JP2006006648A - Blood vessel connecting tool and blood vessel connecting device - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a blood vessel connecting tool and a blood vessel connecting device capable of connecting side walls of two blood vessels safely and easily in a short time. <P>SOLUTION: The blood vessel connecting tool 2 of this invention is used for connecting side walls of two blood vessels, and comprises several pairs of a first clamping piece 21 and a second clamping piece 22. The plurality of pairs are arranged in the circumferential direction. Each of the first clamping pieces 21 is at first in a lying posture with respect to the direction of the central axis of the blood vessel connecting tool 2, and each of the second clamping pieces 22 is in a standing posture with respect to the direction of the central axis from the beginning. By deforming each of the first clamping pieces 21 by plastic deformation so that the every first clamping piece is in the standing posture with respect to the central axis, the circumferences of holes formed on the side walls of the blood vessels are clamped between the first clamping pieces 21 and the second clamping pieces 22. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to a vascular junction device and a vascular junction device.

  With the aging society and the westernization of dietary habits, the number of patients with vascular diseases is increasing. Coronary artery bypass surgery and bypass surgery using artificial blood vessels have been established as treatment methods for these patients, and many patients Is blessed with the benefits. For example, patients with ischemic heart disease are treated by surgically joining the internal thoracic artery and coronary artery, and patients with obstructive arteriosclerosis are treated by revascularization using artificial blood vessels. Treatments that avoid foot amputation are widely used. In addition, as a blood access for hemodialysis patients, hemodialysis therapy is made possible by creating a shunt by directly joining the artery and vein of the patient or joining an artificial blood vessel.

  In general, vascular bonding in these treatments is performed using sutures. Also, in recent years, a technique for sandwiching and joining with a plurality of clips, a technique for facilitating ligation of a suture by providing a spring at the stump of the suture, and further, joining to a target blood vessel after being fixed to a biological blood vessel A device for the purpose has been proposed.

  Conventional suturing using sutures is a time consuming and difficult task and requires a high degree of skill and experience of the surgeon. For example, when joining the internal thoracic artery and coronary artery, it takes a lot of operation time for the procedure, and the blood vessels are joined together using sutures in a state where the heart is stopped once using an oxygenator. Since the method to do is common, it has the subject that the burden to a patient is also large. Moreover, the operation | movement which joins using a suture thread has the subject that the result of treatment greatly influences the result of treatment. Furthermore, joining with sutures and needles often carries the risk of causing vessel tearing in the treatment of pathological blood vessels.

  Under such circumstances, in particular, the technique for joining the internal thoracic artery and the coronary artery is highly interested in providing means for joining safely and easily in a short time for the following reasons.

  (1) During surgery to join the internal thoracic artery and coronary artery, it is necessary to place the patient on a cardiopulmonary bypass device, isolate the heart from general circulation, and generally remove the heart by infusion of cold cardiac anesthetic fluid. Treatment is normally performed by stopping the blood vessel site where the heart joins and leaving the blood vessel free. Such circulatory isolation and cardiopulmonary arrest are very traumatic, and it has been found that the frequency of post-operative complications changes directly with the time the heart is in cardiac anesthesia.

  (2) Due to the high cost of operating room time, the cost of bypass surgery for hospitals and patients is greatly increased if the surgical procedure is prolonged. Therefore, it is desired to shorten the time required for joining and the total operation time.

  As a trial other than sutures, joining means using staples are widely used in the surgical field, and various instruments have been developed for joining hollow organs such as the intestine found in the field of gastrointestinal surgery. However, these instruments are difficult to miniaturize and cannot be used to join small blood vessels, but most critically, these instruments are designed for inversion junctions, so that It should be clearly distinguished from instruments set for the purpose of placing them close to the serosa. In particular, these instruments cannot be used as vascular junctions for the following reasons.

  (1) Inverted blood vessels cause disturbance in blood flow. This can lead to decreased blood flow and turbulent peripheral flow into an ischemic state, and can also cause thrombosis that causes the thrombus to detach or occlude blood vessels due to turbulence or vortices.

