WO2023221712A1

WO2023221712A1 - Covered stent

Info

Publication number: WO2023221712A1
Application number: PCT/CN2023/088841
Authority: WO
Inventors: 朱永锋; 周敏; 刘昭; 李晓强; 朱清; 徐健伟; 刘金宏; 薛彦慧
Original assignee: 上海微创心脉医疗科技(集团)股份有限公司
Priority date: 2022-05-18
Filing date: 2023-04-18
Publication date: 2023-11-23
Also published as: CN114652495B; CN114652495A

Abstract

The present invention provides a covered stent. Two fenestrations are used for enabling a main body part to communicate with a renal artery. Each embedded branch structure is connected to one of the fenestrations. The two embedded branch structures are located in an inner cavity of the main body part. The embedded branch structures are oriented in the same direction as an opening of the renal artery, so as to drain blood flowing out of the opening of the renal artery, and follow the natural course of the blood flow to be in a shape similar to that of an original blood vessel of a human body. Moreover, the embedded branch structures also reduce the flexibility requirement on the ball-expansion covered stent or self-expansion stent for use in cooperation, ensuring the long-term patency rate of the ball-expansion covered stent or self-expansion stent, and greatly avoiding the possible splicing internal leakage when the embedded branch structures are spliced with the ball-expansion covered stent or self-expansion stent.

Description

A covered stent

Technical field

The present invention relates to the technical field of medical devices, and in particular to a covered stent.

Background technique

Vascular interventional therapy, as a minimally invasive treatment method, improves the survival probability of patients with vascular diseases who cannot tolerate surgery. There are many branches of blood vessels in the human body, and the lesion area of some aneurysms will involve the branch blood vessel areas. Take the structure of the abdominal aorta as an example. The abdominal aorta supplies blood to many internal organs of the human body, and both the renal artery and the superior mesenteric artery originate from the abdominal aorta. Therefore, when performing endoluminal surgery, it is necessary to ensure that the abdominal aorta, both The blood flow of the three arteries, the renal artery and the superior mesenteric artery, is smooth to ensure the patient's life safety.

When the starting position of the patient's abdominal aortic aneurysm is below the superior mesenteric artery and the distance from the lower edge of the superior mesenteric artery is greater than 4 mm, the existing standard vascular stent cannot ensure that the stent does not shift and both the renal artery and the superior mesenteric artery are not displaced at the same time. The blood flow is smooth, but these two points are fatal to the patient. However, traditional laparotomy treatment has the disadvantages of large trauma and high risk, and is especially not suitable for older patients. Although there are very few covered stents on the foreign market that can treat such aneurysms, the structural designs and solutions of these covered stents have certain limitations. It has the disadvantages of complex surgical procedures, high price, risk of endoleak at the stent splicing point, and inability to ensure smooth blood flow in both renal arteries and superior mesenteric arteries for a long time.

Contents of the invention

The purpose of the present invention is to provide a covered stent that can solve the problems of the risk of endoleak at the splicing point of the stent and/or the inability to ensure smooth blood flow in both renal arteries and/or superior mesenteric arteries for a long time.

In order to solve the above problems, the present invention provides a covered stent, which includes a main body, the main body including a covered section and two embedded branch structures, the covered section is provided with two windows, and two The fenestration is used to connect the main body part with the renal artery; each of the embedded branch structures is respectively arranged at one of the fenestrations and is connected to the fenestration, and both of the embedded branch structures are It is located in the inner cavity of the main body, and the orientation of the embedded branch structure is consistent with the opening orientation of the renal artery.

Optionally, the embedded branch structure is provided in the inner cavity of the stent graft and is an axially penetrating tubular structure having a first opening and a second opening, and the embedded branch structure includes a first height-increasing opening. The stent segment and the inline branch coating, the inline branch coating wraps the first variable height stent segment, and the inline branch coating at the first opening is fixed at the window opening.

