WO2023142944A1 - 分支鞘 - Google Patents

分支鞘 Download PDF

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Publication number
WO2023142944A1
WO2023142944A1 PCT/CN2023/070678 CN2023070678W WO2023142944A1 WO 2023142944 A1 WO2023142944 A1 WO 2023142944A1 CN 2023070678 W CN2023070678 W CN 2023070678W WO 2023142944 A1 WO2023142944 A1 WO 2023142944A1
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WO
WIPO (PCT)
Prior art keywords
connecting tube
branch
control wire
distal end
coil
Prior art date
Application number
PCT/CN2023/070678
Other languages
English (en)
French (fr)
Inventor
吴伟一
赵明杰
朱永锋
单文雯
高阳
朱清
赵淑华
Original Assignee
上海微创心脉医疗科技(集团)股份有限公司
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Publication date
Application filed by 上海微创心脉医疗科技(集团)股份有限公司 filed Critical 上海微创心脉医疗科技(集团)股份有限公司
Publication of WO2023142944A1 publication Critical patent/WO2023142944A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
    • A61F2/966—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
    • A61F2/97—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve the outer sleeve being splittable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2002/9505—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument
    • A61F2002/9511—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument the retaining means being filaments or wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
    • A61F2/966—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
    • A61F2002/9665—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod with additional retaining means
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
    • Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
    • Y02A30/00—Adapting or protecting infrastructure or their operation
    • Y02A30/14—Extreme weather resilient electric power supply systems, e.g. strengthening power lines or underground power cables

Definitions

  • the invention relates to the technical field of medical instruments, in particular to a branch sheath.
  • intravascular stent placement has become a common treatment method for arch arterial vascular diseases.
  • the aneurysm, breach or dissection is isolated from the blood, avoiding the risk of death due to aneurysm rupture and dissection expansion and bleeding.
  • the Castor bracket adopts the integrated design of the branch bracket and the main bracket.
  • the guide catheter and the guide wire are introduced through the puncture of the branch vessel of the upper limb.
  • This integrated design may cause the branch support to be driven by the main support, resulting in the problem of displacement of the branch support.
  • the corresponding branch stent guiding channel is established, and the branch stent is implanted after the main body conveyor is withdrawn.
  • the main body stent has lost the support of the main body conveyor, requiring an additional anchor point to prevent it from being carried away during branch stent release.
  • the one-piece branch stent also requires a pull to prevent it from dislodging into the aortic lumen.
  • the stent delivery device will inevitably come into contact with the released main body stent, especially in the aortic arch with a large degree of curvature, the tapered head of the delivery device will rub against the main body stent.
  • the friction of the stent itself cannot guarantee that the stent can be fixed on the vessel wall. If the main support is carried, the positioning of the branch support may be inaccurate.
  • the movement of the stent will also damage the vessel wall, and even cause the branch stent that has entered the branch vessel to slip out of the innominate branch vessel and enter the aortic lumen, causing the innominate branch vessel to be blocked. This situation would be very dangerous and would require emergency open surgery.
  • the resistance of the blood flow in the blood vessel during the introduction process will also affect the positioning of the branch stent, and the blood flow will not be smooth, which will also cause various serious complications.
  • the purpose of the present invention is to provide a branch sheath to solve at least one of the problems of how to prevent the displacement of the branch stent during stent delivery, how to avoid blood flow blockage and how to alleviate the influence of blood flow resistance on the positioning of the branch stent.
  • the present invention provides a branch sheath, comprising: a coated sleeve, a first connecting tube, a control wire and a restraint coil;
  • the tube wall of the film-coated sleeve is provided with several drainage holes, and the film-covered sleeve is located on the distal side of the first connecting tube; the control wire runs through the first connecting tube, and The distal end of the control wire is located in the coated sleeve;
  • the proximal end of the binding coil is connected to the distal end of the first connecting tube, and the distal end of the binding coil is used to pass through the bare end hole of the branch stent in the covered sleeve and extend out of the bare end. end aperture; the distal end of the control wire passes through the portion of the tethering coil protruding from the bare end aperture, so as to pull and fix the bare end of the branch stent.
  • control wire is configured to be detached from the tethering coil, the graft sleeve and the first connecting tube, so as to release the branch stent; wherein , the proximal end of the control wire is fixedly connected with the second connecting tube, so as to prevent the proximal end of the control wire from sliding.
  • the radial dimension of the first connecting tube is the same as that of the second connecting tube, and the distal end of the second connecting tube is the same as that of the first connecting tube.
  • the proximal end of the connecting tube is detachably connected.
  • the detachable connection includes heat-shrink tube sleeve or bio-glue bonding.
  • the branch sheath further includes a third connecting tube; the third connecting tube is sheathed on the outer surfaces of the first connecting tube and the second connecting tube, and The distal end of the third connecting tube is connected to the proximal end of the coated sleeve; the proximal end of the third connecting tube is provided with a limiter, and the limiter is also connected to the second connecting tube. The proximal ends are connected to block the sliding of the third connecting tube.
  • the limiting member is a heat-shrinkable tube.
  • the proximal end of the covered sleeve is connected to the distal end of the first connecting tube.
  • the branch sheath further includes a connecting coil; the proximal end of the connecting coil is connected to the distal end of the first connecting tube, and the distal end of the connecting coil is located at the and is configured such that, after the distal end of the binding coil protrudes out of the bare end hole, it passes through and is hooked on the distal end of the connecting coil to form an extension, and the control wire passes through the extension.
  • the axial length of the control wire protruding from the distal end of the first connecting tube is greater than the axial length of the tethering coil protruding from the hole at the bare end; and
  • the axial length of the graft sleeve is greater than or equal to the axial length of the branch stent.
  • the length range of the binding coil is: a ⁇ b+5; wherein, a is the length of the binding coil, and b is the position of the bare end of the branch stent The circumferential length of , in millimeters.
  • the present invention provides a branch sheath, including: a covered sleeve, a first connecting tube, a control wire and a binding coil.
  • the tube wall of the coated sleeve is provided with several drainage holes, which are used to allow the blood to flow out smoothly through the drainage holes during the introduction and release of the branch stent, so as to ease the delivery of the branch stent by blood flow resistance. and positioning, and at the same time reduce complications caused by blood blockage.
