CN209347312U - A kind of individuation branch stent type bow portion reconstruction artificial blood vessel - Google Patents

Abstract

A kind of individuation branch stent type bow portion reconstruction artificial blood vessel, it is related to a kind of artificial blood vessel.The utility model is in order to solve existing full bow replacement operation due to technical requirements height, and easy bleeding, anthemorrhagic difficulty, operating time is too long, the technical problems such as operation risk height.The line artificial blood vessel part of making of the drop portion initiative pulse support blood vessel (2) of the utility model initiative pulse support blood vessel (1) successively extends for bow portion initiative pulse support blood vessel (3) and ascending part initiative pulse support blood vessel (4) to proximal part direction, is issued on bow portion initiative pulse support blood vessel (3) comprising multiple bow parts branch including a branch stent blood vessel (5).The drop portion initiative pulse support blood vessel (2) and bow portion, ascending part of the utility model are integrally formed structures, without coincideing, Deep Hypothermia Circulatory Arrest time being down within 5 minutes for 20 minutes or more by routine can be shortened, greatly reduce the risk of ischemia of spinal cord, paraplegia.The utility model is performed the operation for Aortic arch replacement.

Description

A kind of individuation branch stent type bow portion reconstruction artificial blood vessel

Technical field

The utility model relates to a kind of artificial blood vessels, and in particular to a kind of individuation branch for aorta open surgery Support rack type bow portion rebuilds artificial blood vessel, belongs to medical instruments field.

Background technique

Dissection of aorta is a kind of big blood vessel acute disease for seriously threatening patient safety.Wherein, acute type A interlayer (Standford type A), i.e. lesion involve liter, the dissection of aorta in bow portion, is the highest one kind of risk, onset is hurried, Progress is rapid, lethality is high.Without operative treatment, 24 hours death rates are close to 25%, 48 hour death rate close to 50%, 30 It the death rate is up to 90%.Liter, bow portion blood vessel using surgical resection, displacement lesion are definite effective treatment hands Section.But the operation of acute type A interlayer is complicated, it is the severe challenge put in face of cardiovascular surgeon that technical requirements are high.To the greatest extent Pipe, diagnostic techniques and Perioperative Managements measure improve in recent years, but it is reported that acute type A interlayer operative mortality rate still Up to 15,30%, it would be highly desirable to improve.

Acute type A interlayer operating difficulty is big, and complication is more, in some instances it may even be possible to cause catastrophic big bleeding, limit liter, bow The development of portion's replacement of aorta operation.Until nineteen eighty-three, it is a wide range of that professor Borst uses trunk artificial blood vessel to carry out in a creative way Aorta replacement, just succeeds.1991, the improvement of trunk blood vessel was the trunk blood vessel of merging overturning by professor Safi etc., was mentioned High success rate of operation.It in recent years, is the one of Aortic surgery as trunk vascular treatment dissection of aorta using overlay film frame Big progress, secondary side open chest surgery needed for can avoid traditional operation.

Currently, the common strategy of bow replacement operation is recycled in vitro as shown in Figure 1:, stoped jumping down entirely, processing is risen actively in advance Arteries and veins and root, then profound hypothermia, stop recycling, by overlay film trunk stented vessel implantation, release it is very intracavitary in descending aorta, complete bow Portion Four branches aortic graft distal end and coincideing including overlay film trunk stent-graft proximal part and self descending aorta. The Deep Hypothermia Circulatory Arrest time, this stage, spinal cord blood supply was interrupted mostly more than 20 minutes, increases and spinal cord injury even paraplegia occurs Risk.After restoring circulation, it is also necessary to complete on innominate artery, left common carotid artery, left subclavian artery and artificial blood vessel one by one Respective branch is coincide.Previous anastomotic is more, and especially left subclavian artery position is deep is adjoining recurrent nerve and ductus thoracicus, dissecting Free and identical more difficult, time-consuming, and bleeding probability also increases therewith, and operative mortality rate and complication rate are higher.

In conclusion existing full bow replacement operation, due to complicated for operation, technical requirements are high, and operating time is too long, exists Amount of bleeding is big during patients surgery, the Deep Hypothermia Circulatory Arrest time long problem for easily causing spinal cord lesion etc., so that surgical death Rate and complication rate are higher.