Optionally, the embedded branch structure is an axially penetrating tubular structure having a first opening and a second opening, and the first opening is connected to the corresponding window;

When the opening of the renal artery is toward the proximal end of the main body, the second opening is provided toward the proximal end of the main body; when the opening of the renal artery is toward the distal end of the main body, the second opening is disposed toward the distal end of the main body part; or, when the opening of the renal artery is oriented perpendicular to the axial direction of the main body part, the second opening is disposed horizontally.

Optionally, the embedded branch structure is an axially penetrating tubular structure with a first opening and a second opening, and the embedded branch structure includes a first heightening stent segment, an embedded branch covering and a first opening. Positioning ring structure, the embedded branch coating wraps the first height-increasing bracket section, the embedded branch coating at the first opening and the first positioning ring structure are fixed at the window opening.

Further, the first height-increasing bracket section includes at least two first short ribs and at least two first high ribs, and all the first short ribs are connected in sequence and then connected to all the first high ribs that are connected in sequence. Forming an annular wavy structure, wherein the edge height of the first short edge is smaller than the edge height of the first high edge;

The embedded branch structure is provided with the first short edge and one end of the first high edge as the second opening, and the embedded branch structure is provided with only one end of the first high edge as the second opening. First opening;

In the embedded branch structure, the coating area near the first opening without the first short rib support is an empty film section. The direction of the second opening is determined by the embedded branch coating provided at the first opening. The empty membrane segment is determined by splicing with the proximal side or distal side of the window.

Further, a portion of the embedded branch coating located at the second opening and facing the main body part is connected to the main body part.

Optionally, the axial length of the embedded branch structure is 2 mm to 18 mm.

Optionally, the coated section includes a window, which is axially spaced apart from the two opening windows, and is used to connect and communicate the main body part with the superior mesenteric artery.

Further, the film-coated section includes a main body bracket and a main body coating, and the main body coating covers all The main body stent is formed such that the distal end of the main body stent forms a closed inner cavity along the axial direction. The main body stent includes two second variable-height stent segments and at least one first equal-height stent segment. The two second second stent segments are The variable height stent segments are symmetrically arranged at the proximal end of the main body stent along the radial direction of the main body stent, and all the first equal height stent segments are arranged at the distal end of the main body stent in sequence along the axial direction, and the window Located on the main body coating between the two second height-increasing bracket sections, the window is provided on the main body coating covering the first equal-height bracket section or the second height-changing bracket section.

Further, the second height-increasing bracket section includes two second short ribs and a plurality of second high ribs, and all the second short ribs are connected in sequence and then connected to all the second high ribs that are connected in sequence. An annular wavy structure is formed, the edge height of the second short edge is smaller than the edge height of the second high edge, and the window is located along the axial direction between the second short edge of the two second heightening bracket sections. between the edges.

Furthermore, the first equal-height bracket section is formed by a plurality of equal-length prisms connected end to end to form an annular wavy structure; the window is located between two adjacent prisms, and the two windows are arranged along the perimeter. are located on the main body coating of the same first equal-height bracket segment, or the two windows are circumferentially located on the main body coating of different first equal-height bracket segments; or, two of the windows are located on the main body coating of different first equal-height bracket segments; The window is circumferentially located on the main body covering covering the second height-increasing bracket section.

Further, the embedded branch structure is an axially penetrating tubular structure having a first opening and a second opening, and a first positioning ring structure is provided at both the first opening and the second opening of the embedded branch structure. , the window is provided with a second positioning ring structure, the first positioning ring structure at the first opening is located outside the main body coating, and the first positioning ring structure at the second opening is located at the main body On the inside of the coating, the second positioning ring structure is located on the outside of the main body coating.

Further, the second positioning ring structure and the first positioning ring structure both include a supporting wire and a developing wire, the supporting wire is in an annular shape, the developing wire is wound around the supporting wire or the developing wire and The support wires are arranged in parallel.

Further, it also includes a beam diameter structure, the beam diameter structure is arranged on the main body bracket and the main body coating, and the beam diameter structure includes a beam diameter coil and a suture coil, and the beam diameter coil surrounds all the parts along the circumferential direction. The second variable-height stent section and/or the first equal-height stent section, the suture coil is arranged at the apex of the distal end, the proximal end of the second variable-height stent section and/or the first equal-height stent section, or On the edge.

