WO2020108546A1 - Vascular stent with improved development performance and embedded branch stent thereof - Google Patents

Abstract

The present application provides a vascular stent, comprising an embedded branch stent and at least one branch tube. The embedded branch stent comprises a main tube comprising a tubular main coating film provided with at least one window thereon. The embedded branch stent further comprises at least one embedded branch tube arranged in a lumen of the main tube. A proximal end or a distal end of the at least one embedded branch tube is connected to the at least one window. The at least one embedded branch tube is provided with at least one annular development portion. The present application further provides an embedded branch stent of the vascular stent.

Description

Blood vessel stent with improved imaging performance and its embedded branch stent Technical field

The present application relates to the technical field of implantable blood vessels, in particular to a blood vessel stent with improved imaging performance, and an embedded branch stent of the blood vessel stent.

Background technique

Aortic aneurysm refers to the local or diffuse abnormal expansion of the aortic wall, which causes symptoms by compressing the surrounding organs. Aneurysm rupture is the main risk. It often occurs in the ascending aortic aortic arch, thoracic descending aorta, thoracic and abdominal aorta, and abdominal aorta. According to the structure, aortic aneurysms can be divided into true aortic aneurysms and false aortic aneurysms. Aortic aneurysms cause an increase in the medial pressure of the blood vessels, so they are progressively enlarged. If they develop for a long time, they eventually rupture, and the larger the tumor, the greater the possibility of rupture. According to statistics, if no surgical treatment is performed, 90% of thoracic aortic aneurysms die within 5 years, and 3/4 of abdominal aortic aneurysms die within 5 years.

Aortic dissection is another serious aortic disease. Aortic dissection refers to the destruction of the aortic intima, bleeding within the blood vessel wall, and blood entering between the media and adventitia of the blood vessel wall. Due to the impact of blood flow, once the aortic dissection is formed, the tear can be extended in the direction of blood flow, the dissection and the false cavity can be enlarged, and the true cavity can be compressed. Therefore, the possible risks of patients with aortic dissection include: (1) the threat of complete rupture of the blood vessel. Once the blood vessel is completely ruptured, the mortality rate is extremely high; (2) the dissection gradually expands and compresses the true cavity to supply blood to the distal end cut back. In most cases, the aortic dissection secondary to the thoracic aortic aneurysm, or coexist with the aortic aneurysm. The British Oxford Vascular Disease Study shows that the incidence of aortic dissection in natural population is about 6/100,000 per year, with more men than women, with an average age of 63 years. The incidence of aortic dissection in my country is much higher than that in European and American countries, and the age of onset is relatively young. Aortic aneurysm diseases may involve branched arteries. Once the branched artery is involved, it will be difficult to resolve through interventional methods. At present, arterial cavity treatment has been carried out at home and abroad, that is, a minimally invasive method is used to implant arterial grafts into the diseased artery through the vascular channel to treat arterial disease and improve blood supply, so as to achieve the purpose of treatment. The endoluminal artery stent graft is composed of a tubular rigid wire stent and an artificial blood vessel fixed on the outside of the stent. The tubular rigid wire stent is formed of a flexible rigid wire that is folded in a Z shape to form a ring. A ring-shaped and artificial blood vessel are sutured or glued together to form a tubular stent graft. When in use, the tubular stent graft is compressed axially and loaded into the conveyor, which is delivered to the diseased artery through the smaller femoral artery, iliac artery, and brachial artery and then released due to the elastic force of the wire stent The effect is automatically restored to a straight tube and closely adheres to the inner wall of the aorta, isolating the artery lesion from the blood flow, thereby achieving the purpose of treatment.

In the prior art, commonly used stents related to arterial branch treatment include chimney stents, integrated multi-branch stents, and window-type stents. These stents are limited by the structure of the stent and often require temporary customization, or are prone to internal leakage and other problems. Some split stents composed of multiple modules include multiple shunts that can be connected to branch stents separated by a membrane, and a sealing membrane is provided on the end surface of the end of the membrane stent that is away from the heart to prevent An internal leak occurs between multiple diverter ports on the end face. However, when in use, the alignment and insertion between the branch bracket and the shunt port often encounter difficulties, that is, when multiple branch brackets are released, it is difficult to find the shunt port corresponding to each branch bracket, which increases the application of multi-cavity type. The difficulty and time of endovascular treatment with stent graft can even lead to the failure of endovascular treatment.

Application content

The purpose of the present application is to provide an in-line branch stent which is convenient to use and improves the development performance, and a blood vessel stent provided with the in-line branch stent.

In order to solve the above technical problems, the present application provides an in-line branching bracket with improved development performance, which includes a main body tube, the main body tube includes a tubular main body film, and the main body film is provided with at least one window, The embedded branch stent further includes at least one embedded branch tube disposed in the lumen of the main body tube, at least one proximal end or distal end of the embedded branch tube is connected to at least one of the window openings, at least one At least one annular developing portion is provided on the embedded branch tube.

The present application also provides a vascular stent with improved imaging performance, including an in-line branch stent, and at least one branch tube. The in-line branch stent includes a main body tube, and the main body tube includes a tubular main body covering film, and the main body covering At least one window is provided on the membrane, and the in-line branching bracket further includes at least one in-line branching tube disposed in the inner cavity of the main body tube, and the proximal or distal ends of the at least one in-line branching tube are connected At least one of the window openings, at least one of the embedded branch pipes is provided with at least one annular developing portion.

The in-line branch stent of the vascular stent provided by the present application includes a main body tube and at least one branch pipe disposed in the lumen of the main body pipe, and the in-line branch pipe is provided with at least one annular developing portion. When the branch pipe needs to be connected to the embedded branch bracket, the position of the ring-shaped developing part can be clearly observed through the imaging device, so that the branch pipe can be easily and quickly inserted into the embedded branch. In addition, The in-line branch pipe can sealingly wrap the outer peripheral surface of the proximal end of the branch pipe, thereby effectively preventing internal leakage.

BRIEF DESCRIPTION

In order to more clearly explain the technical solutions in the embodiments of the present application, the following will briefly introduce the drawings required in the embodiments. Obviously, the drawings in the following description are only some embodiments of the present application. For those of ordinary skill in the art, without paying any creative work, other obvious deformation methods can be obtained according to these drawings.

FIG. 1 is a schematic structural diagram of a vascular stent provided in the first embodiment of the present application.

FIG. 2 is a schematic structural diagram of the in-line branch bracket in FIG. 1.

FIG. 3 is a schematic perspective view of the ring-shaped wave supporting rod in FIG. 2.

FIG. 4 is a schematic view of the structure of the ring-shaped wave supporting rod in FIG. 1 connected to the main body film.

5a-5c are structural schematic diagrams of other forms of an embedded branch tube with an embedded branch bracket of the present application.

6 is an enlarged view of the proximal end portion of the in-line branch stent in FIG. 1.

7a and 7b are schematic diagrams of different development structures around the window of the embedded branching bracket of the present application.

FIG. 8 is a schematic structural diagram of an in-line branch stent of a blood vessel stent provided in a second embodiment of the present application.

9 is a schematic structural diagram of an in-line branch stent of a blood vessel stent provided in a third embodiment of the present application.

10 is a schematic structural diagram of a vascular stent provided in a fourth embodiment of the present application.

FIG. 11 is a schematic structural diagram of an embedded branch stent of a blood vessel stent provided in a fifth embodiment of the present application.

12 is a schematic structural diagram of an in-line branch stent of a blood vessel stent provided in a sixth embodiment of the present application.

13 is a usage state diagram of the in-line branch stent provided by the sixth embodiment of the present application.

14 is a schematic structural diagram of an in-line branch stent of a blood vessel stent provided in a seventh embodiment of the present application.

FIG. 15 is a schematic perspective structural view of the proximal annular wave-shaped support rod in FIG. 14.

16 is a schematic structural view of one of the embedded branch pipes in FIG. 14.

FIG. 17 is a usage state diagram of the in-line branch bracket provided by the seventh embodiment.

detailed description

The technical solutions in the embodiments of the present application will be described clearly and completely in conjunction with the drawings in the embodiments of the present application. Obviously, the described embodiments are only a part of the embodiments of the present application, but not all the embodiments. Based on the embodiments in the present application, all other embodiments obtained by a person of ordinary skill in the art without paying any creative work fall within the protection scope of the present application.

