CN208481537U - A kind of children's variable diameter self-expandable stent - Google Patents
A kind of children's variable diameter self-expandable stent Download PDFInfo
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- CN208481537U CN208481537U CN201820260999.7U CN201820260999U CN208481537U CN 208481537 U CN208481537 U CN 208481537U CN 201820260999 U CN201820260999 U CN 201820260999U CN 208481537 U CN208481537 U CN 208481537U
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- 229910001000 nickel titanium Inorganic materials 0.000 claims description 7
- KDLHZDBZIXYQEI-UHFFFAOYSA-N Palladium Chemical compound [Pd] KDLHZDBZIXYQEI-UHFFFAOYSA-N 0.000 claims description 4
- HLXZNVUGXRDIFK-UHFFFAOYSA-N nickel titanium Chemical compound [Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni] HLXZNVUGXRDIFK-UHFFFAOYSA-N 0.000 claims description 4
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- MHOVAHRLVXNVSD-UHFFFAOYSA-N rhodium atom Chemical compound [Rh] MHOVAHRLVXNVSD-UHFFFAOYSA-N 0.000 claims description 2
- WFKWXMTUELFFGS-UHFFFAOYSA-N tungsten Chemical compound [W] WFKWXMTUELFFGS-UHFFFAOYSA-N 0.000 claims description 2
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- KHYBPSFKEHXSLX-UHFFFAOYSA-N iminotitanium Chemical compound [Ti]=N KHYBPSFKEHXSLX-UHFFFAOYSA-N 0.000 description 3
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- Media Introduction/Drainage Providing Device (AREA)
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Abstract
The utility model discloses a kind of self-inflated intravascular stents for Portal vein stenosis after liver transplantation in children, belong to medical instruments field.Rack body is sequentially connected by three scalable tubular reticular structures and is formed, respectively proximal part portion, medial end portions and outer end;The caliber of medial end portions is minimum, and the caliber in proximal part portion is maximum;With oblique shoulder nature transition connection, another open end of medial end portions is connect with an open end in proximal part portion with oblique shoulder nature transition for one open end of medial end portions and an open end of outer end;The pipe type netted structure is made of multiple groups corrugated ring interconnected, or is made of filamentary material braiding.The utility model is narrow at diameter change because caliber mismatch focuses primarily upon for treating lesion vessels, can improve the physiological adaptation of bracket, increase support stability, reduce stent migration incidence;The change that the intracavitary haemodynamics of portal vein can be reduced makes the risk reduction of restenosis after implantation bracket, reduces the generation of adverse events.
Description
Technical field
The utility model relates to a kind of children's variable diameter self-expandable stents, belong to medical instruments field.
Background technique
Lebertransplantationim im Kindesalter is the effective treatment means for solving children's End-stage liver disease.The prognosis of Lebertransplantationim im Kindesalter by it is a variety of because
Element influences, most important of which is that the prevention and treatment of complication.Portal vein stenosis is the postoperative common vascular complication of Lebertransplantationim im Kindesalter, if
Effectively treatment not in time, lethality is up to 24%.Due to the scarcity of donor resource, parent and subtracting volume etc. needs technical treatment to transplant
The Lebertransplantationim im Kindesalter of object, which is performed the operation, to be increased, while after liver transplantation children's blood vessel complication rate is significantly higher than adult, clinically
Have that a large amount of there are the infants of Portal vein stenosis after liver transplantation in children to be detected.Portal vein is narrow after how improving liver transplantation in children
The clinical treatment success rate of narrow infant becomes important clinical problem urgently to be solved.
Mainly having drug for the infant therapeutic modality of Portal vein stenosis after liver transplantation in children, (heparin, tonka-bean class are anticoagulant
Medicine, urokinase etc.), operative treatment (venous shunt, again vein anastomosis, liver retransplantation) and Endovascular interventional treatment (packet
Include Baloon angioplasty, intravascular stent plasty).For after liver transplantation infant, Portal vein stenosis be mostly buckling of vessel at
The mechanical factors such as angle, anastomotic stricture, anticoagulation medicine therapeutic effect are poor.Previous anastomotic proliferation of fibrous tissue nearby, donor money
The scarcity in source can increase operative treatment risk.Compared with above-mentioned therapeutic modality, Endovascular Therapy liver transplantation in children back door is quiet
Arteries and veins is narrow to have the advantages that wound is small, success rate of operation is high, complication rate is low etc., it has also become after liver transplantation Portal vein stenosis
Preferred treatment method.
