CN205729569U - Ink vessel transfusing implant - Google Patents
Ink vessel transfusing implant Download PDFInfo
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- CN205729569U CN205729569U CN201521119449.6U CN201521119449U CN205729569U CN 205729569 U CN205729569 U CN 205729569U CN 201521119449 U CN201521119449 U CN 201521119449U CN 205729569 U CN205729569 U CN 205729569U
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- circumferential openings
- implant
- graft
- extension
- ink vessel
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2/07—Stent-grafts
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/954—Instruments specially adapted for placement or removal of stents or stent-grafts for placing stents or stent-grafts in a bifurcation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2002/061—Blood vessels provided with means for allowing access to secondary lumens
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2002/065—Y-shaped blood vessels
- A61F2002/067—Y-shaped blood vessels modular
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0004—Rounded shapes, e.g. with rounded corners
- A61F2230/0008—Rounded shapes, e.g. with rounded corners elliptical or oval
Abstract
This utility model relates to a kind of Ink vessel transfusing implant.Comprising: along the Part I of vertical axis extension, described Part I includes graft material, graft material limits the graft the most in a tubular form extending to Part I exit opening from Part I entrance opening, and Part I includes that the first circumferential openings being formed in the peripheral surface of described graft the most in a tubular form is to allow described first circumferential openings to connect with the entrance and exit of described Part I；Part II along vertical axis extension, described Part II includes graft material, graft material limits the Part II entrance opening of torso portion, it is along described vertical axis extension to the forked section with Liang Ge branch, Liang Ge branch has respective branch outlet opening, and Part II has the second circumferential openings keeping component and two intervals being formed through the peripheral surface of described torso portion to separate linking to described entrance opening via cuff structure.
Description
Technical field
This utility model relates to a kind of Ink vessel transfusing implant.
Background technology
Aneurysm is one layer or the abnormal dilatation of multilamellar arterial wall, it is common that fault of construction caused by the hardening of arterial wall or, the other system defect such as such as dissection of aorta caused by hypertension causes.The method of the aneurysm (that is, " abdominal aortic aneurysm " or " AAA ") in universally recognized treatment ventral aorta is by surgical repair, relates to replacing aneurysm section with prosthetics.This operation is a big invention, but along with excessive risk and high mortality and sickness rate.
Typical AAA surgical repair enters aorta by abdominal incision with permission internist and performs.Once can enter aorta, aorta can be clamped to allow surgeon to open aorta and in the one end sewing up graft at heart.The other end of graft is being seamed to aorta through aneurysmal position.This allows blood to walk around the weak area flowing of aorta from heart.
One replacement scheme of surgical repair is to use endovascular treatment, is i.e. used for treating aneurysm, especially for the catheter directed technology of AAA.The exploitation of intravascular stent promotes endovascular treatment, intravascular stent can and already in connection with standard or thin-walled graft material use, in order to form stent graft or interior graft.The potential advantages of minimally-invasive treatment include reducing operation M & M and shortening is in hospital and the intensive care unit time of staying.
In use AAA, one of graft (or interior prosthese) has a problem in that: in great majority (if not all) AAA, prosthese is configured to AAA is rendered as kidney mo(u)ld bottom half AAA.Typically present the enough touch-down zones for graft under kidney, thus realize the tight seal between inner surface and the outer surface of interior prosthese of the blood vessel wall of aorta.Wherein, the distance (that is, " neck length ") between renal artery and aneurysm is less than 15 mm, generally believes and uses the interior prosthese being designed for presenting under kidney may cause complication.Thus, in the presenting of the neck length less than 15 mm, for nearly kidney type AAA, other type AAA(of kidney or the situation of kidney mo(u)ld top half AAA, in generally believing the existing AAA of use, prosthese will cause complication.
