CN209847467U

CN209847467U - Intravascular stent special for TIPS operation

Info

Publication number: CN209847467U
Application number: CN201920064055.7U
Authority: CN
Inventors: 李卫校; 翟水亭
Original assignee: Individual
Current assignee: Individual
Priority date: 2019-01-15
Filing date: 2019-01-15
Publication date: 2019-12-27
Anticipated expiration: 2029-01-15

Abstract

An intravascular stent for TIPS (TIPS surgery) aims to solve the problem that portal vein and hepatic vein blood flow are seriously affected when a straight-barrel-shaped covered stent is applied to the TIPS surgery and simultaneously solve the problem that the traditional bare stent is easy to cause stent occlusion due to hyperplasia of tissues into the lumen of the stent. It comprises a straight cylindrical framework and a tubular coating; the tubular film is fixedly arranged in the middle of the straight cylindrical framework, so that exposed anchoring parts are formed at two ends of the straight cylindrical framework. Its both ends all can form the anchor portion that has the thru hole, and the location effect is excellent, and the thru hole can pass through the blood flow, can reduce the influence to the intravascular blood flow of anchor portion when using.

Description

Intravascular stent special for TIPS operation

Technical Field

The utility model relates to a medical support technical field, concretely relates to TIPS (trans vascular intravascular delivery sheath) dedicated endovascular stent of operation.

Background

Worldwide, cirrhosis is the fourth leading cause of death (non-infectious disease) following tumors, cardiovascular disease, chronic lung disease, and the incidence of cirrhosis and liver cancer has increased by about 5000 ten thousand annually over the last 20 years. The reason for this is that the compensation function of liver disease is powerful, and liver disease is hidden and asymptomatic. Patients with cirrhosis will only show various decompensated symptoms after they have progressed to the decompensated stage. In the decompensation phase of cirrhosis, the patient will develop esophageal and gastric varices. Bleeding once the varicose esophageal fundic vein breaks down will cause severe massive hemorrhage of the digestive tract. The gastrointestinal bleeding caused by portal hypertension of cirrhosis accounts for about 70% of patients with gastrointestinal bleeding. The mortality rate of the first bleeding can reach 15-20%, and if the liver function of a patient is Child-Pugh C grade when bleeding, the mortality rate can reach 30%.

Referring to fig. 1, a shunt channel is established within hepatic parenchyma 11 between portal vein 13 and hepatic vein 14 via Transjugular Intrahepatic Portosystemic Shunt (TIPS). The TIPS operation can not only reduce the portal vein pressure, but also be combined with the esophagus and stomach fundus vein embolization operation to thoroughly treat the alimentary tract hemorrhage caused by the portal vein hypertension of the liver cirrhosis. At present, TIPS (tip-assisted surgery) is one of the most important treatment methods for treating portal hypertension digestive tract hemorrhage caused by cirrhosis. Stents currently available for TIPS procedures include bare metal stents, stent graft (fluent, Viabahn) and viaorr stent graft.

The metal bare stent has two manufacturing methods: firstly, a tubular stent with meshes is etched on tubular metal by laser, and the metal bare stent manufactured by the method has high rigidity, strong supporting force and poor flexibility; secondly, the tubular stent with meshes is woven by metal wires, and the metal bare stent manufactured by the method has good flexibility but poor supporting force. When the stent is used, organism tissues can grow into the metal bare stent through the meshes, and a lumen in the metal bare stent is blocked. The covered stent (fluent, Viabahn) and the viaorr composite covered stent are characterized in that a PTFE (polytetrafluoroethylene) membrane is covered outside a bare metal stent, tissues cannot grow into the lumen of the bare metal stent due to the blockage of the PTFE membrane, and the long-term unobstructed effect is good.

The inventors of the present application found that: 1. when a liver portal shunt channel is established by adopting a naked stent, organism tissues can be proliferated into a stent lumen through a stent mesh, and the incidence of postoperative restenosis is high; 2. the naked support can not seal the lacerated opening at the portal vein puncture point, and the risk of bleeding at the portal vein puncture point in the operation is higher; 3. the advantages of two stents can be combined by adopting the combination application of the covered stent and the bare stent, but the cost of using two stents is high, and the operation process is too complex; 4. the use of the viaorr covered stent can simplify part of the operation, but the proximal end of the stent is a covered stent, which influences the blood flow of the main trunk of the hepatic vein and the inferior vena cava.