Current clinically widely applied intravascular stent plasty is all made of the cartridge type bracket of not variable diameter.Studies have reported that
Using Portal vein stenosis after intravascular stent angioplasty in treatment liver transplantation in children technique successful rate be 66.7%, clinical treatment at
Power is 73.0%, but 5 years long-term patency rates are unknown.Anatomy and clinic have confirmed that liver transfer operation donor and receptor door are quiet
The diameter difference of arteries and veins is the postoperative generation Portal vein stenosis of Lebertransplantationim im Kindesalter and influence stent-assisted angioplasty clinical treatment success rate
Key factor.Since the non-reducing support of cartridge type can not combine the diameter of receptor and donor, low age infant blood vessel diameter is with life
Long development and it is broadening, the implantation non-variable diameter shape bracket of cylinder may cause that proximal part is adherent bad, and distal end overdistension is above
Cause injury of blood vessel, endometrial hyperplasia, increases the in-stent restenosis even incidence of Portal Vein Thrombosis.Therefore the non-variable diameter branch of cartridge type
It often cannot be guaranteed that infant portal vein is unobstructed for a long time, influences postoperative clinical treatment success rate after mounting in infant blood vessel.
In general, there are two types of brackets: self-expandable stent and balloon expandable stent.Balloon expandable stent be without
Elastic memory does not have the endovascular stent of the metal or alloy materials for support of shape memory function yet, by by unexpanded branch
Affected area in frame insertion vascular and be placed on the illness section of blood vessel.Before insertion, bracket volume is on sacculus, balloon inflation,
And then expanding stent makes against vascular wall, and makes bracket in diseased vessel.Balloon expandable stent can due to vascular wall from
Right elasticity, which is rebounded, to be lacked restoring force with bracket itself and collapses.
Self-expandable stent oneself can expand, and be made of super-elasticity or shape memory metal, usually using Ni-Ti
(NiTi) alloy is made.Bracket leans on itself super-elasticity and shape memory characteristic after discharging out of sheath, can automatic rebounding arrive
Shape originally generates the supporting role to lesion vessels.Due to receptor side door vein diameter can with infant growth and development and
Increase, reducing type balloon expandable stent can produce the problems such as adherent bad by side.
Utility model content
The technical problems to be solved in the utility model is to provide a kind of for Portal vein stenosis blood vessel after liver transplantation in children
The self-expandable stent of lesion.
To achieve the above object, the utility model uses following technical scheme:
A kind of self-inflated intravascular stent for Portal vein stenosis after liver transplantation in children, rack body are scalable by three
Pipe type netted structure be sequentially connected composition, respectively proximal part portion, medial end portions and outer end;The caliber in proximal part portion is greater than
The caliber of the caliber of outer end, outer end is greater than medial end portions caliber;One open end of medial end portions and the one of outer end open
Mouth end is with oblique shoulder nature transition connection, and another open end of medial end portions and an open end in proximal part portion are with oblique shoulder nature transition company
It connects;The pipe type netted structure is made of multiple groups corrugated ring interconnected, or is made of filamentary material braiding.Corrugated ring one
As using wire winding or laser etching techniques be made, radial support force is strong, expansion after-poppet cripetura it is small;Filamentary material braiding
Net tubular structure has good longitudinal direction submissive, is easy to be placed on tortuous intravascular." caliber " refers to self-inflated intravascular stent
The caliber of each section in use state.
The corrugated ring is distributed along the axial direction of rack body, and multiple wave crests and multiple are successively arranged alternately on each corrugated ring
Trough, it is symmetrical in mirror surface between two adjacent corrugated rings, and connected by least one connector.Mirror surface is symmetrical arranged, and is made
It forms peak between two adjacent corrugated rings to arrange to paddy, this structure is that bracket integrally provides polyaxial flexibility, is kept away
Exempt to generate fish scale phenomenon in movable blood vessel.