In addition, the descriptions of the following embodiments refer to additional drawings to illustrate specific embodiments that can be implemented by the present application. Directional terms mentioned in this application, such as "upper", "lower", "front", "rear", "left", "right", "inner", "outer", "side", etc., only It refers to the directions of the attached drawings. Therefore, the direction terms are used for better and clearer explanation and understanding of the application, rather than indicating or implying that the device or element referred to must have a specific orientation, with a specific orientation The construction and operation cannot therefore be understood as a limitation of this application.

In the description of the present application, the “proximal end” in the present application refers to the end close to the position of the heart, and the “distal end” refers to the end far from the position of the heart. The high and low mentioned in this application are relative to the body tube coating. The end surface that exceeds the body tube coating is called high, and the one that does not exceed the body tube coating is called low. This definition is just for convenience of expression, and It cannot be understood as a limitation of this application.

Please refer to FIG. 1, which is a schematic structural diagram of a vascular stent provided in a first embodiment of the present application. The present application provides a blood vessel stent 100 with improved imaging performance, which includes an embedded branch stent 20 and at least one branch tube 40. The in-line branching bracket 20 includes a main body tube 21 and at least one in-line branching tube 25. The main body tube 21 is of an equal-diameter structure or a non-equi-diameter structure. The main body tube 21 includes a tubular main body film 210, and at least one of the embedded branch tubes 25 is disposed in the inner cavity of the main body tube 21 of the embedded branch bracket 20. At least one window 211 is provided on the main body film 210, the distal end of at least one embedded branch pipe 25 is connected to at least one window 211, and the proximal end of at least one embedded branch pipe 25 faces The proximal end of the body tube 21 extends. At least one proximal end and/or distal end of the embedded branch tube 25 is provided with a ring-shaped developing part, specifically, the annular developing part is located at the proximal end and/or distal end of at least one of the embedded branch tube 25 At the mouth. During the operation, the position of the ring-shaped developing portion can be clearly observed through the imaging device. Therefore, it is more convenient and quick to insert the branch tube 25 into the branch tube 40.

In this embodiment, the main body tube 21 has a non-equal-diameter structure. The proximal end diameter of the main body pipe 21 is larger than the distal end diameter, and the diameter of the main body pipe 21 tapers from the proximal end to the distal end.

At least one of the embedded branch tubes 25 extends from the at least one window 211 toward the inner cavity of the main body tube 21. The axis of the embedded branch pipe 25 and the axis of the main body pipe 21 may be parallel or intersect. In this embodiment, the angle between the axis of the embedded branch pipe 25 and the axis of the main body pipe 21 is greater than 0 degrees.

The main body coating 210 is a tubular structure, and the shape of its lateral end surface is a circle, an ellipse, or a prism that matches the blood vessel. At least one of the window openings 211 is opened on the tubular film. The window openings 211 may be circular holes, elliptical holes, prismatic holes, or irregular curved surfaces. The main body film 210 is made of polyester cloth, PTFE, PET or other polymer materials.

The embedded branch stent 20 and the branch tube 40 are both self-expanding stents. When the embedded branch stent 20 or the branch tube 40 is delivered through the sheath tube, the embedded branch stent 20 or the branch The diameter of the tube 40 can be reduced to a smaller state for delivery in the sheath; when the embedded branch stent 20 or the branch tube 40 is released in the blood vessel, the embedded branch stent 20 or the branch tube 40 It can be automatically expanded to the desired shape and size, so that the embedded branch stent 20 or the branch tube 40 can be supported on the inner wall of the vascular lesion location, the embedded branch stent 20 or the branch tube 40 The inner wall of the tube produces radial support, which can rebuild blood vessels.

The in-line branch stent 20 of the vascular stent 100 of the present application includes a body tube 21 and at least one in-line branch tube 25 disposed in the lumen of the body tube 21, the proximal end of the in-line branch tube 25 and/or A ring-shaped developing section is provided at the distal end. When the branch tube 40 needs to be connected to the embedded branch bracket 20, the position of the ring-shaped developing part can be clearly observed through the imaging device, so that the branch tube can be easily and quickly inserted into the embedded branch tube 25 40, that is, insert the proximal end of the branch tube 40 into the inner cavity of the embedded branch tube 25, the embedded branch tube 25 can sealably wrap the outer peripheral surface of the proximal end of the branch tube 40, thereby effectively Prevent internal leakage.

In this embodiment, since the angle between the axis of the embedded branch pipe 25 and the axis of the main body pipe 21 is greater than 0 degrees, the branch pipe 40 is obliquely connected to the main body pipe 21 to prevent the branching The junction of the tube 40 and the main body tube 21 is bent due to being squeezed due to excessive bending, thereby preventing the branch tube 40 from being blocked.

Preferably, the angle between the axis of the inline branch pipe 25 and the axis of the main body pipe 21 is a value within a range of 5 degrees, 45 degrees, or 5 degrees to 45 degrees. Specifically, when the main body tube 21 and the embedded branch tube 25 are in a released state, the embedded branch tube 25 is obliquely connected to the main body tube 21, that is, the axis of the embedded branch tube 25 and the main body tube The angle between the axes of 21 is a value in the range of 5 degrees, 45 degrees, or 5 degrees to 45 degrees. When the branch pipe 40 is inserted into the embedded branch pipe 25, the axis of the proximal end of the branch pipe 40 coincides with the axis of the embedded branch pipe 25, so that the branch pipe 40 is obliquely connected to On the main body tube 21.

In other embodiments, the angle between the axis of the inline branch pipe 25 and the axis of the main body pipe 21 can be selected according to need.

The axial extension length of the embedded branch pipe 25 is greater than or equal to 2 mm. Preferably, the axial extension length of the embedded branch pipe 25 is a value in the range of 2 mm, 100 mm, or 2 mm to 100 mm. The inner diameter of the embedded branch pipe 25 is greater than or equal to 2 mm. Preferably, the inner diameter of the embedded branch pipe is a value in the range of 2 mm, 5 mm, or 2 mm to 5 mm. The embedded branch pipe 25 serves as an anchor portion for connecting between the main body pipe 21 and the branch pipe 40. The longer the axial extension of the embedded branch pipe 25, the The longer the length of the sealing sleeve is, the more stable the proximal end portion of the branch tube 40 can be connected to the main body tube 21, thereby achieving a better leak-proof effect.

Please refer to FIG. 2 to FIG. 4 together. FIG. 2 is a schematic structural view of the in-line branch bracket in FIG. 1; FIG. 3 is a schematic structural schematic view of the annular wave-shaped support rod in FIG. 2; FIG. A schematic diagram of the structure of the ring-shaped wave supporting rod connected to the main body film. The main body tube 21 further includes a main body support frame 212 provided on the inner or outer circumferential surface of the main body film 210. Specifically, the main body support frame 212 is sewn to the main body film 210 by a suture. Inner peripheral surface or outer peripheral surface. The main body supporting framework 212 may be an elastic metal supporting framework or an elastic non-metallic supporting framework such as a polymer material. In this embodiment, the main body supporting framework 212 is a nickel alloy stent. When the main body supporting framework 212 is transported through the sheath, the diameter of the main body supporting framework 212 may be contracted to a smaller state for transport in the sheath; when When the main body supporting framework 212 is released in the blood vessel, the main body supporting framework 212 can automatically expand to the desired shape and size, so that the main body supporting framework 212 can be supported on the inner wall of the corresponding blood vessel.

The main body supporting framework 212 may be laser-cut with a nickel alloy tube, or may be woven with metal wires such as nickel alloy wires. The degree of density of the mesh structure of the main body supporting skeleton 212 is set as required. In this embodiment, the main body support frame 212 includes a plurality of Z-shaped or sinusoidal wave-shaped support rods 2120, and these ring-shaped support rods 2120 are arranged at intervals along the axial direction of the main body coating 210, that is, these rings The wave-shaped support rods 2120 are arranged in parallel with a gap from the proximal end to the distal end of the main body tube 21.

Each ring-shaped wave support bar 2120 may be a high-wave wave support bar or a high-low wave support bar, etc. The contour wave support bar means that the height of each wave peak on the ring-shaped wave support bar 2120 is the same, and the height of each wave valley is the same That is, the peaks and troughs are on the same plane. The high and low wave support bars mean that the heights of at least two wave peaks on the ring-shaped wave support bar 2120 are different, and/or the heights of at least two wave valleys on the ring-shaped wave support bar 2120 are different. In this embodiment, the annular wave-shaped support rods 2120 of the main body tube 21 are all constant-wave support rods.

