JP2842548B2 - Bifurcated vascular graft - Google Patents
Bifurcated vascular graftInfo
- Publication number
- JP2842548B2 JP2842548B2 JP18517793A JP18517793A JP2842548B2 JP 2842548 B2 JP2842548 B2 JP 2842548B2 JP 18517793 A JP18517793 A JP 18517793A JP 18517793 A JP18517793 A JP 18517793A JP 2842548 B2 JP2842548 B2 JP 2842548B2
- Authority
- JP
- Japan
- Prior art keywords
- blood vessel
- inner diameter
- artificial blood
- tubes
- side tube
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
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Description
【０００１】[0001]
【産業上の利用分野】本発明は、分岐人工血管に関し、
特に大動脈弓の病変部を置換するために用いられる分岐
人工血管に関する。BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a branch artificial blood vessel,
In particular, the present invention relates to a branch vascular prosthesis used to replace a lesion of an aortic arch.
【０００２】[0002]
【従来の技術及びその問題点】心臓から拍出される血液
は心臓の大動脈弁を経て拍出し、大動脈を通って全身に
導かれる。大動脈は肺動脈幹の後ろで右方へ向かって上
行し上行大動脈へ入り、これは弓状になって（この部分
は大動脈弓とよばれている）左の肺根を越えて後方に向
かい第４胸椎の左のすぐそばを通って、その後は背椎の
前を下行に走る下行大動脈に通じ全身の動脈群に通じて
いる。（図１参照） この大動脈弓は全身に血液を送る基幹部分であって、こ
の部分の分岐は頭部へ通じる総頸動脈（左右２本）と腕
部へ通じる鎖骨下動脈（左右２本）へと分岐する。生体
において大動脈弓よりの直接の分岐は３本である。この
分岐部分の近傍において病変が発生するとこの複雑に分
岐した生体血管の分岐部分を人工血管で置換することに
よって治療するが、このとき生体構造にマッチしたもの
が当然良いと考えられる。2. Description of the Related Art Blood pumped from the heart is pumped through the aortic valve of the heart and guided to the whole body through the aorta. The aorta ascends to the right behind the pulmonary trunk and enters the ascending aorta, which forms an arc (this portion is called the aortic arch) and moves posteriorly past the left pulmonary root. It passes immediately to the left of the thoracic vertebra, then to the descending aorta, which runs down the front of the spine, and to the arteries throughout the body. (See Fig. 1) This aortic arch is the main part that sends blood to the whole body. The branch of this part is the common carotid artery (two right and left) leading to the head and the subclavian artery (two right and left) leading to the arm. Branch to In a living body, there are three direct branches from the aortic arch. When a lesion occurs in the vicinity of the bifurcation, treatment is performed by replacing the bifurcation of the intricately bifurcated living blood vessel with an artificial blood vessel. At this time, a blood vessel that matches the biological structure is considered to be good.
【０００３】[0003]
【発明が解決しようとする課題】図２に、大動脈瘤を例
にとって人工血管の置換例を図示した。施術者は生体血
管の病変部を切除し、人工血管を縫い合わせてこの病変
部を人工血管に置換して手術を完了することになる。一
方、この病変部が更に分岐部に及ぶ場合、すなわち、図
３のようになると予め分岐した人工血管が入手出来れば
手術の省力性に力を発揮し、手術時間を短縮することが
可能で、開心術という極めて危険を伴い、高度練達した
施術者をもってしても困難を極めるこの種の手術に抜群
の効果を発揮することができる。本発明は更にこれに改
良を加え、側管の派出位置を変更することによって、生
体適合性を形状的に向上したものである。FIG. 2 shows an example of replacement of an artificial blood vessel using an aortic aneurysm as an example. The practitioner excises the lesion of the living blood vessel, stitches the artificial blood vessel, replaces the lesion with the artificial blood vessel, and completes the operation. On the other hand, when the lesion further extends to the bifurcation, that is, as shown in FIG. 3, if a pre-branched artificial blood vessel can be obtained, the power of the operation can be reduced and the operation time can be shortened. It is extremely dangerous to perform this kind of operation, which involves the extremely risk of open heart surgery and is difficult even for highly skilled practitioners. The present invention is an improvement of the present invention, and the shape of the biocompatibility is improved by changing the projecting position of the side tube.
