CN214908652U

CN214908652U - Bare crown stent releasing assembly for ascending aorta covered stent conveying system

Info

Publication number: CN214908652U
Application number: CN202120740334.8U
Authority: CN
Inventors: 陆清声; 张小武; 赫明
Original assignee: Suzhou Innomed Medical Device Co ltd
Current assignee: Suzhou Innomed Medical Device Co ltd
Priority date: 2021-04-12
Filing date: 2021-04-12
Publication date: 2021-11-30
Anticipated expiration: 2031-04-12

Abstract

The utility model discloses an ascending aorta tectorial membrane support delivery system is with naked coronary support release subassembly belongs to minimal access surgery technical field, is difficult to accurate arrival to set for position department scheduling problem design for solving current support. The utility model discloses rising aorta tectorial membrane support delivery system is with naked coronary support release subassembly includes near heart end naked coronary support, chronic expander and chronic expander release knob, and chronic expander release knob set up respectively on rising aorta tectorial membrane support delivery system, and the chronic expander is located near the inside of heart end naked coronary support, and chronic expander release knob is configured to can control the expansion and the shrink of chronic expander; the proximal bare crown stent is configured to expand upon expansion of the chronic dilator. The utility model discloses rising aorta tectorial membrane support conveying system can make nearly heart-end naked crown support laminate mutually with the vascular inner wall of target pathological change accurately with naked crown support release subassembly, has solved the problem that rising aorta intermediate layer should not carry out minimal access surgery.

Description

Bare crown stent releasing assembly for ascending aorta covered stent conveying system

Technical Field

The utility model relates to a minimal access surgery technical field especially relates to an ascending aorta tectorial membrane support conveying system is with naked coronary support release subassembly and ascending aorta tectorial membrane support conveying system including this naked coronary support release subassembly.

Background

Aortic aneurysms in the ascending aorta often involve the aortic sinus, which causes aortic insufficiency due to aortic valve insufficiency caused by aortic annular deformation and leaflet separation, and long-term effects on the aortic aneurysm cause heart failure. At present, only open surgery, such as open artificial blood vessel replacement (adopting dacron blood vessel replacement with an artificial main artery valve and implanting coronary artery into dacron blood vessel), and Wheat operation, can be adopted for treatment. When the open surgical operation is carried out, cardiac arrest and extracorporeal circulation are needed, the operation wound is huge, and the death rate and complication rate are high.

Because the ascending aorta has a complex anatomical structure, the heart, the valve and the coronary artery are arranged at the front proximal end, the branch artery on the arch for supplying blood to the brain and the upper limb is arranged at the back, the blood pressure of the ascending aorta is high, the flow rate is high, the pulsation and deformation amplitude of the blood vessel wall is large, and the danger and the weight of the ascending aorta interlayer are large, the stent is difficult to accurately position in a very limited area, the anchoring of the stent not only needs to overcome the pulsation and deformation of the blood vessel wall, but also needs to prevent the backward displacement and even tearing the interlayer, and also needs to avoid the stent from extending into the sinus in front to prevent the valve from being damaged and the coronary artery from being blocked, so that the intracavity minimally invasive technology is difficult to be applied to the treatment of the ascending aorta.

SUMMERY OF THE UTILITY MODEL

An object of the utility model is to provide an ascending aorta tectorial membrane support conveying system who can make nearly heart end naked coronary support and target pathological change blood vessel inner wall laminate accurately uses naked coronary support release subassembly.

Another objective of the present invention is to provide a stent graft delivery system for ascending aorta for implementing the minimally invasive technique in the lumen for the treatment of ascending aorta.

To achieve the purpose, on one hand, the utility model adopts the following technical scheme:

a bare crown stent release assembly for an ascending aorta covered stent delivery system, comprising a proximal bare crown stent, a chronic dilator and a chronic dilator release knob, the chronic dilator and the chronic dilator release knob being respectively disposed on the ascending aorta covered stent delivery system, the chronic dilator being located inside the proximal bare crown stent, the chronic dilator release knob being configured to control the expansion and contraction of the chronic dilator; the proximal bare crown stent is configured to expand upon expansion of the chronic dilator.

In particular, the bare crown stent release assembly further comprises a bungee cord fastener through which the proximal bare crown stent is banded on the chronic dilator, the bungee cord fastener being releasable upon release to free the proximal bare crown stent.

In particular, the bare crown stent release assembly further comprises a bare crown stent release switch, one end of the bungee cord fastener being coupled to the bare crown stent release switch, the bare crown stent release switch being configured to release the bungee cord fastener.