Utility model content

Purpose of the utility model is to solve existing full bow replacement operations due to complicated for operation, and technical requirements are high, Operating time is too long, and there are amount of bleeding during patients surgery is big, the Deep Hypothermia Circulatory Arrest time is long easily to cause spinal cord lesion etc. Problem, so that operative mortality rate and the higher problem of complication rate.And then provide a kind of individuation branch stent type bow portion Rebuild artificial blood vessel.

The technical solution of the utility model is:

A kind of individuation branch stent type bow portion reconstruction artificial blood vessel, including initiative pulse support blood vessel, aortic stents blood The line artificial blood vessel part of making of the drop portion initiative pulse support blood vessel of pipe successively extends for bow portion aortic stents to proximal part direction Blood vessel and ascending part initiative pulse support blood vessel are issued comprising including a branch stent blood vessel on bow portion initiative pulse support blood vessel Multiple bow parts branch；Drop portion initiative pulse support blood vessel includes making line artificial blood vessel and multiple descending aorta metallic supports, drop master Artery metallic support is annular metal bracket, makes and is sewed with multiple cyclic annular descending aorta metal branch on the inner wall of line artificial blood vessel Frame；Branch stent blood vessel includes thin-walled artificial blood vessel and multiple branch's metallic supports, and branch stent openings in blood vessels is in the active of bow portion Arteries and veins stented vessel latter end upper limb, branch's metallic support are annular metal bracket, and the inner wall of thin-walled artificial blood vessel is sewed with multiple rings Shape metallic support.

Further, bow portion initiative pulse support blood vessel include unsupported bow portion make line blood vessel main body, branch stent blood vessel, Y shape bow part branch, bow part Zhi Si and collar shape sutural margin one；Make line blood vessel main body upper limb connection Y shape bow before middle section in bow portion Part is propped up, and Y shape bow part branch is further divided into bow part branch one and bow part branch two, and the root of Y shape bow part branch is made with bow portion The junction of line blood vessel main body connects collar shape sutural margin one outward, and bow portion makes line blood vessel main body and is connected to bow portion in middle section facies ventralis Branch four, bow portion make line blood vessel main body and suture connected component's stented vessel by suture in latter end upper limb.

Further, the thin-walled artificial blood vessel of branch stent blood vessel external extends for one section in branch root and unsupported covers Film, the latter end upper limb that this section of overlay film makes line blood vessel main body with bow portion are coincide and are connected by suture.

Further, it further includes fixed ring, and the interface of line blood vessel main body is made in the root and bow portion of branch stent blood vessel Place is supported by fixed ring.

Preferably, descending aorta metallic support is the annular metal carrier unit of closure, between each unit independently of one another, whole Straight tube shape or tapered cylindrical shape are constituted on body.

Further, ascending part initiative pulse support blood vessel includes that unsupported ascending part makes line blood vessel main body and collar shape sutural margin Two, the middle section that ascending part makes line blood vessel main body is radial to being externally connected with collar shape sutural margin two.

Preferably, the total length of initiative pulse support blood vessel is 260-360mm, and the diameter of initiative pulse support blood vessel is 22- 32mm, wherein the length 100-180mm of drop portion initiative pulse support blood vessel.

Preferably, Y shape bow part props up, bends point that part branch one, bow partially prop up two, branch stent blood vessel, bow part Zhi Si Branch diameter is 6-18mm, the length 10-50mm of branch stent blood vessel；Bow part Zhi Yiyu bends the angle that part is propped up between two 30°-150°。

Further, it further includes conveying device, and conveying device includes two groups of mutually independent release systems: i.e. drop portion Initiative pulse support blood vessel discharges system and branch stent blood vessel release system composition, and drop portion initiative pulse support blood vessel discharges system peace Mounted in the side of drop portion initiative pulse support blood vessel, branch stent blood vessel release system is mounted on the side of branch stent blood vessel；Its In, drop portion initiative pulse support blood vessel release system includes that drop portion pulls back bar and drop portion lashing wire, and drop portion lashing wire is looped around back and forth Drop portion pulls back on bar；Branch stent blood vessel release system includes branching back to pull rod and branch's lashing wire, the round-trip ring of branch's lashing wire It is wound on and branches back on pull rod.

Further, it further includes built-in；Built-in includes hard bow portion, and hard bow portion is radius of curvature phase Arc pipe same or equal to the gradually smaller caliber of distal end directional curvature radius from proximal part, hard bow portion is equipped with Multiple branch's windows and cyclic annular dent, hard bow portion is mounted on inside bow portion initiative pulse support blood vessel.

