CN209809267U - Intracranial diversion device for aorta and left internal carotid artery - Google Patents

Intracranial diversion device for aorta and left internal carotid artery Download PDF

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Publication number
CN209809267U
CN209809267U CN201821579006.9U CN201821579006U CN209809267U CN 209809267 U CN209809267 U CN 209809267U CN 201821579006 U CN201821579006 U CN 201821579006U CN 209809267 U CN209809267 U CN 209809267U
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China
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sheath
intracranial
carotid artery
internal carotid
aorta
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CN201821579006.9U
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Inventor
陆信武
赵振
秦金保
李维敏
张省
殷敏毅
叶开创
刘晓兵
刘光
施慧华
崔超毅
彭智猷
杨心蕊
黄新天
陆民
蒋米尔
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Ninth Peoples Hospital Shanghai Jiaotong University School of Medicine
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Ninth Peoples Hospital Shanghai Jiaotong University School of Medicine
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Abstract

The utility model provides an intracranial diversion device for aorta and left internal carotid artery. The utility model has the advantages of, through the interim blood supply passageway that external shunt was established, can simply carry out the interim blood supply of left side internal carotid artery and intracranial blood vessel when going to the tectorial membrane support cover to the aorta arch, treat that the tectorial membrane support opens a window branch and rebuilds the back, resume original blood flow. The method for extracorporeal circulation has the advantages of simple operation, small wound, no need of blocking carotid artery, no need of interrupting intracranial blood flow, little plaque falling, no influence on operation and low stroke incidence of patients.