  • the coated sleeve is located at the distal end side of the first connecting tube; the control wire runs through the first connecting tube, and the distal end of the control wire is located in the coated sleeve; the The proximal end of the binding coil is connected to the distal end of the first connecting tube, and the distal end of the binding coil is used to pass through the bare-end aperture of the branch stent located in the graft sleeve and extend out of the bare-end aperture , to realize the containment of the branch bracket, so as to avoid displacement of the branch bracket due to being pulled by the main bracket after the main bracket is released.
  • control wire passes through the part of the binding coil protruding from the hole of the bare end to pull and fix the bare end of the branch stent, so that after the branch stent is out of the predetermined position during the operation, Under the pulling effect of the control wire, the branch stent can be pulled back into the branch vessel at any time by moving the first connecting tube, so as to realize precise control of the release position of the branch stent.
  • the branch sheath provided by the present invention can not only prevent the displacement of the branch stent, improve the accurate control of the release position of the branch stent, but also alleviate the influence of blood flow resistance on the input and positioning of the branch stent, and reduce the risk caused by blood blockage. complications.
  • Fig. 1 is the structural representation of a kind of branch sheath in the embodiment of the present invention
  • Fig. 2 is a schematic structural view of a branch sheath installed in an embodiment of the present invention
  • Fig. 3 is a schematic diagram of the bare end restrained by the bound coil in the embodiment of the present invention.
  • Fig. 4 is a schematic diagram of the connection between the third connecting pipe and the coated sleeve in the embodiment of the present invention.
  • Fig. 5 is a schematic diagram of the position of the limiting member in the embodiment of the present invention.
  • Fig. 6 is a schematic diagram of the connection relationship between the connection coil, the restraint coil, the control wire and the bare end in the embodiment of the present invention
  • Fig. 7 is a structural schematic diagram of the binding coil hooked on the connecting coil in the embodiment of the present invention.
  • FIGS. 8-10 are schematic diagrams of the release of the branch stent in the embodiment of the present invention.
  • 2-sheath tube part 21-first connecting tube; 22-covered sleeve; 23-binding coil; 231-extending part; 25-connecting coil; 26-third connecting tube; 27-limiting piece;
  • proximal and distal in this article are: “distal” generally refers to the end of the medical device that first enters the patient's body during normal operation, and “proximal” generally refers to the end of the medical device that enters the patient's body during normal operation. The end of the process that is closest to the operator.
  • this embodiment provides a branch sheath, please refer to Figure 1-2, including: control wire 11, first connecting tube 21, film-covered sleeve 22, and binding coil 23; said film-covered sheath Several drainage holes 24 are arranged on the tube wall of the tube 22, and the coated sleeve 22 is located at the distal side of the first connecting tube 21; the control wire 11 runs through the first connecting tube 21, And the distal end of the control wire 11 is located in the covered sheath 22; the proximal end of the binding coil 23 is connected to the distal end of the first connecting tube 21, and the distal end of the binding coil 23 is used for Pass through the bare end aperture of the branch stent 4 located in the graft sleeve 22 and extend out of the bare end aperture, that is, the distal end of the binding coil 23 is used to pass through the aperture located in the graft sleeve 22 After all or part of the pores of the bare end of the branch stent 4 extend out of the bare end of the branch stent 4
  • a drainage hole 24 is provided on the tube wall of the coated sleeve 22, so that during the introduction and release of the branch stent 4, the blood passes through the drainage hole 24 Unobstructed outflow relieves the influence of blood flow resistance on the delivery and positioning of the branch stent 4, and can also reduce complications caused by blood obstruction.
  • the bare end 41 of the branch stent 4 is fixed by the pulling of the binding coil 23 , so as to avoid the displacement of the branch stent 4 due to the dragging of the main body stent 3 when the main body stent 3 is released.
  • control wire 11 passes through the part of the binding coil 23 protruding from the bare end hole, so that after the branch stent 4 is out of the predetermined position during the operation, under the pulling effect of the control wire 11 , by moving the first connecting tube 21, the branch stent 4 can be pulled back into the branch blood vessel at any time, so as to realize precise control of the release position of the branch stent 4 .
  • the branch sheath includes a control part 1 and a sheath tube part 2 .
  • the control part 1 includes a control wire 11 and a second connecting pipe 12 .
  • the control wire 11 is used to control the release of the branch stent 4 . That is, when the branch stent 4 is released, the control wire 11 is pulled out of the binding coil 23 , the graft sleeve 22 and the first connecting tube 21 to realize the release of the branch stent 4 .
  • the distal end of the control wire 11 passes through the first connecting tube 21 and extends into the graft sleeve 22 so as to pass through the extension of the binding coil 23.
  • the part protruding from the hole of the bare end can cooperate with the binding coil 23 to realize the release control of the branch stent 4 .
  • the branch bracket 4 and the main body bracket 3 provided in this embodiment are an integrated structure, that is, the branch bracket 4 and the main body bracket 3 are connected to each other. Therefore, when the main body stent 3 is released, a pulling force will be generated on the branch stent 4, which will not only make the branch stent 4 deviate from the target position, but also cause the branch stent 4 to slide down to the aorta. cavity, resulting in dangerous situations such as branch blood vessels being blocked. Therefore, the distal end of the control wire 11 in the branch sheath provided in this embodiment passes through the part of the binding coil 23 protruding from the hole at the bare end, so that pulling and fixing the branch stent can also be realized.
  • the branch stent 4 can be re-drawn into the branch vessel at any time, which can not only realize the precise control of the release position of the branch stent 4, but also avoid the advance of the branch stent 4. freed.
  • the proximal end of the control wire 11 is fixedly connected to the second connecting tube 12, the purpose is to prevent the proximal end of the control wire 11 from slipping into the first connecting tube 21, or to prevent misoperation from pulling out the first connecting tube 21 in advance.
  • the control wire 11 is described.
  • the second connecting tube 12 can be understood as a handle for pulling away from the control wire 11. On the one hand, it is convenient for the operator to perform the pulling action, avoiding misoperation to release the branch bracket 4 in advance; on the other hand, it prevents the proximal end of the control wire 11 from Get out of the control and slide into the first connecting pipe 21 .
  • the radial dimension of the first connecting pipe 21 is the same as the radial dimension of the second connecting pipe 12 .
  • the connection between the second connecting tube 12 and the first connecting tube 21 is a detachable connection.
  • the detachable connection includes, but is not limited to, a heat-shrinkable tube socket or a bio-glue.
  • the part of the control wire 11 protruding from the proximal end of the first connecting tube 21 is inserted into the second connecting tube 12, and fixed in the second connecting tube 12, the fixing method may be Welding or bonding etc.