Particularly, the proximal bare crown stent is bound on the chronic dilator through a plurality of elastic cord buckles respectively, all the elastic cord buckles are connected in sequence, and a set distance is arranged between every two adjacent elastic cord buckles.

In particular, the elastic cord fastener is formed by knotting a cord having elastic deformability.

Especially, be provided with preceding barb and back barb on the bare crown support of proximal heart end, preceding barb for back barb is in proximal heart position department, the most advanced distal end of orientation of preceding barb, the most advanced proximal end of orientation of back barb.

In particular, the angle of inclination of both the front and rear barbs is between 30 ° and 45 °.

On the other hand, the utility model adopts the following technical scheme:

the stent delivery system comprises a stent delivery device and further comprises a bare crown stent release assembly for the stent delivery system, wherein the stent delivery device comprises an outer sheath tube, a single-cavity inner middle tube, a single-cavity inner tube and an adjusting handle, and a chronic dilator release knob is arranged on the adjusting handle.

In particular, one end of the chronic dilator is connected to the head end of the single-cavity inner tube, the other end of the chronic dilator is connected to the single-cavity inner tube, the single-cavity inner tube is arranged in the single-cavity inner tube in a penetrating mode, the tail end of the single-cavity inner tube and the tail end of the outer sheath tube are respectively connected to the adjusting handle, and the chronic dilator releasing knob is configured to drive the single-cavity inner tube to move relative to the single-cavity inner tube.

In particular, a metal protective sleeve is arranged inside the outer sheath tube in a penetrating way, and the proximal bare crown stent is at least partially positioned in the metal protective sleeve when in a contraction state.

The utility model discloses ascending aorta tectorial membrane support conveying system can control chronic expander expansion and shrink with the chronic expander release knob of naked coronary support release subassembly, can make nearly heart end naked coronary support expand gradually when chronic expander expansion, until nearly heart end naked coronary support and the vascular inner wall of target pathological change laminate mutually, thereby carry out the isolated art in the ascending aorta cavity, with treatment ascending aorta intermediate layer or aneurysm, the problem that ascending aorta intermediate layer should not carry out minimal access surgery has been solved, operative period mortality and complication incidence have been reduced, required postoperative and guardianship time are shorter. The chronic dilator has the function similar to balloon dilation, improves the adherence of the covered stent, ensures that the anchored covered stent does not shift any more while shortening the balloon dilation time, and solves the problems of aortic blood flow retardation, backflow and the like easily caused by long-time balloon dilation.

Drawings

FIG. 1 is a schematic structural diagram of an ascending aorta covered stent delivery system according to an embodiment of the present invention;

FIG. 2 is a schematic structural diagram of a rack conveyor according to an embodiment of the present invention;

fig. 3 is a schematic view of the internal structure of the rack conveyor according to the embodiment of the present invention;

fig. 4 is a schematic structural view of the stent conveyor according to the embodiment of the present invention after the outer sheath is retracted;

FIG. 5 is a schematic illustration of a stent delivery device according to an embodiment of the present invention after inflation of the chronic dilator;

fig. 6 is a schematic structural view of a proximal bare crown stent according to an embodiment of the present invention;

FIG. 7 is a schematic structural view of a stent graft according to an embodiment of the present invention;

FIGS. 8 to 12 are schematic views illustrating the process of delivering the stent graft by the stent delivery device.

In the figure:

100. a rack conveyor; 110. an outer sheath tube; 111. a metal protective sleeve; 120. an adjustable bent pipe; 130. a single lumen inner tube; 140. a single-lumen inner tube; 150. a flexible TIP head; 160. a chronic dilator; 174. a chronic dilator release knob; 176. a bare crown stent release switch; 200. covering a membrane stent; 210. a proximal bare crown stent; 211. front barbs; 212. back barbs; 220. a distal covered stent; 301. and the external thread sliding block.

Detailed Description

The technical solution of the present invention is further explained by the following embodiments with reference to the accompanying drawings.

The embodiment discloses a bare coronary stent release component for an ascending aorta covered stent conveying system and the ascending aorta covered stent conveying system comprising the bare coronary stent release component. As shown in fig. 1-7, the ascending aorta stent graft delivery system includes a stent transporter 100 and a stent graft 200, wherein the stent transporter 100 includes an outer sheath 110, a single lumen inner tube 130, a single lumen inner tube 140, a chronic dilator 160, an adjustment handle, and a chronic dilator release knob 174 disposed on the adjustment handle. The stent graft 200 includes a proximal bare crown stent 210 and a distal stent graft 220 connected together.

