CN209316143U - A kind of novel aortic windowing stent system - Google Patents

A kind of novel aortic windowing stent system Download PDF

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Publication number
CN209316143U
CN209316143U CN201820504471.XU CN201820504471U CN209316143U CN 209316143 U CN209316143 U CN 209316143U CN 201820504471 U CN201820504471 U CN 201820504471U CN 209316143 U CN209316143 U CN 209316143U
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bracket
umbrella
proximal end
aortic
mark point
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Expired - Fee Related
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CN201820504471.XU
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Chinese (zh)
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王李华
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Individual
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Abstract

The utility model discloses a kind of novel aortic windowing stent systems, including proximal end umbrella bracket and distal tubular bracket, it is fixed on inside aortic stents after the proximal end umbrella bracket release, it is anchored in bifurcated artery after the distal tubular bracket release, the proximal end umbrella bracket includes end disc portion bracket, it is connected between the end disc portion bracket and distal tubular bracket by umbrella connecting bracket, the umbrella connecting bracket and distal tubular bracket are coaxially disposed, proximal end umbrella holder part is designed to the umbrella-shaped structure of major diameter, leakage in opening can be reduced to occur and reinforce proximal end anchoring effect, bracket is stuck in the windowing of the lesser aortic stents of diameter when being impacted by blood flow, it is unlikely to shift, and it avoids being located in aortic stent compared with long column shape overlay film frame, reduce the shadow to blood flow state in aorta It rings, reduces the stimulation due to shaking of branch stent to branch vessel wall.