As shown in FIG. 3, each Z-shaped or sinusoidal waveform of each annular waveform support rod 2120 includes a peak 2121, a valley 2123, and a connecting rod 2125 connected between the peak 2121 and the valley 2123 . Each annular wave-shaped support rod 2120 is woven by a super-elastic nickel-titanium wire, and the selectable wire diameter (ie diameter) of the super-elastic nickel-titanium alloy wire is 0.2 mm to 0.5 mm. Each ring-shaped wave supporting rod 2120 is provided with a connecting sleeve 2127, which connects the opposite ends of the nickel-titanium alloy wire to obtain a ring-shaped wave supporting rod 2120, that is, used to form a ring-shaped wave supporting rod 2120 The two free ends of the nickel-titanium alloy wire are accommodated in the connecting sleeve 2127, and then the two ends of the nickel-titanium wire are fixed inside the connecting sleeve 2127 by mechanical compression or welding.

In this embodiment, the annular wave-shaped support rod 2120 is braided with 0.4 mm diameter nickel-titanium wire, the number of Z-shaped or sinusoidal waves is 9, and the vertical height of the annular wave-shaped support rod 2120 is 8-15 mm.

In other embodiments, the main body supporting skeleton 212 may be a woven mesh structure or a cut mesh structure.

In other embodiments, the number of sine waves of the annular wave-shaped support rod 2120 may be determined according to needs, and the vertical height of the annular wave-shaped support rod 2120 may be any height.

As shown in FIG. 4, each ring-shaped wave support rod 2120 of the main body support frame 212 is sewn to the body film 210 by a suture 23, that is, the thread 23 can be along each ring-shaped wave support rod The wave shape of 2120 is accompanied by the entire main body supporting skeleton 212. The suture 23 can also be sutured to the main body covering film 210 by a plurality of unequally spaced stitching knots. The selection range of the diameter of the suture 23 is 0.05mm-0.25mm. Alternatively, the main body support frame 212 may be fixedly connected to the main body film 210 by hot pressing.

As shown in FIG. 2, the distal end of the embedded branch pipe 25 is connected to the window 211, and the distal end surface of the embedded branch pipe 25 is flush with or not flush with the cross section of the window 211. When the end surface of the distal end of the embedded branch pipe 25 is not flush with the cross-section of the window 211, the embedded branch pipe 25 and the window 211 are connected by a tubular transition coating 251. In this embodiment, the inward distance of the distal end surface of the embedded branch pipe 25 relative to the cross section of the window 211 is 0.5 mm, 3 mm, or a value in the range of 0.5 mm to 3 mm, that is, the transition coating 251 The axial length is 0.5 mm, 3 mm, or a value in the range of 0.5 mm to 3 mm. The shape of the lateral end surface of the transition coating 251 corresponds to the shape of the window opening 211, that is, it may be circular, elliptical, or prismatic. The transition film 251 extends from the window 211 toward the inner cavity of the main body tube 21. One end of the transition coating 251 is sealedly connected to the edge of the window 211, the other end of the transition coating 251 is sealingly connected to the proximal end of the embedded branch pipe 25, and the transition coating 251 is near The outer diameter of the end is greater than the outer diameter of the distal end. The transition film 251 is made of polyester cloth, PTFE, PET or other polymer materials. Since the transitional film 251 is connected between the embedded branch pipe 25 and the window 211, the transitional film 251 can be sealingly connected between the main body film 210 and the embedded branch pipe 25, therefore, the The main body coating 210 can prevent internal leakage between the embedded branch pipe 25 and the window 211. In another embodiment, the outer diameter of the distal end of the transitional coating 251 is greater than the outer diameter of the proximal end, so that the transitional coating forms a funnel-shaped inner recess, the inner recess has a guiding effect . Or the cross-section of the distal end of the transition film 251 is recessed inward relative to the window opening to form a guide portion, so that the connection of the branch pipe 40 and the embedded branch pipe 25 is smoother.

In this embodiment, the proximal end of the transition film 251 is stitched to the main body film 210 at the edge of the window 211 by a suture, and the distal end of the transition film 251 is stitched to the inside by a stitch The distal end of the branch pipe 25 is embedded. The distal end of the transition membrane 251 may be an integral structure with the proximal end of the embedded branch tube 25.

In other embodiments, the connection between the proximal end of the transition coating 251 and the main body coating 210 may be connected by medical glue, and the distal end of the transition coating 251 and the embedded branch tube 25 The connection can also be via medical glue.

In other embodiments, a support skeleton may be provided on the transition coating 251 to stretch the transition coating 251. The support frame may be stitched to the inner peripheral surface or the outer peripheral surface of the transition coating 251 by a suture.

The embedded branch pipe 25 includes a tubular embedded branch film 253 and a support frame 255 provided on the embedded branch film 253, that is, the inner or outer surfaces of the support frame 255 are attached There is the embedded branch film 253. Specifically, the support frame 255 is fixed between the inner peripheral surface or the outer peripheral surface of the embedded branch coating 253 or the multilayer coating by means of stitching or hot pressing. The shape of the lateral end surface of the embedded branch coating 253 is a circle, an ellipse, or a prism matching the proximal end of the branch tube 40. The proximal end of the embedded branch coating 253 is connected to the transition coating 251. remote. The distal end of the embedded branch membrane 253 extends toward the inner cavity of the main body tube 21. In the released state, the angle between the axis of the embedded branch film 253 and the axis of the main body tube 21 is greater than 0 degrees. The main body film 210 is made of polyester cloth, PTFE, PET or other polymer materials.

The supporting framework 255 may be an elastic metal supporting framework or an elastic non-metallic supporting framework such as a polymer material. In this embodiment, the support frame 255 is a nickel alloy stent. When the support frame 255 is transported through the sheath tube, the diameter of the support frame 255 can be contracted to a smaller state for transportation in the sheath tube; when the support frame When 255 is released, the support frame 255 can automatically expand to the desired shape and size. The support frame 255 can support the embedded branch coating film 253 to keep the embedded branch coating film 253 in an open state, which is convenient for the connection of the branch tube 40.

The support frame 255 may be laser-cut with a nickel alloy tube, or may be woven with metal wires such as nickel alloy wires. The degree of density of the mesh structure supporting the skeleton 255 is set as required. In this embodiment, the support frame 255 includes a plurality of Z-shaped or sinusoidal ring-shaped wave-shaped support rods, and these ring-shaped wave-shaped support rods are arranged at intervals along the axial direction of the embedded branch coating 253, that is, these ring-shaped support rods The wave-shaped support rods are arranged in parallel gaps from the proximal end to the distal end of the embedded branch covering film 253 in sequence.

The inner diameter of the embedded branch tube 25 is less than or equal to the outer diameter of the proximal end of the branch tube 40. When the proximal end of the branch tube 40 is inserted into the embedded branch tube 25 through the window 211 and released, The support frame 255 squeezes the outer wall of the branch pipe 40 to make the connection of the branch pipe 40 and the embedded branch pipe 25 firmer, and to maintain the shape of the branch pipe 40 entering the embedded branch pipe 25 The embedded branch covering film 253 is wrapped around the outer peripheral surface of the proximal end of the branch tube 40, so as to further prevent internal leakage.

Please refer to FIG. 5a to FIG. 5c together. FIG. 5a to FIG. 5c are schematic structural views of other forms of the embedded branches of the embedded branch bracket of the present application. The embedded branch pipe 25 may be selected from any ring-shaped support frame as shown in FIG. 5a and FIG. 5b or a mesh skeleton shown in FIG. 5c. The ring-shaped support frame includes a number of Z-shaped or sinusoidal wave-shaped ring-shaped support rods, which are arranged at intervals along the axial direction of the embedded branch pipe 25. The mesh skeleton may be woven or cut.

In other embodiments, the embedded branch tube 25 includes only the embedded branch coating 253, that is, the supporting frame 255 on the embedded branch coating 253 can be omitted, and the proximal end of the embedded branch coating 253 is connected to the transition coating The distal end of the membrane 251.