The utility model has the effect that compared with prior art

1), the drop portion initiative pulse support blood vessel of the utility model and bow portion, ascending part are integrally formed structures, without kiss Close, can shorten the Deep Hypothermia Circulatory Arrest time being down within 5 minutes for 20 minutes or more by conventional, greatly reduce ischemia of spinal cord, The risk of paraplegia.

2), the branch stent blood vessel of the utility model carries out intracavitary therapy to left subclavian artery, avoids position and exists deeply Left subclavian artery carry out identical, reduce operating difficulty and risk.

3), the built-in hard bow portion of the utility model creativeness design, application, can quickly, definitely control bleeding, pole The earth reduces bow, the visual area bleeding of drop portion, or even can realize above-mentioned visual area without bleeding, solves the most disaster of full bow replacement technique Point, greatly reduces operation risk and difficulty.

4), the bow portion of the utility model and ascending part make collar shape sutural margin is preset in line blood vessel main body can be with self active Astillen is sutured, and is realized that bow portion and ascending part make line internal blood vessel, can be effectively prevent the small probability thing of long-term postoperative bleeding Part.

5), the branch stent blood vessel of the utility model is made line blood vessel main body with bow portion by one section of overlay film and is communicated, the Duan Rou Soft structure improves the compliance for the individuation variation that branch stent issues left subclavian artery in bow portion, avoids that branch occurs The displacement of bracket and interior leakage.The interface that branch stent vascular root and bow portion make line blood vessel main body is equipped with elastomeric fixed ring, Component inlet compressive deformation is prevented, it is smooth to guarantee that left subclavian artery blood supply flows into.

Detailed description of the invention

Fig. 1 is existing full bow displacement+trunk stenter to implant schematic diagram；

Fig. 2 is that the individuation branch stent type bow portion of the utility model rebuilds the structural schematic diagram after artificial blood vessel's release；

Fig. 3 is that the individuation branch stent type bow portion of the utility model rebuilds artificial blood vessel and its conveying device is discharging Before, the spare schematic diagram under restrained condition；

Fig. 4 is that the individuation branch stent type bow portion of the utility model rebuilds artificial blood vessel and its built-in hard bow portion exists Perspective diagram under use state；

Fig. 5 is the schematic diagram that the internalization of the arch of aorta, aorta ascendens is realized using collar shape sutural margin；

Fig. 6 is the schematic diagram that the internalization of the arch of aorta, part aorta ascendens is realized using collar shape sutural margin；

Fig. 7 is the side view in hard bow portion；

Fig. 8 is the top view in hard bow portion；

Figure label: 1, initiative pulse support blood vessel；2, drop portion initiative pulse support blood vessel；3, bow portion initiative pulse support blood vessel； 4, ascending part initiative pulse support blood vessel；5, branch stent blood vessel；6, Y shape bow part is propped up；7, bend part Zhi Si；8, bow part branch one； 9, bow part branch two；10, collar shape sutural margin one；11, collar shape sutural margin two；12, drop portion aorta metallic support 12；13, Fixed ring；14, bow portion makes line blood vessel main body；15, ascending part makes line blood vessel main body；16, drop portion pulls back bar；17, drop portion lashing wire； 18, pull rod is branched back to；19, branch's lashing wire；20, hard bow portion；21, branch's window one；22, branch's window two；23, branch Window three；24, cyclic annular dent；25, hard ascending part；26, fixation hole；A-1, thin-walled artificial blood vessel；A-2, branch's metallic support.

Specific embodiment

Specific embodiment 1: illustrating present embodiment, a kind of individuation branch of present embodiment in conjunction with Fig. 2 to Fig. 8 Support rack type bow portion rebuilds artificial blood vessel, including initiative pulse support blood vessel 1, the drop portion aortic stents blood of initiative pulse support blood vessel 1 The line artificial blood vessel part of making of pipe 2 successively extends for bow portion initiative pulse support blood vessel 3 and ascending part active pulsation to proximal part direction Frame blood vessel 4 issues on bow portion initiative pulse support blood vessel 3 comprising multiple bow parts branch including a branch stent blood vessel 5； Drop portion initiative pulse support blood vessel 2 includes making line artificial blood vessel and multiple descending aorta metallic supports 12, descending aorta metallic support 12 be annular metal bracket, makes and is sewed with multiple cyclic annular descending aorta metallic supports 12 on the inner wall of line artificial blood vessel；Branch's branch Frame blood vessel 5 includes thin-walled artificial blood vessel A-1 and multiple branch's metallic support A-2, and branch stent blood vessel 5 is opened on bow portion aorta 3 latter end upper limb of stented vessel, branch metallic support A-2 are annular metal bracket, and the inner wall of thin-walled artificial blood vessel A-1 is sewed with Multiple annular metal bracket A-2.