Further, the suture coils are arranged on the edges, and two of the stitches are arranged on each edge. Sewing coils, the distance between the two sewing coils and their corresponding nearest vertices is equal; or, one sewing coil is provided on each edge, and the sewing coil is located at the midpoint of the edge.

Further, the main body part further includes a bare section, the distal end of the bare section is connected to the proximal end of the main body coating, and the bare section overlaps the proximal end portion of the main body stent in the axial direction.

Further, the bare segment includes a stent ring and a barb structure located at the proximal end of the stent ring, the barb structure includes a barb and a barb handle, and the distal end of the barb handle is connected to the stent ring, The proximal end of the barb handle is connected to the proximal end of the barb, the distal end of the barb is everted away from the axis of the stent ring, and the clamp between the barb and the axis of the stent ring The angle is 10°~70°.

Optionally, it also includes a splicing part, the splicing part is spliced at the distal end of the main body part, the splicing part includes a first splicing part, the proximal end of the first splicing part is connected to the distal end of the main body part .

Further, the splicing part further includes a second splicing part, the distal end of the first splicing part has an ipsilateral branch and a contralateral branch, and the proximal end of the second splicing part is connected to the ipsilateral branch and used for The ipsilateral iliac artery blood flow is established, and the contralateral branch is used to establish the contralateral iliac artery blood flow after splicing.

Compared with the prior art, the beneficial effects of the present invention are:

The present invention provides a stent graft, which is used to connect the main body part and the renal artery through two said windows; each of the embedded branch structures is connected to one of the said windows, and the two said windows are connected to each other. The embedded branch structures are all located in the inner cavity of the main body, and the orientation of the embedded branch structures is consistent with the opening of the renal artery, so as to drain the blood flow out of the opening of the renal artery, It also follows the natural direction of blood flow, making it closer to the original blood vessel shape of the human body. It also reduces the compliance requirements for the ball-expanded stent graft or self-expanding stent used to ensure that the ball-expanded stent graft or self-expanding stent is far away from the blood vessel. The long-term good patency rate also greatly avoids the internal leakage that may occur when the embedded branch structure is spliced with a ball-expanded covered stent or a self-expanding stent in vivo.

Further, the embedded branch structure is provided with a first short edge and one end of the first high edge as the second opening, and the embedded branch structure is provided with only one end of the first high edge as the first opening; An empty film section with an embedded branch coating at an opening is spliced with the proximal or distal side of the window to determine the direction of the second opening, even if there is a first high edge and an embedded branch coating. The part of the membrane forms the large curved side of the embedded branch structure, so that only the empty membrane section provided with the embedded branch coating forms the embedded branch structure. The small curved side is easy to splice, and the design of the first variable-height stent segment of the present invention can ensure good flexibility on the small curved side; the small curved side can be strengthened to anchor the ball-expanded covered stent or self-expanding stent used in conjunction with it. At the same time, the overall pressing size of the covered stent is reduced, thereby reducing the requirement for the diameter of the access blood vessel.

Further, the splicing of the main body, the first splicing part and the second splicing part, as well as the window, the window opening and the embedded branch structure are all centrally arranged in the main part, so that the main part can be designed according to the needs, and the first splicing part and the second splicing part can be designed according to the needs. The second splicing part can be mass-produced without special customization, which makes the preparation of the first splicing part and the second splicing part less difficult, allows for quick distribution and delivery, greatly shortening the waiting time for wearing, and the same side branch can directly reconstruct the same side of the iliac Arterial blood flow, compared with the ipsilateral iliac artery stent intracorporeal splicing on the market, eliminates type III endoleak there, and also reduces the economic cost and time cost of the operation.