Others skilled in the art have attempted to overcome the defect of prosthese in existing AAA by the technology utilizing referred in the art as " windowing technology ".This technology depends on home built customization and windows, so that kidney and superior mesenteric artery are incorporated in nearly kidney type AAA to the interior prosthese this customized of kidney mo(u)ld top half AAA.In an aspect of windowing technology, internist can carry out opening with hands to ready-made AAA implant or window.The defect of the amended implant of windowing of internist is: implant is permitted without FDA, it is therefore desirable to internist applies for that supervision is exempted；And internist may spend several hours and make this implant of windowing.In order to reduce these defects, manufacturer has been provided for the customization of aneurysmal imaging based on the 6-12 week before predetermined implantation and windows implant.But, a defect of this technology is: the anatomical structure of renal artery uniqueness may make customization implant lose efficacy.For example, it may be possible to relate to extra renal artery or Hepatic artery, and upwardly-directed renal artery.It addition, implant customized typically requires the long period time, within this long period time, the anatomical structure of AAA may significantly change, thus causes bifurcated artery not to be directed at windowing.Although internist can implant the known implant of amendment on the same day (to avoid problem time lag of the customization implant mentioned before), but the customization caused due to the angulation of anatomical structure is windowed from the skew with the ideal alignment of bifurcated artery, therefore, this internist revise implant (and customization implant) may be the most undesirable.
Summary of the invention
Therefore, we have been designed that prosthese in a kind of implanted, the shortcoming during prosthese overcomes customization windowing in this implanted so that internist made customization implant by hand without several hours before transplant operation.Further, this utility model overcomes the problem that may change during customized implant and actual implantation with the anatomical structure being associated in several weeks in advance before actual AAA operation or aneurysm by the implant of Order creation.In short, this utility model provides three kinds of key improvements: (1) is easy for simplifying and disposes one and window every time；(2) each opening is directed in situ with intended branch tremulous pulse, thus causes the clinical effectiveness of improvement；And (3) are because the various piece of interior prosthese is less, and it is only required to an extra guidewire lumen, so the overall profile of this interior prosthese ultralow (that is, less than the 16French of bigger autologous tremulous pulse, and in most of the cases less than 12French).
Especially, prosthese in we have been devised by a kind of implanted including two major parts.Part I includes graft material, and this graft material limits the graft the most in a tubular form extending to Part I exit opening from Part I entrance opening.Part I includes that the first circumferential openings being formed in the peripheral surface of graft the most in a tubular form is to allow the first circumferential openings to connect with the entrance and exit of Part I.Part II is along vertical axis extension.Part II includes graft material, and this graft material limits the Part II entrance opening of torso portion, and this torso portion is along vertical axis extension to having the forked section of Liang Ge branch, and the two branch has corresponding branch outlet opening.Part II has the circumferential openings keeping component and two intervals through the peripheral surface formation of torso portion to separate linking to entrance opening via cuff structure, to allow the circumferential openings of the Part II separated to connect with trunk entrance and branch outlet, so that the radially aligned permission of the first circumferential openings and the second circumferential openings is by the first circumferential openings and the fluid communication of the second circumferential openings.
In addition to embodiment described above, other features being set forth below can be used in combination with.Such as, each in Part I and Part II includes multiple support hoop, the plurality of support hoop is spaced apart along longitudinal axis line and is attached to graft material to limit stent graft compound implant, each support hoop has the sinusoidal configuration arranged around longitudinal axis line, and wherein summit separates along longitudinal axis line；One summit of one support hoop is arranged between two summits of another support hoop；Graft the most in a tubular form includes material, and described material is selected from such group, and described group is made up of nylon, ePTFE, PTFE, terylene and combinations thereof；Multiple support hoops are arranged in the circumferential interior surface of stent graft；First circumferential openings around being formed through graft material of longitudinal axis line of the Part I close to the first end, thus, when the first implant is deployed in abdomen tremulous pulse together with the second implant so that the first circumferential openings connects with Mesenteric artery；Second circumferential openings is formed around the longitudinal axis line of Part I through graft material, thus, when implant is deployed in abdomen tremulous pulse, make the second circumferential openings and a pair circumferential openings (i.e., opening 104+128 or 106+130) connect with renal artery, thus allow from renal artery to the fluid communication of the second circumferential openings；3rd circumferential openings is formed around the longitudinal axis line of Part II through graft material, thus, when being deployed in abdomen tremulous pulse by implant, the 3rd circumferential openings connects with another renal artery, to allow from renal artery to the fluid communication of the 3rd circumferential openings；Part I can radially adjust about Part II, so that the first circumferential openings over the first portion is directed at substantially with the first circumferential openings on the second portion；Arterial bracket graft extension has the graft material generally constructed in a tubular form, the most generally circular opening is at one end, generally circular opening is tapered towards the extension opening that less second close to the other end is generally circular, and arterial bracket graft extension is configured for insertion at least one circumferential openings in the circumferential openings of Part I and Part II;At least one support hoop is expansible to support arterial bracket graft；Or provide stent graft tubular protrusions, for inserting each in Liang Ge branch so that fluid is passed Part II and Part III from the first opening of Part I and flow to respective branch and flowed out by each extension.