(2) Unlike the intestinal tract, the outer surface of the blood vessel does not grow together.
(3) In order to secure a permanent blood vessel that does not cause thrombosis, the innermost layer (endothelium) must grow together to form a continuous and unhindered lumen of all blood vessels.

  As a proposal for the purpose of blood vessel joining, Japanese Patent Application Publication No. 2002-529141 discloses a technique in which a pawl and a biological blood vessel are fixed before joining, and then the fixed biological blood vessel is connected to another conduit. Although proposed in the publication (Patent Document 1), these prior arts aim to connect the end of the tubular graft to the side wall of the conduit, the first finger, the second finger, the third It consists of a finger and a fourth finger. In particular, it features an engagement hook for drilling the tubular graft for the purpose of fixing the end of the tubular graft.

  This prior art is not constituted by a two-dimensional surface, but is characterized by a three-dimensional structure including an engagement hook. Three-dimensional structures such as engagement hooks have a risk of causing physical trauma to blood vessels when the side walls of blood vessels are connected to each other. It has the disadvantage of causing turbulence in flow and obstruction due to thrombus or long-term patency.

  As described above, no device has been proposed that can safely and easily handle any vascular junction in a short time, reduce physical stimulation to the blood vessel as much as possible, and obtain good patency over the long term. .

Special table 2002-529141 gazette US Patent Application Publication No. 2002/0091398

  An object of the present invention is to provide a blood vessel bonding device and a blood vessel bonding device capable of bonding the side walls of two blood vessels safely and easily in a short time.

Such an object is achieved by the present inventions (1) to (12) below.
(1) A blood vessel joint for joining side walls of two blood vessels,
A plurality of pairs of the first sandwiching piece and the second sandwiching piece are installed along the circumferential direction.
Each of the first clamping pieces is initially in a sleeping position with respect to the central axis direction of the blood vessel connector, and each of the second clamping pieces is in an upright position with respect to the central axis direction. And
By plastically deforming each of the first clamping pieces so as to stand upright with respect to the central axis direction, between the first clamping piece and each of the second clamping pieces, A blood vessel connector characterized by sandwiching an edge of a hole formed in a side wall.

  (2) The blood vessel connector according to (1) above, which is made of a material having a Vickers hardness of 200 or less.

  (3) The blood vessel connector according to (1) or (2), wherein the first holding piece and the second holding piece are formed of a wire and have a frame shape.

  (4) The blood vessel connector according to (3), wherein a wire diameter of the wire is 0.5 mm or less.

  (5) The blood vessel connector according to any one of (1) to (4), wherein the first holding piece and the second holding piece have a substantially symmetrical shape.

  (6) When the vascular connector is developed two-dimensionally, the ratio of the area occupied by the vascular connector itself is 30% or less with respect to the area of the band-shaped region inscribed by the vascular connector (1) ) The vascular connector according to any one of (5) to (5).

(7) The blood vessel connector according to any one of (1) to (6) above,
An elongated insertion portion for supporting the vascular connector from the inside, and inserting the vascular connector into a blood vessel;
A vascular junction device comprising: erecting means for erecting the first holding piece in a sleeping posture.

(8) The insertion portion is inserted inside the blood vessel connector, and a cylindrical body having a deformable portion in which a plurality of slits extending in the axial direction are formed in the side wall in the circumferential direction;
An expansion and contraction mechanism for expanding and contracting the cylindrical body in the axial direction;
By contracting the cylindrical body in the axial direction by the expansion / contraction mechanism, the deformable portion is bent and deformed so as to protrude to the outer peripheral side, and the first holding piece is pressed to stand up, and then the expansion / contraction is performed. The vascular junction device according to (8), wherein the tubular body is extended by a mechanism to return the deformable portion to a flat state, and the insertion portion is removed from the vascular junction tool.