The wave crest and trough is one of sine, cosine, trapezoidal, triangle, conic section, Z-shaped curve.
The connector is straightway, arc segment, one of curved section.
The material of the corrugated ring, connector and filamentary material is wire or high molecular material silk.The wire
Good histocompatbility is provided with high molecular material silk.
The diameter of the wire or high molecular material silk is equal, and bracket is the net ring of equal thickness along its length.
The diameter of the wire or high molecular material silk is unequal, and bracket is the not net ring of equal thickness along its length.
The diameter of the wire or high molecular material silk is 0.4mm-0.6mm.
The material of the wire is selected from platinum-tungsten alloys, platinum, titanium alloy, Nitinol, stainless steel, rhodium, rhenium, palladium or tungsten
One or more of.Preferred material is stainless steel or Ultimum Ti, it is ensured that the support force of endovascular stent.
10-16 millimeters of the proximal part diameter is suitable for adult vein;The caliber of outer end is 6-12 millimeters, is applicable in
In underage child portal vein;The caliber of medial end portions is 5-10 millimeters, is suitable for portal vein previous anastomotic diameter, it is ensured that therapeutic effect.
Bracket is integrally in variable diameter cylindrical shape, and distal end caliber is less than proximal part caliber, and the two caliber differs 2-6 millimeters, and medial end portions are most
Small diameter tube differs 4-6 millimeters with outer end, proximal part portion, and the length of bracket is 10-70 millimeters, preferably 20-40 millimeters.Its
In, the length of distal end is 7-10 millimeters, and the length of middle-end is 6-8 millimeters, the length of proximal part is 10-15 millimeters.
The intravascular stent has developing apparatus, and it is platinum material that developing apparatus, which is developing mark note, can under X line
High-visible, specification is that 1mm marks note, meets the accuracy of positioning.
The release stage: when intervention operation, percutaneous portal vein is punctured, and seal wire is inserted into portal vein by indwelling sheath, along seal wire
It is inserted at stent delivery sheath pipe to portal vein distal end, exits conveying and recycling sheath inner core and seal wire, conveyed and recycled sheath
It is sent at endovascular stent to sheath distal end, according to mark is pre-positioned, it is quiet to be positioned at donor door for before endovascular stent 1/2
In arteries and veins, rear 1/2 is located in receptor portal vein, and medial end portions are placed at portal vein previous anastomotic, and self-expandable stent is released to blood vessel
At previous anastomotic.
Structure feature after self-inflated intravascular stent expansion described in the utility model, reduces bright in donor side stent diameter
It is aobvious, can preferably echo the objective reality that post-transplantation portal vein pipe diameter changes along its length, improve intravascular stent with
The matching of human vas, the distal end generated after being expanded in variable diameter blood vessel so as to improve traditional round straight bracket it is adherent it is bad and
Proximal part overdistension improves Endovascular Therapy to effectively inhibit the adverse reactions such as endometrial hyperplasia, in-stent restenosis
The clinical effective rate of virgin after liver transplantation Portal vein stenosis.
The utility model has the advantages that: the self-inflated intravascular stent of Portal vein stenosis vascular lesion after liver transplantation in children,
For treat lesion vessels because caliber mismatch focus primarily upon it is narrow at diameter change, make the adherent performance of blood vessel distal end,
Proximal part spreading performance is improved, and the physiological adaptation of bracket is improved;The knot of bracket Yu portal vein pipe holder can be increased
Area and frictional force are closed, support stability is increased, reduces stent migration incidence;The intracavitary haemodynamics of portal vein can be reduced
Change, make be implanted into bracket after restenosis risk reduce, reduce the generation of adverse events.
The utility model is described further with reference to the accompanying drawing.Be not limitation of the utility model, it is all according to
This field equivalent replacement that the utility model disclosure carries out, belongs to the protection scope of the utility model.