SUMMERY OF THE UTILITY MODEL

The invention aims to provide a special intravascular stent for a TIPS (percutaneous transluminal angioplasty) operation, which solves the technical problem that the blood flow at the branch part of the portal vein and the hepatic vein is influenced when a straight-tube-shaped covered stent is applied to the TIPS operation in a novel technical route.

In order to solve the technical problem, the utility model adopts the following technical scheme:

designing a special intravascular stent for TIPS surgery, which comprises a straight cylindrical elastic framework and a tubular tectorial membrane; the tubular film is fixedly arranged in the middle of the straight cylindrical elastic framework, so that two ends of the straight cylindrical elastic framework form exposed anchoring parts, and through holes are formed in the anchoring parts.

Preferably, the straight cylindrical elastic framework is a laser engraving framework, and the laser engraving framework and the front end boundary of the tubular coating are provided with developing mark points on the anchoring part.

Preferably, the straight-barrel-shaped elastic framework is a metal wire woven framework, an expansion transition section is formed at the front end of the metal wire woven framework, and the tubular coating is arranged on the expansion transition section.

Compared with the prior art, the beneficial effects of the utility model are that:

the film-coated part of the middle section can prevent the hyperplasia of the inner membrane after operation and improve the long-term patency rate of the stent; the naked support in both ends forms the anchor portion that has the thru hole, and the location effect is excellent, and the thru hole can permeate the blood flow, can reduce the influence to the blood flow of portal vein and hepatic vein's blood vessel bifurcation department when using.

The utility model can be used for the supraarcual artery in-situ fenestration of the external iliac vein compression syndrome and the thoracic aorta intracavity repair besides The Intrahepatic Portosystemic Shunt (TIPS) operation.

Drawings

FIG. 1 is a diagram of the effect of intrahepatic portosystemic shunt (TIPS) surgery.

Fig. 2 is a structural diagram of an embodiment 1 of the intravascular stent special for TIPS surgery of the present invention.

Fig. 3 is a structural view of a laser engraved skeleton in example 1.

Fig. 4 is a structural diagram of an embodiment 2 of the intravascular stent special for TIPS surgery of the present invention.

Fig. 5 is a structural view of a wire knitted skeleton in example 2.

Fig. 6 is a diagram showing the effect of The Intrahepatic Portosystemic Shunt (TIPS) operation after the adoption of the special intravascular stent for TIPS operation of the present invention.

In the figure, 11-hepatic parenchyma, 12-inferior vena cava, 13-portal vein, 14-hepatic vein, 2-endovascular stent, 21-straight cylindrical elastic skeleton, 211-front end anchoring part, 212-rear end anchoring part, 22-tubular coating, 3-visualization marking point, L11-front end anchoring part axial length, L12-tubular coating axial length, L13-rear end anchoring part axial length, L21-front end swelling section, L22-swelling transition section, L23-middle section, L24-swelling transition section, and L25-rear end swelling section.

Detailed Description

The following embodiments are only intended to illustrate the present invention in detail, and do not limit the scope of the present invention in any way.

Example 1: an intravascular stent, see fig. 2-3, comprises a straight cylindrical elastic scaffold 21 and a tubular cover 22.

The straight cylindrical elastic skeleton 21 employs a meshed tubular stent fabricated by laser etching on a tubular metal.

The tubular cover 22 may be a film suitable for a medical stent having good toughness, such as: PTFE material, polytetrafluoroethylene material, and the like.

The tubular coating 22 may be fixedly disposed in the middle of the straight cylindrical elastic framework 21 by wrapping, interweaving, or the like, and the fixing manner may be bonding, tissue base-to-base (tissue base-to-base refers to a case where one substance partially or completely wraps another substance), so that the two ends of the straight cylindrical elastic framework 21 form an exposed front end anchoring portion 211 and a rear end anchoring portion 212, and both the front end anchoring portion 211 and the rear end anchoring portion 212 are bare stents, and may pass blood flow. Thus, the anchoring parts with the through holes are formed at both ends of the bracket, and the influence on the blood flow of the blood vessel can be reduced when the bracket is used.