Description

A kind of novel aortic windowing stent system
Technical field
The utility model relates to a kind of medical instruments, in particular to a kind of novel aortic windowing stent systems.
Background technique
Dissection of aorta (Aortic Dissection, AD) is that a kind of onset is hurried, the state of an illness is dangerous, and the death rate is high Acute Aortic disease.With universal and Examined effect the progress to disease cognitive, the illness rate and detection of dissection of aorta Rate rises year by year.The acute Stanford A type dissection of aorta patient of studies have shown that nearly half untreated was in morbidity 1 month Interior death, 90% Stanford A type dissection of aorta and 60% Stanford Type B dissection of aorta patient morbidity 1 It is dead in year.
Aorta pectoralis endovascular repair (TEVAR) is because of its lower death rate and complication rate at present, in chest active Huge success is achieved in the treatment of arteries and veins tumor and dissection of aorta.Have become the primary treatment regimen of Type B dissection of aorta. But TEVAR art is still faced with many problem and challenge at present, wherein arch of aorta top set reconstructing blood vessel is maximum difficult point.
Orthotopic fenestration technology becomes a kind of effective means for rebuilding aorta in recent years, after it refers to aortic stents release Branch vessel is covered, then drive in the wrong direction the distal end through bifurcated artery rupture of membranes.Balloon expandable after rupture of membranes success, puts in last branch vessel Set bracket.Aortic stents orthotopic fenestration technology makes full use of currently available instrument, before retaining bow top set's blood vessel It puts, plays the minimally invasive advantage of TEVAR as far as possible.
But it is mostly at present cylindrical overlay film frame applied to the branch stent of orthotopic fenestration, generally has after bracket release The even longer part 1.5cm is located in aortic stents.Have the following problems in the specific application process: 1, branch stent is in master Led to local deformation, narrow by influence of blood flow in lumen of artery;2, branch stent is without special witness marker, and when release is difficult to accurately handle It holds and protrudes into length in aorta;3, branch stent plays the role of barrier sample to blood flow in aorta lumen, influences blood flow Form, part thrombus easy to form is so as to cause distal artery embolism;4, blood flow is intravascular to rebuilding through columnar bracket, not close to Physiological phenomenon easily leads to branch vessel blood flow and pressure, blood flow morphologic change;5, branch vessel is in aorta lumen with blood flow It impacts and swings, stent migration easily occur.And it is easy by stress influence is swung for a long time between bracket tail end and reconstruction branch vessel wall Lead to local inner film injury, hyperplasia;If 6, branch reconstruction bracket lumen is relatively thick, it is excessive in aorta lumen to protrude into, especially double to open Window, three-way window case will affect blood flow in aorta and pass through, and alteration of left ventricular afterload increase and active distal arteries and veins blood supply is caused to subtract It is few;7, branch vessel, which is excessively located in aorta lumen, influences secondary intracavity operation.
200520113624.0 Chinese patent of Patent No. provides a kind of carnival hat bracket, and providing one kind prevents junction The bracket of interior leakage.But the bracket is due to being uniform disk carnival hat, when using three-way window treatment Type B dissection of aorta, bracket gift Cap diameter is excessive, and two neighboring bracket carnival hat overlapping can be caused excessive, cannot be bonded aorta tectorial membrane stent so as to cause carnival hat On overlay film, cause interior leakage may.Furthermore the invention fails to explain the release system of the bracket of illustrating, in our concrete applications, one As selection sheath encase bracket, to designated position after slowly exit epitheca and open carnival hat (rear release), but to enable carnival hat to use up Amount fitting aorta tectorial membrane stent, is at this time typically chosen and bracket is dropped back.During this, if sheath removes excessive, bracket Barrel can then be opened, and influence bracket in the movement of vascular wall, if moving by force, can cause the possibility of vascular wall tearing Property.If sheath recession is very little, it will lead to carnival hat and open incomplete, when rear removing supporters, occur that bracket recession is too many or even carnival hat Into in branch vessel.
Therefore one kind in short supply can be able to solve the above problem specifically for the branch stent of orthotopic fenestration in the market.
Utility model content
In order to solve the above technical problems, technical solution provided by the utility model are as follows: a kind of novel aortic windowing stent System, including proximal end umbrella bracket and distal tubular bracket are fixed in aortic stents after the proximal end umbrella bracket release Portion is anchored in bifurcated artery after the distal tubular bracket release, and the proximal end umbrella bracket includes end disc portion bracket, institute It states and is connected between end disc portion bracket and distal tubular bracket by umbrella connecting bracket, the umbrella connecting bracket and distal tube The coaxial arrangement of shape bracket;
The distal tubular bracket forms tubular bracket by several Z-type bracing rings, and the Z-type bracing ring includes close to proximal end The second Z-type bracing ring of the first Z-type bracing ring and distal end of umbrella bracket, the first Z-type bracket bracing ring to proximal end umbrella branch The distance of frame is greater than the spacing between the second Z-type bracing ring of distal end.
Umbrella connecting bracket two sides and the junction of end disc portion bracket are respectively equipped with the first mark point, the second label Point.
