WO2023033488A1

WO2023033488A1 - Apparatus for supporting outer wall of blood vessel

Info

Publication number: WO2023033488A1
Application number: PCT/KR2022/012905
Authority: WO
Inventors: 하현수; 강미란; 이세원; 박주영
Original assignee: 주식회사 티엠디랩
Priority date: 2021-09-02
Filing date: 2022-08-30
Publication date: 2023-03-09
Also published as: KR102555918B1; KR20230034077A

Abstract

Disclosed is an apparatus for supporting an outer wall of a blood vessel. An apparatus for supporting an outer wall of a blood vessel according to an embodiment of the present invention comprises: an artificial blood vessel support part which has a curved shape and is provided so as to surround an outer wall of an artificial blood vessel anastomosed with a vein; and a vein support part which is provided so as to surround an outer wall of the vein, and is connected to the artificial blood vessel support part at a distal end of the artificial blood vessel support part.

Description

Blood vessel outer wall support device

The present invention relates to a device for supporting the outer wall of a blood vessel, and more particularly, to a device for supporting the outer wall of a blood vessel for supporting the outer wall of an artificial blood vessel anastomosed with a vein and the outer wall of a vein when arteriovenous transplantation is performed using the artificial blood vessel.

As the prevalence of end-stage renal disease continues to rise, the number of patients undergoing arteriovenous fistula (AVF) surgery for hemodialysis vascular access continues to increase. Dialysis line formation is necessary for patients undergoing hemodialysis when uremia occurs due to end-stage renal failure, pulmonary edema, or electrolyte imbalance occurs. will continue At this time, depending on the state of the autologous blood vessel and clinical findings, the autologous vein and artery may be joined, or a dialysis path may be formed using an artificial blood vessel.

A complication that occurs frequently in patients undergoing dialysis by forming the dialysis line is blockage of the dialysis line due to blood vessel stenosis. Looking at the mechanism of such vascular stenosis, abnormal blood flow (disturbed flow) caused by the inflow of arterial blood into the vascular structure and veins around the vascular junction causes vascular endothelial cell activation and functional abnormalities, resulting in inflammatory response and neointimal formation ( Neo-intima formation process progresses, resulting in vascular stenosis and thrombosis.

In order to prevent abnormal blood flow, which is the fundamental cause of vascular stenosis, and to prevent changes in veins that are remodeled into irregular shapes due to abnormal blood flow, a structure supporting the outer wall of the blood vessel is inserted during arteriovenous fistula surgery to prevent abnormal blood flow. Techniques for inducing laminar flow have been proposed.

When reviewing related prior art, US 10849627 B2 and US 2015/0119908 A1 suggest designs for external and internal wall supports of an Arteriovenous Fistula (AVF) model connecting autologous arteries and autologous veins. However, hemodynamic studies on arteriovenous graft (AVG) that connects an artificial non-autologous artery (graft) with an autologous vein and proposals for a support for the outer wall of a blood vessel are hardly found.

Autologous arteries and artificial vessels have physical differences in their physical properties, and there is a clear difference between the flow of arterial blood that flows in when an autologous artery is directly connected to a vein and the flow of arterial blood that enters and joins through an artificial vessel. Therefore, in order to create ideal blood flow in the AVG that connects artificial blood vessels and autologous veins, what angle should blood flow be spliced and what anatomical structure should the outer wall support of blood vessels be induced to maintain artificial blood vessels and autologous veins after surgery? Technology development is required.

Meanwhile, like a stent used in angina pectoris and myocardial infarction due to arteriosclerosis, the outer wall support of a blood vessel also accepts pulsatile blood flow that repeats contraction and relaxation. Therefore, there is a demand for the development of a technology for minimizing deformation of blood vessels due to pulsatile blood flow in relation to the AVG blood vessel outer wall support.

(Patent Document 1) US 10849627 B2

(Patent Document 2) US 2015/0119908 A1

The present invention is to solve the problems of the prior art described above, and an object of the present invention is to support the outer wall of the artificial blood vessel and the autologous vein after arteriovenous graft (AVG) connecting the artificial blood vessel and the autologous vein to provide an ideal blood flow. It is to provide a device for supporting the outer wall of a blood vessel that induces.

Another object of the present invention is to provide a device for supporting the outer wall of a blood vessel that minimizes deformation of blood vessels due to pulsatile blood flow that repeats contraction and relaxation after arteriovenous graft (AVG) connecting artificial blood vessels and autologous veins.