【０００４】[0004]
【課題を解決するための手段】本発明は、大動脈弓の病
変部を置換するための分岐人工血管に係り、人工血管の
主部に３本の側管が派生しており、この側管のうち最端
のひとつが他の２つの側管より内径が大きく、かつこの
内径の最も大きい側管が当該人工血管の主部の長さ方向
に並んだ他の２本の側管の中心を結んだ線よりずれて配
設されてなることを特徴とする分岐人工血管に関する。SUMMARY OF THE INVENTION The present invention relates to a bifurcated vascular prosthesis for replacing a lesion of the aortic arch, wherein three side tubes are derived from a main portion of the prosthetic tube. One of the end tubes has a larger inner diameter than the other two side tubes, and the side tube having the largest inner diameter connects the centers of the other two side tubes arranged in the longitudinal direction of the main portion of the artificial blood vessel. The present invention relates to a bifurcated vascular prosthesis, which is arranged at a position deviated from an elliptical line.
【０００５】該人工血管のより太い側管は、生体の腕頭
動脈へ対応するものであり、人体の右側への総頸動脈と
鎖骨下動脈へと通じるものである。心臓から大動脈弁を
出て上行大動脈より大動脈弓へと湾曲してゆく部位から
右側への腕頭動脈に向かう分岐と左側へ導かれる２つの
側管（左側総頸動脈と左側鎖骨下動脈）の派生方向が生
体の構造とうまく適合しなければ、スムースに病変部分
を人工血管に置換することが難しい。[0005] The thicker side tube of the artificial blood vessel corresponds to the brachiocephalic artery of the living body and leads to the common carotid artery and the subclavian artery to the right side of the human body. Bifurcation toward the brachiocephalic artery from the site where the ascending aorta leaves the heart and curves from the ascending aorta to the aortic arch, and two lateral vessels (left common carotid artery and left subclavian artery) guided to the left If the derivation direction does not match well with the structure of the living body, it is difficult to smoothly replace the diseased part with an artificial blood vessel.
【０００６】本発明は、実際の生体血管の位置関係を考
慮し生体の血管の病変部を置換する人工血管のあるべき
姿を種々検討した結果、派生側管の配設位置の検討を進
めて本発明に到達したものである。According to the present invention, as a result of various studies on the ideal form of an artificial blood vessel that replaces a lesion of a living body blood vessel in consideration of the actual positional relationship of a living blood vessel, the position of the derived side tube is examined. The present invention has been reached.
【０００７】図４（Ａ），（Ｂ），（Ｃ）によって本発
明を詳しく説明する。図４（Ａ）は本例による分岐人工
血管の長さ方向およびその直角方向からみたもので、ｐ
−ｐ’が長さ方向である。この人工血管の主部は内径１
８ｍｍ〜３６ｍｍであり、側管のうち比較的細い内径の
もの（ｂ，ｃ）は、内径５ｍｍ〜１５ｍｍで、当該人工
血管の長さ方向の線ｐ−ｐ’上にその中心が乗っている
ように縫合されている。一方、最も太い内径の側管の中
心は、ｐ−ｐ’上で表される線よりｘｍｍ（例えば、ｘ
＝３ｍｍ）ずれて縫合されている。このために側管の派
生方向が、当該人工血管の長さ方向へ向かって、換言す
れば人工血管の断面円方向からみた場合、図４（Ｂ）に
示すように異方向への派生が本発明の特徴の中核をなす
ものである。The present invention will be described in detail with reference to FIGS. 4 (A), 4 (B) and 4 (C). FIG. 4 (A) is a view of the bifurcated vascular graft according to the present example as viewed from the longitudinal direction and the direction perpendicular thereto.
-P 'is the length direction. The main part of this artificial blood vessel has an inner diameter of 1
The side tube (b, c) having a relatively small inner diameter of 8 mm to 36 mm and an inner diameter of 5 mm to 15 mm has its center on the line pp ′ in the length direction of the artificial blood vessel. Is sewn. On the other hand, the center of the side pipe having the largest inner diameter is x mm (for example, x
= 3 mm). For this reason, when the derivation direction of the side tube is viewed in the length direction of the artificial blood vessel, in other words, when viewed from the cross-sectional circular direction of the artificial blood vessel, the derivation in the different direction as shown in FIG. It is at the core of the features of the invention.