Accompanying drawing explanation
Above and other feature and advantage of the present utility model will become obvious, as shown in drawings by following to the more particularly description of preferred embodiment of the present utility model.
Fig. 1 shows the first major part 108 and the second major part 108 of implant 100；
Figure 1A shows the close-up view via the circumferential openings 104 being particularly configured for graft part 103 such that it is able to expand to match with actual branch tremulous pulse when making opening 104 in position；
Fig. 2 shows the limb extension of the branch for torso portion 108；
Fig. 3 shows the arterial graft extension of the circumferential openings 104 and 130 for implant 100；
Fig. 4 A shows the perspective view of two parts 102 and 108 in the AAA showing as nearly kidney type AAA；
Fig. 4 B shows the perspective view of the another kind of modification of the implant 100 being expressed as 100 ', and wherein, multiple Part I 102 may be used for kidney mo(u)ld top half AAA；
Fig. 5 to Fig. 7 shows and is expressed as 100 ' ' the perspective view of another kind of modification of implant 100, wherein, fan-shaped Part I 102 ' ' can be with main portion 108 ' ' it is used together；
Fig. 7 A and Fig. 7 B shows the delivery apparatus for implant described herein；
Accompanying drawing is incorporated herein and constitutes the part of this specification, it illustrates presently preferred embodiment of the present utility model, and it is used for illustrating feature of the present utility model (wherein, identical reference represent identical key element) together with above-mentioned general introduction and detailed description below.
Detailed description of the invention
Detailed description below should be read with reference to the drawings, and wherein, in different drawings, similar or identical key element carrys out labelling by identical numeral.These accompanying drawings are not drawn necessarily to scale, and depict selected embodiment, it is not intended that limit scope of the present utility model.These specific descriptions show principle of the present utility model by way of example rather than in a restricted way.This description can clearly enable those skilled in the art to make and use this utility model, and describe various embodiments of the present utility model, change, modification, substitute and use, including being presently believed to be enforcement best mode of the present utility model.
As used in this article, show to allow the part of parts or some suitable dimension tolerances being used as to be intended to purpose as described in this article for any number or the term " about " of scope or " approximation ".More specifically, " about " or " approximation " can refer to values listed ± the value scope of 50%, such as, " about 50% " can refer to the value scope from 51% to 99%.In addition, term " patient ", " host ", " user " and " main body " refers to any mankind or animal subject as used in this article, but it is not intended as this system or method is confined to for the mankind, although this utility model use in human patients represents preferred embodiment.In this application, term " cranium side " or the relative position or the direction that use for indicating the individual relative to receiving implant of " caudal ".When applying " cranium side ", this term indicates the position closer to heart or direction；And term " caudal " indicates position or the direction of the heart further from this main body.
Fig. 1 shows the first embodiment of interior prosthetic implants 100, and the limb extension during this interior prosthetic implants 100 can be performed the operation with the EVAR at the AAA in addition to kidney mo(u)ld bottom half AAA is used together.In other words, implant 100 may be used for being categorized as because of its particular configuration in the AAA of nearly kidney type AAA, other type AAA of kidney or kidney mo(u)ld top half AAA.Especially, as it is shown in figure 1, (implant 100) Part I 102 is configured to extend along longitudinal axis L-L.Part I 102 can be made up of suitable bio-compatible graft material 102a, and such as, material, described material is selected from such group, and described group is made up of nylon, ePTFE, PTFE, terylene and combinations thereof.
Graft material 102a of Part I 102 limits graft 103 the most in a tubular form, and it extends to Part I exit opening 102c from Part I entrance opening 102b.Part I 102 includes the first circumferential openings 104, this first circumferential openings 104 is formed in the peripheral surface of graft 103 the most in a tubular form (and through peripheral surface of graft 103 the most in a tubular form), thus allows the first circumferential openings 104 to connect with the entrance 102b and outlet 102c of Part I 102.