In other embodiments, the embedded branch pipe 25 only includes a support frame 255, that is, the embedded branch film 253 on the support frame 255 may be omitted, the support frame 255 is a bare support, and the bare support may be a braid Or cut the bare bracket of the structure. The proximal end of the bare stent is connected to the distal end of the transition membrane 251.

In other embodiments, the in-line branch tube 25 includes an in-line branch film 253 directly connected to the window 211, and the in-line branch film 253 and the main body film 210 are hermetically connected except for the window 211 The embedded branch film 253 is used to wrap the proximal end of the branch tube 40. Specifically, the transition film 251 between the embedded branch tube 25 and the window 211 may be omitted, but directly connected to the main body film through the proximal end of the embedded branch film 253 directly and sealingly 210 at the edge of the window 211. The embedded branch coating film 253 has a tubular structure, and the shape of the lateral end surface of the embedded branch coating film 253 is consistent with the shape of the window 211, and is specifically circular, elliptical, or prismatic. The embedded branch coating film 253 may be provided with an elastic embedded branch skeleton, and the embedded branch skeleton is attached to the inner peripheral surface or the outer peripheral surface of the embedded branch coating film 253. The embedded branch skeleton can make the connection of the branch pipe 40 connected in the embedded branch pipe 25 firmer, and can maintain the shape of the branch pipe 40 entering the embedded branch pipe 25. In other embodiments, the embedded branch skeleton on the embedded branch coating 253 may also be omitted.

As shown in FIG. 6, a support member 214 is provided at the edge of the window opening 211, and the support member 214 is used to support the window opening 211 to keep the window opening 211 open. The support member 214 is a support rod fixed to the edge of the window opening 211, the support rod extends along the edge of the window opening 211, the support rod adapts to the shape of the edge of the window opening 211, specifically, The support rod may have a circular, elliptical or prismatic ring structure.

Preferably, the support member 214 is a support ring extending along the edge of the window 211, and the support ring has elasticity. When the branch pipe 40 is connected in the window opening 211, the support ring can be closely attached to the outer surface of the branch pipe 40 to prevent internal leakage at the junction of the branch pipe 40 and the main body pipe 21. The support 214 is made of memory alloy, preferably nickel-titanium alloy.

In this embodiment, the main body film 210 is provided with a developing structure 215 around the window 211. The developing structure 215 is provided on the main body film 210 continuously or along the edge of the window 211. Multiple development points arranged intermittently. These developing points can be fixed on the main body cover film 210 by sewing, stamping, setting or sticking. These developing points are arranged at least once along the peripheral edges of the window 211. The material of the developing structure 215 may be made of a material with good X-ray opacity, strong corrosion resistance and good biocompatibility. Materials of the developing member include, but are not limited to, gold, platinum, tantalum, osmium, rhenium, tungsten, iridium, rhodium and other materials or alloys or composites of these metals. In this embodiment, the developing point is a nickel-titanium alloy metal sheet containing tantalum. The ring formed by these developing points is consistent with the shape of the window 211. Therefore, these developing points form a connected or intermittent ring-shaped developing mechanism. During the operation, the position of the developing structure 215 can be clearly observed by the imaging device, that is, It can be observed that the developing point near the window opening 211 is a ring-shaped developing mechanism that surrounds the edge of the window opening 211, so it is more convenient and quick to insert the branch tube 40 into the embedded branch tube 25.

As shown in FIG. 7a, in other embodiments, the developing structure 215 is a developing wire wound continuously or intermittently on the support member 214. The developing wire may be a nickel-titanium alloy wire containing tantalum, and the diameter of the nickel-titanium alloy wire is 0.10-0.40 mm. Since the developing structure 215 is developable and ring-shaped, the position of the developing structure 215 can be clearly observed through the imaging device during the operation, that is, the developing structure 215 can be observed around the edge of the window 211 The ring-shaped developing structure of the ring is not a scattered developing point. Therefore, the embedded branch pipe 25 is inserted into the branch pipe 40 more conveniently and quickly.

As shown in FIG. 7b, in other embodiments, the developing structure 215 is a developing point that is continuously or intermittently fixed on the supporting member 214, and the developing point is stitched, stamped, hot-pressed, set or pasted. It is fixed on the support 214. These developing points are arranged at least once around the supporting member 214.

In other embodiments, the supporting member 214 is made of an alloy mixed with a developing material, that is, the developing structure is the developing material fused in the supporting member 214. The support member 214 is surrounded by a nickel-titanium alloy wire containing tantalum, and the wire diameter of the support member 214 is 0.10-0.40 mm. Since the supporting member 214 is made of an alloy containing a developing material, the supporting member 214 can be directly used as a developing structure, and no additional developing structure needs to be provided on the supporting member 214. During the operation, the position of the support 214 can be clearly observed through the imaging equipment, and the branch tube 40 can be inserted into the window 211 conveniently and quickly, which is convenient to use.

In other embodiments, the outer surface of the support member 214 may be inlaid with a nickel titanium alloy wire for at least one week, or the outer surface of the support member 214 may be pasted with a nickel nickel alloy wire for at least one week. Preferably, tantalum wire is wound on the support member 214.

As shown in FIG. 6, a support ring 256 is provided at the proximal and/or distal nozzles of the embedded branch tube 25, and the support ring 256 is used to prop up the embedded branch coating 253 so that the The embedded branch covering film 253 keeps the unfolded state, which facilitates the insertion of the branch tube 40. The support ring 256 extends along the edge of the opening at the proximal end or the distal end of the embedded branch film 253, and the support ring 256 adapts to the edge shape of the cross section of the embedded branch tube 25. Specifically, the support The ring 256 may be circular, elliptical or prismatic. The support ring 256 has elasticity. When the branch pipe 40 needs to be connected in the window 211, the support ring 256 can press the outer surface of the branch pipe 40 to prevent the branch pipe 40 from contacting the embedded branch pipe 25 An internal leak has occurred. The support ring 256 is made of memory alloy, preferably nickel titanium alloy.

A ring-shaped developing portion is provided at the proximal end and/or the distal end of the embedded branch tube 25, and the ring-shaped developing portion is disposed at least once around the circumference of the embedded branch tube 25. The ring-shaped developing part may be provided at the edge of the opening of the proximal end and/or the distal end of the in-line branching film 253, and the ring-shaped developing part may also be a support ring provided in the inline branching tube 25 256. The ring-shaped developing portion is provided on the support ring 256 and includes but is not limited to the following: a development wire, such as a nickel-titanium alloy wire containing tantalum and a nickel-titanium wire, is connected or intermittently wound on each support ring 256 The diameter of the alloy wire is 0.10-0.40mm; the developing wire on the support ring 256 has developability and is ring-shaped, thereby forming a ring-shaped developing portion; the support ring 256 can be clearly observed by the imaging device during the operation The position of the developing wire can be inserted into the branch pipe 40 in the embedded branch pipe 25 conveniently and quickly. Secondly, there are continuous or intermittently fixed development points on each support ring 256. These development points surround a ring-shaped development section, and these development points are fixed to the support ring 256 by sewing, stamping, hot pressing, setting or pasting. on. In addition, each supporting ring 256 may also be made of an alloy doped with a developing material, for example, a nickel-titanium alloy wire containing tantalum, so that the supporting ring 256 itself forms an annular developing portion.

In a further preferred embodiment, the annular developing structure 215 is provided at the position of the window opening or at the distal end of the embedded branch tube, or at the same time at the proximal end and the distal end of the embedded branch tube. The developing structure 215 can adopt any method of the developing structure described above. Through the proximal and distal annular imaging, it can help the surgeon quickly find the entrance and exit of the branch tube during the operation, quickly establish the channel of the branch tube, greatly shorten the operation time, and improve the efficiency of the operation.

Please refer to FIG. 8, which is a schematic structural diagram of an in-line branch support provided by a second embodiment of the present application. The structure of the in-line branch bracket provided by the second embodiment of the present application is similar to the structure of the first embodiment, except that in the second embodiment, the main body supporting framework 212 of the main body pipe 21 is located at the window 211 A support portion 2122 with a small waveform is provided at the proximal end and/or the distal end, and the support portion 2122 is used to better prop up the window 211.