Further, the end disc portion bracket is circular support, and the central axis of the umbrella connecting bracket passes through circle The center of circle of bracket.
Further, the distance of the circular support outer to umbrella connecting bracket outer wall is 5mm.
Further, umbrella connecting bracket both ends and the junction of circular support are equipped with the first mark point.
Further, first mark point is " 8 " font mark point.
Further, the end disc portion bracket is ellipse support, and the umbrella connecting bracket is set to oval branch It is divided into larger side and smaller side, the larger side long axis endpoint to umbrella connecting bracket outer wall on frame long axis and by ellipse support Distance be 5mm, the distance of the smaller side long axis endpoint to umbrella connecting bracket outer wall is 3mm.
Further, the junction of the umbrella connecting bracket and larger side is equipped with the first mark point, the umbrella connection The junction of bracket and smaller side is equipped with the second mark point.
Further, second mark point is " 0 " font mark point.
Further, the end disc portion bracket is made discoid of a plane Z-type bracing ring.
Further, the distal tubular bracket is externally provided with structure of film.
After using the above structure, the utility model is had the advantages that
1, the utility model bracket is two different models, the first umbrella branch according to branch vessel different designs are used Frame part is that size is identical uniformly discoid, and disk protrusion is 5mm, is suitable for branch vessel opening apart from periphery weight Want branch vessel >=5mm.Second umbrella holder part is ellipse, wherein larger side be 5mm, smaller side 3mm, it is main suitable The case where closing the 2 branch vessel distance < 5mm that need to be rebuild, such setting solve the problems, such as to rebuild three branch vessels.
2, the utility model proximal end umbrella holder part is designed to the umbrella-shaped structure of major diameter, it is possible to reduce leakage in opening Occur and reinforce proximal end anchoring effect, allows bracket to be stuck in the lesser aortic stents of diameter when being impacted by blood flow and opened In window, it is unlikely to shift, and avoids being located in aortic stent compared with long column shape overlay film frame, reduces to blood flow shape in aorta The influence of state reduces the stimulation due to shaking of branch stent to branch vessel wall, and distal portions are fixed in bifurcated artery, Diameter and length are determined by bifurcated artery anatomical conditions.
3, the Z-type bracing ring spacing on the utility model distal tubular bracket is not identical, the width of first Z-type bracing ring Greater than the distance of other Z-type structures, it is such design be conducive to bracket use after discharge when removing vagina vasorum, umbrella part energy Enough sufficiently to open, bracket umbrella part is unlikely to move in branch vessel when cradle fits aortic stents of dropping back, safely and effectively.
4, the utility model proximal end umbrella bracket contact that is connected with distal tubular holder part has mark point, convenient for quasi- in art It determines position, confirms the direction of bracket, realize the accurate release of bracket.
The present invention is specific to the branch stent of orthotopic fenestration, can be realized the accurate release of bracket, and few intercurrent disease.
Detailed description of the invention
Fig. 1 is a kind of structural schematic diagram of novel aortic windowing stent system embodiment one of the utility model.
Fig. 2 is a kind of bottom surface structure schematic diagram of novel aortic windowing stent system embodiment one of the utility model.
Fig. 3 is a kind of structural schematic diagram of novel aortic windowing stent system embodiment two of the utility model.
Fig. 4 is a kind of bottom surface structure schematic diagram of novel aortic windowing stent system embodiment two of the utility model.
Fig. 5 is a kind of novel aortic windowing stent system of the utility model locally release process schematic.
Fig. 6 is status diagram when a kind of novel aortic windowing stent system of the utility model removes sheath.
Fig. 7 is the structural schematic diagram under a kind of novel aortic windowing stent system use state of the utility model.
It is as shown in the figure: 1, proximal end umbrella bracket, 1.1, end disc portion bracket, 1.1a, circular support, 1.1b, ellipse branch Frame, 1.1c, larger side, 1.1d, smaller side, 1.2, umbrella connecting bracket, 2, distal tubular bracket, 2.1, Z-type bracing ring, 2.1a, the first Z-type bracing ring, 2.1b, the second Z-type bracing ring of distal end, the 3, first mark point, the 4, second mark point, 5, aorta Bracket, 6, bifurcated artery, 7, aorta, 8, sheath, 9, tubular bracket release the control line.
Specific embodiment
In conjunction with attached drawing
Embodiment one
A kind of novel aortic windowing stent system, including proximal end umbrella bracket 1 and distal tubular bracket 2, the proximal end Umbrella bracket 1 is fixed on inside aortic stents 5 after discharging, and is anchored to bifurcated artery 6 after 2 bracket of the distal tubular release Interior, the proximal end umbrella bracket 1 includes end disc portion bracket 1.1, the end disc portion bracket 1.1 and distal tubular bracket 2 it Between connected by umbrella connecting bracket 1.2, the umbrella connecting bracket 1.2 is coaxially disposed with distal tubular bracket 1;
The distal tubular bracket 2 forms tubular bracket by several Z-type bracing rings 2.1, and the Z-type bracing ring 2.1 includes Close to the second Z-type bracing ring 2.1b of the first Z-type bracing ring 2.1a and distal end of proximal end umbrella bracket 1, the first Z-type bracket branch The distance of support ring 2.1a to proximal end umbrella bracket 1 is greater than the spacing between the second Z-type bracing ring 2.1b of distal end.
1.2 two sides of umbrella connecting bracket and the junction of end disc portion bracket 1.1 are respectively equipped with the first mark point 3.