  (9) The blood vessel joining device according to (7), wherein an operation unit that operates the expansion and contraction mechanism is provided on a proximal end side of the insertion unit.

  (10) The vascular junction device according to any one of (7) to (9), wherein an outer diameter of the insertion portion is 1 to 40 mm.

  (11) The blood vessel joining device according to any one of (7) to (10), wherein a distal end portion of the insertion portion has a cutting edge for puncturing a blood vessel.

  (12) The blood vessel joining device according to (11), wherein the insertion portion includes a cylindrical storage portion that can store the cutting edge.

  According to the present invention, since the second clamping piece is in an upright posture from the beginning, the blood vessel connector can be easily aligned with the puncture hole of the blood vessel. Moreover, since it is possible to prevent the blood vessel connector from passing through the puncture hole by mistake, there is no possibility of causing physical injury to the blood vessel wall.

  In addition, since the blood vessel wall is pinched by plastically deforming the first pinching piece, there is no risk of trauma to the blood vessel, and there is no risk of trauma to the blood vessel. It is possible to reduce the risk of obstruction caused by

  Because of this, blood vessels can be joined easily and in a short time, and safety is extremely high.

  DETAILED DESCRIPTION OF THE INVENTION Hereinafter, a vascular junction device and a vascular junction device of the present invention will be described in detail based on preferred embodiments shown in the accompanying drawings.

  1, 2 and 3 are a perspective view, a front view and a side view, respectively, showing an embodiment of the blood vessel connector of the present invention.

  The blood vessel connector 2 of the present invention shown in these drawings forms an anastomosis by sandwiching and bonding the side walls of two blood vessels. The blood vessel connector 2 can be applied to both a living blood vessel and an artificial blood vessel.

  As shown in FIG. 1 and FIG. 2, the vascular connector 2 includes a pair of a first sandwiching piece 21 and a second sandwiching piece 22, and a plurality of pairs (in the form of an annulus) along the circumferential direction. In the configuration shown in FIG.

  The preferred number of the first clamping piece 21 and the second clamping piece 22 varies depending on their shape and the blood vessel diameter to be applied, but it is usually preferably 4 to 30 pairs, preferably 6 to More preferably, there are 12 pairs.

  In the present embodiment, the first clamping piece 21 and the second clamping piece 22 are arranged in a substantially circular shape (along the circumferential direction), but may be arranged in an elliptical shape (oval shape). Good.

  As shown in FIG. 3, the first clamping piece 21 is initially in a sleeping position with respect to the direction of the central axis Ax of the vascular connector 2. On the other hand, the 2nd clamping piece 22 is the attitude | position which stood up from the beginning with respect to the central-axis Ax direction.

  At the time of use, the vascular connector 2 is plastically deformed so that the first holding piece 21 is in an upright posture with respect to the central axis Ax direction, so that the gap between the first holding piece 21 and the second holding piece 22 is reduced. Can hold the side walls of the two blood vessels.

  The blood vessel connector 2 of the present invention is characterized in that the blood vessel wall is sandwiched by plastic deformation without using spring properties or superelasticity. Thereby, it has the characteristic that it is excellent in the alignment in the case of a connection, and certainty.

  Further, as can be seen from FIG. 3, since the blood vessel connector 2 is constituted by a two-dimensional surface, there is no risk of trauma to the blood vessel, and there is a risk of blood flow disturbance, clot obstruction, etc. Risk can be reduced.

  The 1st clamping piece 21 and the 2nd clamping piece 22 have comprised the substantially symmetrical shape (shape which mutually overlaps). Thereby, after the blood vessel joining is completed, the first sandwiching piece 21 and the second sandwiching piece 22 accurately overlap with each other through the blood vessel wall, so that the blood vessel wall can be more reliably sandwiched.

  The first clamping piece 21 and the second clamping piece 22 are formed by bending a wire material or cutting a pipe material and have a frame shape. Although the wire diameter of the wire which comprises the 1st clamping piece 21 and the 2nd clamping piece 22 is not specifically limited, It is preferable that it is 0.5 mm or less, and it is more preferable that it is 0.05-0.3 mm. .