Further, the second height-increasing bracket section includes two second short ribs and a plurality of second high ribs, and all the second short ribs are connected in sequence and then connected with all the second high ribs in sequence to form a ring. It has a wavy structure, the edge height of the second short rib is smaller than the edge height of the second high edge, and the window is located along the axial direction between the second short ribs of the two second heightening bracket sections. This structure can improve the flexibility of the proximal end of the stent graft. The second short rib can avoid superior mesenteric artery fenestration. At the same time, the symmetrical distribution of the two second short ribs can provide sufficient space for fenestration (ie, superior mesenteric artery fenestration). The avoidance space can also provide sufficient radial support for the coating that is flush with the superior mesenteric artery window in the horizontal direction, ensuring the tightness of the coating that is flush with the superior mesenteric artery window in the horizontal direction with the abdominal aorta. fit.

Description of the drawings

Figure 1 is a schematic structural diagram of a stent graft according to an embodiment of the present invention;

Figure 2 is a schematic structural diagram of the main body of an embodiment of the present invention;

Figures 3a-3c are structural schematic diagrams of the embedded branch structure in different directions according to an embodiment of the present invention;

Figure 4 is a schematic diagram of the first variable-height stent segment wrapped with an embedded branch coating according to an embodiment of the present invention after circumferential expansion;

FIG. 5 is a schematic structural diagram of the splicing part according to an embodiment of the present invention.

Explanation of reference symbols:

1-Main part; 2-Splicing part; 3-Superior mesenteric artery window; 4-Embedded branch structure;

100-bare section; 110-stent ring; 120-barb handle; 130-barb; 141-8-shaped developing point; 142-O-shaped developing point; 200-first coated section; 210, 220-th Two variable height bracket sections; 211, 221 - the second short edge; 212, 222 - the second high edge; 300 - the second coated section; 310 - the first equal height bracket section; 311 - prism; 410 - the first variable height High stent section; 411-first short edge; 412-first high edge; 413-larger curved side; 414-smaller curved side; 415-fasting section; 420-embedded branch coating; 400a-first opening; 400b -Second opening; 500-beam diameter structure; 510-beam diameter coil; 520-suture coil; 600-first splicing part; 610-lower section of main body; 611-second equal height bracket section; 620-bifurcation section; 621 -ipsilateral branch; 622-contralateral branch; 623-elliptical stent segment; 700-second splicing part; 710-first equal diameter section; 720-transition section; 730-second equal diameter section.

Detailed ways

The stent graft of the present invention will be described in further detail below. The invention will now be described in more detail with reference to the accompanying drawings, in which preferred embodiments of the invention are shown, it being understood that those skilled in the art may modify the invention described herein while still achieving the advantageous effects of the invention. Therefore, the following description should be understood as being widely known to those skilled in the art and is not intended to limit the present invention.

In the interest of clarity, not all features of an actual embodiment are described. In the following description, well-known functions and constructions are not described in detail since they would obscure the invention with unnecessary detail. It is understood that in the development of any actual embodiment, numerous implementation details must be made to achieve the developer's particular goals, such as changing from one embodiment to another in accordance with relevant system or relevant business constraints. Additionally, it should be appreciated that such development efforts may be complex and time consuming, but are simply routine tasks for those skilled in the art.

In order to make the purpose and features of the present invention more obvious and understandable, specific implementation modes of the present invention will be further described below with reference to the accompanying drawings. It should be noted that the drawings are in a very simplified form and use imprecise ratios, and are only used to conveniently and clearly assist in explaining the embodiments of the present invention. As used herein, the term "or" is generally used in its sense including "and/or" unless the content clearly dictates otherwise. The terms "inner", "outer", and similar expressions used herein are for illustrative purposes only and do not represent the only implementation manner. In this article, the terms "distal" and "proximal" refer to the relative orientation, relative position, relative position, relative position, and relative position of components or actions relative to each other from the perspective of a physician using the medical device. Position and direction. Although "distal" and "proximal" are not restrictive, "distal" usually refers to the end of the medical device that is close to the operator during normal operation, and "proximal" usually refers to the end that is close to the operator during normal operation. One end of the patient's heart. Herein, the term "edge height" refers to, for example, the length of the two adjacent vertices A and A' in the second heightening stent segment in Figure 2 in the axial direction of the stent graft. In this article, "lateral" refers to the direction perpendicular to the axis of the main body, that is, the direction from left to right in Figure 1 .