As the present embodiment preferred embodiment, the end disc portion bracket 1.1 is circular support 1.1a, the umbrella The central axis of shape connecting bracket 1.2 passes through the center of circle of circular support 1.1a.
As the present embodiment preferred embodiment, outside the outer the circular support 1.1a to umbrella connecting bracket 1.2 The distance of wall is 5mm.
As the present embodiment preferred embodiment, 1.2 both ends of umbrella connecting bracket are with circular support 1.1a's Junction is equipped with the first mark point 3.
As the present embodiment preferred embodiment, first mark point 3 is " 8 " font mark point.
As the present embodiment preferred embodiment, the end disc portion bracket 1.1 is by a plane Z-type bracing ring system At discoid.
As the present embodiment preferred embodiment, the distal tubular bracket 2 is externally provided with structure of film.
Embodiment two
A kind of novel aortic windowing stent system, including proximal end umbrella bracket 1 and distal tubular bracket 2, the proximal end Umbrella bracket 1 is fixed on inside aortic stents 5 after discharging, and is anchored to bifurcated artery 6 after 2 bracket of the distal tubular release Interior, the proximal end umbrella bracket 1 includes end disc portion bracket 1.1, the end disc portion bracket 1.1 and distal tubular bracket 2 it Between connected by umbrella connecting bracket 1.2, the umbrella connecting bracket 1.2 is coaxially disposed with distal tubular bracket 1;
The distal tubular bracket 2 forms tubular bracket by several Z-type bracing rings 2.1, and the Z-type bracing ring 2.1 includes Close to the second Z-type bracing ring 2.1b of the first Z-type bracing ring 2.1a and distal end of proximal end umbrella bracket 1, the first Z-type bracket branch The distance of support ring 2.1a to proximal end umbrella bracket 1 is greater than the spacing between the second Z-type bracing ring 2.1b of distal end.
The junction of 1.2 two sides of umbrella connecting bracket and end disc portion bracket 1.1 be respectively equipped with the first mark point 3, Second mark point 4.
The end disc portion bracket 1.1 is ellipse support 1.1b, and the umbrella connecting bracket 1.2 is set to oval branch Divide on frame 1.1b long axis and by ellipse support 1.1b for larger side 1.1c and smaller side 1.1d, the larger side 1.1c longitudinal end The distance of point to 1.2 outer wall of umbrella connecting bracket is 5mm, outside the smaller side 1.1d long axis endpoint to umbrella connecting bracket 1.2 The distance of wall is 3mm.
As the present embodiment preferred embodiment, the junction of the umbrella connecting bracket 1.2 and larger side 1.1c Equipped with the first mark point 3, the junction of the umbrella connecting bracket 1.2 and smaller side 1.1d is equipped with the second mark point 4.
As the present embodiment preferred embodiment, second mark point 4 is " 0 " font mark point.
As the present embodiment preferred embodiment, first mark point 3 is " 8 " font mark point.
As the present embodiment preferred embodiment, the end disc portion bracket 1.1 is by a plane Z-type bracing ring system At discoid.
As the present embodiment preferred embodiment, the distal tubular bracket 2 is externally provided with structure of film.
For the surgical procedure of the present embodiment are as follows:
1, in the case where 0.035 common 180cm loach seal wire and routine 5F angiography catheter are worked in coordination, through descending aorta by conduit It is sent into aorta ascendens 7, fixed catheter exits loach seal wire exchange Lunderquist seal wire, is put into aorta ascendens 7, Gu This fixed seal wire.
2, enter aortic stents 5 to aortic arch along Lunderquist seal wire, position left common carotid artery distal end and discharge Bracket, bracket cover left subclavian artery.
3, enter 0.018 seal wire after left subclavian artery enters the success of disposable liver biopsy needle rupture of membranes, along seal wire It respectively enters sacculus (4*40mm, 8*40mm) and carries out expansion backed off after random sacculus.
4, enter the present embodiment windowing stent along seal wire, observe mark point, make the first mark point 3 (" 8 " font mark point) It is directed at 7 longitudinal axis of aorta distal end, the second mark point 4 (" 0 " word mark point) is made to be directed at 7 longitudinal axis proximal end of aorta (nearly arteria carotis one Side), into aortic stents in after recession formula (exiting sheath 8) release bracket open proximal end umbrella bracket 1, slowly withdraw bracket It is close to proximal end umbrella bracket 1 with aortic stents 5, the first mark point 3, the second mark point 4 retreat to big cradle wall and experience Second step release operation is executed after to resistance, is pulled out distal tubular bracket and is released the control line 9, discharges distal tubular bracket 2, exit Release system.
5, it is expanded after using sacculus in left subclavian artery branch stent.
6, umbrella-shaped structure is helped to be attached at master using three leaf balloon expandables in the aortic stents of left subclavian artery root In arterial bracket.
7, seal wire, conduit and sacculus are exited, operation terminates.
When specific operation, the present apparatus is divided to two sections of releases, and proximal end umbrella bracket 1 is convenient for using recession formula (recession sheath 8) It is precisely controlled the release of proximal end umbrella bracket 1,2 part of distal tubular bracket is discharged using stay-supported, easy to operate easy to learn, positioning Accurately.
The utility model and embodiments thereof are described above, this description is no restricted, shown in attached drawing Be also one of the embodiments of the present invention, actual structure is not limited to this.All in all if this field Those of ordinary skill is enlightened by it, without deviating from the purpose of the present invention, not inventively design with The similar frame mode of the technical solution and embodiment, all should belong to the protection range of the utility model.