The technical problem to be solved in the present invention is not limited thereto, and other technical problems not mentioned will be clearly understood by those skilled in the art from the following description.

According to one aspect of the present invention, an artificial blood vessel support having a curved shape and arranged to surround an outer wall of an artificial blood vessel anastomosed with a vein and disposed to surround an outer wall of the vein, distal to the artificial blood vessel support An apparatus for supporting an outer wall of a blood vessel including a vein support unit connected to the artificial vessel support unit at an end thereof is provided.

In this case, the artificial blood vessel support has an arc shape, the vein support has a straight shape, and the artificial blood vessel support may intersect the vein support at the distal end.

In addition, the artificial blood vessel support may come into contact with the vein support at an angle of 15 degrees or more and less than 60 degrees at an intersection with the vein support.

In addition, the artificial blood vessel support may have a length of 15 to 25 mm.

In addition, a length from a connection portion with the artificial blood vessel support to a proximal end of the vein support may be 20 to 40 mm.

In addition, at least one of the artificial blood vessel support part and the vein support part may include a plurality of annular segments spaced apart from each other in a longitudinal direction and disposed continuously in a wave shape along the circumferential direction, and a pair of adjacent annular segments. It may include a connecting member that is connected and disposed.

In addition, the connecting member may include a bridge connecting a pair of adjacent troughs or a pair of ridges along the longitudinal direction.

In addition, the connecting member connects the peaks located on both sides of the bridge in the circumferential direction and the valleys where the longitudinal ends of the bridge are in contact, or the valleys located on both sides of the bridge in the circumferential direction and the longitudinal ends of the bridge are in contact An auxiliary bridge connecting the mountain part may be further included.

According to the device for supporting the outer wall of the blood vessel of the present invention having the above configuration, the artificial blood vessel support portion having a curved shape and surrounding the outer wall of the artificial blood vessel anastomosed with the vein is configured to be connected to the vein support portion at a predetermined angle. As a result, the occurrence of abnormal blood flow in the arteriovenous graft can be minimized and the flow of blood can be smoothed.

In addition, according to the device for supporting the outer wall of a blood vessel of the present invention, a plurality of annular segments that are continuously disposed apart from each other in a longitudinal direction and disposed in a wavy shape along the circumferential direction, and a connection that is disposed by connecting a pair of adjacent annular segments. Through this member, deformation of blood vessels due to repeated pulsatile blood flow at the arteriovenous transplant site can be minimized.

The effects of the present invention are not limited to the above effects, and should be understood to include all effects that can be inferred from the detailed description of the present invention or the configuration of the invention described in the claims.

1 is a diagram showing the configuration of an apparatus for supporting the outer wall of a blood vessel according to an embodiment of the present invention.

2 is a view showing an anatomical structure in which blood vessel stenosis occurs frequently due to abnormal blood flow in an anastomotic portion between an artificial blood vessel and a vein.

3 is a view showing examples in which an artificial blood vessel having a straight shape is anastomosed with a vein.

FIG. 4 shows a result of analyzing abnormal blood flow regions in the examples of FIG. 3 .

5 is a view showing examples in which an artificial blood vessel having an arc shape is anastomosed with a vein.

FIG. 6 shows a result of analyzing abnormal blood flow regions in the examples of FIG. 5 .

7 is an upper perspective view of the device for supporting the outer wall of a blood vessel according to another embodiment of the present invention.

8 is a lower perspective view of the device for supporting the outer wall of a blood vessel according to another embodiment of the present invention.

9 is a rear view of the device for supporting the outer wall of a blood vessel according to another embodiment of the present invention.

10 is a view showing an annular segment and a connecting member of the device for supporting the outer wall of a blood vessel according to another embodiment of the present invention.

11 is a graph showing the hemodynamic effect provided by the device for supporting the outer wall of a blood vessel according to another embodiment of the present invention.

Hereinafter, with reference to the accompanying drawings, embodiments of the present invention will be described in detail so that those skilled in the art can easily carry out the present invention. This invention may be embodied in many different forms and is not limited to the embodiments set forth herein. In order to clearly describe the present invention, parts irrelevant to the description are omitted in the drawings, and the same reference numerals are assigned to the same or similar components throughout the specification.

In this specification, terms such as "include" or "have" are intended to describe the presence of features, numbers, steps, operations, components, parts, or combinations thereof described in the specification, but one or more other features It should be understood that the presence or addition of numbers, steps, operations, components, parts, or combinations thereof is not precluded.