The utility model is because of its drop portion initiative pulse support blood vessel 2 and bow portion initiative pulse support blood vessel 3 and ascending part active pulsation Frame blood vessel 4 is integrally formed structure, reduces previous anastomotic, can shorten the Deep Hypothermia Circulatory Arrest time by conventional 20 minutes or more It is down within 5 minutes, greatly reduces the risk of ischemia of spinal cord, paraplegia.Meanwhile because the built-in hard bow portion of creativeness is set Meter, application, can quickly, definitely control bleeding, considerably reduce bow, the visual area bleeding of drop portion, in addition can realize above-mentioned visual area without Bleeding solves the maximum difficult point of full bow replacement technique, greatly reduces operation risk and difficulty.

The blood vessel wall thickness of the thin-walled artificial blood vessel A-1 meaning of present embodiment is 0.2mm hereinafter, to guarantee branch stent blood Pipe can be sufficiently spread out in small-bore left subclavian artery, guarantee interior lumen bore close to normal physiological condition bore.

The utility model can significantly shorten the Deep Hypothermia Circulatory Arrest time, avoid or mitigate ischemia of spinal cord damage.Avoid a left side Coincideing for subclavian artery, reduces previous anastomotic quantity, hence it is evident that reduces intraoperative hemorrhage, shortens extracorporal circulatory system and operating time, reduces Operating difficulty improves success rate of operation.

Specific embodiment 2: illustrating present embodiment, the bow portion aortic stents of present embodiment in conjunction with Fig. 2 to Fig. 4 Blood vessel 3 includes that unsupported bow portion makes line blood vessel main body 14, branch stent blood vessel 5, Y shape bow part branch 6, bow part 47 and of branch Collar shape sutural margin 1；Make line blood vessel main body 14 upper limb connection Y shape bow part branch 6, Y shape bow part branch 6 before middle section in bow portion It is further divided into bow part branch 1 and bow part branch 29, make the company of line blood vessel main body 14 for the root and bow portion of Y shape bow part branch 6 Place's connection collar shape sutural margin 1 outward is connect, bow portion makes line blood vessel main body 14 and is connected to bow part branch 47, bow in middle section facies ventralis It makes line blood vessel main body 14 and connected component's stented vessel 5 is sutured by suture in latter end upper limb in portion.It is arranged such, it can be achieved to complete The treatment of size brachial artery proximal end, including to position it is deep left subclavian artery carry out quick intracavitary therapy, reduce and coincide Operating time is shortened in operation.Being preset with collar shape sutural margin can be sutured with self aorta wall, realize that bow drop portion is intravascular Portion can effectively prevent the small probability event of long-term postoperative bleeding.Other compositions and connection relationship and specific embodiment one It is identical.

Specific embodiment 3: illustrating present embodiment, the branch stent blood vessel 5 of present embodiment in conjunction with Fig. 2 to Fig. 4 The thin-walled artificial blood vessel A-1 of outer layer extends for one section of unsupported overlay film in branch root, this section of overlay film and bow portion make line blood vessel The latter end upper limb of main body 14 is coincide and is connected by suture.Left subclavian artery is being bent so set, improving branch stent The compliance for the individuation variation that portion issues, avoids displacement and interior leakage that branch stent occurs.It is other composition and connection relationship and Specific embodiment two is identical.

Specific embodiment 4: illustrate that present embodiment, present embodiment further include fixed ring 13 in conjunction with Fig. 2 to Fig. 4, point The interface that line blood vessel main body 14 is made in the root and bow portion of branch stented vessel 5 is supported by elastomeric fixed ring 13.So set, Component inlet compressive deformation is prevented, it is smooth to guarantee that left subclavian artery blood supply flows into.It is other composition and connection relationship with specifically Embodiment one, 2 is three identical.

The elastomeric fixed ring 13 of present embodiment is worked out using elastic material silk, such as titanium alloy wire.

Specific embodiment 5: illustrating present embodiment, the descending aorta metal branch of present embodiment in conjunction with Fig. 2 to Fig. 4 Frame 12 is the annular metal carrier unit of closure, between each unit independently of one another, constitutes straight tube shape or tapered cylinder on the whole Shape.So set, can compress after bracket release, close false chamber, restore effective true chamber blood supply.Other compositions and company It is identical to meet relationship and specific embodiment one, two, three or four.