【０００８】側管ｂ，ｃの間隔ｙは、例えば８ｍｍであ
り、この間隔ｙは１０ｍｍ以下でないと狭い位置関係で
宿主血管との吻合が難しい。また側管ａとｂとの間隔ｚ
は、例えば、１０ｍｍであり、このｚは１８ｍｍ以下で
あることが狭い生体内の位置関係から必要で、この間隔
が１９ｍｍより大きいと宿主血管との吻合において位置
的に無理が生じる。図４（Ａ）に示したものは、側管の
うち２本は主管人工血管の長さ方向に並んでいるが、必
ずしもこの２本は長さ方向に並ぶ必要はない。The distance y between the side tubes b and c is, for example, 8 mm. Unless the distance y is 10 mm or less, it is difficult to anastomose with the host blood vessel in a narrow positional relationship. Also, the distance z between the side tubes a and b
Is, for example, 10 mm, and it is necessary that z is 18 mm or less due to a narrow positional relationship in a living body. If the distance is larger than 19 mm, positional anesthesia with an anastomosis with a host blood vessel occurs. In the one shown in FIG. 4A, two of the side tubes are arranged in the length direction of the main vascular prosthesis, but these two tubes need not necessarily be arranged in the length direction.
【０００９】図４（Ｃ）にその一例を示す。本例では比
較的内径の小さい２つの側管は、主管人工血管の長さ方
向とはある角度θをもって傾斜している。側管の内径
は、例えば側管ａは１１ｍｍ、ｂは７．５ｍｍ、ｃは８
ｍｍであってよい。本発明のより太い側管と他の２本の
側管との位置関係は、図４（Ａ），（Ｃ）で示されるよ
うに、２本のより細い２つの側管の中心を結ぶ直線と平
行に走る直線の間の最短距離ｘが１ｍｍ〜１０ｍｍ以内
にあり、更に好ましくは２ｍｍ〜８ｍｍの範囲内にあ
る。この距離が１ｍｍ未満では効果が薄く、逆に１０ｍ
ｍを越えると比較的太い側管の角度が極端で逆に宿主血
管との吻合が難しくなる。FIG. 4C shows an example. In this example, the two side tubes having relatively small inner diameters are inclined at a certain angle θ with respect to the length direction of the main vascular prosthesis. The inner diameter of the side tube is, for example, 11 mm for side tube a, 7.5 mm for b, and 8 for c.
mm. As shown in FIGS. 4A and 4C, the positional relationship between the thicker side tube of the present invention and the other two side tubes is a straight line connecting the centers of the two thinner side tubes. The shortest distance x between the straight lines running in parallel with each other is within 1 mm to 10 mm, and more preferably within the range of 2 mm to 8 mm. If this distance is less than 1 mm, the effect is thin, and conversely, 10 m
If it exceeds m, the angle of the relatively thick side tube is extreme, and conversely, it becomes difficult to anastomose with the host blood vessel.
【００１０】図５は本例の人工血管を生体心臓に置換し
たときの置換人工血管の分岐方向の位置関係を理解のた
めに立体的に図示したものである。本図より容易に理解
されるように左側へ血液を導く２本の側管（ｂ，ｃ）と
右側へ血液を導く比較的太い側管（ａ）とが、ある角度
をもって配設され、これが生体血管と無理なく吻合でき
ることが理解されよう。FIG. 5 is a three-dimensional view for understanding the positional relationship in the branching direction of the replacement artificial blood vessel when the artificial blood vessel of this embodiment is replaced with a living heart. As can be easily understood from this figure, two side tubes (b, c) for guiding blood to the left and a relatively thick side tube (a) for guiding blood to the right are arranged at a certain angle. It will be understood that the anastomosis can be easily made with the living blood vessel.
【００１１】本発明に用いられる人工血管は、３本の側
管が分岐してなるポリエステル人工血管であって、側管
の内径が異なっており、最も大きい内径を有する側管の
内径と他の任意の側管の内径の比が１．１〜１．７の範
囲内にある。さらに、３本の側管を派生してなるその分
岐人工血管において、最も大きい内径を有する側管とそ
れに隣接する側管との間の間隔が１８ｍｍ以下であるこ
とが好ましい。The artificial blood vessel used in the present invention is a polyester artificial blood vessel in which three side tubes are branched, wherein the inner diameter of the side tube is different, and the inner diameter of the side tube having the largest inner diameter is different from that of the other side tube. The ratio of the inner diameters of any side tubes is in the range of 1.1 to 1.7. Further, in the branched artificial blood vessel derived from the three side tubes, the distance between the side tube having the largest inner diameter and the side tube adjacent thereto is preferably 18 mm or less.