In this specification, spatially relative terms such as "front", "rear", "upper" or "lower" may be used to describe the correlation with components shown in the drawings. These are relative terms based on what is shown in the drawings, and the positional relationship may be interpreted in the opposite way according to the orientation. In addition, in the present specification, 'proximal' means a position relatively close to the heart, and 'distal' means a position relatively far from the heart in the direction of blood flow. Therefore, it can be interpreted that arterial blood proceeds in a proximal to distal direction, and venous blood proceeds in a distal to proximal direction. On the other hand, that a component is “connected” to another component includes cases where they are not only directly connected to each other but also indirectly connected to each other unless there are special circumstances.

The device for supporting the outer wall of a blood vessel 100 according to an embodiment of the present invention is provided to surround and arrange an arteriovenous graft (AVG) artificial blood vessel and an autologous vein anastomosed with the artificial blood vessel. The device for supporting the outer wall of blood vessels 100 minimizes the occurrence of abnormal blood flow in the arteriovenous graft and makes the blood flow smooth.

Referring to FIG. 1 , an apparatus for supporting an outer wall of a blood vessel 100 according to an embodiment of the present invention includes an artificial blood vessel support unit 110 and a vein support unit 130 .

The artificial blood vessel support 110 is disposed to surround the outer wall of the artificial blood vessel anastomosed with the vein. Here, the artificial blood vessel refers to an arteriovenous transplanted blood vessel that is artificially created and connects an autologous artery to an autologous vein. For example, the material of the artificial blood vessel may be polytetrafluoroethylene (ePTFE).

The artificial blood vessel support 110 has a curved shape. More specifically, the artificial blood vessel support 110 may have an arc shape. The artificial blood vessel support 110 includes a tubular body 112 having a space inside the artificial blood vessel, an inlet 111 formed at a proximal end of the body 112, and a distal end of the body 112. It may be provided with an outlet 113 formed in.

Vein support 130 is provided to be disposed while surrounding the outer wall of the vein. Here, the vein refers to a vein joined to an artificial blood vessel at an arteriovenous transplant site.

The vein support 130 is connected to the artificial blood vessel support 110 at the distal end of the artificial blood vessel support 110 . That is, the vein support 130 may communicate with the artificial blood vessel support 110 through the outlet 113 of the artificial blood vessel support 110 .

Vein support 130 may have a straight shape. The vein support 130 includes a distal portion 131 disposed distal with respect to a connection portion with the artificial blood vessel support 110, an anastomosis portion 132 intersecting the outlet 113 of the artificial blood vessel support 110, A proximal portion 133 disposed proximal to the connection portion with the artificial blood vessel support 110 may be included.

In one embodiment of the present invention, the artificial blood vessel support 110 has an arc shape, the vein support 130 has a straight shape, and the artificial blood vessel support 110 intersects the vein support 130 at the distal end. can

More specifically, the artificial blood vessel support 110 may come into contact with the vein support 130 at an angle of 15 degrees or more and less than 60 degrees at an intersection with the vein support 130 . At this time, the angle between the artificial blood vessel support 110 and the vein support 130 is the tangential line TL of the artificial blood vessel support 110 at the intersection of the artificial blood vessel support 110 and the vein support 103. ) and an angle (θ).

Hereinafter, when the blood vessel support 110 has an arc shape and is connected to the vein support 130 at an angle of 15 degrees or more and less than 60 degrees, computational fluid dynamics factor analysis for verifying the effect of improving blood flow at the vascular anastomosis site explain the results.

Referring to FIG. 2, when arterial blood (A) is introduced into an autologous vein through an artificial blood vessel anastomosed with an autologous vein through which venous blood (V) flows, the site where abnormal blood flow occurs is the toe (toes) by replicating the shape of a human foot. T), heel region (H), and bottom region (F), and these regions can be interpreted as regions of interest when analyzing computational fluid dynamics factors.

At this time, the diameter of the artificial blood vessels and veins may be assumed to be 3 mm. In addition, the blood flow of arterial blood (A) flows into the inlet 111 at the highest speed in the range of 0.2 to 0.9 m/s, and is assumed to have a static pressure of 3700 to 5500 Pa at the outlet 113 , venous blood (V) can be assumed to have a constant velocity of 0.1 m/s.

On the other hand, ANSYS Fluent 20.0 was used as a software for computational fluid dynamics, and to change the partial differential equation (PDE) representing the flow into the differential equation (FDE), which is an algebraic equation, continuous After the finite volume method (FVM) is finitely discretized using a mesh, the continuity equation, the momentum equation, and the energy equation ( After setting the energy equation), the K-ω SST turbulence model was additionally applied to simulate the turbulent flow of the fluid.