Implant 100 also includes Part II 108.Part II 108 extends along longitudinal axis L-L and can include graft material 108a, and this graft material 108a can be selected from the suitable bio-compatible material as mentioned about the material 102a of Part I 102 before.Graft material 108a, by its design structure, limits the Part II entrance opening 110 of torso portion 112, and torso portion 112 extends to forked section 114 along longitudinal axis L-L.Forked section 114 has Liang Ge branch 116,118, and the two branch 116,118 has respective branch outlet opening 120,122.It should be noted that Part II 108 has holding component 124, this holding component 124 is designed as (via support or cuff structure 126) and is attached to entrance opening 110.Similar to Part I 102, the circumferential openings 128,130 that two intervals separate is formed through the peripheral surface of torso portion 112.This allows circumferential openings 128,130 of separating of (Part II 108) interval to connect with trunk entrance 110 and branch outlet 120,122, thus realizes radially aligned about (Part II 108) second circumferential openings 128,130 of (Part I 102) first circumferential openings 104.In other words, two parts (102 and 108) allow to pass through the first circumferential openings 104 of Part I 102 and the fluid communication of the second circumferential openings 128 of Part II 108 from the entrance 102b of Part I 102 along constructing of its corresponding circumferential openings (104,106,128 and 130).
In an exemplary application, as shown in Figure 4 A, second circumferential openings 106 is formed around the longitudinal axis L-L of Part I 102 through graft material 102a of Part I 102, thus, when implant 100 is deployed in abdomen tremulous pulse, the corresponding circumferential openings 104 and 106 of Part I 102 second circumferential openings 128,130 alignment corresponding to Part II 108 and a pair circumferential openings (being for a pair 104+128, another is to for 106+130) connect with renal artery.
Can see from Fig. 4 B such as a kind of modification of the 100 ' implants 100 represented.In figure 4b, implant 100 ' is constructed so that, and first circumferential openings (104) of Part I is formed around the longitudinal axis (L-L) of the Part I (102) close to the first end (102b) through graft material (102a), thus, when being deployed in abdomen tremulous pulse together with the second implant by the first implant, the first circumferential openings (104) connects with Mesenteric artery.
In another embodiment, as shown in Figure 5 and Figure 6, the first circumferential openings 106 of Part I 102 is it is so structured that from the weld access hole 132 of the circumferentially extending exit opening 102c to Part I 102 of Part I 102.In other words, perforate 132 has three sides rather than four sides, as the embodiment of Fig. 1.
Reference Fig. 3, arterial bracket graft extension (or bridge joint support, as known in the art) 424 may be used for inserting in circumferential openings 104 and 130, such that it is able to make side tremulous pulse be incorporated in the flowing of implant.Extension 424 has suitable bio-compatible graft material 424a similar to the graft material of previously mentioned main portion.Extension 424 be configured to generally the most in a tubular form flow through structure.In one embodiment, at extension 424 at one end 425a, there is the opening 424b being generally circular in shape.Extension 424 is tapered towards less extension the second opening 424c being generally circular in shape close to other end 425b from the first end 425a.Arterial bracket graft extension 424 is configured for insertion at least one circumferential openings in the circumferential openings of Part I and Part II, wherein at the often end in 425a and 425b of end, it is provided with keeper, remains to the major part of implant or blood vessel with the portion of will extend over.
When each part in the first and second parts 102 and 108 or limb extension 130 need self supporting structure, multiple support hoops can be attached to the graft material of implant.Especially, each of which in Part I and Part II 102,108 can have multiple support hoop 109, and the plurality of support hoop 109 is spaced apart along longitudinal axis L-L and is attached to graft material to limit preferred compound implant.It should be noted that each support hoop 109 has the sinusoidal configuration arranged around longitudinal axis L-L, wherein summit separates along longitudinal axis L-L.In order to allow thin contour before deployment, i.e., bigger in some cases at autologous tremulous pulse less than 12French(, implant disposes profile in advance can be less than 16French), support hoop is designed as by we: a summit of a support hoop is arranged between two summits of another support hoop, as shown in the example of figure 1.
In a preferred embodiment, multiple support hoops 109 are arranged in the circumferential inner surface of stent graft Part I 102 and stent graft Part II 108.Similarly, tremulous pulse extension can have expansible to support at least one support hoop 426 of arterial bracket graft 424a.Alternatively, support hoop 426 can be the multiple single support hoop being connected to each other via the graft material for extension 424.As used in this article, term " individually " meaning about support hoop is that support hoop is not connected with the adapter being made up of the material identical with support hoop, but connects via different materials.In the embodiment shown in fig. 3, support hoop 426 is the support that cut is got off from tubing.Preferably, window or circumferential openings is arranged in the open space between the longitudinally spaced sinusoidal support hoop separated.It should be noted that support hoop is preferably sinusoidal (Fig. 1 and Fig. 5), but be not necessarily sinusoidal, and therefore may be irregular zigzag structure (Fig. 2 and Fig. 3).