Specifically, the support portion 2122 is disposed on the crest and/or trough of the annular wave-shaped support rod 2120 adjacent to the window opening 211, so that the support portion 2122 is located at the proximal end and/or far away of the window opening 211 end. When the support portion 2122 is disposed on the crest of the annular wave-shaped support rod 2120, the support portion 2122 includes a trough 2124 adjacent to the edge of the window 211, connecting rods 2128 at opposite ends of the trough 2124, and A wave peak 2126 connected to an end of each connecting rod 2128 away from the trough 2124, and each wave peak 2126 is connected to an adjacent connecting rod 2125. Since the wave trough 2124 and the two wave crests 2126 are both near the proximal end of the window 211, the support portion 2122 can better support the window 211, thereby reducing the deformation of the window 211, It is convenient to insert the branch pipe 40 in the window 211.

As shown in FIG. 9, FIG. 9 is a schematic structural diagram of an in-line branch stent provided in the third embodiment of the present application. The structure of the embedded branch bracket provided in the third embodiment of the present application is similar to the structure of the second embodiment, except that in the third embodiment, the main body supporting framework 212 of the main body pipe 21 is located at the window 211 A supporting portion with a small waveform is also provided at the distal end, and the supporting portion is disposed on the wave valley of the annular waveform supporting rod 2120 adjacent to the window 211. Specifically, the support portion includes a crest 2126a adjacent to the distal edge of the window 211, connecting rods 2128a at opposite ends of the crest 2126a, and a end connected to each connecting rod 2128a away from the crest 2126a Valley 2124a; each valley 2124a is connected to the adjacent connecting rod 2125. Since the wave crest 2126a and the two wave troughs 2124a are adjacent to the window opening 211, the supporting portion can better support the window opening 211 and reduce the deformation of the window opening 211.

Please refer to FIG. 10, which is a schematic structural diagram of an in-line branch support provided by a fourth embodiment of the present application. The structure of the in-line branch stent provided by the fourth embodiment of the present application is similar to the structure of the first embodiment, except that in the fourth embodiment, the main body tube 21a includes a proximal tube body in order from the proximal end to the distal end 216. A middle tube 217 and a distal tube 218. The diameter of the middle tube 217 is smaller than that of the proximal tube 216 and the distal tube 218. In a modified embodiment, the diameter of the middle tube 217 is smaller than one of the proximal tube 216 and the distal tube 218. A tubular body coating 210a is provided on the inner or outer peripheral surface of the body tube 21a, and the body coating 210a is made of polyester cloth, PTFE, PET, or other polymer materials.

The proximal tube body 216 includes a tubular proximal support frame 2160 attached to the inner or outer peripheral surface of the main body film 210a. The proximal support frame 2160 includes a plurality of wave-shaped proximal rings The waveform-shaped support rods 2161 are arranged at intervals along the axial direction of the main body coating 210a. These proximal annular wave-shaped support rods 2161 may be equal-high wave support rods or high-low wave support rods. In this embodiment, the proximal annular wave-shaped support rod 2161 is braided with nickel-titanium wire. The proximal annular wave-shaped support rod 2161 includes several Z-shaped or sine waves. The number of the Z-shaped or sine waves can be adjusted as required It is determined that the vertical height of the proximal annular wave-shaped support rod 2161 may be any height.

The middle tube body 217 includes a tubular middle support frame 2170 attached to the main body film 210a. The middle support frame 2170 includes several wave-shaped middle ring-shaped wave-shaped support rods 2172, and these middle ring-shaped waves The support rods 2172 are arranged at intervals along the axial direction of the main body film 210a. These middle annular wave-shaped support rods 2172 may be equal-high wave support rods or high-low wave support rods. In this embodiment, these middle circular wave-shaped support rods 2172 are high and low wave support rods. The central annular wave-shaped support rod 2172 is braided with nickel-titanium wire. The central annular wave-shaped support rod 2172 includes several Z-shaped or sine waves. The number of the Z-shaped or sine waves can be determined as required. The vertical height of the rod 2172 may be any height. The diameter of the central annular wavy support rod 2172 is smaller than the diameter of the proximal annular wavy support rod 2161.

The distal tube body 218 includes a tubular distal support frame 2180 attached to the main body film 210a. The distal support frame 2180 includes a plurality of waveform-shaped distal annular wave-shaped support rods 2182. These The distal annular wave-shaped support rods 2182 are arranged at intervals along the axial direction of the main body film 210a. These distal ring-shaped wave-shaped support rods 2182 may be equal-high wave support rods or high-low wave support rods. In this embodiment, the distal end circular wave-shaped support rods 2182 are all equal-wave support rods. The distal annular wave-shaped support rod 2182 is braided with nickel-titanium wire. The distal annular wave-shaped support rod 2182 includes several Z-shaped or sinusoidal waves. The number of the Z-shaped or sinusoidal waves can be determined as required. The vertical height of the wave supporting rod 2182 may be any height. The diameter of the distal annular wave-shaped support rod 2182 is larger than the diameter of the middle annular wave-shaped support rod 2172.

In other modified embodiments, the supporting skeletons in the proximal tube body 216, the middle tube body 217, and the distal tube body 218 may adopt other regular or irregular waveforms other than the Z-shaped or sine wave, which will not be repeated here.

The distal end of the proximal tube 216 and the proximal end of the central tube 217 are connected by a transition tube 2164. The proximal end of the distal tube 218 and the distal end of the central tube 217 It is connected by a second transition 2184. The transition tube body 2164 is a portion of the body coating 210a connected between the distal end of the proximal support frame 2160 and the proximal end of the middle support frame 2170, and the body coating film located at the transition tube body 2164 210a includes a connection region 2165 provided extending in a direction perpendicular to the axis of the main body tube 21a. At least one window 211 is provided on the connecting area 2165, and at least one embedded branch pipe 25 is provided in the proximal tube body 216, and one end of the embedded branch pipe 25 is hermetically connected to the window 211 At the edge, the opposite end of the embedded branch tube 25 extends toward the proximal end of the proximal tube body 216. The axis of the embedded branch pipe 25 and the axis of the main body pipe 21a may be parallel or intersect. In this embodiment, the axis of the embedded branch pipe 25 is parallel to the axis of the main body pipe 21a. The structure of the embedded branch pipe 25 is the same as that of the first embodiment, and will not be repeated here.

The embedded branch pipe 25 in this embodiment may be connected to the edge of the window 211 through a transition film, or the tubular embedded branch film of the embedded branch pipe 25 may be directly connected to the window 211 The specific structure and connection method are the same as those in the first embodiment, and will not be repeated here.

A support member may be provided around the window 211 on the connection film 2165. The support member is the same as the support member 214 in the first embodiment, and details are not described herein again.

The proximal and/or distal positions of the in-line branch tube 25 connected to the coating film 2165 may be provided with a developing structure, which is the same as the developing structure 215 in the first embodiment, and will not be repeated here.

The second transition section 2184 has a conical shape, which includes a connection region 2185 of the main body covering film 210a connected between the proximal end of the distal support frame 2180 and the distal end of the middle support frame 2170, and is provided in the The transition support rod 2186 on the connection region 2185 of the main body film 210a is connected. The transition support rod 2186 is a conical wave-shaped support rod. The proximal end diameter of the transition support rod 2186 is smaller than the distal end diameter. The proximal end of the transition support rod 2186 is adjacent to the distal end of the middle support frame 2170. The distal end of the transition support rod 2186 is adjacent to the proximal end of the distal support skeleton 2180. The body coating 210a at the second transition section 2184 has a conical shape, that is, the connection area 2185 has a conical shape. The connecting film 2165, the main body film 210a at the middle tube body 217, and the main body film 210a at the second transition section 2184 enclose a recessed space 2175, and the recessed space 2175 is used to receive a plug The branch tube 40 in the window 211 connected to the connection film 2165 can provide the branch tube 40 with enough space to prevent the main body tube 21a from squeezing the branch tube 40, thereby preventing the branch tube 40 from being blocked.

Please refer to FIG. 11, which is a schematic structural diagram of an in-line branch support provided by a fifth embodiment of the present application. The structure of the embedded branch bracket provided in the fifth embodiment of the present application is similar to the structure of the fourth embodiment, except that in the fifth embodiment, at least one window 211 is provided on the connection area 2165, and the near At least one in-line branch pipe 25 is provided in the end tube body 216 corresponding to at least one window 211, and the distal end of at least one in-line branch pipe 25 is hermetically connected to the at least one window 211 through a transition film 251a the edge of. Specifically, the proximal end of the transition film 251a is connected to the periphery of the distal end of the embedded branch tube 25, and the distal edge of the transition film 251a is sealingly connected to the edge of the window 211. The structure of the embedded branch pipe 25 in this embodiment is the same as that in the first embodiment, and will not be repeated here.