Figure 1 is a schematic structural diagram of a stent graft in this embodiment. As shown in Figure 1, this embodiment provides a covered stent that can be used to treat abdominal aortic aneurysms whose starting position is below the superior mesenteric artery and the distance from the lower edge of the superior mesenteric artery is greater than 4 mm. Figure 2 is a schematic structural diagram of the main body of this embodiment. As shown in Figures 1 and 2, the stent graft includes a main body part 1 and a splicing part 2. The proximal end of the splicing part 2 is connected to the distal end of the main body part 1. The main body part 1 is used to be arranged in the visceral area of the aorta.

The main body 1 includes a bare section 100 and a covered section. The distal end of the bare section 100 is connected to the proximal end of the covered section. The bare section 100 is used to anchor the proximal end of the covered stent. The coating section includes a main body stent and a main body coating. The main body coating covers the main body stent and causes the distal end of the main body stent to form a closed inner cavity along the axial direction. The main body coating is wrapped on the main body bracket to form the coating section. The covered section of the main body 1 can isolate the aneurysm from the blood flow and allow the blood flow to flow through the inside of the covered stent.

The coating section includes a first coating section 200 and a second coating section 300 arranged along the axial direction. The main body coating of the proximal end of the first coating section 200 is connected to the distal end of the bare section 100 , the main body coating at the distal end of the first coating section 200 is connected to the main body coating at the proximal end of the second coating section 300 . The superior mesenteric artery window 3 is provided on the main body coating of the first covered segment 200, and the superior mesenteric artery window 3 is used to communicate with the superior mesenteric artery; the main body covering of the second covered segment 300 is provided with a superior mesenteric artery window 3. There is an embedded branch structure 4, which is used to communicate with the renal artery. The stent graft in this embodiment can provide radial support force for anchoring the proximal end of the stent graft from the bare section 100 to the first covered section 200 . The radial cross-sections of the bare section 100, the first coated section 200 and the second coated section 300 are annular, and the diameters of the bare section 100, the first coated section 200 and the second coated section 300 are the same. .

The bare section 100 is used to anchor the proximal end of the stent graft with the normal blood vessel, and is used to extend the anchoring area of the stent graft and to be released after reaching the bare section when the stent graft cooperates with the delivery device. Purpose. In order to ensure that the bare segment 100 fully adheres to normal blood vessels, the bare segment 100 needs to have sufficient radial support. The ways to achieve this include but are not limited to the bare segment being made of 316 stainless steel, cobalt-chromium alloy or nickel-titanium alloy. Pipe diameter cut.

In order to further improve the anchoring effect of the bare segment 100, the bare segment 100 has multiple barb structures, and the barb structures are used to anchor the proximal end of the stent graft. As shown in Figure 2, the bare segment 100 includes a wavy stent ring 110. The wavy stent ring 100 has good radial stretchability to facilitate the bare segment to be pressed and held, and can also provide anchoring support. . The diameter of the stent ring 100 is 18mm-38mm to adapt to the size of blood vessels. The barb structure is disposed on the crest (vertex M) of the stent ring 110 near the proximal end of the bare segment 100 .

The barb structure includes a barb handle 120 and a barb 130. The distal end of the barb handle 120 is connected to the vertex M of the stent ring 110 near the proximal end of the bare segment for supporting the barbs. 130. The proximal end of the barb 130 is connected to the proximal end of the barb handle 120. The barb 130 and the barb handle 120 are connected after being formed separately. For example, they are cut and formed separately and then connected by welding, or , the barb 130 and the barb handle 120 are an integral structure, for example, they can be cut and formed in one piece. The distal end of the barb 130 is a free end, which is everted away from the axis of the stent ring 110 , and the angle between the barb 130 and the axis of the stent ring 110 is 10° to 70°. , the barb structure facilitates the barb protection before the stent graft is completely released from the transporter, so that the stent graft will not scratch the blood vessel when it is adjusted in the blood vessel cavity in a semi-constrained state. The length of the barb 130 is 1 mm to 6 mm, and the distal end of the barb 130 is tapered. The above-mentioned shape cooperation of the bare section 100 can provide space for the introduction of other consumables in the semi-bound state of the stent graft.