  • the material of the control wire 11 and the second connecting pipe 12 is nickel-titanium alloy.
  • the sheath tube part 2 at least includes a first connecting tube 21 , a covered sleeve 22 and a binding coil 23 .
  • the first connecting tube 21 is the basic skeleton of the branch sheath.
  • the first connecting tube 21 provides support and fixation for the graft sleeve 22 and the binding coil 23 .
  • both the first connecting tube 21 and the film-covered sleeve 22 are hollow tubes, that is, they both have inner cavities communicated at both ends.
  • the distal end of the first connecting tube 21 is connected to the proximal end of the membrane sleeve 22, and the lumens of the two are connected.
  • the covered sleeve 22 is used to accommodate the branch stent 4 to prevent the branch stent 4 from damaging the vessel wall when the stent is introduced.
  • the axial length of the graft sleeve 22 is greater than or equal to the axial length of the branch stent 4 , so as to ensure that the branch stent 4 is completely contained therein.
  • a plurality of drain holes 24 are provided on the tube wall of the film-coated casing 22 . The drain hole 24 is used for the process of introducing and releasing the branch stent 4. The blood flows out smoothly through the drain hole 24, so as to alleviate the influence of blood flow resistance on the delivery and positioning of the branch stent 4, and reduce the flow caused by blood blockage. caused complications.
  • the present embodiment does not limit the number of the drain holes 24 , one, two, three or four etc. can be selected. However, in order to ensure the strength of the film-coated sleeve 22, the area ratio of the drain hole 24 to the outer surface of the film-coated sleeve 22 should not be too large, and the data selection of the drain hole 24 should be moderate.
  • the drain holes 24 may reduce the strength of the film-coated sleeve 22, so preferably, The film-covered sleeve 22 is controlled separately from the binding coil 23, so that the film-covered sleeve 22 is pulled out first, and then the control wire 11 is pulled to connect the control wire 11 and the bare end 41 Released from the binding coil 23.
  • the branch sheath further includes a third connecting tube 26 .
  • the third connecting pipe 26 is sheathed on the outer surfaces of the first connecting pipe 21 and the second connecting pipe 12, and the first connecting pipe 21 is not connected to the coated casing 22, but The distal end of the third connecting tube 26 is connected with the proximal end of the membrane sleeve 22 .
  • the connection method between the third connecting pipe 26 and the film-coated sleeve 22 includes, but is not limited to, using a shrink tube to heat-melt, glue, or directly connect end is fused into the distal end of the third connecting tube 26.
  • the proximal end of the third connecting tube 26 is arranged Limit piece 27.
  • the limiting member 27 is also connected to the proximal end of the second connecting tube 12 .
  • the limiting member 27 includes but is not limited to a heat-shrinkable tube, and may also be a mechanical connection that is easy to remove. In the release process, firstly separate the stopper 27 from the second connecting pipe 12 and the third connecting pipe 26, and then pull the third connecting pipe 26 and the film-covered sleeve 22 apart first. , and finally use the control wire 11 to adjust the position of the branch support 4 and release the branch support 4 .
  • the material of the first connecting pipe 21 , the third connecting pipe 26 and the coated sleeve 22 is nickel-titanium alloy.
  • the proximal end of the restraint coil 23 is connected to the distal end of the first connecting tube 21 .
  • the distal end of the binding coil 23 sequentially passes through all or part of the bare-end apertures of the branch stent 4, and protrudes out of the bare-end aperture, so as to bind the bare-end 41 of the branch stent 4, This avoids displacement of the branch bracket 4 due to the pull of the main bracket 3 after the main bracket 3 is released, so as to ensure the accuracy of the release position.
  • the length of the tethering coil 23 can be greater than the axial length of the membrane-grafted sleeve 22, that is, the distal end of the tethering coil 23 can extend out of the membrane-grafted sleeve 22, or it can be less than or equal to the length of the membrane-grafted sleeve 22.
  • the axial length of the cannula 22 ie the distal end of the tethering coil 23 is located in the grafted cannula 22 .
  • the end of the branch bracket 4 away from the main body bracket 3 is a free end, which is called a bare end 41 in this embodiment.
  • the branch stent 4 may be a covered stent, wherein, since the bare end pore is used for connection, the bare end 41 is not provided with a covered film.
  • the branch stent 4 is in a normal state, that is, uncompressed state. Moreover, the bare ends 41 are not bundled and tightened, but are still in a relaxed state. The purpose is to reserve the space between the bare ends 41, so that blood can flow freely during the introduction and release of the branch stent 4 The unobstructed outflow through the gap further alleviates the influence of blood flow resistance on the delivery and positioning of the branch stent 4 and ensures smooth blood flow.
  • FIG. 1 shows that is, uncompressed state.
  • the control wire 11 and the binding coil 23 will be driven by moving the first connecting tube 21 to pull the branch bracket 4 .
  • the binding coil 23 applies traction to the bare segment through the restriction of the control wire 11, thereby tightening the the bare segment, causing the void to shrink.
  • the covered sheath 22 in the branch sheath provided in this embodiment is provided with several drainage holes 24, which are sufficient to realize smooth blood flow and avoid complications caused by blood blockage.
  • the material of the binding coil 23 is polytetrafluoroethylene, and the coefficient of friction of polytetrafluoroethylene is small, so that when the branch stent 4 is released, the binding coil 22 can quickly break away from the bare end hole.
  • the branch sheath further includes a connecting coil 25 .
  • the proximal end of the connecting coil 25 passes through the graft sleeve 22 and connects with the distal end of the first connecting tube 21 .
  • the distal end of the connecting coil 25 is configured to pass through and hook on the distal end of the connecting coil 25 to form an extension 231 after the distal end of the binding coil 23 protrudes out of the bare end aperture,
  • the control wire 11 passes through the extension part 231 .
  • the protruding portion 231 is in the shape of a hook, which is convenient for hooking on the connecting coil 25 . Therefore, the binding coil 23 is bent upwards and hooked on the connecting coil 25, then the binding coil 23 extends upwards, so that the control wire 11 can pass through the connecting coil 25 at the position of the connecting coil 25.
  • the binding coil 23 the purpose of shortening the control wire 11 is achieved, and the damage to the graft sleeve 22 and the branch stent 4 caused by the excessive length of the control wire 11 is avoided.