【００１２】本発明は、人工血管のうち、大動脈弓の病
変部を置換するための分岐人工血管に係り、人工血管の
主部に３本の側管が分岐しており、この側管のうち１本
は他の側管よりも内径が大きい。また人工血管の主部の
内径は、１８ｍｍ〜３６ｍｍ、好ましくは２０ｍｍ〜３
２ｍｍの間にある。この内径が１８ｍｍより小さいとき
は、成人の場合生体大動脈とマッチせず、また３６ｍｍ
より大きい場合には、また生体血管の径との整合性がな
く吻合困難又は不能となる。生体血管は人によりその大
きさは様々であるが、１８ｍｍ〜３６ｍｍの中にほとん
どの場合入ることになる。幼児、小児の場合には更に小
さい径のものが必要になるが、それ程その例は多くな
い。なぜなら、この人工血管が適用される病変は通常成
人の場合がほとんどであることによる。The present invention relates to a bifurcated vascular prosthesis for replacing a lesion of an aortic arch in a prosthetic blood vessel, wherein three side pipes are branched into a main part of the prosthetic blood vessel. One has a larger inside diameter than the other side tubes. The inner diameter of the main part of the artificial blood vessel is 18 mm to 36 mm, preferably 20 mm to 3 mm.
Between 2 mm. When this inner diameter is smaller than 18 mm, it does not match with the living aorta in an adult, and 36 mm
If it is larger, it is also inconsistent with the diameter of the living vessel, making anastomosis difficult or impossible. Living blood vessels vary in size from person to person, but most often fall within 18 mm to 36 mm. In the case of infants and children, smaller diameters are required, but there are not many examples. This is because the lesion to which this artificial blood vessel is applied is usually almost the same for adults.
【００１３】本発明の分岐人工血管において、側管は人
工血管の主部に３本派生するのであるが、そのうち１
本、殊に一方の端の管の内径が他の側管よりも大きいこ
とが必要である。その理由は、生体の大動脈において、
左側は首へ通じる総頸動脈と左腕へ通じる鎖骨動脈が直
接大動脈弓から独立して派生するのに対して、右ではま
ず比較的太い腕頭動脈が大動脈弓から派生し、これが２
つに分かれて総頸動脈と鎖骨下動脈に分かれるのであ
る。換言すれば、大動脈弓より直接派生している分岐動
脈は比較的太い腕頭動脈とこれに比べて比較的細い鎖骨
下動脈と総頸動脈の計３本である。当然、腕頭動脈の血
液の流量は鎖骨下動脈と総頸動脈の血液流量の和に匹敵
すべきであることも理解される。[0013] In the branched artificial blood vessel of the present invention, three side tubes are derived from the main part of the artificial blood vessel.
It is necessary that the inner diameter of the book, especially one end tube, be larger than the other side tube. The reason is that in the aorta of the body,
On the left, the common carotid artery leading to the neck and the clavicle artery leading to the left arm derive directly and independently from the aortic arch, while on the right first the relatively thick brachiocephalic artery derives from the aortic arch.
It is divided into common carotid artery and subclavian artery. In other words, there are three branch arteries directly derived from the aortic arch: a relatively thick brachiocephalic artery, a relatively thin subclavian artery, and a common carotid artery. Of course, it is also understood that the blood flow in the brachiocephalic artery should be comparable to the sum of the blood flow in the subclavian artery and the common carotid artery.
【００１４】本発明において、比較的内径の大きい側管
の内径と他の比較的細い任意の側管の内径の比は１．１
〜１．７の間にあり、更に好ましくは１．２０〜１．５
０で、更に好ましくは１．２５〜１．４５の間である。
この比が１．１未満だと人体の左右の血液量がアンバラ
ンスになり、人体の右側に充分な血液量を供給するのに
無理がかかり、１．７を越えて大きいと逆に右側への血
液の量が多くなってしまう。すなわち、生体の自然の姿
より乖離して不自然になり、これは生体にとって好まし
いことではない。In the present invention, the ratio of the inside diameter of the side tube having a relatively large inside diameter to the inside diameter of any other relatively small side tube is 1.1.