Description

Intracranial diversion device for aorta and left internal carotid artery
Technical Field
The utility model relates to a medical science and engineering cross field especially relate to an interim intracranial diversion's of aorta and left side internal carotid device.
Background
Aortic aneurysms and aortic dissections are a life-threatening disease in humans. At present, the surgical operation is still an effective treatment method for aortic dissection and aneurysm, but the technical difficulty is high, the requirements on operators and operating rooms are high, the popularization and the application are limited, but the technology needs general anesthesia downlink bypass transplantation, the operation risk is higher than that of simple internal cavity treatment, the operation time and the postoperative recovery time are long, and the complications such as infection, bleeding and the like are relatively more.
In recent years, the application and development of aortic endoluminal repair (TEVAR) has greatly changed the condition of the disease treatment, and the advantages of minimal invasion, safety, effectiveness and the like have been widely accepted. In some patients, the management of the arcus lesions is a significant challenge facing current vascular surgeons due to the complexity of aortic arch anatomy, the high risk of stroke. The aortic arch has complex anatomical morphology, and has torsion with different degrees on the coronary position, the sagittal position and the axial position, and the torsion is continuously changed along with the age, thereby not only increasing the difficulty of accurately measuring the diameter of the cross section of the aortic arch and the difficulty of accurately releasing the stent during the intracavity treatment, but also leading to the need of a longer anchoring area when the stent is effectively anchored. The branch vessels on the arch, which provide the blood supply to the upper limbs, especially the head and neck, limit the free upward movement of the anchoring zone and also bring more risks to the technical operations in the treatment of the lesions on the arch, the variation of the branches of which further aggravates the complexity thereof. Therefore, it is very important to establish a temporary device for intracranial diversion between the aorta and the left carotid artery.
SUMMERY OF THE UTILITY MODEL
The technical problem to be solved by the utility model is to provide a device of the intracranial diversion of aorta and left side carotid, its easy and simple to handle, the wound is less, need not block the carotid, need not interrupt intracranial blood flow, arouses the plaque to drop very little, does not influence operation and patient's apoplexy incidence and is lower.
In order to solve the above problem, the utility model provides a device of the intracranial diversion of aorta and left side carotid, include: the first sheath can be implanted at the aortic arch near the heart end through the left common carotid artery, and the tail end of the first sheath faces the left internal carotid artery; a second sheath implantable distal to the left internal carotid artery, the second sheath having a trailing end directed toward the left common carotid artery; a third sheath, the one end that the aortic arch that the third sheath can be implanted nearly heart end through artery under the left side clavicle is close to the aorta root, the tail end of third sheath is located in artery under the left side clavicle, the third sheath with second sheath intercommunication.
In an embodiment, the apparatus for intracranial diversion of the aorta and the left carotid artery further includes a diversion tube, and two ends of the diversion tube are respectively connected to the branch tube at the tail end of the second sheath and the branch tube at the tail end of the third sheath, so that the third sheath is communicated with the second sheath.
In one embodiment, the first sheath is a sheath greater than 12F.
In one embodiment, the second sheath is a sheath greater than 6F.
In one embodiment, the second sheath is greater than 6 centimeters in length.
In one embodiment, the length of the second sheath is greater than the depth to which the second sheath is implanted in the left internal carotid artery.
In one embodiment, the third sheath is a 6F-8F sheath.
In one embodiment, the length of the third sheath is in a range of 45-80 cm.
In one embodiment, the length of the third sheath is greater than the implantation depth of the third sheath.
The utility model has the advantages of, through the interim blood supply passageway that external shunt was established, can simply carry out the interim blood supply of left side internal carotid artery and intracranial blood vessel when going to the tectorial membrane support cover to the aorta arch, treat that the tectorial membrane support opens a window branch and rebuilds the back, resume original blood flow. The method for extracorporeal circulation has the advantages of simple operation, small wound, no need of blocking carotid artery, no need of interrupting intracranial blood flow, little plaque falling, no influence on operation and low stroke incidence of patients.
Drawings
Fig. 1 is a schematic structural diagram of the device for intracranial diversion of aorta and left carotid artery of the present invention.
Detailed Description
The following describes in detail a specific embodiment of the device for intracranial diversion of aorta and left carotid artery provided by the present invention with reference to the accompanying drawings.
Fig. 1 is a schematic structural diagram of the device for intracranial diversion of aorta and left carotid artery of the present invention. Referring to fig. 1, the device for intracranial diversion of aorta and left carotid artery of the present invention includes a first sheath 1, a second sheath 2 and a third sheath 3.
The first sheath 1 is a sheath of 12F or more. Where F is the unit of the sheath, "French," which is a description of the sheath circumference. For example, a 6F sheath may have an inner diameter of about 2mm, and a 24F sheath may have an inner diameter of about 8 mm. The first sheath 1 can be implanted through the left common carotid artery 10 at the proximal aortic arch 11. Specifically, in the case of using the device for intracranial diversion between the aorta and the left carotid artery, the first sheath 1 is implanted proximally through the left common carotid artery 10 to the aortic arch 11. For example, in this embodiment, a large sheath of 12F is implanted proximally through the left common carotid artery 10 to the aortic arch 11.
The second sheath 2 is longer than 6 cm and is a short sheath. The second sheath 2 can be implanted at the distal end of the left internal carotid artery 12. Wherein the length of the second sheath 2 is greater than the depth of implantation of the second sheath 2 into the left internal carotid artery 12. Specifically, when the device for intracranial diversion between the aorta and the left carotid artery is used, the second sheath 2 is implanted distally of the left internal carotid artery 12. For example, in the present embodiment, a short sheath of 6F is implanted into the distal end of the left internal carotid artery 12, the implantation depth is 4-6 cm, and the length of the second sheath 2 is greater than the implantation depth, i.e. the tail end of the second sheath 2 is exposed. At the rear end of the second sheath 2 there is at least one branch 20 to facilitate connection with other sheaths.
The length range of the third sheath pipe 3 is 45-80 cm, and the third sheath pipe is a long sheath. The third sheath 3 is a 6F-8F sheath. The third sheath 3 can be implanted at one end of the proximal aortic arch 11 close to the aortic root, and the tail end of the third sheath 3 is in the left subclavian artery 13. Wherein the length of the third sheath 3 is larger than the implantation depth of the third sheath 3. Specifically, when the device for intracranial drainage between the aorta and the left carotid artery is used, the third sheath 3 is implanted proximally through the left brachial artery to the aortic arch 11 near the aortic root. For example, in the present embodiment, an 8F long sheath (60 cm in length) is implanted proximally through the left brachial artery to the aortic arch 11 near the aortic root, and the length of the third sheath 3 is greater than the implantation depth of the third sheath 3, i.e. the tail of the third sheath 3 is exposed. At the end of the third sheath 3 there is at least one branch 30 to facilitate connection with other sheaths.
The second sheath tube 2 and the third sheath tube 3 are communicated. Specifically, the device for intracranial diversion of the aorta and the bilateral carotid artery further comprises a diversion tube 4, and two ends of the diversion tube 4 are respectively connected with the branch tube 20 at the tail end of the second sheath tube 2 and the branch tube 30 at the tail end of the third sheath tube 3, so that the second sheath tube 2 is communicated with the third sheath tube 3. The flow diverter 4 is a double-ended flow diverter of conventional construction in the art, available to those skilled in the art. In the present embodiment.
The utility model discloses the device of the intracranial diversion of aorta and left side carotid passes through the interim blood supply passageway that external diversion pipe established, can simply carry out the interim blood supply of left side carotid and intracranial blood vessel when going the tectorial membrane support to the aorta arch and cover, treats that the tectorial membrane support windows branch and rebuilds the back, resumes original blood flow. The method for extracorporeal circulation has the advantages of simple operation, small wound, no need of blocking carotid artery, no need of interrupting intracranial blood flow, little plaque falling, no influence on operation and low stroke incidence of patients.
The operation of the device for intracranial diversion of the aorta and the left carotid artery of the present invention is described below. When using the device of the utility model for intracranial diversion of aorta and left carotid artery, the flow direction of blood is shown by the arrow of dotted line and the arrow of solid line in the figure, wherein, the arrow of dotted line shows the blood flow direction before the windowing of left internal carotid artery blood vessel and in the windowing operation, and the arrow of solid line is the blood flow direction after the windowing of left internal carotid artery blood vessel.
After the general anesthesia is successful, the left carotid artery and the left subclavian artery are incised and exposed under the aseptic condition, and the intracranial diversion method of the aorta and the left internal carotid artery is established. The method mainly comprises the following three parts:
the first part establishes a diverting sheath for the left common carotid artery and the left internal carotid artery. A first sheath 1 is implanted through the left common carotid artery 10 towards the proximal end of the aortic arch, and a second sheath 2 is implanted at the distal end of the left internal carotid artery 12.
The second part establishes a left subclavian artery shunt sheath. A third sheath 3 is implanted through the left brachial artery towards the proximal end of the heart to the aortic arch near the aortic root.
The third part establishes a diversion system for the left subclavian artery and the left internal carotid artery. The branch pipes at the tail end of the second sheath pipe 2 and the branch pipes at the tail end of the third sheath pipe 3 are respectively connected through the shunt pipes 4, so that the second sheath pipe 2 is communicated with the third sheath pipe 3 to ensure blood supply of the left intracranial artery.
Before the left internal carotid artery is windowed, a covered stent (not shown in the drawing) is implanted into the aortic arch 11, and at the moment, the covered stent can block the blood circulation at the left common carotid artery 10, so that after the covered stent is implanted and in the left internal carotid artery windowing operation process, the blood flows into the left internal carotid artery 12 through the third sheath tube 3, the shunt tube 4 and the second sheath tube 2 to ensure the blood supply of the left intracranial artery; after the left internal carotid artery vessel is windowed, the left common artery 11 is no longer blocked by the stent graft, and then blood flows into the left internal carotid artery 12 through the first sheath 1 and the second sheath 2 to ensure the blood supply of the left intracranial artery.
The foregoing is only a preferred embodiment of the present invention, and it should be noted that, for those skilled in the art, a plurality of improvements and decorations can be made without departing from the principle of the present invention, and these improvements and decorations should also be regarded as the protection scope of the present invention.