  • the length range of the binding coil 23 is: a ⁇ b+5; wherein, the unit is millimeter; a is the length of the binding coil 23 Length, that is, the axial length along the branch sheath before the binding coil 23 passes through the bare end aperture; b is the circumferential length at the position of the bare end 41 of the branch stent 4; wherein, the branch stent
  • the circumferential length of the bare end 41 of 4 is longer than the circumferential length of the middle section of the branch bracket 4, that is, the bare end 41 of the branch bracket 4 is trumpet-shaped.
  • the axial length of the distal end of the control wire 11 protruding from the first connecting tube 21 is greater than that of the binding coil 23 Axial length extending beyond the bare end aperture.
  • the length between the distal end of the straightened control wire 11 and the distal end of the first connecting tube 21 is greater than that of the binding coil 23 passing through. The axial length behind the bare end 41 .
  • Fig. 4, 8-10 when delivering the branch stent 4 and the main body stent 3, first install the branch stent 4 into the branch sheath, that is, the branch stent 4 is accommodated in the overlay In the membrane sleeve 22 , the binding wire 23 loops through the bare end opening of the branch stent 4 , and the control wire 11 passes through the binding coil 23 . Then, after the compressed main body stent 3 is bundled, the compressed main body stent 3 and branch stent 4 are delivered to the target position, and after the release position is determined, the main branch guide wire is pulled out to release Take out the main body bracket 3.
  • the control wire 11 and the binding coil 23 can be driven to adjust the branch bracket by moving the first connecting tube 21. 4 positions. After the release position is determined, as shown in Figures 9 and 10, the connection between the first connecting tube 21 and the second connecting tube 12 is broken, the control wire 11 is pulled out and the sheath tube part 2 is moved as a whole, so as to Realize the release of branch support 4. Because the covered sleeve 22 is provided with a drain hole 24, when the branch stent 4 is released, the blood can flow through the drain hole 24 to avoid blood clogging and reduce complications caused by blood blockage .
  • the second connecting pipe 12 and the first connecting pipe 21 can be driven by moving the third connecting pipe 26. , the restraint coil 23 and the control wire 11 to adjust the position of the branch stent 4 .
  • the connection between the stopper 27 and the third connecting pipe 26 and the second connecting pipe 12 is destroyed, and the third connecting pipe 26 and the film-covered sleeve 22 are connected to each other. pull out.
  • the connection between the limiting member 27 and the third connecting pipe 26 and the second connecting pipe 12 is broken first, and the third connecting pipe 26 and the film-covered sleeve 22 are pulled out.
  • the present embodiment provides a branch sheath, including: a grafted sleeve 22 , a first connecting tube 21 , a control wire 11 and a binding coil 23 .