Specific embodiment 6: illustrating present embodiment, the ascending part aortic stents of present embodiment in conjunction with Fig. 2 to Fig. 4 Blood vessel 4 includes that unsupported ascending part makes line blood vessel main body 15 and collar shape sutural margin 2 11, and ascending part is made in line blood vessel main body 15 Section is radial to being externally connected with collar shape sutural margin 2 11.It is arranged such, it can be achieved that the arch of aorta, part aorta ascendens blood vessel Internalization can effectively prevent the small probability event of long-term postoperative bleeding.Other compositions and connection relationship and specific embodiment five It is identical.

Specific embodiment 7: illustrating present embodiment, the initiative pulse support blood vessel 1 of present embodiment in conjunction with Fig. 2 to Fig. 4 Total length be 260-360mm, the diameter of initiative pulse support blood vessel 1 is 22-32mm, wherein drop portion initiative pulse support blood vessel 2 Length 100-180mm.So set, convenient for being suitable for different use environments.Other compositions and connection relationship and specific implementation Mode six is identical.

Specific embodiment 8: illustrating present embodiment, the Y shape bow part branch 6 of present embodiment, bow in conjunction with Fig. 2 to Fig. 4 Part branch 1, bow part prop up 29, branch stent blood vessel 5, branch's diameter of bow part branch 47 is 6-18mm, branch stent The length 10-50mm of blood vessel 5；Angle between bow part branch 1 and bow part branch 29 is 30 ° -150 °.So set, being applicable in Range is wide, and other compositions and connection relationship are identical as specific embodiment seven.

Specific embodiment 9: illustrating present embodiment in conjunction with Fig. 2 to Fig. 8, present embodiment further includes conveying device, defeated Sending device includes two groups of mutually independent release systems: i.e. drop portion initiative pulse support blood vessel release system and branch stent blood vessel are released Place system composition, drop portion initiative pulse support blood vessel release system are mounted on the side of drop portion initiative pulse support blood vessel 2, branch stent Blood vessel release system is mounted on the side of branch stent blood vessel 5；Wherein, drop portion initiative pulse support blood vessel release system includes drop portion It pulls back bar 16 and drop portion lashing wire 17, drop portion lashing wire 17 is looped around drop portion back and forth and pulls back on bar 16；The release of branch stent blood vessel System includes branching back to pull rod 18 and branch's lashing wire 19, and branch's lashing wire 19 is looped around branches back on pull rod 18 back and forth.So Setting, is easy to implement the smooth delivery of power of blood vessel.Other compositions and connection relationship are identical as specific embodiment seven.

Specific embodiment 10: illustrating that present embodiment, present embodiment further include built-in in conjunction with Fig. 4 to Fig. 8；

The first built-in includes hard bow portion 20, and hard bow portion 20 is that radius of curvature is identical or from proximal part to remote The equal arc pipe of the gradually smaller caliber of heart extreme direction radius of curvature, hard bow portion 20 are equipped with multiple branch's windows and ring Shape dent 24, hard bow portion 20 are mounted on inside bow portion initiative pulse support blood vessel 3；

Second of built-in includes hard ascending part, and hard ascending part is in straight or hettocyrtosis tubular, in hard bow portion 20 Equipped with fixation hole 26 and cyclic annular dent 24, hard ascending part is mounted on the inside of aorta ascendens Yu ascending part initiative pulse support blood vessel 4, firmly Matter bow portion 20 is mounted on inside bow portion initiative pulse support blood vessel 3.

So set, realizing the suture connection of aorta ascendens rapid free, other compositions and connection relationship and specific embodiment Seven is identical.

Preceding upper limb in the middle section in hard bow portion 20 is equipped with branch's window 1, is equipped with branch's window two in its latter end upper limb 22, section facies ventralis is equipped with branch's window 3 23 wherein；Between branch's window 1 and branch's window 2 22 and hard bends The bow portion surface of 20 proximal part of portion is equipped with cyclic annular dent 24.

The opening that branch's window 1 and branch's window 3 23 are round or oval, branch's window 2 22 are half The open hole of rounded distal.

The distal end of hard ascending part is equipped with fixation hole 26, and the middle part surface of hard ascending part is equipped with cyclic annular dent 24.

When hard bow portion 20 is in the tubular of hettocyrtosis, bending angle refers to 30 ° -90 °, and caliber (diameter) is 22-32mm, bending radius 30-60mm.