In this embodiment, the distal end of the bare section 100 is sutured to the main body covering of the proximal end of the first covered section 200 , and the bare section 100 is axially connected to the proximal part of the main body stent. Overlap, that is, the distal end of the bare segment 100 and the proximal end of the first covered segment 200 have an overlapping area along the axial direction of the main body stent, and the distal end of the bare segment 100 is close to the first covered segment 200 . The distance from the vertex M' of the proximal end of the membrane segment 200 to the proximal edge of the main body membrane is located in the overlapping area, and the bare segment 100 is close to the distance from the apex M' of the proximal end of the first membrane segment 200. is 2 mm to 4 mm. In this way, the bare segment 100 and the second higher height stent segment at the proximal end of the first covered segment 200 have an overlapping area in the axial direction of the main stent (for example, from the proximal edge of the first covered segment At a distance of 2 mm, the distance between the bare section 100 and the first coated section is The second higher stent segment at the end overlaps in the axial direction of the main stent), which can increase the radial support point of the stent graft, making the proximal end of the stent graft better rounded, thereby effectively preventing the stent graft from being Type Ia endoleak occurs when the proximal end does not fit closely with the inner wall of the blood vessel.

The first film-coated section 200 includes two second variable-height bracket sections. In this embodiment, the first film-coated section 200 includes two second variable-height bracket sections 210 and 220. The two second variable-height bracket sections 210 and 220. The two second variable height stent sections 210 and 220 are symmetrically arranged at the proximal end of the main body stent (that is, the two second variable height stent sections 210 and 220 are symmetrical along the radial direction of the main body stent and are arranged at the proximal end of the main body stent). ), and the two second variable-height bracket sections 210 and 220 are spaced apart along the axial direction of the main body bracket, and the minimum axial distance between the two second variable-height bracket sections 210 and 220 is 1 mm to 6 mm. , the axial spacing between the two second variable height stent segments 210, 220 can be adjusted according to the degree of blood vessel curvature, so as to adjust the compliance of the second variable height stent segment near the superior mesenteric artery window, and finally fully adapt to the situation. Match the direction of blood vessels. When the degree of curvature of the abdominal aorta at the opening of the superior mesenteric artery is severe, the axial distance between the two second variable height stent segments can be increased; conversely, the axial distance between the two second variable height stent segments can be reduced. direction spacing.

The second increased height stent section 210 can make the proximal end of the stent graft fit more closely with the normal blood vessel wall, thereby effectively preventing type Ia caused by the loose fit of the proximal end of the stent graft with the normal blood vessel wall. Internal leakage. In this embodiment, the second increased-height stent segment 210 and the bare segment 100 serve as anchoring areas for the proximal end of the stent graft, and both of them can provide radial areas for anchoring the proximal end of the stent graft. supporting force, and jointly ensure the full adhesion between the proximal end of the covered stent and the normal blood vessel.