In addition, the Carreau-Yasuda model was applied to the blood to apply the non-Newtonian model, and the density was set to 1060 kg/m 3 .

In addition, in order to confirm the hemodynamic abnormality, the maximum shear stress WSSmax (Wall Shear Stress Max), time-average wall shear stress TAWSS (Time-Average Wall Shear Stress) and alternating shear index OSI (Oscillatory Shear Index) were measured in Table 1 below. ], and areas with OSI ≥ 0.1, TAWSS ≤ 2 Pa, and WSSmax ≥ 70 Pa were classified as vulnerable to atherosclerosis.

[Table 1]

3 is a view showing examples in which an artificial blood vessel having a straight shape is anastomosed with a vein. The examples shown in FIG. 3 are those in which the artificial graft has a straight shape and is connected to the vein, and the artificial graft has an angle of 15 degrees and 30 degrees, respectively, to the vein. straight 30°), 45° (straight 45°), and 60° (straight 60°) angles. FIG. 4 shows the result of analyzing the abnormal blood flow area in the examples of FIG. Specifically, FIG. 4 shows the area of the area of OSI≥0.1, the area of TAWSS≤2Pa, and the area of WSSmax≥70Pa in the toe area T.

Referring to FIG. 4 , it can be confirmed that the examples of FIG. 3 all have areas where errors occur in OSI, TAWSS, and WSSmax. On the other hand, when the artificial graft has a straight shape and forms a straight 15° with the vein, the region with OSI≥0.1 and the region with TAWSS≤2Pa are eliminated, showing relatively good blood flow, but still A region in which shear stress was high was observed with WSSmax≥70Pa.

5 is a view showing examples in which an artificial blood vessel having an arc shape is anastomosed with a vein. The examples shown in FIG. 5 are those in which the artificial graft has an arc shape and is connected to the vein. Round 30°), 45° (Round 45°) and 60° (Round 60°) are meeting.

FIG. 6 shows a result of analyzing abnormal blood flow regions in the examples of FIG. 5 . Specifically, FIG. 6 shows the area of the area of OSI≥0.1, the area of TAWSS≤2Pa, and the area of WSSmax≥70 Pa in the toe area (T).

Referring to FIG. 6, in all the examples of FIG. 5, the region with WSSmax ≥ 70 Pa where a high shear force of 70 Pa or more is applied is lost regardless of the angle, and the region with OSI ≥ 0.1 and TAWSS ≤ 2 Pa is artificial blood vessel (Graft) vein. (Vein) has been confirmed to appear only when it forms an angle of 60 degrees. However, when the tangential angle exceeded 60 degrees, a tendency for abnormal blood flow to increase was observed.

Considering these results, it is preferable that the artificial graft has an arc shape and is connected to the vein at an angle of 15 degrees or more and less than 60 degrees. Accordingly, the apparatus 100 for supporting the outer wall of the blood vessel according to an embodiment of the present invention needs to support the artificial blood vessel (graft) and the vein (vein) to maintain these shapes, and for this purpose, the artificial blood vessel support unit 110 In shape, the vein support 130 has a straight shape, but the artificial blood vessel support 110 is in contact with the vein support 130 at an angle of 15 degrees or more and less than 60 degrees at an intersection with the vein support 130. desirable.

In one embodiment of the present invention, the artificial blood vessel support 110 having an arc shape forms an angle of 30 degrees with the vein support 130, and the diameter d1 of the artificial blood vessel support 110 and the diameter of the vein support 130 When (d2) is 3 mm, the radius of curvature R is 20 mm, and the distance from the center of curvature O of the artificial blood vessel support 110 to the outermost radial side of the artificial blood vessel support 110 ( R+d1) becomes 23 mm.

At this time, the innermost length L1 of the artificial blood vessel support 110 in the radial direction is 25.8 mm, the outermost length L3 of the artificial blood vessel support 110 in the radial direction is 16.4 mm, and the length of the artificial blood vessel support 110 is 16.4 mm. (L2) becomes 20 mm. In addition, the crossing length L4 of the artificial blood vessel support 110 and the vein support 130 is 10.954 mm, and the intersection area of the artificial blood vessel support 110 and the vein support 130 is 39.47 mm 2 .

Considering these measurements, in one embodiment of the present invention, the length L2 of the artificial blood vessel support 110 is preferably 15 to 25 mm for the anatomical structure of blood vessels and the convenience of the operator. For example, the length L2 of the artificial blood vessel support 110 may be 20 mm.