20 bent angle alpha of hard bow portion is 30 °, and caliber d is 22mm, radius of curvature R 40mm.Hard bow portion 20 is constituted Material is titanium alloy, stainless steel or polypropylene plastics, preferably titanium alloy.

Embodiment 1

A kind of individuation branch stent type bow portion reconstruction artificial blood vessel, comprising: initiative pulse support blood vessel 1, drop portion is actively The line vasculature part of making of arteries and veins stented vessel 2 extends for bow portion initiative pulse support blood vessel 3 and ascending part aortic stents blood to proximal part Pipe 4, bow portion initiative pulse support blood vessel 3 are issued comprising multiple bow parts branch including a branch stent blood vessel 5；Actively The principal length of arteries and veins stented vessel 1 is 300mm, and diameter 24mm, initiative pulse support blood vessel 2 length in drop portion is 120mm；Point The structural schematic diagram that branch support rack type bow portion is rebuild after artificial blood vessel's release is as shown in Figure 2；

The branch stent blood vessel 5, including drop thin-walled artificial blood vessel A-1 and multiple branch's metallic support A-2, thin-walled people Work blood vessel A-1 is sewed with multiple cyclic annular branches' metallic supports in Nei Bi, branch root extend for one section of unsupported overlay film with The latter end upper limb that bow portion makes line blood vessel main body 14 is coincide and is connected by suture；5 length of branch stent blood vessel is 32mm, and diameter is 12mm, thin-walled artificial blood vessel's A-1 constituent material is polyester woven object, cylindrical such as thin dacron fabric blood vessel.

Drop portion initiative pulse support blood vessel 2 is by descending aorta metallic support 12 and makes line artificial blood vessel and forms, and makes the artificial blood of line Inside pipe wall is sewed with multiple cyclic annular descending aorta metallic supports 12；The main body of drop portion initiative pulse support blood vessel 2 and ascending part 4, bow portion 3 Be it is integrated make line blood vessel, constituent material is polyester woven object, such as dacron blood vessel.

The descending aorta metallic support 12 is the annular enclosed carrier unit of Z-shaped or wavy shaped configuration, each bracket Between unit independently of one another, by wave crest to wave crest or trough to trough in the form of arrange.Metallic support 12 is closed by nickel-titanium shape memory Gold or cochrome silk etc. customize, and constitute straight tube shape on the whole.

Bow portion initiative pulse support blood vessel 3, main body issue Y shape bow part branch 6, bow part branch 47, branch stent blood Pipe 5 bends part branch three, and Y shape bow part branch 6 is further separated into bow part branch 1 and bow part branch 29；Above-mentioned branch's diameter is 10-16mm；9 one-tenth 60 ° of bow part branch 1 and bow part branch 2.

The ascending part initiative pulse support blood vessel 4, bow portion initiative pulse support blood vessel 3 are respectively in the former middle section, the latter and its Y shape The junction of the root of bow part branch 6, collar shape sutural margin 2 11, collar shape sutural margin are connected each by medical suture outward One 10.Collar shape sutural margin constituent material is polyester woven object, such as terylene or polytetrafluoroethylene (PTFE) (PTFE).

The conveying device is by two groups of mutually independent release systems: drop portion initiative pulse support blood vessel 2 discharges system and divides Branch stented vessel 5 discharges system composition, and initiative pulse support blood vessel 2 release system in drop portion is pulled back bar 16 and drop portion lashing wire by drop portion 17 compositions, 5 release system of branch stent blood vessel are formed by branching back to pull rod 18 and branch's lashing wire 19.Before implantation, use is medical Suture respectively fetters drop portion initiative pulse support blood vessel 2 and branch stent blood vessel 5, greatly reduces the two cross-sectional diameter In stand-by state, as shown in Figure 3.

The built-in hard bow portion 20 is the arc pipe that radius of curvature, caliber are equal, wherein section preceding upper limb, Latter end upper limb and middle section facies ventralis are respectively equipped with branch's window 1, branch's window 2 22, branch's window 3 23；In branch's window Cyclic annular dent 24 is equipped between one 21 and branch's window 2 22 and on the bow portion surface of 20 proximal part of hard bow portion.