  • the tube wall of the coated sleeve 22 is provided with several drainage holes 24, which are used in the process of introducing and releasing the branch stent 4. The blood flows out smoothly through the drainage holes 24, so as to alleviate the impact of blood flow resistance on The impact of the delivery and positioning of the branch stent 4 can also reduce complications caused by blood blockage.
  • the membrane sleeve 22 is located on the distal side of the first connecting tube 21; the control wire 11 runs through the first connecting tube 21, and the distal end of the control wire 11 is located on the membrane covering Inside the casing 22.
  • the proximal end of the binding coil 23 is connected to the distal end of the first connecting tube 21, and the distal end of the binding coil 23 is used to pass through the bare end aperture of the branch stent 4 located in the graft sleeve 22 And protrude out the bare end hole to realize the containment of the branch bracket 4, so as to avoid the displacement of the branch bracket due to the pulling of the main bracket after the main bracket is released.
  • the control wire 11 passes through the part of the binding coil 23 protruding from the opening of the bare end to pull and fix the bare end 41 of the branch stent 4, so that the branch stent 4 can After leaving the predetermined position, under the pulling effect of the control wire 11, the branch stent 4 can be pulled back into the branch vessel at any time by moving the first connecting tube, so as to realize precise control of the release position of the branch stent 4 . Therefore, the branch sheath provided in this embodiment can not only prevent the displacement of the branch stent 4, improve the accurate control of the release position of the branch stent 4, but also alleviate the influence of blood flow resistance on the input and positioning of the branch stent, and reduce the Complications due to obstruction.

Abstract

一种分支鞘，包括：覆膜套管（22）、第一连接管（21）、控制丝（11）和束缚线圈（23）。其中，覆膜套管（22）的管壁上设置有若干个排液孔，用于在分支支架（4）导入与释放的过程，缓解血流阻力对分支支架（4）输送和定位的影响，同时还减少因血液不畅通引起的并发症。且覆膜套管（22）位于第一连接管（21）的远端侧；控制丝（11）贯穿第一连接管（21），且控制丝（11）的远端位于覆膜套管（22）内；束缚线圈（23）的近端与第一连接管（21）的远端相连，束缚线圈（23）的远端用于穿过分支支架（4）的裸端（41）孔隙并伸出；控制丝（11）穿过束缚线圈（23）的伸出裸端（41）孔隙的部分，以牵拉并固定分支支架（4）的裸端（41），从而在分支支架（4）于术中脱离预定位置后，可以随时将其重新拉入分支血管，避免分支支架（4）受主体支架（3）的拉拽而出现移位，实现对释放位置的精准控制。

Description

分支鞘 技术领域
本发明涉及医疗器械技术领域，特别涉及一种分支鞘。
背景技术
随着腔内器具和微创介入治疗的发展，血管内放置支架已成为弓部动脉血管疾病的常用治疗手段，其原理是通过特制的输送系统将覆膜支架送入病变部位后张开，使瘤体、破口或夹层与血液隔绝，避免因动脉瘤破裂、夹层扩张出血而引起死亡的危险。
虽然微创介入覆膜支架相比开胸手术有创伤小的优势，但也存在一些问题，尤其是分支血管的处理。目前Castor支架采用的是分支支架与主体支架一体化设计。在主体支架植入前，先经上肢分支血管穿刺导入导引导管与导丝，分支鞘的导丝可以经此导引通道，十分顺利的进入分支血管，免去了在主体支架进入血管之后再选分支血管的问题。但是这种一体化设计可能导致分支支架被主体支架带动，导致分支支架移位的问题。在主体支架释放过程中建立相应的分支支架导引通道，撤出主体输送器后，再植入分支支架。在此过程中，主体支架已经失去主体输送器的支撑，需要一个额外的固定点，以防止在分支支架释放过程中被带动移位。同时，一体式分支支架也需要一个牵拉，以防止其移位至主动脉腔中。
此外，在支架导入与释放的过程中，支架输送器会不可避免的接触到已经释放了的主体支架，尤其是在弯曲程度较大的主动脉弓部，输送器的锥形头会剐蹭到主体支架。单靠支架本身的摩擦力是无法保证支架可以固定在血管壁上的。如果主体支架被带动，分支支架的定位可能会不准确。支架移动也会损伤血管壁，甚至导致已经进入分支血管的分支支架滑脱出无名分支血管进入主动脉腔，导致无名分支血管被堵塞。这种情况将十分凶险，需要转紧急开放手术。同时，导入过程中血管中血流的阻力也会对分支支架的定位产生影响，且血流不畅通，还会引起各种严重的并发症。