  As shown in FIG. 2, in the present embodiment, the first sandwiching piece 21 and the second sandwiching piece 22 are formed in a gourd shape (or a plurality of continuous arcs so that the bending direction changes alternately) (or It has the shape of a stacked cocoon or cloud). Thereby, the physical load and stress which the 1st clamping piece 21 and the 2nd clamping piece 22 give to the blood vessel wall can be reduced more.

  As shown in FIGS. 1 and 3, the root portion of the first clamping piece 21 and the root portion of the second clamping piece 22 are connected via a linear (bar-shaped) connecting portion 23 parallel to the direction of the central axis Ax. Are connected. The connecting part 23 functions as a pinch margin for the blood vessel wall. The connecting portion 23 is not limited to being provided intermittently along the circumferential direction as shown in the figure, but may be a shape that is continuous along the circumferential direction, that is, a cylindrical shape.

  In such a blood vessel connector 2, it is preferable that the area occupied by the blood vessel connector 2 with respect to the blood vessel lumen area after completion of the blood vessel bonding can reduce the risk of causing thrombus formation. From this viewpoint, it is preferable that the blood vessel connector 2 has a shape that satisfies the following conditions.

  As shown in FIG. 12, when the vascular connector 2 is developed two-dimensionally (in a plane), a band-shaped (or rectangular or parallelogram) region (two-dot chain line in FIG. 12) in which the vascular connector 2 is inscribed. The ratio of the area occupied by the vascular connector 2 itself (the area of the hatched area in FIG. 12) to the area of the area surrounded by (3) is preferably 30% or less, and is 3 to 20%. Is more preferable. As a result, the area occupied by the blood vessel connector 2 can be reduced with respect to the blood vessel lumen area after completion of the blood vessel joining, so that the risk of causing thrombus formation can be reduced, and the anastomosis can be safely, reliably and long-term. Can be patented.

  In addition, the hatching in FIG. 12 is included for easy understanding of the region occupied by the blood vessel connector 2 itself, and does not indicate a cross section.

  As a constituent material of the blood vessel connector 2, a material that is plastically deformed when the first holding piece 21 is erected and maintains the standing state of the first holding piece 21 is used. For example, stainless steel, Tantalum or tantalum alloy, platinum or platinum alloy, gold or gold alloy, pure titanium or titanium alloy, Ni-Ti alloy, cobalt base alloy, magnesium, etc. are preferably used. As stainless steel, SUS316L having the most corrosion resistance is particularly suitable.

  Moreover, it is preferable that the vascular connector 2 is annealed. By performing the annealing, the flexibility, deformation followability and plasticity of the blood vessel connector 2 are improved, and the indwellability in the bent blood vessel becomes better. In addition, compared with the case where annealing is not performed, the force to restore the shape before expansion after the vascular connector 2 is expanded, in particular, the linear shape that is developed when the vascular joint 2 is expanded at a bent blood vessel site. The force is reduced, the physical stimulation applied to the bent inner wall of the blood vessel is reduced, and factors such as thickening and perforation can be reduced. Further, no directionality occurs in the bending deformation, and bending in any direction becomes easy, and stress applied to the blood vessel can be further reduced with the movement of the blood vessel.

Further, the constituent material of the blood vessel connector 2 is preferably relatively flexible, and specifically, a material having a Vickers hardness of 200 or less is preferable. As a result, even after blood vessel bonding, the bent blood vessel or the like can be easily bent (deformed) following the curve of the blood vessel, and the bent (deformed) shape is maintained by the blood vessel connector 2 itself. The burden is reduced. As a result, it is possible to contribute to the reduction of complications and long-term patency associated with the physical property mismatch between the vascular connector 2 and the flexible blood vessel. Moreover, since it is a flexible property, the irritation | stimulation accompanying the diameter reduction of a blood vessel can be reduced.
The Vickers hardness can be measured based on JIS Z 2244.