To 1.7, more preferably 1.20 to 1.5
0, more preferably between 1.25 and 1.45.
If this ratio is less than 1.1, the blood volume on the left and right sides of the human body will be unbalanced, and it will be impossible to supply a sufficient blood volume to the right side of the human body. The blood volume of the blood becomes large. That is, the living body deviates from the natural state and becomes unnatural, which is not preferable for the living body.
【００１５】また、生体とマッチするという点で重要な
ことは、人工血管の分岐側管の間隔である。人工血管の
生体血管との置換には、極めて狭い局所的なところに分
岐があるので、この間隔が適正でないと狭い場所にある
病変部の置換が実際に不可能となってしまう。ここで分
岐側管の間隔が極めて重要となる。本発明において、図
４に示す比較的太い側管（ａ，内径ｄ1 ）とそれに隣接
する側管（ｂ，内径ｄ2 ）との距離（ｚ）は１８ｍｍ以
下、好ましくは１５ｍｍ以下、更に好ましくは１０ｍｍ
以下、３ｍｍ以上であり、比較的細い側管（ｂ，ｃ）間
の距離（ｙ）は０〜１０ｍｍであり、好ましくは０〜８
ｍｍ、更に好ましくは０〜６ｍｍである。そして、ｚ＞
ｙ； d1 ＞ d2 , d3 ； d1/ d2, d3 = 1.1〜1.7 で
あり、更に好ましくは d1/ d2, d3 = 1.20 〜1.50 で
ある。このように、寸法適合性がないと生体血管との吻
合、場所的な適合が不可能もしくは不自然となる。人工
血管は当然、生体血管の置換代用であり生体血管に無理
なく自然に適合することが大切である。これらの条件を
満たすことは、施術者の手術のやりやすさ、手術時間の
短縮に通じ、患者にとっても術後の自然な血液循環に寄
与するため、健常な状態に近くなり好結果をもたらすこ
とになる。What is important in matching with the living body is the distance between the branch tubes of the artificial blood vessel. In the case of replacing the artificial blood vessel with the living blood vessel, there is a branch in an extremely narrow local area. Therefore, if this interval is not appropriate, it is actually impossible to replace a lesion in a narrow place. Here, the interval between the branch pipes is extremely important. In the present invention, the distance (z) between the relatively thick side pipe (a, inner diameter d 1 ) shown in FIG. 4 and the adjacent side pipe (b, inner diameter d 2 ) is 18 mm or less, preferably 15 mm or less, more preferably. Is 10mm
Hereinafter, the distance (y) between the side pipes (b, c) which is 3 mm or more and is relatively thin is 0 to 10 mm, preferably 0 to 8 mm.
mm, more preferably 0 to 6 mm. And z>
y; d 1> d 2, d 3; d 1 / d 2, a d 3 = 1.1 to 1.7, more preferably from d 1 / d 2, d 3 = 1.20 ~1.50. As described above, if there is no dimensional compatibility, anastomosis with a living blood vessel and locational fitting become impossible or unnatural. Naturally, the artificial blood vessel is a substitute for a living blood vessel, and it is important that the artificial blood vessel fits naturally and naturally. Satisfying these conditions leads to ease of operation for the operator, shortens the operation time, and contributes to the postoperative natural blood circulation for the patient. become.
【００１６】[0016]
【発明の効果】本発明は大動脈弓の置換に用いられる分
岐人工血管であって、３本の側管を派生した大動脈用人
工血管であり、そのうち最も内径の大きい側管の中心が
他の２本の中心を結ぶ線上からずれて配置したことによ
り、位置関係の適合性を向上させ、手術の容易さ、的確
さに威力を発揮し、手術時間の短縮、術後の患者の血液
循環の適正化に寄与し、患者及び施術者への福音をもた
らすものである。The present invention relates to a bifurcated vascular prosthesis used for replacement of the aortic arch, which is an aortic prosthesis derived from three side vessels, of which the center of the side pipe having the largest inner diameter is the other two. By dislocating from the line connecting the centers of the books, the compatibility of the positional relationship is improved, the power of simplicity and accuracy is demonstrated, the operation time is shortened, and the blood circulation of the patient after surgery is appropriate And bring the gospel to patients and practitioners.