发明内容
本发明的目的在于提供一种分支鞘，以解决如何在支架输送过程中，防止分支支架移位，如何避免血流不畅通以及如何缓解血流阻力对分支支架定位的影响中的至少一个问题。
为解决上述技术问题，本发明提供一种分支鞘，包括：覆膜套管、第一连接管、控制丝和束缚线圈；
所述覆膜套管的管壁上设置有若干个排液孔，且所述覆膜套管位于所述第一连接管的远端侧；所述控制丝贯穿所述第一连接管，且所述控制丝的远端位于所述覆膜套管内；
所述束缚线圈的近端与所述第一连接管的远端相连，所述束缚线圈的远端用于穿过位于所述覆膜套管内的分支支架的裸端孔隙并伸出所述裸端孔隙；所述控制丝的远端穿过所述束缚线圈的伸出所述裸端孔隙的部分，以牵拉并固定所述分支支架的裸端。
可选的，在所述的分支鞘中，所述控制丝被配置为可抽离出所述束缚线圈、所述覆膜套管和所述第一连接管，以释放所述分支支架；其中，所述控制丝的近端与第二连接管固定连接，以阻挡所述控制丝的近端滑动。
可选的，在所述的分支鞘中，所述第一连接管的径向尺寸与所述第二连接管的径向尺寸相同，且所述第二连接管的远端与所述第一连接管的近端可拆卸连接。
可选的，在所述的分支鞘中，所述可拆卸连接包括热缩管套接或生物胶粘连。
可选的，在所述的分支鞘中，所述分支鞘还包括第三连接管；所述第三连接管套设于所述第一连接管和所述第二连接管的外表面，且所述第三连接管的远端与所述覆膜套管的近端相连；所述第三连接管的近端设置有限位件，且所述限位件还与所述第二连接管的近端相连，以阻挡所述第三连接管的滑动。
可选的，在所述的分支鞘中，所述限位件为热缩管。
可选的，在所述的分支鞘中，所述覆膜套管的近端与所述第一连接管的 远端相连。
可选的，在所述的分支鞘中，所述分支鞘还包括连接线圈；所述连接线圈的近端与所述第一连接管的远端相接，所述连接线圈的远端位于所述覆膜套管内并被配置为，所述束缚线圈的远端伸出所述裸端孔隙后，穿过并钩挂在所述连接线圈的远端形成伸出部，所述控制丝穿过所述伸出部。
可选的，在所述的分支鞘中，所述控制丝伸出所述第一连接管的远端的轴向长度大于所述束缚线圈伸出所述裸端孔隙后的轴向长度；且所述覆膜套管的轴向长度大于或等于所述分支支架的轴向长度。
可选的，在所述的分支鞘中，所述束缚线圈的长度范围为：a≥b+5；其中，a为所述束缚线圈的长度，b为所述分支支架的裸端所在位置处的周向长度，单位为毫米。
综上所述，本发明提供一种分支鞘，包括：覆膜套管、第一连接管、控制丝和束缚线圈。其中，所述覆膜套管的管壁上设置有若干个排液孔，用于在分支支架导入与释放的过程，血液经所述排液孔通畅流出，缓解血流阻力对分支支架的输送和定位的影响，同时还可以减少因血液不通畅引起的并发症。以及，所述覆膜套管位于所述第一连接管的远端侧；所述控制丝贯穿所述第一连接管，且所述控制丝的远端位于所述覆膜套管内；所述束缚线圈的近端与所述第一连接管的远端相连，所述束缚线圈的远端用于穿过位于所述覆膜套管内的分支支架的裸端孔隙并伸出所述裸端孔隙，实现对分支支架的牵制，以避免在主体支架释放后，分支支架受主体支架的拉拽而出现移位。并且，所述控制丝穿过所述束缚线圈的伸出所述裸端孔隙的部分，以牵拉并固定所述分支支架的裸端，从而在所述分支支架于术中脱离预定位置后，在所述控制丝的牵拉作用下，通过移动所述第一连接管即可随时将所述分支支架重新拉入分支血管，实现对分支支架释放位置的精准控制。
因此，本发明提供的所述分支鞘不仅能够防止分支支架的移位，提高对分支支架释放位置的准确控制，还能够缓解血流阻力对分支支架输入和定位的影响，减少因血液不通畅引起的并发症。
附图说明
图1是本发明实施例中的一种分支鞘的结构示意图；
图2是本发明实施例中的一种分支鞘安装后的结构示意图；
图3是本发明实施例中的束缚线圈约束裸端的示意图；
图4是本发明实施例中的第三连接管与覆膜套管的连接示意图；
图5是本发明实施例中的限位件的位置示意图；
图6是本发明实施例中的连接线圈、束缚线圈、控制丝和裸端的连接关系示意图；
图7是本发明实施例中的束缚线圈钩挂在连接线圈上的结构示意图；
图8-10是本发明实施例中的分支支架的释放示意图；
其中，附图标记为：
1-控制部；11-控制丝；12-第二连接管；
2-鞘管部；21-第一连接管；22-覆膜套管；23-束缚线圈；231-伸出部；25-连接线圈；26-第三连接管；27-限位件；
3-主体支架；4-分支支架；41-裸端。
具体实施方式
为使本发明的目的、优点和特征更加清楚，以下结合附图和具体实施例对本发明作进一步详细说明。需说明的是，附图均采用非常简化的形式且未按比例绘制，仅用以方便、明晰地辅助说明本发明实施例的目的。此外，附图所展示的结构往往是实际结构的一部分。特别的，各附图需要展示的侧重点不同，有时会采用不同的比例。还应当理解的是，除非特别说明或者指出，否则说明书中的术语“第一”、“第二”、“第三”等描述仅仅用于区分说明书中的各个组件、元素、步骤等，而不是用于表示各个组件、元素、步骤之间的逻辑关系或者顺序关系等。
本文中“近端”和“远端”的定义为：“远端”通常指该医疗设备在正常操作过程中首先进入患者体内的一端，而“近端”通常是指该医疗设备在正常操作过程中靠近操作者的一端。
为解决上述技术问题，本实施例提供一种分支鞘，请参阅图1-2，包括：控制丝11、第一连接管21、覆膜套管22、和束缚线圈23；所述覆膜套管22的管壁上设置有若干个排液孔24，且所述覆膜套管22位于所述第一连接管21的远端侧；所述控制丝11贯穿所述第一连接管21，且所述控制丝11的远端位于所述覆膜套管22内；所述束缚线圈23的近端与所述第一连接管21的远端相连，所述束缚线圈23的远端用于穿过位于所述覆膜套管22内的分支支架4的裸端孔隙并伸出所述裸端孔隙，即所述束缚线圈23的远端用于穿过位于所述覆膜套管22内的分支支架4的裸端的全部孔隙或部分孔隙后伸出所述裸端孔隙；所述控制丝11的远端穿过所述束缚线圈23的伸出所述裸端孔隙的部分，以牵拉并固定所述分支支架4的裸端41。
可见，本实施例提供的所述分支鞘，在所述覆膜套管22的管壁上设置排液孔24，以使在分支支架4导入与释放的过程，血液经所述排液孔24通畅流出，缓解血流阻力对分支支架4的输送和定位的影响，同时还可以减少因血液不通畅引起的并发症。以及，通过所述束缚线圈23的牵拉，固定了所述分支支架4的裸端41，实现避免在主体支架3释放时，因主体支架3的拖拽而导致分支支架4产生移位。且所述控制丝11穿过所述束缚线圈23的伸出所述裸端孔隙的部分，使得在所述分支支架4于术中脱离预定位置后，在所述控制丝11的牵拉作用下，通过移动所述第一连接管21即可随时将所述分支支架4重新拉入分支血管中，实现对分支支架4释放位置的精准控制。
以下结合附图1-10具体介绍本实施例提供的所述分支鞘：
请参阅图1-3，所述分支鞘包括控制部1和鞘管部2。其中，所述控制部1包括控制丝11和第二连接管12。所述控制丝11用于控制所述分支支架4的释放。即，在释放所述分支支架4时，将所述控制丝11抽离出所述束缚线圈23、所述覆膜套管22和所述第一连接管21，实现释放所述分支支架4。其中，在释放所述分支支架4之前，所述控制丝11的远端贯穿所述第一连接管21，并伸入所述覆膜套管22中，以穿过所述束缚线圈23的伸出所述裸端孔隙的部分，从而能够与所述束缚线圈23配合，实现对所述分支支架4的释放控制。