  4 is a perspective view showing an embodiment of the blood vessel joining device of the present invention, FIG. 5 is a longitudinal sectional view of the distal end portion of the blood vessel joining device shown in FIG. 4, and FIG. 6 is a cylinder in the blood vessel joining device shown in FIG. It is a perspective view which shows the deformable part of a cylindrical body. In the following description, the left side in FIG. 5 will be described as “tip”, and the right side will be described as “base end”.

  As shown in FIG. 4, the blood vessel joining device 1 includes the blood vessel joining device 2 described above, an elongated insertion portion 3 that supports the blood vessel joining device 2 at the distal end portion, and an operation installed on the proximal end side of the insertion portion 3. Part 4.

The distal end portion of the insertion portion 3 is inserted inside the blood vessel connector 2 and functions as a support portion that supports the blood vessel connector 2 from the inside. The outer diameter of the insertion portion 3 is substantially the same as the inner diameter of the blood vessel connector 2, but is, for example, about 1 to 40 mm, more preferably about 1 to 10 mm.
The blood vessel connector 2 is inserted into the blood vessel while being supported by the distal end portion of the insertion portion 3.

  The insertion part 3 may be either rigid (not flexible) or flexible (soft).

  Further, the constituent material of the insertion portion 3 may be either a synthetic polymer material or a metal material. Examples of the synthetic polymer material include polyurethane, silicone resin, polyester, polycarbonate, polyethylene, polypropylene, and copolymers thereof. Examples thereof include various fluororesins such as polyester elastomer, styrene elastomer, olefin elastomer, Teflon (PTFE) (“Teflon” is a registered trademark), and other rubber materials. Examples of the metal material include various alloys such as stainless steel, titanium, and Ni—Ti alloy.

  Moreover, the insertion part 3 may have a taper-shaped part from which an outer diameter changes along an axial direction. In addition, the shape of the insertion portion 3 is not limited to a linear shape as shown in the figure, and may be any shape such as a bow shape, a U shape, and an S shape.

  Although the full length of the insertion part 3 is not specifically limited, Usually, about 10-600 mm is preferable and it is more preferable that it is about 50-200 mm.

  In the configuration shown in the drawing, a cutting edge (needle tip) 71 for puncturing a blood vessel is provided at the distal end portion of the insertion portion 3. In the present invention, the cutting edge 71 does not have to be provided in the insertion portion 3, the blood vessel wall is punctured with a separate puncture tool, and the insertion portion 3 is inserted along the guide wire inserted through the puncture hole. May be.

  The operation unit 4 includes a cylindrical gripping part 41 fixed to the base end part of the insertion part 3, a finger hook part 42 installed so as to be movable in the axial direction with respect to the gripping part 41, and a base end part of the gripping part 41 And a rounded finger rest 43.

  The finger resting portion 42 can be pulled to the proximal end side by placing a thumb on the finger resting portion 43 and placing an index finger and a middle finger on the finger resting portion 42. As will be described later, the finger hooking portion 42 can be pulled in two stages. When the first stage is pulled, the cutting edge 71 can be accommodated, and when the first stage is pulled, the first holding piece 21 of the blood vessel connector 2 is raised. Can be made.

  As shown in FIG. 5, the insertion portion 3 has an outer tube 5, an inner tube 6 inserted into the outer tube 5, and a cylindrical body 7 installed between the outer tube 5 and the inner tube 6. is doing.

  A proximal end portion of the outer tube 5 is fixed to the grip portion 41. The blood vessel connector 2 is attached to the outside of the support portion 51 in the vicinity of the distal end portion of the outer tube 5. The outer diameter of the support portion 51 is substantially the same as the inner diameter of the blood vessel connector 2.

  The distal end portion of the outer tube 5 constitutes a storage portion 53 that can store the cutting edge 71.