The transition coating 251a has a conical ring shape, that is, the outer diameter of the distal end of the transition coating 251a is greater than the outer diameter of the proximal end, so that the transition coating 251a forms an inverted funnel-shaped inner recess 2512, The concave portion 2512 has a guiding function. When the proximal end of the branch pipe 40 is inserted into the embedded branch pipe 25 through the window 211, the inner recess 2512 can guide the branch pipe 40 to be inserted into the embedded branch pipe 25 to facilitate the insertion of the branch pipe 40.

In this embodiment, at least one embedded branch tube 25 is also provided in the middle tube body 217. Specifically, at least one window 211 is provided on the body coating 210a at the proximal end of the middle tube body 217, at least One opening 211 corresponds to the concave space 2175, and at least one embedded branch pipe 25 is provided in the middle tube 217 corresponding to at least one opening 211. The distal end of at least one of the embedded branch tubes 25 is hermetically connected to the edge of the window 211 through a transition film 251a. The outer diameter of the distal end of the transition film 251a is greater than the outer diameter of the proximal end, so that all The transition film 251a forms an inverted funnel-shaped inner concave portion, and the inner concave portion has a guiding function to facilitate the insertion of the branch tube 40 into the embedded branch tube 25.

The middle annular wave-shaped support rods 2172 on the middle tube body 217 are contoured wave support rods, and these contoured wave-supported rods are arranged at intervals along the axial direction of the main body film 210a, adjacent to the two middle annular wave-shaped support rods The peaks and troughs between 2172 are directly opposite and close to each other, so that a large area prismatic area is enclosed between the peaks and the troughs, and the prismatic areas are convenient for opening windows 211.

In other embodiments, the cross-section of the distal end of the transition film 251a is recessed inward with respect to the window 211 by 0.5-3 mm to form a guide portion that facilitates the insertion of the branch tube 40 into the embedded branch tube 25 Inside.

In other embodiments where the transition coating 251a is omitted, the cross section of the distal end of the embedded branch coating 253 of the embedded branch tube 25 is recessed inward by 0.5-3 mm relative to the cross section of the window 211 to form a guide The guide portion facilitates the insertion of the branch pipe 40 into the embedded branch pipe 25.

Please refer to FIG. 12, which is a schematic structural diagram of an in-line branch support provided in a sixth embodiment of the present application. The structure of the in-line branch stent provided in the sixth embodiment of the present application is similar to the structure of the fourth embodiment, except that in the sixth embodiment, the main body tube 21b includes a proximal proximal tube body 216 and a connection The connecting tube 219 is connected to the distal end of the proximal tube 216, and the diameter of the proximal tube 216 is larger than the diameter of the connecting tube 219. A tube-shaped body coating 210b is provided on the inner or outer surface of the body tube 21b, and the body coating 210b is made of polyester cloth, PTFE, PET, or other polymer materials.

The proximal tube body 216 includes a tubular proximal support frame 2160 attached to the main body film 210b. The proximal support frame 2160 includes a number of Z-shaped or sinusoidal waveform-shaped proximal ring-shaped supports Rods 2161, and these proximal annular wave-shaped support rods 2161 are arranged at intervals along the axial direction of the body coating 210b. These proximal annular wave-shaped support rods 2161 may be equal-high wave support rods or high-low wave support rods.

The connecting pipe body 219 includes a tubular connecting support frame 2190 attached to the main body film 210b. The connecting support frame 2190 includes a plurality of ring-shaped support rods 2192 with a Z-shaped or sinusoidal waveform. These rings The wave-shaped support rods 2192 are arranged at intervals along the axial direction of the main body film 210b. These ring-shaped wave support bars 2192 may be equal high wave support bars or high and low wave support bars. The diameter of the annular waveform support rod 2192 is smaller than the diameter of the proximal annular waveform support rod 2161.

The distal end of the proximal tube body 216 and the proximal end of the connecting tube body 219 are connected by a transition section, which is connected to the distal end of the proximal support frame 2160 and the connection support frame Between the proximal end of 2190 and the portion of the body coating 210b, the transition section includes a connection region 2165 extending in a direction perpendicular to the axis of the body tube 21b. At least one window 211 is provided on the connecting area 2165, and at least one embedded branch pipe 25 is provided in the proximal tube body 216, and one end of the embedded branch pipe 25 is hermetically connected to the window 211 At the edge, the opposite end of the embedded branch tube 25 extends toward the proximal end of the proximal tube body 216. The axis of the embedded branch pipe 25 is parallel to or intersects with the axis of the main body pipe 21a. In this embodiment, the axis of the embedded branch pipe 25 is parallel to the axis of the main body pipe 21a. In this embodiment, two openings 211 are provided on the connecting area 2165, two in-line branch tubes 25 are provided in the proximal tube body 216, and the distal ends of the two in-line branch tubes 25 are sealed and connected respectively At one edge of the window 211. The structure of the embedded branch pipe 25 is the same as that of the first embodiment, and will not be repeated here.

At least one in-line branch pipe 25 is provided at the proximal end of the connecting pipe body 219, and at least one window 211 is provided on the body coating 210b at the proximal end of the connecting pipe body 219. The distal end is sealingly connected to the edge of the window 211, and the proximal end of the embedded branch tube 25 extends toward the proximal tube body 216. The angle between the axis of the inline branch pipe 25 and the axis of the main body tube 21b is greater than 0 degrees, preferably, the angle between the axis of the inline branch pipe 25 and the axis of the main body tube 21b The angle is a value in the range of 5 degrees, 45 degrees, or 5 degrees to 45 degrees.

Please refer to FIG. 13, which is a usage state diagram of the in-line branch bracket provided by the sixth embodiment. Three branch pipes 40 or small braided branch pipes or other branch branches are connected to the main body pipe 21b. When in use, the branch pipe 40 or other branch pipes can be released into the corresponding embedded branch pipes 25 of the main body tube 21b, and the diameter of each embedded branch pipe 25 is smaller than that of the corresponding branch pipe 40, small braided branch pipe or other The diameter of the proximal end of the branch branch pipe, so that the embedded branch pipe 25 can compress the branch pipe 40, small braided branch pipe or other branch branch pipe, so that the branch pipe 40, small braided branch pipe or other branch branch pipe is attached to the inner wall of the embedded branch pipe 25 To prevent internal leakage; the branch tube 40, small braided branch tube or other branch brackets can be accommodated in the concave space 2175 on the main body tube 21b to avoid stacking of brackets.

When released, the conveyor is pushed along the super-hard guide wire to push the pre-installed main body tube 20 to the lesion location of the thoracic aortic dissection, positioned by the development ring at the front end of the main body tube 20 and the development point at the proximal end, and by controlling the conveyor, Release the main body tube 20; then, push the conveyor along the super-hard guide wire to push the pre-installed branch tube 40 or other branch branches to the adjacent main body tube 20, through the developing structure around the window 211 and the embedded branch tube 25 The ring-shaped developing part on the upper part inserts the proximal end of the branch pipe 40 or other branch pipe into the embedded branch pipe 25 through the corresponding window 211, releases the branch pipe 40 or other branch pipe, the embedded branch pipe 25 compresses the branch pipe 40 Or other branch pipes, so that the release branch pipe 40 or other branch pipes are sealingly connected with the embedded branch pipe 25 to prevent internal leakage.

Please refer to FIG. 14, which is a schematic structural diagram of an in-line branch support provided by a seventh embodiment of the present application. The structure of the in-line branch stent provided in the seventh embodiment of the present application is similar to the structure of the fourth embodiment, except that in the seventh embodiment, the main body tube 21c includes a proximal tube body in order from the proximal end to the distal end 216. A middle tube body 217 and a distal tube body 218. The diameter of the middle tube body 217 is smaller than that of the proximal tube body 216 and the distal tube body 218. A tube-shaped body coating 210c is provided on the inner peripheral surface or outer peripheral surface of the body tube 21c, and the body coating 210c is made of polyester cloth, PTFE, PET or other polymer materials. The distal end of the proximal tube 216 and the proximal end of the central tube 217 are connected by a conical transition tube 2176; the proximal end of the distal tube 218 and the central tube 217 The distal ends are connected by a conical second transition 2178. The outer peripheral surface of the middle tube body 217 encloses a concave space 2175 between the proximal tube body 216 and the distal tube body 218, the concave space 2175 is used to receive a window that is inserted into the main body tube 21c The branch pipe 40 in the 211 can provide the branch pipe 40 with enough space to prevent the main body pipe 21c from squeezing the branch pipe 40 or the branch pipe 40 from being stacked, thereby avoiding the blockage of the branch pipe 40.