In addition, in one embodiment of the present invention, the length from the connection portion with the artificial blood vessel support 110 of the vein support 130 to the proximal end, in other words, the length L5 of the proximal portion 133 is 20 to 40 mm. can As a result of hemodynamic factor analysis, the arc-shaped artificial vessel support 110 forms an angle of 30 degrees with the vein support 130, and the diameter d1 of the artificial vessel support 110 and the diameter d2 of the vein support 130 When each of these is 3 mm, it has been confirmed that no turbulent flow occurs in the vein even when the proximal portion 133 has a length of 20 mm.

7 is an upper perspective view of the device for supporting the outer wall of a blood vessel according to another embodiment of the present invention, FIG. 8 is a perspective view of the lower side of the device for supporting the outer wall of a blood vessel according to another embodiment of the present invention, and FIG. It is a rear view of the device for supporting the outer wall of a blood vessel according to the embodiment. Also, FIG. 10 is a view showing an annular segment and a connecting member of the device for supporting the outer wall of a blood vessel according to another embodiment of the present invention.

Referring to FIGS. 7 to 10 , an apparatus 200 for supporting an outer wall of a blood vessel according to another embodiment of the present invention includes an artificial blood vessel support 210 and a vein support 230 . In another embodiment of the present invention, the shape of the artificial blood vessel support part 210 and the vein support part 230, the angle formed with each other, the length of the artificial blood vessel support part 210, and the artificial blood vessel support part 210 among the vein support parts 230 The length from the connection site to the proximal end (length of the proximal portion) is the same as described in relation to one embodiment of the present invention. Therefore, detailed descriptions of overlapping contents will be omitted, and only non-overlapping contents will be described.

In another embodiment of the present invention, the vein support 230 has a slot 230a formed along the longitudinal direction. During the operation of the outer wall support device 200 for the blood vessel, the patient's vein can be easily inserted into the vein support 230 through the slot 230a and placed therein.

The vein support 230 may be made of a material that memorizes its shape depending on temperature. For example, the vein support 230 has a shape in which the slot 230a is open during surgery, but has a shape in which the slot 230a is closed so as to entirely cover the vein at a predetermined temperature (eg, body temperature). can be transformed into In this case, in the course of surgery, the slot 230a of the vein support 230 is opened to facilitate insertion of the vein, but after surgery, the slot 230a is closed inside the patient's body, and the vein support 230 is The outer wall can be supported as a whole. Meanwhile, once the slot 230a is deformed into a closed shape, the shape may be maintained regardless of temperature.

Of course, the vein support 230 may be made of a material that does not remember its shape, and the slot 230a may be artificially closed by a surgeon after inserting the vein.

Meanwhile, as shown in FIG. 10, in the device for supporting the outer wall of a blood vessel 200 according to another embodiment of the present invention, both the artificial blood vessel support 210 and the vein support 230 are spaced apart in the longitudinal direction and are continuously disposed. It includes a plurality of annular segments 300 arranged in a wavy shape along the circumferential direction, and a connecting member 400 connected to a pair of adjacent annular segments 300 and disposed.

According to another embodiment of the present invention, deformation of a blood vessel due to repeated pulsatile blood flow in an arteriovenous transplant unit can be minimized through the plurality of annular segments 300 and the connection member 400 .

A plurality of annular segments 300 are spaced apart in the longitudinal direction and continuously arranged, and are arranged in a wavy shape along the circumferential direction, respectively. The plurality of annular segments 300 may form the artificial blood vessel support 210 and the vein support 230 . In this case, the plurality of annular segments 300 may integrally form the artificial blood vessel support 210 and the vein support 230 .

The connecting member 400 connects a pair of adjacent annular segments 300 and is disposed. The connection member 400 may include a bridge 410 connecting a pair of valleys or a pair of peaks adjacent to each other along the longitudinal direction.

In addition, in another embodiment of the present invention, the connecting member 400 connects the peaks located on both sides of the bridge 410 in the circumferential direction and the valley where one end of the bridge 410 in the longitudinal direction is in contact, or connects the bridge in the circumferential direction ( An auxiliary bridge 420 may be further included to connect valleys located on both sides of 410 and hills where one end of the bridge 410 in the longitudinal direction is in contact.