  A flange (locking portion) 52 is formed on the outer periphery of the base end portion of the support portion 51. The blood vessel joint 2 is positioned with respect to the outer tube 5 by the proximal end inner peripheral portion of the blood vessel joint 2 coming into contact with the flange 52.

  A proximal end portion of the inner tube 6 is connected to a finger hook portion 42 inside the grip portion 41. Thereby, the inner tube 6 can be moved in the axial direction with respect to the outer tube 5 by the operation of the finger hooking portion 42.

  The cylindrical body 7 is inserted between the outer tube 5 and the inner tube 6 on the tip side with almost no gap. That is, the outer diameter and inner diameter of the cylindrical body 7 are substantially equal to the inner diameter of the outer tube 5 and the outer diameter of the inner tube 6, respectively.

  The cylindrical body 7 and the inner tube 6 are fixed at a joint 10 between their tips. Thereby, the cylindrical body 7 slides in the outer tube 5 as the inner tube 6 moves in the axial direction. The method for fixing the joint 10 is not particularly limited, and examples thereof include welding, brazing, fusion (thermal fusion, high frequency fusion, ultrasonic fusion, etc.), and adhesion using an adhesive.

  A blade edge (blade surface) 71 inclined with respect to the axial direction is formed at the tip of the cylindrical body 7. In a state where the finger hooking portion 42 is not pulled in the proximal direction, the cutting edge 71 protrudes from the distal end of the outer tube 5 (housing portion 53).

  As shown in FIG. 6, the cylindrical body 7 includes a deformable portion 72 in which a plurality of slits (elongate side holes) 721 extending in the axial direction are formed in the side wall along the entire circumference in the circumferential direction. Have on the way. That is, the deformable portion 72 has a structure in which a plurality of rod-like portions 722 formed between the slits 721 are intermittently present along the circumferential direction.

  As shown in FIG. 5, the deformable portion 72 is located in the vicinity of the first holding piece 21 of the blood vessel connector 2. In addition, the same number and opposite phase of slits (elongated side holes) 54 as the slits 721 are formed in a portion of the outer tube 5 located outside the deformable portion 72. That is, the slits 54 are formed at the positions of the respective rod-like portions 722.

  When the cylindrical body 7 is compressed in the axial direction, the deformable portion 72 (each rod-like portion 722) is bent and deformed into a mountain shape, passes through the slit 54, and protrudes to the outer peripheral side (radially outward). The deformable portion 72 functions as an erecting means that presses and erects the first sandwiching piece 21 in the lying posture by this deformation.

  A projection (stopper) 55 is formed on the outer tube 5 at the base end portion of the cylindrical body 7 so as to protrude toward the inner peripheral side.

  When the finger hanger 42 is pulled and the inner tube 6 moves in the proximal direction, and when the tubular body 7 moves in the proximal direction, the proximal end of the tubular body 7 comes into contact with the protrusion 55. The movement range of the cylindrical body 7 in the proximal direction is limited.

  When the inner tube 6 further moves in the proximal direction after the proximal end of the cylindrical body 7 abuts on the protrusion 55, the tubular body 7 can be compressed in the axial direction, and the inner tube 6 is moved in the distal direction. When moved, the cylindrical body 7 can be extended to the original state. That is, the outer tube 5 and the inner tube 6 also function as an expansion / contraction mechanism that expands and contracts the cylindrical body 7 in the axial direction.

  FIG. 7 to FIG. 11 are diagrams for sequentially explaining the method of using the vascular junction device of the present invention. Hereinafter, an example of a method of using the vascular connector 2 will be described based on these drawings.

  [1] The bypass blood vessel 100 and the bypassed blood vessel 200 to be joined are exposed and peeled, the bypassed blood vessel 200 is clipped at both ends with vascular forceps, the bypass blood vessel 100 is ligated at one end, and the other end is clipped at the vascular forceps. . Thereafter, the bypass blood vessel 100 is cut at a position from the ligation portion side between the ligation portion and the clipping portion of the bypass blood vessel 100.