By our design, we can explain the modification in biological anatomical structure, and at biological anatomical structure, renal artery orients relative to the ventral aorta being connected to heart, keeps the excellent sealing between arterial wall and the main torso portion of implant simultaneously.In other words, main torso portion 108 can be disposed, then Part I 102 can be disposed, thus, by junction point (being expressed as being tightly connected a SJ with the broken circle in Figure 4 A) place being connected with renal artery interface at aneurysm wall (" AW " in Fig. 4 A), main torso portion 108 is attached to Part I 102 and forms the sealing being considered good.In the case of AAA is shown as kidney mo(u)ld top half AAA as shown in Figure 4 B, it is believed that be owing to main portion 108 and the first tubular portion 102 define and are tightly connected a SJ to the connection of main abdomen arterial wall, as shown in Figure 4 B.
With reference to Fig. 1, visible Part I 102 can radially adjust (as shown in R1) or radially adjust (as shown in R2), so that the first circumferential openings 104 on Part I 102 can be directed at circumferential openings 128 on the second portion about Part II 108 about longitudinal axis L-L.The orientation of circumferential openings can be determined, such as, such as, via the fluoroscopic imaging systems using the radiopaque labelling being attached to the first and second implant parts by using suitable imaging technique.Although the orientation of opening 104 can be any orientation, but it is typically the situation that (Part I 102) first circumferential openings 104 is directed at substantially with the second circumferential openings 128 on Part II 108.Once the circumferential openings in appropriate section is directed at and inserts in these circumferential openings by tremulous pulse extension 424, provide for tubular stent graft extension 130, for being inserted in each in Liang Ge branch 116,118, thus allow fluid can flow out through Part II 108 to the corresponding branch of implant 116,118 and by each tubular stent graft extension 130 from the entrance opening 102b of Part I 102.
Although it should be noted that circumferential openings is shown as the circular open being formed on the circumference of implant, but other shapes and structure can be utilized in the range of this utility model.Such as, circumferential openings can be as cone circumferential openings extend outwardly away from longitudinal axis and towards the shape of the tapered truncated cones of small radii.Alternatively, spine or holding rib can be arranged on the circumference of this tapered circular cone, to allow rib or spine in the case of not using bridge joint stent graft 424 this tapered cone circumferential openings to be maintained in the inner surface of bifurcated artery.
Circumferential openings or window can be configured with threading at the 107(Figure 1A that windows) circumference on stitching thread 500 to provide initial little opening.The extra length 502 of stitching thread 500 can be arranged on the end of stitching thread 500 to provide be building up in stitching thread to relax, thus, when opening 104 expands, lax 502 in stitching thread allow expansion of windowing, in order to make the side bifurcated artery of different-diameter and 107 mate with windowing.Stitching thread 500 can be configured with the predetermined relaxed length 502 of eyelet 504, to prevent the excessive expansion of circumferential openings 104.In addition to stitching thread 500, it is also possible at the reinforcement of the another type suture form provided circumferentially about of circumferential openings 104.Radiopaque labelling can be arranged on the circumference of circumferential openings 104 (or interweave with stitching thread 500 in), the actual size visualization of 107 so that internist can make to window.Imported to the suitable intumescent balloon catheter windowed via seal wire GW2 by insertion, circumferential openings (in autologous tremulous pulse) can expand into intended size (Fig. 7 B) in situ.When arrival is windowed, when being monitored via the labelling windowed, air bag can gradually expand.
With reference to Fig. 7 A, show delivery apparatus 600 in the perspective, in order to a part for the handle 602 of the person that succinctly shows Proximity operation is handled for by operator.It should be noted that distal portions 603 is provided with epitheca 604, in pipe 606 of windowing allows while being imported by the first seal wire GW1, sheath 608 passes.Pipe 606 of windowing allows also to install implant (Part I or Part II) in this wise, the circumferential openings making implant can be fixed to pipe 606 of windowing so that rotating of pipe 606 of windowing allows the circumferential openings of graft implant to be directed at desired bifurcated artery.For the unique aspect of the pipe that illustrates to window, it is the enlarged perspective of the far-end of delivery apparatus 600 with reference to Fig. 7 B, Fig. 7 B.