Wherein the proximal bare crown stent 210, the chronic dilator 160, and the chronic dilator release knob 174 together comprise a bare crown stent release assembly. The chronic dilator 160 and the chronic dilator release knob 174 are respectively arranged on the ascending aorta covered stent delivery system, the chronic dilator 160 is positioned inside the proximal bare-crown stent 210, and the chronic dilator release knob 174 is configured to control the expansion and contraction of the chronic dilator 160; the proximal bare crown stent 210 is configured to expand as the chronic dilator 160 expands.

The chronic dilator release knob 174 of the bare crown stent release assembly can control the expansion and contraction of the chronic dilator 160 according to needs, when the chronic dilator 160 expands, the bare crown stent 210 near the heart end can be gradually expanded until the bare crown stent 210 near the heart end is attached to the inner wall of a target lesion blood vessel, so that an ascending aorta intracavity isolation operation is performed, the ascending aorta interlayer or aneurysm is treated, the problem that the ascending aorta interlayer is not suitable for minimally invasive surgery is solved, the mortality and complication rate in the operation period are reduced, and the required hospitalization and postoperative monitoring time is shorter. The chronic dilator 160 has the function similar to balloon dilation, improves the adherence of the covered stent 200, shortens the balloon dilation time, ensures that the anchored covered stent 200 does not shift any more, and solves the problems of aortic blood flow retardation, backflow and the like easily caused by long-time balloon dilation.

On the basis of the above structure, the bare crown stent releasing assembly further comprises a bungee cord fastener (not shown), the bare crown stent 210 at the proximal end is bound on the chronic dilator 160 through the bungee cord fastener, and the bungee cord fastener can release the binding of the bare crown stent 210 at the proximal end when being loosened. As the chronic dilator 160 is expanded, the proximal bare crown stent 210 will be slowly released; after the elastic cord fastener is removed, the proximal bare crown stent 210 is completely released. After the proximal bare crown stent 210 is completely released, the chronic dilator 160 can still be used to perform a similar "balloon-back" action on the proximal bare crown stent 210.

The specific release manner of the bungee cord fastener is not limited, and preferably, the bare crown stent release assembly further comprises a bare crown stent release switch 176, one end of the bungee cord fastener is connected to the bare crown stent release switch 176, and the bare crown stent release switch 176 is configured to release the bungee cord fastener, thereby completing the complete release of the proximal bare crown stent 210.

In order to improve the firmness of the binding, the proximal bare crown support 210 is bound on the chronic dilator 160 through a plurality of elastic cord buckles respectively, all the elastic cord buckles are connected in sequence, and a set distance is arranged between two adjacent elastic cord buckles, so that the proximal bare crown support 210 is prevented from being bound by the elastic cord buckles when expanding. Preferably, the elastic cord fastener is formed by tying a cord with elastic deformability, and allows the proximal bare crown stent 210 to be extended to a greater extent.

On the basis of the above structure, as shown in fig. 6 and 7, a front barb 211 and a rear barb 212 are arranged on the proximal bare crown stent 210, the front barb 211 is located at the proximal position relative to the rear barb 212, the tip of the front barb 211 faces the distal end, and the tip of the rear barb 212 faces the proximal end.

The arrangement of the front barb 211 and the rear barb 212 ensures that the proximal bare crown stent 210 is anchored more stably in a very limited area, so that adverse conditions such as high blood pressure and high blood flow speed can be resisted, the overall release position and release angle of the covered stent 200 are ensured to be accurate enough, the adherence is better, internal leakage or displacement is avoided, and the aortic valve and coronary artery inlet are not interfered.

The proximal bare crown stent 210 is composed of a proximal part and a distal part, wherein the proximal part is in a flared trumpet shape, and the flared inclination angle is 10-30 degrees. The proximal bare crown stent 210 is preferably made of a nickel-titanium alloy material and is carved into a plurality of diamond structures which are connected in sequence by laser, all the diamond structures are wound into a circle, the uniformly arranged diamond structures have certain radial force and simultaneously reduce the stimulation to the inner wall of the blood vessel, and the stress on the inner wall of the blood vessel is uniform.