The proximal tube body 216 includes a tubular-shaped proximal support frame 2160 attached to the inner circumferential surface or the outer circumferential surface of the main body film 210c. The proximal support frame 2160 includes several Z-shaped or sinusoidal waveforms The proximal annular wave-shaped support rods 2161 are arranged at intervals along the axial direction of the body coating 210c. These proximal annular wave-shaped support rods 2161 may be equal-high wave support rods or high-low wave support rods. In this embodiment, there are two near-end annular wave-shaped support rods 2161 respectively provided with window opening support portions 2162 for supporting the window opening 211.

Please refer to FIG. 15 in conjunction with FIG. 14. FIG. 15 is a three-dimensional structural diagram of the proximal annular wave-shaped support rod in FIG. 14. Each Z-shaped or sinusoidal waveform of the proximal annular wave-shaped support rod 2161 provided with the window-opening support 2162 includes a peak 2163, a valley 2167, and a connection between the peak 2163 and the valley 2167 Rod 2168. Each proximal annular wave-shaped support rod 2161 is braided by a piece of superelastic nickel-titanium wire. The wire diameter (ie diameter) of the superelastic nickel-titanium alloy wire can be selected from 0.2 mm to 0.55 mm. Each proximal annular wave-shaped support rod 2161 is provided with a connecting sleeve that connects the opposite ends of the superelastic nickel-titanium alloy wire, that is, the opposite ends of the superelastic nickel-titanium alloy wire are accommodated in In the connecting sleeve, the two ends of the nickel-titanium wire are then fixed inside the connecting sleeve by mechanical compression or welding to form a proximal annular wave-shaped support rod 2161. The window-opening support 2162 is disposed on one of the troughs 2167 of the proximal annular wave-shaped support rod 2161, that is, the window-opening support 2162 is located between two adjacent peaks 2163. The window-opening support 2162 is a V-shaped or U-shaped support rod, and opposite ends of the support rod are respectively connected to corresponding connecting rods 2168. The window-opening support 2162 and the corresponding two connecting rods 2168 and A window space 2169 is enclosed between the wave peaks 2163.

In this embodiment, the proximal tube body 216 is provided with two proximal annular wave-shaped support rods 2161 with window-opening support 2162, and the two proximal annular wave-shaped support rods 2161 are evenly arranged in the near The window support 216 of the end tube body 216 reserves sufficient space for the window 211. The wire diameter of the proximal annular wave-shaped support rod 2161 is 0.45 mm, the number of wave peaks 2163 provided on the proximal annular wave-shaped support rod 2161 is 6, and the vertical height of the proximal annular wave-shaped support rod 2161 is 15 mm.

As shown in FIG. 14, the central tube 217 includes a tubular central support frame attached to the main body film 210c, and the central support frame includes at least one Z-shaped or sinusoidal central ring-shaped waveform support The rods 2172 and the central annular wave-shaped support rods 2172 are arranged at intervals along the axial direction of the body coating 210c. The central annular wave-shaped support rod 2172 may be an equal high wave support rod or a high and low wave support rod. In this embodiment, only one central annular wave-shaped support rod 2172 is provided on the central tube body 217, and the central annular wave-shaped support rod 2172 is a contour wave support rod. The diameter of the central annular wavy support rod 2172 is smaller than the diameter of the proximal annular wavy support rod 2161.

The distal tube body 218 includes a tubular distal support frame attached to the main body film 210c. The distal support frame includes at least one distal ring-shaped wave-shaped support rod 2182 with a Z-shaped or sinusoidal wave shape. The end-shaped wave-shaped support rods 2182 are arranged at intervals along the axial direction of the body coating 210c. The distal annular wave-shaped support rod 2182 may be an equal high wave support rod or a high and low wave support rod. In this embodiment, only one distal ring-shaped wave support rod 2182 is provided on the distal tube body 218, and the distal ring-shaped wave support rod 2182 is a contour wave support rod. The diameter of the distal annular wave-shaped support rod 2182 is larger than the diameter of the middle annular wave-shaped support rod 2172.

The inner surface or outer surface of the main body coating 210c at the transition tube body 2176 is provided with a conical wave-shaped support rod 2177 with a Z-shaped or sinusoidal waveform. The diameter of the proximal end of the conical wave-shaped support rod 2177 is larger than that of the distal end In diameter, the proximal end of the conical wave-shaped support rod 2177 is connected to the distal end of the proximal tube body 216, and the distal end of the conical wave-shaped support rod 2177 is connected to the proximal end of the central tube body 217. The diameter of the conical wave-shaped support rod 2177 gradually increases from the distal end to the proximal end, that is, the diameter of the proximal end of the conical wave-shaped support rod 2177 is equivalent to the diameter of the proximal support skeleton 2160, and the conical wave-shaped support rod 2177 The diameter of the distal end of is equivalent to the diameter of the central annular wave-shaped support rod 2172.

The inner surface or outer surface of the main body film 210c located at the second transition section 2178 is provided with a Z-shaped or sinusoidal conical wave-shaped support rod 2179, and the diameter of the proximal end of the conical wave-shaped support rod 2179 is less than For the diameter of the distal end, the proximal end of the conical wave-shaped support rod 2179 is connected to the distal end of the central tube body 217, and the distal end of the conical wave-shaped support rod 2179 is connected to the proximal end of the distal tube body 218. The diameter of the conical wave-shaped support rod 2179 gradually decreases from the distal end to the proximal end, that is, the diameter of the proximal end of the conical wave-shaped support rod 2179 is equivalent to the diameter of the central annular wave-shaped support rod 2172. The diameter of the distal end of the rod 2179 is equivalent to the diameter of the distal annular wave-shaped support rod 2182.

The main body coating 210c of the proximal tube 216 is provided with two window opening spaces 2169 corresponding to the two window opening support portions 2162, and the connection between the center points of the two window openings 211 is provided. The line is parallel to the axis of the main body tube 21c, wherein the window 211 adjacent to the proximal end of the proximal tube body 216 is a groove-shaped structure, and the groove may be a square, U-shaped or semi-circular structure. The edge of the window opening 211 is provided with a square, U-shaped or semi-circular support rod; the window opening 211 adjacent to the distal end of the proximal tube 216 is circular or oval, and the edge of the window opening 211 is provided There is a support ring, which is preferably a memory metal ring. In a modified embodiment, the window 211 on the proximal tube 216 may also have other shapes not mentioned above. The window opening 211 is also provided with a developing structure, which is the same as the developing structure 215 in the first embodiment, and will not be repeated here.

In a modified embodiment, the line between the center points of the two openings 211 of the proximal tube 216 is not parallel to the axis of the main body tube 21c, and the shapes of the two openings 211 on the proximal tube 216 can be as required Flexible settings.

The two opening windows 211 of the proximal tube body 216 do not need to be provided with corresponding embedded branch tubes, and blood flows from the proximal tube body 216 through the window 211 into the corresponding branch blood vessels. It can be understood that, in a modified embodiment, the proximal tube body 216 is provided with two inline branch tubes, and the proximal ends of the two inline branch tubes are respectively sealingly connected to the proximal tube body Two windows 211 on 216. The embedded branch pipe has the same structure as the embedded branch pipe 25 in the first embodiment, and will not be described here.