进一步的，因本实施提供的所述分支支架4与主体支架3为一体化结构，即所述分支支架4与所述主体支架3是相互连接的。所以，在所述主体支架3释放时，会对所述分支支架4产生拉拽的作用力，则不仅会使得所述分支支架4偏离目标位置，还可能使所述分支支架4滑落至主动脉腔中，造成分支血管被堵塞等危险情况。因而，本实施例提供的所述分支鞘中的所述控制丝11的远端穿过所述束缚线圈23的伸出所述裸端孔隙的部分，还可以实现牵拉并固定所述分支支架4的裸端41的作用，以使得在所述分支支架4于术中脱离预定位置后，在所述控制丝11的牵拉作用下，通过移动所述第一连接管21来带动所述控制丝11和所述裸端41的移动，则所述分支支架4可以随时被重新拉入分支血管中，不仅可以实现对分支支架4释放位置的精准控制，还可以避免所述分支支架4的提前释放。
进一步的，所述控制丝11的近端与第二连接管12固定连接，目的在于阻挡所述控制丝11的近端滑入所述第一连接管21内，或者防止误操作提前拉出所述控制丝11。所述第二连接管12可以理解为抽离所述控制丝11的把手，一方面便于操作者执行抽拉的动作，避免误操作提前释放分支支架4；另一方面防止控制丝11的近端脱离控制，滑入所述第一连接管21。对此，所述第一连接管21的径向尺寸与所述第二连接管12的径向尺寸相同。为了便于术中操作，所述第二连接管12与所述第一连接管21之间的连接方式为可拆卸连接。所述可拆卸连接包括但不限于为经热缩管套接或者经生物胶粘连。具体的，将所述控制丝11伸出所述第一连接管21的近端的部分伸入所述第二连接管12中，且固定于所述第二连接管12中，固定方式可以为焊接或粘接等。当需要抽离所述控制丝11时，破坏所述第二连接管12与所述第一连接管21的近端的连接，例如划破所述热缩管或所述生物胶，以将所述控制丝11抽出，实现释放分支支架4。可选的，所述控制丝11和所述第二连接管12的材质为镍钛合金。
请继续参阅图1-3，所述鞘管部2至少包括第一连接管21、覆膜套管22和束缚线圈23。所述第一连接管21为所述分支鞘的基本骨架。在一个实施例中，所述第一连接管21为所述覆膜套管22和所述束缚线圈23提供支撑力及 固位。进一步的，所述第一连接管21和所述覆膜套管22均为中空管，即均具有两端连通的内腔。所述第一连接管21的远端与所述覆膜套管22的近端相接，则二者的内腔相连通。
所述覆膜套管22用于容置所述分支支架4，防止在导入支架时分支支架4损伤到血管壁。其中，所述覆膜套管22的轴向长度大于或等于所述分支支架4的轴向长度，以保证将所述分支支架4全部囊括其中。进一步的，所述覆膜套管22的管壁上设置有若干排液孔24。所述排液孔24用于在分支支架4导入与释放的过程，血液经所述排液孔24通畅流出，缓解血流阻力对分支支架4的输送和定位的影响，以及减少因血液不通畅引起的并发症。进一步的，本实施例不限定所述排液孔24的数量，可以选择的为1个、2个、3个或4个等。但为保证所述覆膜套管22的强度，所述排液孔24占所述覆膜套管22的外表面的面积比例不宜过大，则所述排液孔24数据选择需适中。
请参阅如4-5，因所述覆膜套管22上设置有若干个所述排液孔24，所述排水孔24可能会导致所述覆膜套管22的强度降低，故优选的，将所述覆膜套管22与所述束缚线圈23分开控制，以先将所述覆膜套管22拉出，再拉动所述控制丝11以将所述控制丝11和所述裸端41从所述束缚线圈23中解脱。对此，在另一个实施例中，所述分支鞘还包括第三连接管26。所述第三连接管26套设于所述第一连接管21和所述第二连接管12的外表面，所述第一连接管21与所述覆膜套管22并不相连，而是由所述第三连接管26的远端与所述覆膜套管22的近端相连。可选的，所述第三连接管26和所述覆膜套管22的连接方式包括但不限于为采用缩管热熔相连、采用胶水粘连，或者直接把所述覆膜套管22的近端熔进所述第三连接管26的远端。
为防止所述第三连接管26滑动，造成提前拉出所述覆膜套管22或将所述覆膜套管22朝向所述主体支架3推进，所述第三连接管26的近端设置有限位件27。所述限位件27还与所述第二连接管12的近端相连。进一步的，所述限位件27包括但不限于为热缩管，还可以是便于拆除的机械连接。在释放过程中，先将所述限位件27与所述第二连接管12和第三连接管26分开后，再将所述第三连接管26和所述覆膜套管22先抽离，最后再利用所述控制丝 11调整所述分支支架4的位置，并释放所述分支支架4。进一步的，所述第一连接管21、所述第三连接管26和所述覆膜套管22的材质为镍钛合金。
请继续参阅图1和2，所述束缚线圈23的近端与所述第一连接管21的远端相接。所述束缚线圈23的远端依次穿过所述分支支架4的全部裸端孔隙或部分的裸端孔隙，且伸出所述裸端孔隙，以实现束缚所述分支支架4的裸端41，避免在所述主体支架3释放后，所述分支支架4受主体支架3的拉拽而出现移位，保证释放位置的准确性。所述束缚线圈23的长度可以大于所述覆膜套管22的轴向长度，即所述束缚线圈23的远端能够伸出所述覆膜套管22，也可以小于或等于所述覆膜套管22的轴向长度，即所述束缚线圈23的远端位于所述覆膜套管22中。其中，本实施例中所述分支支架4远离所述主体支架3的一端为自由端，本实施例称之为裸端41。进一步的，所述分支支架4可以为覆膜支架，其中，因所述裸端孔隙用于连接，则所述裸端41上不设置覆膜。
进一步的，在所述束缚线圈23的远端穿过所述分支支架4的裸端孔隙，并伸出所述裸端孔隙之后，如图2所示，所述分支支架4处于正常状态，即非压缩状态。并且，所述裸端41并未被捆束收紧，而是仍处于放松状态，目的在于保留所述裸端41之间的空隙，以使在所述分支支架4导入与释放的过程，血液经所述空隙通畅流出，进一步缓解血流阻力对分支支架4的输送和定位的影响，保证血流畅通。当然，如图8所示，在后续调整所述分支支架4的位置时，会通过移动所述第一连接管21来带动所述控制丝11和所述束缚线圈23牵拉所述分支支架4。鉴于所述控制丝11穿过所述束缚线圈23而产生的相交关系，在牵拉过程中，所述束缚线圈23通过所述控制丝11的限制向所述裸段施加牵引力，从而收紧所述裸段，导致所述空隙缩小。但本实施例提供的所述分支鞘中的所述覆膜套管22上设置有若干排液孔24，足以实现血流畅通，避免因血液不通畅引起的并发症。在释放所述分支支架4时，通过抽离所述控制丝11并在轻微的外力作用下，所述束缚线圈23会脱离所有所述裸端孔隙，即可实现对所述分支支架4的释放。
进一步的，所述束缚线圈23的材质为聚四氟乙烯，聚四氟乙烯的摩擦系 数较小，便于在释放所述分支支架4时，所述束缚线圈22能够快速脱离所述裸端孔隙。
请参阅图6-7，因在所述控制丝11抽离的过程中，会经过所述覆膜套管22，且当所述控制丝11过长时，在抽拉的过程中很容易刺穿覆膜套管22以及分支支架4上的覆膜，造成覆膜套管22和分支支架4的损坏。故为了缩短所述控制丝11的长度，保证覆膜套管22和分支支架4不被破坏，在一个实施例中，所述分支鞘还包括连接线圈25。所述连接线圈25的近端穿过所述覆膜套管22，与所述第一连接管21的远端相接。所述连接线圈25的远端被配置为：在所述束缚线圈23的远端伸出所述裸端孔隙后，穿过并钩挂在所述连接线圈25的远端形成伸出部231，所述控制丝11穿过所述伸出部231。如图7所示，所述伸出部231呈弯钩形，便于钩挂在所述连接线圈25上。因此，所述束缚线圈23向上弯曲，且钩挂在所述连接线圈25上，则所述束缚线圈23向上延伸，从而使得所述控制丝11在所述连接线圈25位置处就可以穿进所述束缚线圈23中，实现缩短所述控制丝11的目的，避免因所述控制丝11过长而导致对覆膜套管22和分支支架4的损坏。