The front barb 211 and the rear barb 212 are each inclined at an angle of 30-45 deg. with respect to the surface of the proximal bare crown stent 210 body. After the proximal bare crown stent 210 is released, the front barbs 211 and the rear barbs 212 are slowly pressed into the inner wall of the blood vessel respectively by utilizing the ball expansion-like function of the chronic dilator 160, so that the proximal bare crown stent 210 can be anchored at a set position more firmly and reliably, and the risk of displacement of the proximal bare crown stent 210 is reduced; the front barb 211 and the back barb 212 have small areas, have little influence on the aortic blood flow, and improve the tightness of the head end of the proximal bare crown stent 210.

The specific manner of expanding and contracting the chronic dilator 160 is not limited, preferably, one end of the chronic dilator 160 is connected to the head end of the single-lumen inner tube 130 and the other end is connected to the single-lumen inner tube 140, the single-lumen inner tube 140 is inserted into the single-lumen inner tube 130, the end of the single-lumen inner tube 140 and the end of the outer sheath tube 110 are respectively connected to the adjusting handle, and the chronic dilator release knob 174 is configured to drive the single-lumen inner tube 140 to move relative to the single-lumen inner tube 130. Preferably, the distal end of the single lumen inner tube 140 is attached to an externally threaded slider 301, and the externally threaded slider 301 is attached to the chronic dilator release knob 174.

When the distance between the head end of the single-cavity inner tube 140 and the head end of the single-cavity inner middle tube 130 is gradually increased, the chronic dilator 160 is axially extended and radially reduced, and the contraction of the chronic dilator 160 is realized; when the distance between the head end of the single-cavity inner tube 140 and the head end of the single-cavity inner middle tube 130 is gradually reduced, the chronic dilator 160 is axially contracted and radially expanded, so that the chronic dilator 160 is expanded.

On the basis of the above structure, as shown in fig. 2 and 3, a metal protective sleeve 111 with a length of 10mm to 15mm is inserted into the inner side of the outer sheath 110, and the proximal bare crown stent 210 is at least partially located in the metal protective sleeve 111 when in the contracted state, so as to avoid damaging the inner wall of the outer sheath 110 when the proximal bare crown stent 210 is contracted in the outer sheath 110.

The using method of the ascending aorta covered stent delivery system comprises the following steps:

step 1, constructing a channel, as shown in fig. 8 and 9, pushing the flexible TIP head 150 along the blood vessel until reaching the set position. Considering that the stent transporter 100 made of a four-layer structure is relatively stiff, the outer sheath 110 may be withdrawn first at a location with a large turn, and the stent graft 200 may be delivered to the target lesion site using the adjustable bend 120.

Step 2, after the covered stent 200 reaches the target disease displacement, as shown in fig. 10 and 11, the outer sheath 110 is removed, and the semi-expanded covered stent 200 is exposed; the single lumen inner tube and the single lumen inner middle tube 130 are pushed forward as a whole, exposing the proximal bare crown stent 210.

Step 3, withdrawing the single-lumen inner tube and the single-lumen inner middle tube 130 until the chronic dilator is aligned with the proximal bare crown stent 210; after the release angle is adjusted, the single-lumen inner tube is withdrawn independently, so that the chronic dilator expands radially, and the bound proximal bare crown stent 210 gradually expands along with the expansion of the chronic dilator.

And 4, adjusting the angle of the proximal bare crown stent 210 in the process of expanding the chronic dilator until the proximal bare crown stent 210 is attached to the inner wall of the target lesion blood vessel. That is, in the process of releasing the proximal bare crown stent 210, the angle of the proximal bare crown stent 210 can be adjusted at any time as needed.

Step 5, as shown in fig. 12, the drawstring is firstly drawn out, and the distal covered stent 220 is completely released; the single-lumen inner tube 140 is then advanced separately to slowly contract the chronic dilator until the chronic dilator is completely separated from the proximal bare crown stent 210, completing the release and angular adjustment of the proximal bare crown stent 210.

In the using method, the distal end covered stent 220 and the proximal end bare crown stent 210 are released respectively in sequence. By arranging the adjustable bent tube 120 and the chronic dilator, the release angle of the proximal bare crown support 210 can be adjusted while the proximal bare crown support is slowly released, so that the proximal bare crown support 210 can be anchored at a target position more accurately, and can be anchored accurately even if the target position is extremely limited, thereby realizing the completion of a minimally invasive operation in a diseased blood vessel of an ascending aorta with an abnormally complex physiological anatomical structure and extremely high critical importance.

In the prior art, when the covered stent is released, the near end of the covered stent is released first, the far end of the covered stent is in a contracted state, the covered stent is in a 'pocket' shape, a 'storm' effect is easily formed, the impact of blood flow on the covered stent is increased, the near cardiac end of the covered stent is easily displaced in serious cases, even the interlayer is broken due to stimulation to the inner wall of a blood vessel, and the covered stent is not suitable for ascending aorta with an abnormal and complex current physiological anatomical structure.