Please refer to FIG. 14 to FIG. 16 together, an opening 211 is opened on two opposite sides of the main body film 210a at the transition tube 2176, that is, the two openings 211 are along the axis of the main body tube 21c Symmetrical; the edge of each window 211 includes a V-notch. The transition tube body 2176 is provided with two of the embedded branch tubes 25, and the distal ends of the two embedded branch tubes 25 are respectively sealed and connected to the edges of the two window openings 211, and the embedded branch tubes 25 The opposite proximal end extends toward the proximal end of the proximal tube body 216. The axis of the embedded branch pipe 25 is parallel to or intersects with the axis of the main body pipe 21c. In this embodiment, the axis of the embedded branch pipe 25 is parallel to the axis of the main body pipe 21c. Each window opening 211 is also provided with a support member and a developing structure. The support member is provided with a support member 256 in the first embodiment except that a V-shaped structure corresponding to the V-shaped notch of the window opening 211 is provided. In the same way, the developing structure on the window opening 211 is also the same as that in the first embodiment, which will not be repeated here. Each embedded branch pipe 25 in the transition pipe body 2176 includes an embedded branch coating 253a, a support frame 255a, and a support ring 256a. The support ring 256a includes a V-shaped notch corresponding to the corresponding window 211. V-shaped structure. The structure of the embedded branch pipe 25 in this embodiment is the same as that of the embedded branch pipe 25 in the first embodiment except that the structure corresponding to the V-shaped notch of the window 211 is provided, which will not be repeated here.

Please refer to FIG. 17, which is a usage state diagram of the in-line branch bracket provided by the seventh embodiment. Four branch pipes 40 or small braided branch pipes or other branch branches are connected to the main body pipe 21c. When in use, the branch pipe 40 or other branch pipes can be released into the four windows of the main body tube 21c respectively. The proximal end of the branch pipe 40 inserted on the transition pipe body 2176 is accommodated on the corresponding body of the transition pipe body 2176. In the embedded branch pipe 25, the diameter of each embedded branch pipe 25 is smaller than the diameter of the proximal end of the corresponding branch pipe 40, small braided branch pipe or other branch branch pipe, so that the embedded branch pipe 25 can compress the branch pipe 40, small Braided branch pipe or other branched branch pipe, so that branch pipe 40, small braided branch pipe or other branched branch pipe fits with the inner wall of embedded branch pipe 25 to prevent internal leakage; branch pipe 40, small braided branched pipe or other branched branch pipe can be accommodated in the In the concave space 2175 formed on the outer wall of the main body tube 21c, stacking of brackets is avoided. In a modified embodiment, the two openings 211 of the proximal tube 216 omits the setting of the branch tube 40 used in conjunction therewith, that is, blood flows into the corresponding branch blood vessel from the proximal tube 216 through the window 211 without passing through the branch tube 40 .

When releasing, push the conveyor along the super-hard guide wire to push the pre-installed in-line branch stent to the lesion location of the aortic dissection, locate by the developing ring at the front of the in-line branch stent, and release the in-line branch stent by controlling the conveyor ; Then, push the conveyor along the super-hard guide wire to push the pre-installed branch tube 40 or other branch branch tube to each adjacent window 211, through the developing structure around the window 211 and/or the ring on the embedded branch tube 25 The shape developing part releases the proximal end of the branch tube 40 or other branch branches through the corresponding window 211, inserts the branch tube 40 on the transition tube body 2176 into the embedded branch tube 25, that is, releases the branch tube 40 or other branch branches The embedded branch pipe 25 compresses the branch pipe 40 or other branch pipe, so that the release branch pipe 40 or other branch pipe is sealedly connected with the embedded branch pipe 25 to prevent internal leakage. At this time, the two windows 211 on the proximal tube body 216 and the two windows 211 on the transition tube body 2176 are respectively inserted with branch tubes 40, and the two branch tubes 40 connected to the proximal tube body 216 may be located in the abdominal cavity, respectively In the trunk and in the superior mesenteric artery, the branch tube 40 connected to the transitional tube body 2176 may be located in the renal aorta.

In a modified embodiment, at least one window is provided on the distal tube body 218, and at least one branch tube is inserted into the corresponding window on the distal tube body 218. The distal tube body 218 may be provided with an embedded branch tube to seal the branch tube as required.

The above is the implementation of the embodiments of the present application. It should be pointed out that, within the spirit of the present invention, the specific technical solutions in the above embodiments can be applied to each other. For those of ordinary skill in the art, without departing from the present application On the premise of the principles of the embodiments, several improvements and retouches can also be made, and these improvements and retouches are also regarded as the scope of protection of the present application.

Claims (20)

1. An in-line branching bracket with improved developing performance includes a main body tube, the main body tube includes a tubular main body covering film, at least one window is opened on the main body covering film, characterized in that the in-line branching support It also includes at least one embedded branch tube disposed in the lumen of the main body tube, at least one proximal end or distal end of the at least one embedded branch tube is connected to at least one window opening, and at least one of the embedded branch tube At least one annular developing portion is provided on the upper portion.
2. The in-line branch stent according to claim 1, wherein at least one of the in-line branch tubes is provided with a ring-shaped developing portion at the proximal end and/or the distal end, or the ring-shaped developing portion is provided at the The opening of the window in which the branch pipe is embedded.
3. The in-line branching bracket according to claim 2, wherein the annular developing portion includes a supporting member and a developing member.
4. The in-line branch bracket according to claim 3, wherein the support member is a support ring.
5. The in-line branching bracket according to claim 3, wherein the developing member is a developing wire continuously or intermittently wound on the support ring; or a developing point on the support ring is continuously or intermittently set ; Or the development material doped in the development section manufacturing material; or a number of development points around the window.
6. The in-line branch stent according to claim 1, wherein the in-line branch tube includes an in-line branch membrane, and the distal end of the in-line branch membrane and the main body membrane except the edge of the window Sealed connection, the embedded branch film is used to wrap the branch tube.
7. The in-line branch stent according to claim 6, wherein a cross section of the distal end of the in-line branch film is recessed inwardly relative to the window to form a guide portion, and the guide portion is convenient for in-line embedding The branch pipe is inserted into the branch pipe.
8. The in-line branch stent according to claim 1, wherein the main body tube has a non-equal diameter structure.
9. The in-line branched stent according to claim 8, wherein the diameter of the proximal end of the main body tube is larger than the diameter of the distal end, and the diameter of the main body tube gradually narrows from the proximal end to the distal end.
10. The in-line branch stent according to claim 8, wherein the main body tube comprises a proximal tube body, a middle tube body and a distal tube body in order from the proximal end to the distal end, and the diameter of the middle tube body is relatively small The proximal tube body and/or the distal tube body are small.
11. The in-line branch stent according to claim 10, wherein the window is opened on the main body film at the junction of the proximal tube body and the middle tube body, and the middle tube body Or opened on the distal tube body.
12. The in-line branch stent according to claim 11, wherein the inner cavity of the proximal tube body, the inner cavity of the middle tube body, and/or the inner cavity of the distal tube body are provided There is the embedded branch tube.
13. The in-line branch bracket according to any one of claims 1 to 12, wherein the axis of the in-line branch tube is parallel to the axis of the main body tube.
14. The in-line branch bracket according to claim 1, wherein a distal end of the in-line branch tube is connected to the window, and a cross-section of the distal end surface of the in-line branch tube and the window is not Flush.
15. The in-line branch stent according to claim 14, wherein a transition coating is connected between the distal end of the in-line branch tube and the cross-sectional edge of the window, the transition coating and the main body coating Sealed connection.
16. The in-line branch stent of claim 1, wherein the main body tube includes a proximal tube body and a distal tube body, and the distal end of the proximal tube body and the proximal end of the distal tube body Are connected by a transitional tube body, the transitional tube body is a conical tube, the proximal diameter of the transitional tube body is greater than the distal diameter, the embedded branch tube is provided in the internal cavity of the transitional tube body, so A window is opened on the main body covering film where the embedded branch pipe is connected to the transition pipe body.
17. The in-line branch stent according to claim 16, wherein two internal in-line branch tubes are provided in the inner cavity of the transition tube body, and the main body film at the transition tube body is coated on the Two opposite sides of the axis of the transition pipe body are respectively provided with window openings, and the two embedded branch pipes are respectively connected to the two window openings.
18. The in-line branching bracket according to claim 1, wherein at least one circle of development points or development wires connected or intermittently is provided around the window opening.
19. A blood vessel stent, characterized by comprising the in-line branch stent according to any one of claims 1 to 18, and at least one branch tube, and a proximal end portion of the branch tube is connected to the in-line branch stent Embedded in the branch pipe.
20. The vascular stent according to claim 19, wherein the inner diameter of the embedded branch tube is less than or equal to the outer diameter of the proximal end of the branch tube, and when the branch tube is inserted into the embedded branch tube, The embedded branch pipe compresses the branch pipe.

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