Detailed description of the invention
Fig. 1 be embodiment 1 liver transplantation in children after Portal vein stenosis lesion vessels self-inflated intravascular stent structure
Schematic diagram (side view)
Fig. 2 be embodiment 2 liver transplantation in children after Portal vein stenosis lesion vessels self-inflated intravascular stent structure
Schematic diagram (side view)
Fig. 3 A- Fig. 3 E is toroidal support partial structural diagram
Specific embodiment
Embodiment 1
As shown in Figure 1, a kind of self-inflated intravascular stent for Portal vein stenosis after liver transplantation in children, rack body
(1) it is sequentially connected and is formed by three telescopic pipe type netted structures, respectively proximal part portion (11), medial end portions (12) and telecentricity
End (13), the caliber of proximal part portion (11) are greater than the caliber of outer end (13), and the caliber of outer end (13) is greater than middle-end
Portion (12) caliber;One open end of medial end portions (12) is connect with an open end of outer end (13) with oblique shoulder nature transition, in
Another open end of end (12) is connect with an open end of proximal part portion (11) with oblique shoulder nature transition;The pipe type netted knot
Structure is made of multiple groups corrugated ring interconnected (2).
The corrugated ring (2) is distributed along the axial direction of rack body, is successively arranged alternately multiple wave crests on each corrugated ring (2)
(21) and multiple troughs (22), symmetrical in mirror surface between two adjacent corrugated rings, and pass through at least one linear section shape
Connector (3) connection.
The corrugated ring (2) and connector (3) are made of the wire of Nitinol material.The diameter phase of the wire
It is the net ring of equal thickness along its length Deng, bracket.The diameter of the wire is 0.5 millimeter.
Outer end (13) and proximal part portion (11) are linked into an integrated entity by wire.The material of the wire is NiTi
Memorial alloy, it is ensured that the support force of endovascular stent.
16 millimeters of diameter of the proximal part (11) is suitable for adult vein;The caliber in distal end (13) portion is 12 millimeters, is fitted
For underage child portal vein;The caliber of medial end portions (12) is 10 millimeters, is suitable for portal vein previous anastomotic diameter, it is ensured that treatment effect
Fruit.Bracket is integrally in variable diameter cylindrical shape, and the length of distal end is 10 millimeters, and the length of middle-end is 8 millimeters, and the length of proximal part is
15 millimeters.
Referring to shown in Fig. 3 A- Fig. 3 E, the multiple wave crests (21) and multiple troughs (22) of the corrugated ring (2) be can also be
Cosine, triangle, the other shapes such as conic section.
According to portal vein physiologic characteristic, the proximal part portion (11) of the utility model bracket is inserted into donor portal vein blood vessel
Interior, outer end (13) the insertion receptor portal vein of bracket is intravascular, and it is quiet that the medial end portions (12) of bracket are located at transplantation of liver back door
Arteries and veins previous anastomotic.
Embodiment 2
As shown in Fig. 2, a kind of self-inflated intravascular stent for Portal vein stenosis after liver transplantation in children, rack body
(1) it is sequentially connected and is formed by three telescopic pipe type netted structures, respectively proximal part portion (11), medial end portions (12) and telecentricity
End (13), the caliber of proximal part portion (11) are greater than the caliber of outer end (13), and the caliber of outer end (13) is greater than middle-end
Portion (12) caliber;One open end of medial end portions (12) is connect with an open end of outer end (13) with oblique shoulder nature transition, in
Another open end of end (12) is connect with an open end of proximal part portion (11) with oblique shoulder nature transition;The pipe type netted knot
Structure is made of filamentary material (4) braiding.
The filamentary material is made of the wire of Nitinol material.The diameter of the filamentary material is equal, and bracket is
The net ring of equal thickness along its length.The diameter of the filamentary material is 0.5 millimeter.
The material of the filamentary material is Ultimum Ti, it is ensured that the support force of endovascular stent.
10 millimeters of the proximal part diameter is suitable for adult vein;The caliber of outer end is 6 millimeters, is suitable for low age
Children's portal vein;The caliber of medial end portions is 5 millimeters, is suitable for portal vein previous anastomotic diameter, it is ensured that therapeutic effect.Bracket is integrally in
Variable diameter is cylindric, and the length of distal end is 7 millimeters, and the length of middle-end is 6 millimeters, and the length of proximal part is 10 millimeters.