【００１７】[0017]
【実施例】 実施例１ ポロシティ５０ｍｌのポリエステル製のウーブン人工血
管（内径２８ｍｍ、長さ５０ｃｍ）を用い、この側面を
円形に切り出し、これに内径１１ｍｍを１本、内径８ｍ
ｍ２本の同じポリエステル製人工血管（ポロシティ５０
ｍｌ）を縫合して３本の側管をもつ人工血管をつくっ
た。この場合、比較的太い側管（本例の場合１１ｍｍ）
と比較的細い人工血管の内径（本例では８ｍｍ）の比は
１．３８である。本例では内径８ｍｍの２本の側管は、
主管人工血管（内径２８ｍｍ）の長さ方向のその中心が
乗るように縫合されたものである（図４、ｂ，ｃ参
照）。一方、内径１１ｍｍの側管は、前記内径８ｍｍの
２つの側管の中心を結ぶ直線から４ｍｍ離れて縫合され
た（図４参照、ｘ＝４ｍｍ）。この内径１１ｍｍの側管
と内径８ｍｍの側管の間隔は１０ｍｍ、内径８ｍｍの２
本の側管の間隔は８ｍｍであった。この分岐人工血管で
実際に病的大動脈弓の置換が行われたが、位置適合性が
極めてよく、吻合術がスムースに行われ、予想以上に短
時間に手術が的確に行われた。Example 1 Using a woven artificial blood vessel (inner diameter 28 mm, length 50 cm) made of polyester with a porosity of 50 ml, the side face was cut out in a circular shape, and one 11 mm inner diameter and 8 m inner diameter were cut out.
m2 artificial vascular graft made of the same polyester (porosity 50
ml) was sutured to make an artificial blood vessel having three side tubes. In this case, a relatively thick side tube (11 mm in this example)
The ratio of the inner diameter of the artificial blood vessel (8 mm in this example) to the relatively thin artificial blood vessel is 1.38. In this example, the two side tubes having an inner diameter of 8 mm are:
It is sutured so that its center in the length direction of the main vessel artificial blood vessel (inner diameter 28 mm) rides (see FIGS. 4, b and c). On the other hand, the side pipe having an inner diameter of 11 mm was sewn at a distance of 4 mm from a straight line connecting the centers of the two side pipes having an inner diameter of 8 mm (see FIG. 4, x = 4 mm). The distance between the side pipe having an inner diameter of 11 mm and the side pipe having an inner diameter of 8 mm is 10 mm, and the side pipe having an inner diameter of 8 mm is 2 mm.
The distance between the side tubes of the book was 8 mm. Although the replacement of the pathological aortic arch was actually performed with this bifurcated vascular graft, the positional compatibility was extremely good, the anastomosis was performed smoothly, and the operation was performed accurately in a shorter time than expected.
【００１８】実施例２ 内径２５ｍｍのウーブン人工血管（ポロシティ１５０ｍ
ｌ，長さ７０ｃｍ）の側面に円形の切り出し口をつく
り、これに内径１０ｍｍの側管１本、内径７．５ｍｍ及
び８ｍｍの側管各１本を上記の順に縫合し、３本の分岐
をもつ分岐人工血管をつくった。この場合、最も太い側
管（内径１０ｍｍ）と他の側管（内径７．５ｍｍおよび
８ｍｍ）の内径比はそれぞれ１．３３及び１．２５であ
る。本例では、内径８ｍｍと７．５ｍｍの２本の側管の
中心が主管人工血管（内径２５ｍｍ）の長さ方向に乗る
ように縫合され、これの２本の側管の中心を結ぶ直線か
ら３ｍｍずれて、最も内径の大きい側管の中心を配して
縫合してある。側管間の間隔は、内径１０ｍｍの側管と
隣接する内径７．５ｍｍの側管との間の距離は１０ｍ
ｍ、内径７．５ｍｍの内径８．０ｍｍの側管との間隔は
７ｍｍであった。この分岐人工血管を実際の臨床の場で
立体位置的な関係を調べたところ、極めて形状的な適合
性が認められた。Example 2 A woven artificial blood vessel having an inner diameter of 25 mm (porosity 150 m)
l, 70 cm in length) make a circular cutout on the side, and sew one side tube with an inner diameter of 10 mm, and one side tube each with an inner diameter of 7.5 mm and 8 mm in the above order, and cut three branches. We made a branch artificial blood vessel. In this case, the inner diameter ratio between the thickest side pipe (inner diameter 10 mm) and the other side pipes (inner diameter 7.5 mm and 8 mm) is 1.33 and 1.25, respectively. In this example, the centers of the two side tubes having an inner diameter of 8 mm and 7.5 mm are sutured so as to ride in the length direction of the main tube artificial blood vessel (inner diameter of 25 mm), and a straight line connecting the centers of the two side tubes is used. It is stitched with the center of the side tube with the largest inner diameter shifted by 3 mm. The distance between the side tubes is 10 m between the side tube having an inner diameter of 10 mm and the adjacent side tube having an inner diameter of 7.5 mm.