为保证所述束缚线圈23的长度足够钩挂在所述连接线圈25上，所述束缚线圈23的长度范围为：a≥b+5；其中，单位为毫米；a为所述束缚线圈23的长度，即束缚线圈23未穿过所述裸端孔隙之前沿所述分支鞘的轴向长度；b为所述分支支架4的裸端41所在位置处的周向长度；其中，所述分支支架4的裸端41所在位置处的周向长度比所述分支支架4的中间段的周向长度要长，即所述分支支架4的裸端41处呈喇叭状。并且，为保证所述控制丝11能够对所述分支支架4进行位置调整以及控制释放，所述控制丝11伸出所述第一连接管21的远端的轴向长度大于所述束缚线圈23伸出所述裸端孔隙后的轴向长度。换言之，沿所述第一控制管21的轴向上，拉直后的所述控制丝11的远端和所述第一连接管21的远端之间的长度大于所述束缚线圈23穿过所述裸端41之后的轴向长度。
进一步的，请参阅图4、8-10，在输送所述分支支架4和所述主体支架3时，首先将分支支架4安装至分支鞘中，即所述分支支架4容置于所述覆膜 套管22中，所述束缚线23圈穿过所述分支支架4的裸端孔隙，且所述控制丝11穿过所述束缚线圈23。然后，将经压缩的所述主体支架3捆束完成后，再将压缩的主体支架3和分支支架4输送至目标位置，并在确定释放位置之后，拉出所述主支导丝，以释放出所述主体支架3。其次，若所述覆膜套管22直接与所述第一连接管21相连，则可以通过移动所述第一连接管21来带动所述控制丝11和所述束缚线圈23调整所述分支支架4的位置。待确定释放位置后，如图9和10所示，破坏所述第一连接管21和第二连接管12之间的连接，抽出所述控制丝11并整体移动所述鞘管部2，以实现对分支支架4的释放。因所述覆膜套管22上设置有排液孔24，故在释放所述分支支架4时，血液可经所述排液孔24流动，避免血液堵塞，减少因血液不通畅引起的并发症。
若所述分支鞘设置有所述第三连接管26和所述限位件27，则可通过移动所述第三连接管26来带动所述第二连接管12、所述第一连接管21、所述束缚线圈23和所述控制丝11来整所述分支支架4的位置。待确定释放位置后，破坏所述限位件27与所述第三连接管26和所述第二连接管12之间的连接，将所述第三连接管26和所述覆膜套管22拉出。或者，先破坏所述限位件27与所述第三连接管26和所述第二连接管12之间的连接，将所述第三连接管26和所述覆膜套管22拉出。再通过移动所述第一连接管21来带动所述控制丝11和所述束缚线圈23，实现调整所述分支支架4的位置。最后，破坏所述第一连接管21和第二连接管12之间的连接，抽出所述控制丝11并抽离所述第一连接管21，以实现对分支支架4的释放。
综上所述，本实施例提供一种分支鞘，包括：覆膜套管22、第一连接管21、控制丝11和束缚线圈23。其中，所述覆膜套管22的管壁上设置有若干个排液孔24，用于在分支支架4导入与释放的过程，血液经所述排液孔24通畅流出，缓解血流阻力对分支支架4的输送和定位的影响，同时还可以减少因血液不通畅引起的并发症。以及，所述覆膜套管22位于所述第一连接管21的远端侧；所述控制丝11贯穿所述第一连接管21，且所述控制丝11的远端位于所述覆膜套管22内。所述束缚线圈23的近端与所述第一连接管21的远 端相连，所述束缚线圈23的远端用于穿过位于所述覆膜套管22内的分支支架4的裸端孔隙并伸出所述裸端孔隙，实现对分支支架4的牵制，以避免在主体支架释放后，分支支架受主体支架的拉拽而出现移位。并且，所述控制丝11穿过所述束缚线圈23的伸出所述裸端孔隙的部分，以牵拉并固定所述分支支架4的裸端41，从而在所述分支支架4于术中脱离预定位置后，在所述控制丝11的牵拉作用下，通过移动所述第一连接管即可随时将所述分支支架4重新拉入分支血管，实现对分支支架4释放位置的精准控制。因此，本实施例提供的所述分支鞘不仅能够防止分支支架4的移位，提高对分支支架4释放位置的准确控制，还能够缓解血流阻力对分支支架输入和定位的影响，减少因血液不通畅引起的并发症。
此外还应该认识到，虽然本发明已以较佳实施例披露如上，然而上述实施例并非用以限定本发明。对于任何熟悉本领域的技术人员而言，在不脱离本发明技术方案范围情况下，都可利用上述揭示的技术内容对本发明技术方案作出许多可能的变动和修饰，或修改为等同变化的等效实施例。因此，凡是未脱离本发明技术方案的内容，依据本发明的技术实质对以上实施例所做的任何简单修改、等同变化及修饰，均仍属于本发明技术方案保护的范围。

Claims (10)

  1. 一种分支鞘，其特征在于，包括：覆膜套管、第一连接管、控制丝和束缚线圈；
    所述覆膜套管的管壁上设置有若干个排液孔，且所述覆膜套管位于所述第一连接管的远端侧；所述控制丝贯穿所述第一连接管，且所述控制丝的远端位于所述覆膜套管内；
    所述束缚线圈的近端与所述第一连接管的远端相连，所述束缚线圈的远端用于穿过位于所述覆膜套管内的分支支架的裸端孔隙并伸出所述裸端孔隙；所述控制丝的远端穿过所述束缚线圈的伸出所述裸端孔隙的部分，以牵拉并固定所述分支支架的裸端。
  2. 根据权利要求1所述的分支鞘，其特征在于，所述控制丝被配置为可抽离出所述束缚线圈、所述覆膜套管和所述第一连接管，以释放所述分支支架；其中，所述控制丝的近端与第二连接管固定连接，以阻挡所述控制丝的近端滑动。
  3. 根据权利要求2所述的分支鞘，其特征在于，所述第一连接管的径向尺寸与所述第二连接管的径向尺寸相同，且所述第二连接管的远端与所述第一连接管的近端可拆卸连接。
  4. 根据权利要求3所述的分支鞘，其特征在于，所述可拆卸连接包括热缩管套接或生物胶粘连。
  5. 根据权利要求2所述的分支鞘，其特征在于，所述分支鞘还包括第三连接管；所述第三连接管套设于所述第一连接管和所述第二连接管的外表面，且所述第三连接管的远端与所述覆膜套管的近端相连；所述第三连接管的近端设置有限位件，且所述限位件还与所述第二连接管的近端相连，以阻挡所述第三连接管的滑动。
  6. 根据权利要求5所述的分支鞘，其特征在于，所述限位件为热缩管。
  7. 根据权利要求1所述的分支鞘，其特征在于，所述覆膜套管的近端与所述第一连接管的远端相连。
  8. 根据权利要求1所述的分支鞘，其特征在于，所述分支鞘还包括连接线圈；所述连接线圈的近端与所述第一连接管的远端相接，所述连接线圈的远端位于所述覆膜套管内并被配置为，所述束缚线圈的远端伸出所述裸端孔隙后，穿过并钩挂在所述连接线圈的远端形成伸出部，所述控制丝穿过所述伸出部。
  9. 根据权利要求1所述的分支鞘，其特征在于，所述控制丝伸出所述第一连接管的远端的轴向长度大于所述束缚线圈伸出所述裸端孔隙后的轴向长度；且所述覆膜套管的轴向长度大于或等于所述分支支架的轴向长度。
  10. 根据权利要求1所述的分支鞘，其特征在于，所述束缚线圈的长度范围为：a≥b+5；其中，a为所述束缚线圈的长度，b为所述分支支架的裸端所在位置处的周向长度，单位为毫米。
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