta is replaced.In art smoothly, post-operative recovery is good, and recovery from illness in postoperative 26th day is left hospital.
Embodiment 2
Patient Xue's ××, man, 69 years old, because of abdominal pain 4 days, increases the weight of emergency treatment in 1 day and is admitted to hospital.Diagnosis: Aortic Dissection (DeBakey I type), aortic incompetence.Using modified type belt supporting frame artificial blood vessel row aorta valved prosthesis art+ascending aorta replacement+improvement aortic arch replacement+modified form belt supporting frame artificial blood vessel implantation under general anesthesia extracorporeal circulation after Preoperative Method.General anesthesia metasternum median incision in art, femoral artery and superior and inferior vena cava intubate, set up extracorporeal circulation and make a connection, and be separated tremulous pulse under aortic arch and innominate artery, left common carotid, left collarbone, cuff is for subsequent use.Left heart drainage-tube is inserted through right superior pulmonary vein.Cooling, clamping of aorta, cut ascending aorta through left and right coronary ostium perfusion myocardium protecting liquid, cardiac arrest, heart surface puts ice bits, prunes proximal part, and row " sandwich " reinforces near-end ascending aorta tube wall.Stop circulation during anus temperature drop to 25 DEG C, at the cross-section ascending aorta of the near-end of innominate artery, adopt bilateral selective cerebral perfusion to carry out brain protection by innominate artery and left common carotid.By cross-section ascending aorta by modified form belt supporting frame artificial blood vessel (diameter 26mm, distally holder part length 10cm, near-end artificial blood vessel length 8cm) insert from the true intracavity of interlayer and discharge, the support of far-end artificial blood vessel is fully launched, as trunk.The artificial blood vessel of the far-end artificial blood vessel proximal part of belt supporting frame part (length 8cm) is launched to aortic arch side, wedge shape wipes out the artificial blood vessel of aortic arch three bifurcated artery (left subclavian artery, left common carotid artery, innominate artery) opening part, exposes left subclavian artery opening, left common carotid artery opening, innominate artery opening.Its proximal part wedge shape of the far-end artificial blood vessel of belt supporting frame wipes out edge and above-mentioned brachiocephalic trunk blood vessel periphery aorta is sewed up, and artificial blood vessel's proximal part and the aorta broken ends of fractured bone " sandwich " are reinforced and sewed up.Such bow portion aorta inwall removing aorta brachiocephalic trunk openings in blood vessels part is almost all covered by artificial blood vessel, is equivalent to the aortic arch displacement that island three branch vessel is built again.Then displacement ascending aorta is made.In art smoothly, post-operative recovery is good, and post-operative recovery is good, and recovery from illness in postoperative 25th day is left hospital.
Last it is noted that above embodiment is only in order to illustrate the technical solution of the utility model, be not intended to limit; Although be described in detail this utility model with reference to previous embodiment, those of ordinary skill in the art is to be understood that: it still can be modified to the technical scheme described in foregoing embodiments, or carries out equivalent replacement to wherein portion of techniques feature; And these amendments or replacement, do not make the essence of appropriate technical solution depart from the spirit and scope of each embodiment technical scheme of this utility model.
Claims (8)
1. a belt supporting frame artificial blood vessel, it is characterized in that, comprise near-end artificial blood vessel and far-end artificial blood vessel, described far-end artificial blood vessel is the extension of near-end artificial blood vessel, and described far-end artificial blood vessel inner surface fixedly has " W " shape Ti-Ni alloy metal rack of some self-expanding functions.
2. belt supporting frame artificial blood vessel according to claim 1, is characterized in that, described " W " shape Ti-Ni alloy metal rack spacing is between any two 5mm.
3. belt supporting frame artificial blood vessel according to claim 1, is characterized in that, described near-end artificial blood vessel is artificial terylene blood vessel.
4., according to the arbitrary described belt supporting frame artificial blood vessel of claim 1-3, it is characterized in that, described near-end artificial blood vessel partial-length is 5-10cm.
5. belt supporting frame artificial blood vessel according to claim 4, is characterized in that, described near-end artificial blood vessel partial-length is 5cm or 6cm or 7cm or 8cm or 9cm or 10cm.
6., according to the arbitrary described belt supporting frame artificial blood vessel of claim 1-3, it is characterized in that, the length of described far-end artificial blood vessel is 10cm.
7., according to the arbitrary described belt supporting frame artificial blood vessel of claim 1-3, it is characterized in that, the diameter of stent-graft is 24-30mm.
8. belt supporting frame artificial blood vessel according to claim 7, is characterized in that, the diameter of stent-graft is 24mm, 25mm, 26mm, 27mm, 28mm, 29mm, 30mm.
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| CN201420462262.5U CN204133644U (en) | 2014-08-18 | 2014-08-18 | Belt supporting frame artificial blood vessel |
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| CN201420462262.5U CN204133644U (en) | 2014-08-18 | 2014-08-18 | Belt supporting frame artificial blood vessel |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN105167880A (en) * | 2015-09-21 | 2015-12-23 | 郑俊猛 | Artificial blood vessel and covered stent connection mechanism for aortic operation |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN105167880A (en) * | 2015-09-21 | 2015-12-23 | 郑俊猛 | Artificial blood vessel and covered stent connection mechanism for aortic operation |
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