In figure 7b, epitheca 604 surrounds the outer surface of graft 102, and the inner surface of graft 102 generally surrounds window pipe or the outer surface of sheath 606.Sheath 606 of windowing is generally parallel with the outer surface of the interior sheath 608 that can pass epitheca 604.In order to ensure being properly aligned with of circumferential openings 107 of implant 102, pipe 606 of windowing is provided with block 612 of windowing, and circumferential openings 107 coordinates is windowing on block 612 so that implant radial compression always is in its pre-delivery profile.Here it should be noted, although show the example (adjoint bigger outer dia does not meets the inner surface of abdomen tremulous pulse) of implant in Fig. 1 to Fig. 7 with bigger deployment profile, the implant in its pre-delivery profile is compressed in the medium to small constraint profile much of sheath 604 (have little to 14French or less less outer dia).
As it is well known in the art, by the interior sheath 608 following the first seal wire GW1, stent graft implant (such as, implant 102) is moved adjacent to aneurysmal desired locations.Once implant 102 has arrived at close to desired locations, epitheca 604 can retract (or being pulled out from sheath 604 by implant) to expose block 612 of windowing.This allows the second seal wire GW2 to pull out from block 612 via the inner chamber that in pipe 606, (or being building up in another inner chamber in interior sheath 608) is arranged of windowing.At suitable bootstrap technique (such as, fluoroscopy) under, second seal wire GW2 is handled, so that seal wire GW2 can enter in arterial branch (such as, renal artery RN1 or RN2 in Fig. 6) by (via pipe 606 of windowing around the translation of its longitudinal axis L-L or rotation).Second seal wire GW2 is inserted in arterial branch and ensures that circumferential openings (such as, 107) is fully mated with arterial branch.If desired, the second seal wire may be used for inserting tremulous pulse extension or bridge joint support.Subsequently, other implant parts can be inserted into desired locations along the first seal wire GW1, and be deployed to make other implant parts be attached to the first implant part.
For disposing the similar handle of AAA graft and the details of program the operation instructions of InCraft AAA implant (can buy from Europe) will illustrate and describe, the operation instructions of described InCraft AAA implant illustrate a kind of InCraft AAA stent graft system, it is the Endovascular stent-graft system for treating kidney mo(u)ld bottom half abdominal aortic aneurysm, and this description it also illustrates the specific configuration of InCraft AAA stent graft system, uses and prepare explanation.In the case of performance AAA in addition to kidney mo(u)ld bottom half AAA, for dispose delivery apparatus can via shown in U.S. Patent number US8771333, U.S. Patent Application Publication No. US20070156224 and US20130085562 and describe device, these patents are incorporated herein the most by way of reference.It should be noted that, the example provided is originally for AAA, such as, in aneurysm of thoracic aorta or TAA, in the case of the angle of tremulous pulse may cause and is difficult between tremulous pulse and graft form tight seal, it is also possible to utilize the application of other artery positions with bifurcated artery.
All support hoops described herein are substantially tubular element, and these elements can utilize any amount of technology and any amount of material to be formed.In preferred exemplary embodiment, all of support hoop is formed by Nitinol (Nitinol), setting cut tubing.
For cover support hoop graft material can by any amount of suitable biocompatible material (include being formed polyester, politef, silicones, polyurethane rubber and the braiding of Ultralight polyethylene, knitting, sew up, extrude or founding materials, such as, can be at trade names SPECTRADACRONPET type polymer.
As it has been described above, graft material is attached to each support hoop.Graft material can be attached to support hoop by any amount of appropriate ways.In the exemplary embodiment, graft material is attached to support hoop by stitching thread.
According to support hoop position, it is possible to use different types of stitching thread is tied.Details for each embodiment of the stitching thread knot of stitching thread can be in U.S. Patent Application Publication No. US20110071614 of JIUYUE in 2009 submission on the 24th to find, it is incorporated herein by way of reference.
Although this utility model being described in terms of illustrating accompanying drawing in particular variant, but those of ordinary skill in the art should be understood that this utility model is not limited to described modification or accompanying drawing.Such as, although example is shown as AAA, but these implants can be used for perhaps without the aneurysm of thoracic aorta (TTA) keeping barb used in TAA.It addition, in the case of some event that said method and step instruction occur in certain sequence, those skilled in the art should be understood that and can modify the sequence of some step, and these amendments should be according to modification of the present utility model.Additionally, if it is possible, some step can be carried out in parallel procedure simultaneously, and carry out the most in order.Therefore, in the scope of the disclosure or be equal in the degree of this utility model modification of the present utility model that finds in detail in the claims, it is intended that this patent is likewise covered by these modification.