When operation, it can be intubated and be irrigated through right side axillary artery, profound hypothermia after stopping circulation, splits a liter master along antetheca long axis Artery and the arch of aorta, the branch stent type bow portion after taking binding rebuild artificial blood vessel such as Fig. 3, drop portion initiative pulse support blood vessel 2 and branch stent blood vessel 5 be inserted into descending aorta and the true chamber of left subclavian artery respectively simultaneously, adjust the angle, successively pull back branch Pull back bar 18, drop portion pulls back bar 16, and medical suture is freed therewith, and branch stent blood vessel 5 and drop portion initiative pulse support blood vessel 2 are immediately It is released in place, the intracavitary therapy of corresponding two arteries of completion.

Then, the hard bow portion 20 built-in from the insertion of the proximal part of ascending part initiative pulse support blood vessel 4, makes its branch's window one 21, branch's window 2 22, be respectively aligned to Y shape bow part branch 6, the root of branch stent blood vessel 5.With thick line by the self arch of aorta Vascular wall, bow portion make line blood vessel main body, tighten on the cyclic annular dent 24 in built-in hard bow portion 20, knot.As shown in Figure 4. By bow part branch 47 carry out antegrade perfusions, be sequentially completed left common carotid artery, innominate artery coincide.Then ascending part master is carried out Bow portion reconstruction operations are completed at the end end or intralumenal anastomosis of 4 proximal end of arterial bracket blood vessel and aorta ascendens.

For some cases, proximal part lesion can be first handled during cooling, such as the replacement of row aorta root and bilateral hat Shape arterial ostium transplants (Bentall), the aorta petal for retaining aortic sinus and aorta ascendens and replaces the operation such as (Wheat), it Afterwards, profound hypothermia, stop recycling, as aforesaid operations carry out the reconstruction of bow portion.It is carrying out 4 proximal part of ascending part initiative pulse support blood vessel and is rising to lead Artery artificial blood vessel it is identical when, can apply the utility model built-in hard ascending part, carry out rapid free suture connection.

For most of cases, rise, collar shape sutural margin reserved in bow portion initiative pulse support blood vessel main body need not use. A small number of cases will can rise, in bow portion initiative pulse support blood vessel main body in vitro after circulation terminates to take precautions against long-term postoperative bleeding Reserved collar shape sutural margin carries out the connection that coincide with corresponding self aorta wall, realize the arch of aorta, aorta ascendens it is interior Portionization such as Fig. 5.Or internalization such as Fig. 6 of the arch of aorta, part aorta ascendens, for further taking precautions against the small of long-term postoperative bleeding Probability event.

Embodiment 2

The principal length of initiative pulse support blood vessel 1 is 320mm, diameter 26mm, wherein drop portion initiative pulse support blood vessel 2 Principal length 140mm；Branch stent blood vessel 5 length 34mm, diameter 14mm.45 ° of 20 bending angle of hard bow portion, caliber are 24mm, bending radius 50mm.Other are same as Example 1.

Embodiment 3

The principal length of initiative pulse support blood vessel 1 is 340mm, diameter 28mm, wherein drop portion initiative pulse support blood vessel 2 Principal length 160mm；Branch stent blood vessel 5 length 36mm, diameter 16mm.60 ° of 20 bending angle of hard bow portion, caliber are 26mm, bending radius 60mm.Other are same as Example 1.

Above-described embodiment within the spirit and principle of the utility model, is appointed not to limit the utility model What modification, equivalent replacement, improvement etc., should be included within the scope of protection of this utility model.

Claims (10)

1. a kind of individuation branch stent type bow portion rebuilds artificial blood vessel, it includes initiative pulse support blood vessel (1), and feature exists Line artificial blood vessel part is made to proximal part direction successively in: the drop portion initiative pulse support blood vessel (2) of initiative pulse support blood vessel (1) Extend for bow portion initiative pulse support blood vessel (3) and ascending part initiative pulse support blood vessel (4), bow portion initiative pulse support blood vessel (3) It is upper to issue comprising multiple bow parts branch including a branch stent blood vessel (5)；

Drop portion initiative pulse support blood vessel (2) includes making line artificial blood vessel and multiple descending aorta metallic supports (12), descending aorta Metallic support (12) is annular metal bracket, makes and is sewed with multiple cyclic annular descending aorta metallic supports on the inner wall of line artificial blood vessel (12)；

Branch stent blood vessel (5) includes thin-walled artificial blood vessel (A-1) and multiple branch's metallic supports (A-2), branch stent blood vessel (5) it is opened on bow portion initiative pulse support blood vessel (3) latter end upper limb, branch's metallic support (A-2) is annular metal bracket, thin-walled people The inner wall of work blood vessel (A-1) is sewed with multiple annular metal brackets (A-2).