  [2] After inserting the insertion portion 3 from the end of the cut bypass blood vessel 100, the cutting edge 71 is punctured from the lumen of the bypass blood vessel 100 toward the outside of the blood vessel. Next, the cutting edge 71 protruding outside the bypass blood vessel 100 is punctured into the side wall of the bypass blood vessel 200, and the distal end portion of the insertion portion 3 is inserted into the bypass blood vessel 200. At this time, the blade edge 71 is advanced as much as possible in parallel with the bypassed blood vessel 200, and care is taken not to penetrate the bypassed blood vessel 200. As a result, the state shown in FIG. 7 is obtained.

  [3] In the state shown in FIG. 7, when the finger hook portion 42 is pulled, the cylindrical body 7 moves in the proximal direction along with the inner tube 6 until the proximal end abuts the protrusion 55. As a result, the blade edge 71 is retracted in the proximal direction and stored in the storage portion 53.

  [4] Next, when the insertion portion 3 is advanced into both blood vessels, the second holding piece 22 of the blood vessel connector 2 is caught by the puncture portion of the bypass blood vessel 100, and a response is felt, so the insertion is stopped here. To do. As a result, the state shown in FIG. 8 is obtained, and the first sandwiching piece 21 is inserted into the bypassed blood vessel 200, and the second sandwiching piece 22 remains in the bypass blood vessel 100.

  As described above, since the second sandwiching piece 22 is in an upright posture from the beginning, the blood vessel connector 2 can be easily aligned with the puncture portions of the bypass blood vessel 100 and the bypassed blood vessel 200, and Since it is possible to prevent accidental passage through the puncture portion, there is no risk of physical damage to the blood vessel wall. Therefore, both blood vessels can be joined safely and efficiently in a short time.

  Further, in the present embodiment, since the blade edge 71 is housed in the housing portion 53 in [3], when the insertion portion 3 is advanced, the blade edge 71 does not damage the bypassed blood vessel 200 and is extremely safe. Is expensive.

  [5] When the finger hooking portion 42 is further pulled from the state shown in FIG. 8, the cylindrical body 7 is compressed from both ends by the joint portion 10 and the projection 55, so that it can be deformed as shown in FIG. The portion 72 is bent into a mountain shape and protrudes to the outer peripheral side through the slit 54. Then, the 1st clamping piece 21 which was a sleeping posture is pressed by the deformable part 72, and stands up.

  [6] As shown in FIG. 10, when the finger-hanging portion 42 is pulled out, the deformable portion 72 has a flange shape, and the first holding piece 21 stands up completely, and the standing state is plastically deformed as described above. Maintained by Thereby, the edge of the puncture hole formed in the side wall (blood vessel wall) of the bypass blood vessel 100 and the bypassed blood vessel 200 is overlapped and sandwiched between the first sandwiching piece 21 and the second sandwiching piece 22, and both blood vessels Is achieved.

  [7] After joining both blood vessels, when the finger hook portion 42 is pushed back in the distal direction, the inner tube 6 moves in the distal direction, thereby extending the cylindrical body 7 to the original state and flattening the deformable portion 72. After returning to the correct state, the insertion portion 3 is removed from the blood vessel connector 2. Thereby, the state shown in FIG. 11 is obtained. Thereafter, the end of the bypass blood vessel 100 is ligated, the vascular forceps are removed, and blood flow is resumed. Thereby, the blood vessel joining procedure is completed.

  As mentioned above, although the illustrated embodiment of the blood vessel joining device and the blood vessel joining device of the present invention has been described, the present invention is not limited to this, and each part constituting the blood vessel joining device and the blood vessel joining device is the same It can be replaced with any structure that can perform its function. Moreover, arbitrary components may be added.