Claims (12)
1. an Ink vessel transfusing implant, it is characterised in that comprising:
Part I along vertical axis extension, described Part I includes graft material, described graft material limits the graft the most in a tubular form extending to Part I exit opening from Part I entrance opening, and described Part I includes that the first circumferential openings being formed in the peripheral surface of described graft the most in a tubular form is to allow described first circumferential openings to connect with the entrance and exit of described Part I；
Part II along described vertical axis extension, described Part II includes graft material, described graft material limits the Part II entrance opening of torso portion, it is along described vertical axis extension to the forked section with Liang Ge branch, said two branch has respective branch outlet opening, described Part II has the second circumferential openings keeping component and two intervals being formed through the peripheral surface of described torso portion to separate linking to described entrance opening via cuff structure, connect with described trunk entrance and branch outlet with the circumferential openings of Part II allowing described interval to separate, make the radially aligned permission with described second circumferential openings of described first circumferential openings through described first circumferential openings and the fluid communication of described second circumferential openings.
Ink vessel transfusing implant the most according to claim 1, wherein, described first circumferential openings includes weld access hole, and described weld access hole is from the described exit opening of circumferentially extending to the described Part I of described Part I.
Ink vessel transfusing implant the most according to claim 1, wherein, each of which in described Part I and Part II includes multiple support hoop, the plurality of support hoop separates along described longitudinal axis and is attached to graft material to limit compound implant, each described support hoop has the sinusoidal configuration arranged around described longitudinal axis, and wherein summit separates along described longitudinal axis.
Ink vessel transfusing implant the most according to claim 3, wherein, a summit of a support hoop is arranged between two summits of another support hoop.
Ink vessel transfusing implant the most according to claim 3, wherein, described graft the most in a tubular form includes material, and described material is selected from such group, and described group is made up of nylon, ePTFE, PTFE, terylene and combinations thereof.
The most according to claim 3, Ink vessel transfusing implant, wherein, the plurality of support hoop is arranged in the circumferential interior surface of described stent graft.
Ink vessel transfusing implant the most according to claim 3, wherein, described first circumferential openings of described Part I is formed around the described longitudinal axis of the described Part I close to the first end through described graft material, thus, when being deployed in abdomen tremulous pulse together with the second implant by the first implant, described first circumferential openings connects with Mesenteric artery.
Ink vessel transfusing implant the most according to claim 7, wherein, second circumferential openings is formed around the described longitudinal axis of described Part I through the described graft material of described Part I, thus, when being deployed in described abdomen tremulous pulse by described implant, described first circumferential openings of described Part I connects with renal artery with described second circumferential openings alignment and a pair circumferential openings of described Part II.
Ink vessel transfusing implant the most according to claim 8, wherein, described Part I can radially adjust relative to described Part II, so that described first circumferential openings on described Part I is generally directed at described second circumferential openings on described Part II.
Ink vessel transfusing implant the most according to claim 9, wherein, it is provided with tubular stent graft extension, for being inserted in each in said two branch to allow fluid to flow to the respective branch of described implant and through each tubular stent graft extension of described tubular stent graft extension from the described entrance opening of described Part I through described Part II.
11. Ink vessel transfusing implants according to claim 10, it farther includes arterial bracket graft extension, described arterial bracket graft extension has the graft material generally constructed in a tubular form, the opening being wherein generally circular in shape is at one end, it is tapered towards less extension the second opening being generally circular in shape close to the other end, and described arterial bracket graft extension is configured to be inserted at least one described circumferential openings of described Part I and described Part II.
12. Ink vessel transfusing implants according to claim 11, wherein, described arterial bracket graft extension includes expansible to support at least one support hoop of described arterial bracket graft.