The utility model is provided while ensuring endovascular stent support force, can preferably echo post-transplantation portal vein
The objective reality that blood vessel diameter changes along its length improves the matching of intravascular stent and human vas, so as to improve tradition
The distal end that generates is adherent bad after circle straight bracket expand in variable diameter blood vessel and proximal part overdistension, thus effectively in inhibition
The adverse reactions such as film hyperplasia, in-stent restenosis improve the clinic of Portal vein stenosis after Endovascular Therapy liver transplantation in children
It is efficient.
Claims (13)
1. a kind of children's variable diameter self-expandable stent, it is characterised in that: rack body by three telescopic pipe type netted structures according to
Secondary connection composition, respectively proximal part portion, medial end portions and outer end;The caliber in proximal part portion is greater than the caliber of outer end,
The caliber of outer end is greater than medial end portions caliber;One open end of medial end portions and an open end of outer end are with oblique shoulder nature mistake
Connection is crossed, another open end of medial end portions is connect with an open end in proximal part portion with oblique shoulder nature transition;It is described pipe type netted
Structure is made of multiple groups corrugated ring interconnected, or is made of filamentary material braiding.
2. children's variable diameter self-expandable stent according to claim 1, it is characterised in that: the corrugated ring is along rack body
It is axial to be distributed, it is successively arranged alternately multiple wave crests and multiple troughs on each corrugated ring, is in mirror between two adjacent corrugated rings
Face is symmetrical, and is connected by least one connector.
3. children's variable diameter self-expandable stent according to claim 2, it is characterised in that: the wave crest and trough is positive
One of string, cosine, trapezoidal, triangle, conic section, Z-shaped curve.
4. children's variable diameter self-expandable stent according to claim 3, it is characterised in that: the connector is straightway, arc
Line segment, one of curved section.
5. according to claim 1 to children's variable diameter self-expandable stent described in any one of 4, it is characterised in that: the ripple
The material of ring, connector and filamentary material is wire or high molecular material silk.
6. children's variable diameter self-expandable stent according to claim 5, it is characterised in that: the wire or high molecular material
The diameter of silk is equal or diameter is unequal.
7. children's variable diameter self-expandable stent according to claim 5, it is characterised in that: the wire or high molecular material
The diameter of silk is 0.4mm-0.6mm.
8. children's variable diameter self-expandable stent according to claim 6, it is characterised in that: the wire or high molecular material
The diameter of silk is 0.4mm-0.6mm.
9. children's variable diameter self-expandable stent according to claim 5, it is characterised in that: the material of the wire is selected from platinum
One or more of tungsten alloy, platinum, titanium alloy, Nitinol, stainless steel, rhodium, rhenium, palladium or tungsten.
10. according to claim 1 to children's variable diameter self-expandable stent described in any one of 4,6 to 9, it is characterised in that: institute
The caliber for stating proximal part portion is 10-16 millimeters, and the caliber of medial end portions is 5-10 millimeters, and outer end caliber is 6-12 millimeters, branch
The length of frame is 10-70 millimeters.
11. children's variable diameter self-expandable stent according to claim 5, it is characterised in that: the caliber in the proximal part portion is
10-16 millimeters, the caliber of medial end portions is 5-10 millimeters, and outer end caliber is 6-12 millimeters, and the length of bracket is 10-70 milli
Rice.
12. children's variable diameter self-expandable stent according to claim 10, it is characterised in that: the length of the bracket is 20-
40 millimeters, wherein the length of distal end is 7-10 millimeters, and the length of middle-end is 6-8 millimeters, the length of proximal part is 10-15 milli
Rice.
13. children's variable diameter self-expandable stent according to claim 11, it is characterised in that: the length of the bracket is 20-
40 millimeters, wherein the length of distal end is 7-10 millimeters, and the length of middle-end is 6-8 millimeters, the length of proximal part is 10-15 milli
Rice.
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Cited By (1)
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CN112472360A (en) * | 2020-11-25 | 2021-03-12 | 四川大学华西医院 | Vena cava stent |
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Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
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CN112472360A (en) * | 2020-11-25 | 2021-03-12 | 四川大学华西医院 | Vena cava stent |
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