The ascending aorta covered stent and conveying system component can sequentially release the distal end covered stent 220 and the proximal bare crown stent 210 step by step, after the outer sheath tube 110 is removed, the distal end covered stent 220 bound by a soft membrane or binding wire with the diameter of 10mm-15mm is released in half, the flexibility is enhanced, the storm effect is reduced, and the safety and the feasibility of the minimally invasive surgery are further improved.

It should be noted that the foregoing is only a preferred embodiment of the present invention and the technical principles applied. It will be understood by those skilled in the art that the present invention is not limited to the particular embodiments described herein, but is capable of various obvious changes, rearrangements and substitutions as will now become apparent to those skilled in the art without departing from the scope of the invention. Therefore, although the present invention has been described in greater detail with reference to the above embodiments, the present invention is not limited to the above embodiments, and may include other equivalent embodiments without departing from the scope of the present invention.

Claims

1. A bare crown stent release assembly for an ascending aorta covered stent delivery system, comprising a proximal bare crown stent (210), a chronic dilator (160) and a chronic dilator release knob (174), wherein the chronic dilator (160) and the chronic dilator release knob (174) are respectively arranged on the ascending aorta covered stent delivery system, the chronic dilator (160) is positioned inside the proximal bare crown stent (210), and the chronic dilator release knob (174) is configured to control the expansion and contraction of the chronic dilator (160); the proximal bare crown stent (210) is configured to expand upon expansion of the chronic dilator (160).

2. The bare crown stent release assembly for an ascending aorta covered stent delivery system according to claim 1, further comprising a bungee cord fastener, wherein the proximal bare crown stent (210) is tied to the chronic dilator (160) through the bungee cord fastener, and the bungee cord fastener releases the proximal bare crown stent (210) when released.

3. The bare crown stent release assembly for an ascending aortic stent graft delivery system according to claim 2, further comprising a bare crown stent release switch (176), wherein one end of the bungee cord fastener is connected to the bare crown stent release switch (176), and wherein the bare crown stent release switch (176) is configured to release the bungee cord fastener.

4. The bare crown stent release assembly for the ascending aorta covered stent delivery system according to claim 2, wherein the proximal bare crown stent (210) is bound on the chronic dilator (160) by a plurality of the elastic cord fasteners, all the elastic cord fasteners are connected in sequence, and two adjacent elastic cord fasteners are spaced apart by a set distance.

5. The bare crown stent release assembly for the ascending aorta stent graft delivery system according to claim 4, wherein the elastic cord fastener is formed by knotting a cord with elastic deformation capability.

6. The bare crown stent release assembly for an ascending aorta covered stent delivery system according to any one of claims 1 to 5, wherein a front barb (211) and a rear barb (212) are provided on the proximal bare crown stent (210), the front barb (211) is located at a proximal position relative to the rear barb (212), the tip of the front barb (211) faces the distal end, and the tip of the rear barb (212) faces the proximal end.

7. The bare crown stent release assembly for an ascending aorta stent graft delivery system according to claim 6, wherein the inclination angles of the front barbs (211) and the rear barbs (212) are each between 30 ° and 45 °.

8. An ascending aorta stent graft delivery system, comprising a stent conveyor (100), and further comprising a bare crown stent release assembly for the ascending aorta stent graft delivery system according to any one of claims 1 to 7, wherein the stent conveyor (100) comprises an outer sheath tube (110), a single lumen inner middle tube (130), a single lumen inner tube (140), and an adjustment handle, and a chronic dilator release knob (174) is disposed on the adjustment handle.

9. The ascending aorta stent graft delivery system according to claim 8, wherein a chronic dilator (160) has one end connected to a head end of the single-lumen middle tube (130) and the other end connected to the single-lumen inner tube (140), the single-lumen inner tube (140) is inserted into the single-lumen middle tube (130), a distal end of the single-lumen inner tube (140), and a distal end of the outer sheath tube (110) are respectively connected to the adjustment handle, and the chronic dilator release knob (174) is configured to drive the single-lumen inner tube (140) to move relative to the single-lumen middle tube (130).

10. The ascending aorta stent graft delivery system according to claim 8, wherein a metal protective sleeve (111) is arranged inside the outer sheath (110), and the proximal bare crown stent (210) is at least partially positioned in the metal protective sleeve (111) when in a contracted state.