m, the distance from the side tube having an inner diameter of 8.0 mm having an inner diameter of 7.5 mm was 7 mm. When the three-dimensional positional relationship of this branched artificial blood vessel was examined in an actual clinical setting, extremely conformity in shape was recognized.
【００１９】[0019]
【図１】人体における大動脈弓及び関連動脈の位置を示
す。FIG. 1 shows the location of the aortic arch and associated arteries in the human body.
【図２】弓部大動脈瘤を分岐のない人工血管で置換した
例を示す。FIG. 2 shows an example in which an arch aortic aneurysm is replaced with an artificial blood vessel having no branch.
【図３】弓部大動脈瘤を分岐人工血管で置換した例を示
す。FIG. 3 shows an example in which an arch aortic aneurysm is replaced with a branch vascular prosthesis.
【図４】（Ａ）：本発明の分岐人工血管の側管の位置関
係を示す。 （Ｂ）：（Ａ）の分岐人工血管の断面円方向からみた側
管の位置関係を示す。 （Ｃ）：本発明の分岐人工血管の側管の位置関係を示
す。FIG. 4 (A) shows the positional relationship of the side tube of the branch vascular prosthesis of the present invention. (B): shows the positional relationship of the side tube viewed from the circular direction of the cross section of the branched artificial blood vessel of (A). (C): Shows the positional relationship of the side tubes of the branched artificial blood vessel of the present invention.
【図５】本発明の分岐人工血管を生体心臓に置換したと
きの置換人工血管の分岐方向の位置関係を立体的に示
す。FIG. 5 is a three-dimensional view showing the positional relationship in the branching direction of the replacement artificial blood vessel when the artificial blood vessel of the present invention is replaced with a living heart.
Claims (1)
側管の１つは、他の側管より内径が大きく、この最も内
径の大きい側管の中心が、他の２つの側管の中心を結ぶ
直線よりずれて配置してなる分岐人工血管。1. An artificial blood vessel derived from three side tubes,
One of the side tubes has a larger inner diameter than the other side tubes, and is a branch artificial blood vessel in which the center of the side tube having the largest inner diameter is displaced from a straight line connecting the centers of the other two side tubes.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP18517793A JP2842548B2 (en) | 1993-07-27 | 1993-07-27 | Bifurcated vascular graft |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP18517793A JP2842548B2 (en) | 1993-07-27 | 1993-07-27 | Bifurcated vascular graft |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| JPH0739556A JPH0739556A (en) | 1995-02-10 |
| JP2842548B2 true JP2842548B2 (en) | 1999-01-06 |
Family
ID=16166189
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP18517793A Expired - Lifetime JP2842548B2 (en) | 1993-07-27 | 1993-07-27 | Bifurcated vascular graft |
Country Status (1)
| Country | Link |
|---|---|
| JP (1) | JP2842548B2 (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN100457197C (en) * | 2007-03-07 | 2009-02-04 | 中国人民解放军第二军医大学 | Adjustable artificial aortic arch transplant |
Families Citing this family (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6187033B1 (en) | 1997-09-04 | 2001-02-13 | Meadox Medicals, Inc. | Aortic arch prosthetic graft |
| CN113440305A (en) * | 2020-03-25 | 2021-09-28 | 脉通医疗科技(嘉兴)有限公司 | Artificial blood vessel suturing method and artificial blood vessel |
-
1993
- 1993-07-27 JP JP18517793A patent/JP2842548B2/en not_active Expired - Lifetime
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN100457197C (en) * | 2007-03-07 | 2009-02-04 | 中国人民解放军第二军医大学 | Adjustable artificial aortic arch transplant |
Also Published As
| Publication number | Publication date |
|---|---|
| JPH0739556A (en) | 1995-02-10 |
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