In this embodiment, the second height-changing bracket sections 210 and 220 are two identical brackets. The second height-changing bracket section 210 includes a second short edge 211 and a second high edge 212. The tall bracket section 220 includes a second short rib 221 and a second high rib 222, wherein the number of the second short ribs 211 and 221 is two, the number of the second tall ribs 212 and 222 is multiple, and all the second short ribs 211 and 222 are in number. The ribs 211 are connected in sequence and then connected to all the second high ribs 212 in sequence to form an annular wavy second height-increasing bracket section 210. All the second short ribs 221 are connected in sequence and connected in sequence to all the second short ribs 212 in sequence. The second high edges 222 are then connected to form an annular wavy second height-increasing bracket section 220 . Wherein, the edge height of the second short ribs 211 and 221 is smaller than the edge height of the second high ribs 212 and 222, and the edge height of the second short ribs 211 and 221 is 2 mm to 8 mm. The second high rib The edge height of 212 and 222 is 8mm~16mm. Because the second highest edge The edge heights of the second short edge and the second short edge are both small, and the length of the second heightening stent segments 210 and 220 formed along the axial direction of the stent graft is smaller, which can improve the flexibility of the proximal end of the stent graft. Since the second height-changing bracket sections 210 and 220 are arranged laterally symmetrically, the apex A formed at the distal end of the second height-changing bracket section 210 after the two second short edges of the second height-changing bracket section 210 are connected and the two second height-changing bracket sections 220 are connected. The apex A' formed at the proximal end of the second short rib after being connected is arranged directly opposite to the apex formed at the distal end of any two second high edges of the second height-increasing stent section 210 after being connected with the second height-increasing stent. The vertices formed by the proximal ends of the two second high edges of the segment 220 are facing each other, which causes the distance between the vertex A and the vertex A' to be the distal vertex of the second height-increasing stent segment 210 and its The opposite second heightening stent section 220 has the greatest distance at its proximal apex. This spacing can effectively reserve space for the superior mesenteric artery window 3. Therefore, the design of the second short ribs 211 and 221 is mainly used to avoid the superior mesenteric artery window 3, and can also be used to wrap the second short ribs 211 and 221 in the radial direction. The coating of the increased-height stent segments 210 and 220 provides sufficient radial support force to ensure that the coating around the superior mesenteric artery window 3 adheres closely to the abdominal aorta. According to the size of the blood vessel, the distance between the vertices A and A' and the superior mesenteric artery window 3 is less than 3 mm.

The superior mesenteric artery window 3 is used to reshape the blood flow of the superior mesenteric artery smoothly. The superior mesenteric artery window 3 includes a window (such as a circular window) cut out on the main body covering between the vertices A and A' and a second positioning ring structure disposed at the window. Preferably, the The second positioning ring structure is a circular structure, and the second positioning ring structure is sewn on the main body covering outside the window. The size of the superior mesenteric artery window 3 is the size of the second positioning ring structure. The inner diameter is sized such that the superior mesenteric artery window 3 is aligned with the opening of the superior mesenteric artery. The second positioning ring structure is composed of a supporting wire and a developing wire. Furthermore, the supporting wire and the developing wire are arranged in parallel (independent of each other and not entangled) or the supporting wire and the developing wire are entangled with each other. The second positioning ring structure The composition not only ensures the stiffness requirements of the superior mesenteric artery window opening, but also ensures position tracking under rays, thereby increasing the visibility of the covered stent and facilitating surgical operations. Wherein, the material of the supporting wire is 316 stainless steel, cobalt-chromium alloy or nickel-titanium alloy, etc., and the material of the developing wire is gold with good developability, etc. Preferably, the support wire and the development wire are in the shape of a ring, and the diameters of the rings formed by the support wire and the development wire are the same. As a preferred technical solution, the developing wire is wound around the body of the supporting wire (for example, spirally wound), thereby forming the annular second positioning ring structure. The inner diameter of the second positioning ring structure is 6 mm to 14 mm to match the opening diameter of the superior mesenteric artery. The mesenteric upward movement A ball-expanded covered stent or a self-expanding stent can be placed in the pulse window 3 to reconstruct the superior mesenteric artery blood flow.

The second covered section 300 is used to support the blood vessel wall to improve the adhesion of the covered stent. The second coating section 300 includes at least one first equal-height bracket section 310. The first equal-height bracket section is formed by a plurality of equal-length prisms 311 connected end to end to form an annular wave-shaped bracket section. The first equal-height bracket section 310 can effectively reserve space for the embedded branch structure 4 . Wherein, the second variable-height bracket sections 210 and 220 and at least one first equal-height bracket section 310 are sequentially spaced along the axial direction of the covered stent and are fixedly connected through the main body coating. The edge height of the prism 311 is 6 mm to 12 mm. Since the edge height of the prism 311 is small, the overall flexibility of the stent graft can be ensured. The distance between the second variable-height bracket section 220 and its adjacent first equal-height bracket section 310 is 1 mm to 5 mm. When the number of first equal-height bracket segments 310 is at least two, the spacing between adjacent first equal-height bracket segments 310 is 1 mm to 5 mm, and at least two first equal-height bracket segments 310 can be uniform along the axial direction. The distribution may also be non-uniformly distributed along the axial direction to achieve the purpose of avoiding the opening of the embedded branch structure 4 .