Claims (8)

1. An apparatus for intracranial diversion of an aorta and a left internal carotid artery, comprising:
the first sheath is used for being arranged at the aortic arch near the heart end through the left common carotid artery, and the tail end of the first sheath faces the direction of the left internal carotid artery;
the second sheath is used for being arranged at the distal end of the left internal carotid artery, and the tail end of the second sheath faces the direction of the left common carotid artery;
the third sheath tube is used for being arranged at one end, close to the root of the aorta, of the aortic arch at the proximal end through the left subclavian artery, the tail end of the third sheath tube is positioned in the left subclavian artery, and the third sheath tube is communicated with the second sheath tube; and the number of the first and second groups,
and two ends of the diversion pipe are respectively connected with the branch pipe at the tail end of the second sheath pipe and the branch pipe at the tail end of the third sheath pipe, so that the third sheath pipe is communicated with the second sheath pipe.
2. The aortic and left internal carotid intracranial diversion apparatus as claimed in claim 1, wherein the first sheath is a sheath greater than 12F.
3. The aortic and left internal carotid intracranial diversion apparatus as claimed in claim 1, wherein the second sheath is a sheath greater than 6F.
4. The aortic and left internal carotid intracranial flow reversal device of claim 1, wherein the second sheath has a length greater than 6 cm.
5. The device for intracranial diversion of the aorta and the left internal carotid artery according to claim 1, wherein the length of the second sheath is greater than the depth at which the second sheath is disposed in the left internal carotid artery.
6. The intracranial inflow apparatus for aortic and left internal carotid arteries as recited in claim 1, wherein the third sheath is a 6-8F sheath.
7. The intracranial flow diversion apparatus as claimed in claim 1, wherein the length of said third sheath is in the range of 45-80 cm.
8. The aortic and left internal carotid intracranial diversion apparatus as claimed in claim 1, wherein the length of the third sheath is greater than the depth at which the third sheath is disposed.
CN201821579006.9U 2018-09-27 2018-09-27 Intracranial diversion device for aorta and left internal carotid artery Active CN209809267U (en)

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CN201821579006.9U CN209809267U (en) 2018-09-27 2018-09-27 Intracranial diversion device for aorta and left internal carotid artery

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CN201821579006.9U CN209809267U (en) 2018-09-27 2018-09-27 Intracranial diversion device for aorta and left internal carotid artery

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109125885A (en) * 2018-09-27 2019-01-04 上海交通大学医学院附属第九人民医院 The device of aorta and left side internal carotid artery encephalic turn of tidal stream

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109125885A (en) * 2018-09-27 2019-01-04 上海交通大学医学院附属第九人民医院 The device of aorta and left side internal carotid artery encephalic turn of tidal stream
CN109125885B (en) * 2018-09-27 2024-03-22 上海交通大学医学院附属第九人民医院 Intracranial transfer device for aorta and left internal carotid artery

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