Referring to fig. 2, at the front boundary between the laser engraved frame 21 and the tubular coating 22, the development mark points 3 are preferably provided on the front anchoring portion 211.

Preferably, the inner diameter of the straight cylindrical elastic bobbin 21 may be set to 8mm, 10mm, 12mm, which is common, the length of the front end anchoring portion 211 may be set to 2cm, and the length of the rear end anchoring portion 212 may be set to 2cm, 3 cm.

Taking The Intrahepatic Portosystemic Shunt (TIPS) operation as an example, the front anchoring portion 211 is located in the portal vein 13, the rear anchoring portion 212 is located in the hepatic vein 14, the middle membrane covering section 22 is located in the liver parenchyma 11, the middle section with the membrane covering part 22 can prevent tissues from proliferating towards the lumen of the stent, and the front anchoring portion 211 and the rear anchoring portion 212 enable the two ends of the stent to be fixed in the portal vein and the hepatic vein without affecting the blood flow of the hepatic vein and the portal vein. The front end of the laser engraving framework 21 specifically refers to one end positioned in the portal vein 13, and the position of the boundary between the laser engraving framework 21 and the front end of the tubular coating 22 in the portal vein 13 can be judged by observing the development mark points 3 through a developing device.

Example 2: an intravascular stent, see fig. 2-4, comprises a straight cylindrical elastic framework 21 and a tubular coating 22.

The straight tubular elastic framework 21 is a braided fabric formed by braiding filaments, and the filaments may be wires for intravascular stents, such as nickel titanium wires.

Referring to fig. 4 to 6, an expansion transition section (corresponding to L24) is formed at the front end of the wire braided skeleton, a tubular coating film is provided on the expansion transition section, and one end of the tubular coating film 22 is preferably provided at the maximum outer diameter of the expansion transition section.

Referring to fig. 4, at the boundary between the front ends of the straight cylindrical elastic bobbin 21 and the tubular coating film 22, the development mark point 3 is preferably provided on the front end anchor portion 211.

Taking The Intrahepatic Portosystemic Shunt (TIPS) operation as an example, the posterior anchoring portion 212 is located in the hepatic vein 14 and the inferior vena cava 12, the anterior anchoring portion 211 is located in the portal vein 13, the middle tectorial membrane section 22 is located in the hepatic parenchyma, the middle section with the tectorial membrane section 22 can prevent the tissue from proliferating towards the stent lumen, and the anterior anchoring portion 211 and the posterior anchoring portion 212 enable the two ends of the stent to be fixed in the portal vein and the hepatic vein without affecting the blood flow of the hepatic vein and the portal vein. The front end of the metal wire knitted framework refers to the end which is positioned in the portal vein 13.

The present invention has been described in detail with reference to the accompanying drawings and embodiments, but those skilled in the art will understand that various specific parameters in the above embodiments can be changed without departing from the spirit of the present invention to form a plurality of specific embodiments, which are the common variation ranges of the present invention and will not be described in detail herein.

Claims

1. An intravascular stent special for TIPS surgery comprises a straight cylindrical elastic framework and is characterized by also comprising a tubular tectorial membrane; the tubular film is fixedly arranged in the middle of the straight cylindrical elastic framework, so that two ends of the straight cylindrical elastic framework form exposed anchoring parts, and through holes are formed in the anchoring parts.

2. The intravascular stent of claim 1, wherein the straight-cylindrical elastic scaffold is a laser-engraved scaffold, and a development mark point is provided on the anchoring portion at a boundary between the laser-engraved scaffold and the front end of the tubular cover film.

3. The intravascular stent of claim 1, wherein the straight tubular elastic framework is a metal wire woven elastic framework, a swelling transition section is formed at a front end of the metal wire woven framework, and the tubular coating is arranged on the swelling transition section.