Claims (6)

1. a kind of novel aortic windowing stent system, it is characterised in that: including proximal end umbrella bracket and distal tubular bracket, institute It is fixed on inside aortic stents after stating the release of proximal end umbrella bracket, is anchored to bifurcated artery after the distal tubular bracket release Interior, the proximal end umbrella bracket includes end disc portion bracket, passes through umbrella between the end disc portion bracket and distal tubular bracket The connection of shape connecting bracket, the umbrella connecting bracket and distal tubular bracket are coaxially disposed;
The distal tubular bracket forms tubular bracket by several Z-type bracing rings, and the Z-type bracing ring includes close to proximal end umbrella The second Z-type bracing ring of the first Z-type bracing ring and distal end of bracket, the first Z-type bracket bracing ring to proximal end umbrella bracket Distance is greater than the spacing between the second Z-type bracing ring of distal end;
Umbrella connecting bracket two sides and the junction of end disc portion bracket are respectively equipped with the first mark point, the second mark point;
The end disc portion bracket is ellipse support, and the umbrella connecting bracket is set on ellipse support long axis and will be ellipse Circular support is divided into larger side and smaller side, and the distance of the larger side long axis endpoint to umbrella connecting bracket outer wall is 5mm, institute The distance for stating smaller side long axis endpoint to umbrella connecting bracket outer wall is 3mm;The connection of the umbrella connecting bracket and larger side Place is equipped with the first mark point, and the junction of the umbrella connecting bracket and smaller side is equipped with the second mark point;Second label Point is " 0 " font mark point;
The distal tubular bracket is externally provided with structure of film.
2. a kind of novel aortic windowing stent system according to claim 1, it is characterised in that: the end disc portion branch Frame is circular support, and the central axis of the umbrella connecting bracket passes through the center of circle of circular support.
3. a kind of novel aortic windowing stent system according to claim 2, it is characterised in that: outside the circular support It is 5mm along the distance to umbrella connecting bracket outer wall.
4. a kind of novel aortic windowing stent system according to claim 3, it is characterised in that: the umbrella connection branch Frame both ends and the junction of circular support are equipped with the first mark point.
5. a kind of novel aortic windowing stent system according to claim 4, it is characterised in that: first mark point For " 8 " font mark point.
6. a kind of novel aortic windowing stent system according to claim 1, it is characterised in that: the end disc portion branch Frame is made discoid of a plane Z-type bracing ring.
CN201820504471.XU 2018-04-11 2018-04-11 A kind of novel aortic windowing stent system Expired - Fee Related CN209316143U (en)

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Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111150523A (en) * 2020-03-17 2020-05-15 范卫东 Special support for aortic branch
CN111249031A (en) * 2020-01-17 2020-06-09 中国人民解放军陆军军医大学第一附属医院 Femoral artery covered stent with branches
CN111685919A (en) * 2020-06-30 2020-09-22 董红霖 Flat-mouth branch covered stent and pushing device
CN112826634A (en) * 2021-01-05 2021-05-25 冯俊波 Covered stent system for implanting into branch blood vessel

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111249031A (en) * 2020-01-17 2020-06-09 中国人民解放军陆军军医大学第一附属医院 Femoral artery covered stent with branches
CN111249031B (en) * 2020-01-17 2021-08-17 中国人民解放军陆军军医大学第一附属医院 Femoral artery covered stent with branches
CN111150523A (en) * 2020-03-17 2020-05-15 范卫东 Special support for aortic branch
CN111150523B (en) * 2020-03-17 2024-02-23 范卫东 Special support for aortic branch
CN111685919A (en) * 2020-06-30 2020-09-22 董红霖 Flat-mouth branch covered stent and pushing device
CN112826634A (en) * 2021-01-05 2021-05-25 冯俊波 Covered stent system for implanting into branch blood vessel

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Granted publication date: 20190830