Applications Claiming Priority (6)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US14/587,621 US20160184077A1 (en) | 2014-12-31 | 2014-12-31 | Circular Sectional Inserts For Insertion with a Trunk Section in Endoprosthesis for Aortic Aneurysm |
| US14/587621 | 2014-12-31 | ||
| US14/587526 | 2014-12-31 | ||
| US14/587801 | 2014-12-31 | ||
| US14/587,801 US20160184078A1 (en) | 2014-12-31 | 2014-12-31 | Sectional Inserts for Trunk Section in Endoprosthesis for Aortic Aneurysm |
| US14/587,526 US20160184076A1 (en) | 2014-12-31 | 2014-12-31 | Implantable Endoprosthesis for Aortic Aneurysm |
Publications (1)
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| CN205729569U true CN205729569U (en) | 2016-11-30 |
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| CN201511011155.6A Pending CN105726161A (en) | 2014-12-31 | 2015-12-30 | Sectional Inserts For Trunk Section In Endoprosthesis For Aortic Aneurysm |
| CN201511011172.XA Pending CN105726163A (en) | 2014-12-31 | 2015-12-30 | Sectional Inserts For Trunk Section In Endoprosthesis For Aortic Aneurysm |
| CN201511011164.5A Pending CN105726162A (en) | 2014-12-31 | 2015-12-30 | Sectional Inserts For Trunk Section In Endoprosthesis For Aortic Aneurysm |
| CN201521119449.6U Active CN205729569U (en) | 2014-12-31 | 2015-12-30 | Ink vessel transfusing implant |
| CN201521119459.XU Active CN205729570U (en) | 2014-12-31 | 2015-12-30 | Ink vessel transfusing implant and implant is deployed in the delivery apparatus in health tremulous pulse |
| CN201521119464.0U Active CN205729571U (en) | 2014-12-31 | 2015-12-30 | Ink vessel transfusing implant |
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| CN201511011155.6A Pending CN105726161A (en) | 2014-12-31 | 2015-12-30 | Sectional Inserts For Trunk Section In Endoprosthesis For Aortic Aneurysm |
| CN201511011172.XA Pending CN105726163A (en) | 2014-12-31 | 2015-12-30 | Sectional Inserts For Trunk Section In Endoprosthesis For Aortic Aneurysm |
| CN201511011164.5A Pending CN105726162A (en) | 2014-12-31 | 2015-12-30 | Sectional Inserts For Trunk Section In Endoprosthesis For Aortic Aneurysm |
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| CN201521119459.XU Active CN205729570U (en) | 2014-12-31 | 2015-12-30 | Ink vessel transfusing implant and implant is deployed in the delivery apparatus in health tremulous pulse |
| CN201521119464.0U Active CN205729571U (en) | 2014-12-31 | 2015-12-30 | Ink vessel transfusing implant |
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| CN (6) | CN105726161A (en) |
| WO (3) | WO2016109738A2 (en) |
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| CN110868960A (en) * | 2017-07-14 | 2020-03-06 | 乔泰克公司 | Endovascular vascular prosthesis |
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| US9974671B2 (en) | 2014-11-03 | 2018-05-22 | Medtronic Vascular, Inc. | Devices and methods for treating aneurysms and other vascular conditions |
| BR112019003113A2 (en) | 2016-08-17 | 2019-05-21 | Neuravi Limited | clot removal system to remove occlusive clot from a blood vessel |
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| CN106580518B (en) * | 2016-12-20 | 2018-11-16 | 有研医疗器械（北京）有限公司 | A kind of combined type endovascular stent for abdominal aorta system and its application method |
| US10881497B2 (en) | 2017-01-26 | 2021-01-05 | DePuy Synthes Products, Inc. | Composite vascular flow diverter |
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- 2015-12-30 CN CN201511011155.6A patent/CN105726161A/en active Pending
- 2015-12-30 CN CN201511011172.XA patent/CN105726163A/en active Pending
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| CN110868960A (en) * | 2017-07-14 | 2020-03-06 | 乔泰克公司 | Endovascular vascular prosthesis |
| US11826271B2 (en) | 2017-07-14 | 2023-11-28 | Jotec Gmbh | Intraluminal vascular prosthesis |
Also Published As
| Publication number | Publication date |
|---|---|
| WO2016109738A2 (en) | 2016-07-07 |
| CN205729571U (en) | 2016-11-30 |
| WO2016109738A3 (en) | 2017-01-05 |
| CN205729570U (en) | 2016-11-30 |
| CN105726162A (en) | 2016-07-06 |
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| WO2016109763A1 (en) | 2016-07-07 |
| CN105726163A (en) | 2016-07-06 |
| CN105726161A (en) | 2016-07-06 |
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