2. a kind of individuation branch stent type bow portion according to claim 1 rebuilds artificial blood vessel, it is characterised in that: bow portion Initiative pulse support blood vessel (3) includes that unsupported bow portion makes line blood vessel main body (14), branch stent blood vessel (5), Y shape bow part branch (6), bend part Zhi Si (7) and collar shape sutural margin one (10)；

Bow portion makes line blood vessel main body (14) upper limb connection Y shape bow part branch (6) before middle section, and Y shape bow part branch (6) is further divided For bow part one (8) of branch and bow part two (9) of branch, make the company of line blood vessel main body (14) for the root and bow portion of Y shape bow part branch (6) Place's connection collar shape sutural margin one (10) outward is connect, bow portion makes line blood vessel main body (14) and is connected to bow part Zhi Si in middle section facies ventralis (7), bow portion makes line blood vessel main body (14) and sutures connected component's stented vessel (5) by suture in latter end upper limb.

3. a kind of individuation branch stent type bow portion according to claim 2 rebuilds artificial blood vessel, it is characterised in that: branch The thin-walled artificial blood vessel (A-1) of stented vessel (5) outer layer extends for one section of unsupported overlay film in branch root, this section of overlay film with The latter end upper limb that bow portion makes line blood vessel main body (14) is coincide and is connected by suture.

4. a kind of individuation branch stent type bow portion according to claim 1,2 or 3 rebuilds artificial blood vessel, feature exists In: it further includes fixed ring (13), and the interface that line blood vessel main body (14) is made in the root and bow portion of branch stent blood vessel (5) supports There are fixed ring (13).

5. a kind of individuation branch stent type bow portion according to claim 4 rebuilds artificial blood vessel, it is characterised in that: drop master Artery metallic support (12) is the annular metal carrier unit of closure, between each unit independently of one another, constitutes straight tube shape on the whole Or tapered cylindrical shape.

6. a kind of individuation branch stent type bow portion according to claim 5 rebuilds artificial blood vessel, it is characterised in that: ascending part Initiative pulse support blood vessel (4) includes that unsupported ascending part makes line blood vessel main body (15) and collar shape sutural margin two (11), ascending part are made The middle section of line blood vessel main body (15) is radial to being externally connected with collar shape sutural margin two (11).

7. a kind of individuation branch stent type bow portion according to claim 1 or 6 rebuilds artificial blood vessel, it is characterised in that: The total length of initiative pulse support blood vessel (1) is 260-360mm, and the diameter of initiative pulse support blood vessel (1) is 22-32mm, wherein drop The length 100-180mm of portion's initiative pulse support blood vessel (2).

8. a kind of individuation branch stent type bow portion according to claim 7 rebuilds artificial blood vessel, it is characterised in that: Y shape Partially one (8) of branch, bow part two (9) of branch, branch stent blood vessel (5), the branch of bow part Zhi Si (7) are straight for bow part branch (6), bow Diameter is 6-18mm, the length 10-50mm of branch stent blood vessel (5)；Between bow part one (8) of branch and bow part two (9) of branch Angle is 30 ° -150 °.

9. a kind of individuation branch stent type bow portion reconstruction artificial blood vessel according to claim 2 or 8, it is characterised in that: It further includes conveying device, and conveying device includes two groups of mutually independent release systems: i.e. drop portion initiative pulse support blood vessel discharges System and branch stent blood vessel release system composition, drop portion initiative pulse support blood vessel release system are mounted on drop portion aortic stents The side of blood vessel (2), branch stent blood vessel release system are mounted on the side of branch stent blood vessel (5)；

Wherein, drop portion initiative pulse support blood vessel release system includes that drop portion pulls back bar (16) and drop portion lashing wire (17), and drop portion is tied Wiring (17) is looped around drop portion back and forth and pulls back on bar (16)；

Branch stent blood vessel release system includes branching back to pull rod (18) and branch's lashing wire (19), and branch's lashing wire (19) is round-trip It is looped around and branches back on pull rod (18).

10. a kind of individuation branch stent type bow portion according to claim 9 rebuilds artificial blood vessel, it is characterised in that: it It further include built-in；Built-in includes hard bow portion (20), and hard bow portion (20) is that radius of curvature is identical or by the nearly heart The arc pipe equal to the gradually smaller caliber of distal end directional curvature radius is held, hard bow portion (20) is equipped with multiple branches Window and cyclic annular dent (24), it is internal that hard bow portion (20) is mounted on bow portion initiative pulse support blood vessel (3).