In another embodiment of the present invention, the bridge 410 and the auxiliary bridge 420 of the connection member 400 minimize deformation of blood vessels due to repeated pulsatile blood flow in the arteriovenous transplant. More specifically, it improves the distribution of stress applied to the inside of the apparatus 200 for supporting the outer wall of blood vessels, thereby reducing maximum stress and alleviating stress concentration. Through this, it is possible to reduce fatigue and prevent breakage of the device for supporting the outer wall of the blood vessel 200 .

11 is a graph showing the hemodynamic effect provided by the device for supporting the outer wall of a blood vessel according to another embodiment of the present invention. Specifically, FIG. 11 shows that the thickness of the annular segment 300 is 0.4 mm, the diameter (r) of the valley or peak is 0.3 mm, the amplitude (A) of the valley or peak is 1.27 mm, and the length (l) of the valley or peak is 0.3 mm. 0.65 mm, the distance (S) between a pair of adjacent valleys or ridges along the longitudinal direction is designed to be 2.4 mm, and the diameter of the blood vessel is assumed to be 3 mm. The results of the analysis of hemodynamic factors are shown.

In the hemodynamic analysis shown in FIG. 11, for verification, the vein (Model A) to which the outer wall support device 200 is not applied, and the connecting member 400 is provided with only the bridge 410 and no auxiliary bridge 420. A vein (Model B) disposed inside the vessel outer wall supporting device 200 and a connecting member 400 disposed inside the vessel outer wall supporting device 200 having both the bridge 410 and the auxiliary bridge 420 It was performed on a vein (Model C).

Referring to FIG. 11 , compared to the vein (Model A) to which the device 200 for supporting the outer wall of the blood vessel is not applied, the connecting member 400 includes only the bridge 410 and supports the outer wall of the blood vessel without the auxiliary bridge 420. A vein (Model B) disposed inside the device 200 and a vein (Model B) disposed inside the vessel outer wall supporting device 200 having both the bridge 410 and the auxiliary bridge 420 in the connecting member 400 C) decreased hemodynamic stability, such as a decrease in the WSS area of the diastolic phase (see FIG. 11(a)), low TAWSS (see FIG. 11(b)), and a decrease in OSI (see FIG. 11(c)) you can check what you see.

In particular, the vein (Model C) in which the connection member 400 is disposed inside the vessel outer wall support device 200 having both the bridge 410 and the auxiliary bridge 420 shows the most stable hemodynamic factor. Therefore, hemodynamic stability can be maximized when the connection member 400 includes both the bridge 410 and the auxiliary bridge 420 .

Although one embodiment of the present invention has been described, the spirit of the present invention is not limited by the embodiments presented herein, and those skilled in the art who understand the spirit of the present invention, within the scope of the same spirit, the components Other embodiments may be easily proposed by adding, changing, deleting, adding, or the like. However, it will be said that this is also within the scope of the present invention.

Claims

An artificial blood vessel support having a curved shape and disposed surrounding the outer wall of the artificial blood vessel anastomosed with the vein; and

An apparatus for supporting an outer wall of a blood vessel, comprising a vein support portion disposed surrounding an outer wall of the vein and connected to the artificial blood vessel support portion at a distal end of the artificial blood vessel support portion.
According to claim 1,

The artificial blood vessel support has an arc shape,

The vein support has a straight shape,

The artificial blood vessel support portion intersects the vein support portion at the distal end of the blood vessel outer wall support device.
According to claim 2,

The artificial blood vessel support unit is in contact with the vein support unit at an intersection with the vein support unit at an angle of 15 degrees or more and less than 60 degrees.
According to claim 3,

The artificial blood vessel support unit has a length of 15 to 25 mm.
According to claim 3,

The vessel outer wall support device having a length of 20 to 40 mm from a connection portion with the artificial blood vessel support part to a proximal end of the vein support part.
According to claim 1,

At least one of the artificial blood vessel support and the vein support,

A plurality of annular segments spaced apart from each other in the longitudinal direction and continuously disposed, each having a wavy shape along the circumferential direction;

An apparatus for supporting an outer wall of a blood vessel comprising a connection member disposed to connect a pair of adjacent annular segments.
According to claim 6,

The connecting member includes a bridge connecting a pair of valleys or a pair of hills adjacent to each other in a longitudinal direction.
According to claim 7,

The connection member connects peaks located on both sides of the bridge in the circumferential direction and valleys at which one end of the bridge is in contact with the peaks, or connects peaks located at both sides of the bridge and one end in the longitudinal direction of the bridge in contact with the peaks in the circumferential direction. A device for supporting the outer wall of a blood vessel further comprising an auxiliary bridge connected thereto.