It is a perspective view which shows embodiment of the vascular junction tool of this invention. It is a front view which shows embodiment of the vascular junction tool of this invention. It is a side view which shows embodiment of the vascular junction tool of this invention. It is a perspective view showing an embodiment of a vascular junction device of the present invention. It is a longitudinal cross-sectional view of the front-end | tip part of the vascular junction apparatus shown in FIG. It is a perspective view which shows the deformable part of the cylindrical body in the vascular junction apparatus shown in FIG. It is a figure for explaining the usage method of the vascular junction device of the present invention later on. It is a figure for explaining the usage method of the vascular junction device of the present invention later on. It is a figure for explaining the usage method of the vascular junction device of the present invention later on. It is a figure for explaining the usage method of the vascular junction device of the present invention later on. It is a figure for explaining the usage method of the vascular junction device of the present invention later on. It is a figure which shows the shape which expand | deployed two-dimensionally the vascular junction shown in FIG.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Vascular joining apparatus 2 Vascular joining tool 21 1st clamping piece 22 2nd clamping piece 23 Connection part 3 Insertion part 4 Operation part 41 Holding part 42 Fingering part 43 Finger rest part 5 Outer pipe 51 Support part 52 Flange 53 Storage part 54 Slit 55 Projection 6 Inner Tube 7 Cylindrical Body 71 Cutting Edge 72 Deformable Part 721 Slit 722 Bar Part 10 Joining Part 100 Bypass Blood Vessel 200 Bypass Blood Ax

Claims (12)

A blood vessel joint for joining the side walls of two blood vessels,
A plurality of pairs of the first sandwiching piece and the second sandwiching piece are installed along the circumferential direction.
Each of the first clamping pieces is initially in a sleeping position with respect to the central axis direction of the blood vessel connector, and each of the second clamping pieces is in an upright position with respect to the central axis direction. And
By plastically deforming each of the first clamping pieces so as to stand upright with respect to the central axis direction, between the first clamping piece and each of the second clamping pieces, A blood vessel connector characterized by sandwiching an edge of a hole formed in a side wall.   The blood vessel joint device according to claim 1, wherein the blood vessel connector is made of a material having a Vickers hardness of 200 or less.   The vascular connector according to claim 1 or 2, wherein the first holding piece and the second holding piece are formed of a wire and have a frame shape.   The vascular connector according to claim 3, wherein the wire has a wire diameter of 0.5 mm or less.   The blood vessel connector according to any one of claims 1 to 4, wherein the first holding piece and the second holding piece have a substantially symmetrical shape.   The ratio of the area occupied by the vascular joint itself is 30% or less with respect to the area of the band-shaped region inscribed by the vascular joint when the vascular joint is deployed two-dimensionally. The vascular connector according to any one of the above. The vascular joint device according to any one of claims 1 to 6,
An elongated insertion portion for supporting the vascular connector from the inside, and inserting the vascular connector into a blood vessel;
A vascular junction device comprising: erecting means for erecting the first holding piece in a sleeping posture. The insertion portion is inserted inside the blood vessel connector, and a cylindrical body having a deformable portion in which a plurality of axially extending slits are formed side by side on the side wall,
An expansion and contraction mechanism for expanding and contracting the cylindrical body in the axial direction;
By contracting the cylindrical body in the axial direction by the expansion / contraction mechanism, the deformable portion is bent and deformed so as to protrude to the outer peripheral side, and the first holding piece is pressed to stand up, and then the expansion / contraction is performed. The blood vessel joining apparatus according to claim 8, wherein the tubular body is extended by a mechanism to return the deformable portion to a flat state, and the insertion portion is removed from the blood vessel joining tool.   The vascular junction device according to claim 7, wherein an operation unit that operates the expansion and contraction mechanism is provided on a proximal end side of the insertion unit.   The vascular junction device according to any one of claims 7 to 9, wherein an outer diameter of the insertion portion is 1 to 40 mm.   The blood vessel joining device according to any one of claims 7 to 10, further comprising a cutting edge for puncturing a blood vessel at a distal end portion of the insertion portion.   The vascular junction device according to claim 11, wherein the insertion portion has a cylindrical storage portion that can store the cutting edge.

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