The main body part also includes two inline branch structures 4. The inline branch structures 4 are provided on the main body coating of the second coating section 300, so that the interior of the stent graft passes through the two inline branches. Structure 4 is connected to two renal arteries respectively. In this embodiment, there are two openings on the main body coating of the second coating section 300, and the two openings can be disposed circumferentially on two sides of the same first equal-height bracket section 310. Between two adjacent prisms, it can also be provided between two adjacent prisms in different first equal-height bracket sections 310 . In other embodiments, the two opening windows may also be provided on the main body covering covering the second height-increasing bracket section, and the two opening windows are circumferentially located on the main body covering the second height-increasing bracket segment. The main body of the segment is covered with film. Each fenestration is aligned with the opening of a renal artery, and each fenestration is used to connect an embedded branch structure 4 . During surgery, a ball-expanding covered stent or a self-expanding stent can be placed within the embedded branch structure to reconstruct renal artery blood flow.

The embedded branch structure 4 includes a first variable-height bracket section, an embedded branch coating 420 and two first positioning ring structures. The embedded branch coating 420 wraps the first variable-height bracket section to form The axially penetrating tubular structure, that is, the embedded branch structure 4 is a tubular structure with openings at both ends. For convenience of description, the openings at both ends are respectively the first opening 400a and the second opening 400b. Specifically, the first positioning ring structure is fixed at both the first opening 400a and the second opening 400b of the tubular structure. The first positioning ring structure connected to the first opening 400a is first placed on the main body coating. on the outer surface, and then connect the inner Embedded branch structure 4. The embedded branch structure 4 is provided in the inner cavity of the stent graft, and the embedded branch structure 4 and the first positioning ring structure at the first opening are fixed at the window, and the The first positioning ring structure at the first opening is located on the outside of the main body coating. The second opening 400b is a free end without a connecting structure. The first positioning ring structure at the second opening is located on the outside of the main body coating. inside. The first positioning ring structure and the second positioning ring structure are made of the same material and shape respectively, and the inner diameter of the first positioning ring structure is 3 mm to 9 mm to match the diameter of the human renal artery.

The portion of the embedded branch coating near the second opening facing the main body is connected to the main body. In detail, Figures 3a-3c are schematic structural diagrams of the embedded branch structure in different directions in this embodiment. As shown in Figures 3a-3c, the orientation of the embedded branch structure 4 is designed according to the direction of the blood vessels. Specifically, the orientation of the embedded branch structure 4 (that is, the orientation of the second opening of the embedded branch structure 4) is consistent with the direction of the kidney. The openings of the arteries are oriented in the same direction. As shown in Figure 3b, when the opening of the renal artery near the abdominal aorta moves towards the proximal end (i.e. above), the second opening of the embedded branch structure 4 can be directed towards the proximal end (i.e. above) to comply with the flow of the blood vessel. The natural trend reduces the compliance requirements for the ball-expanded stent graft or self-expanding stent used, and is also closer to the original blood vessel shape of the human body, ensuring good long-term patency of the ball-expanded stent graft or self-expanding stent. As shown in Figure 3a, when the opening of the renal artery faces the distal end (that is, downward), the second opening of the embedded branch structure 4 can be directed toward the distal end (that is, downward), and the same effect as above can be achieved. As shown in Figure 3c, when the renal artery runs essentially horizontally near the abdominal aorta (that is, the opening of the renal artery is oriented perpendicular to the axis of the main body), sewing can be performed horizontally to reduce bulbar expansion. The flexibility of the membrane stent or the self-expanding stent requires that the second opening be set horizontally, that is, the connection line between the second opening of the embedded branch structure 4 and the opening of the renal artery is perpendicular to the axial direction of the main body. In this embodiment, the sewing methods of the embedded branch structures 4 can be upward sewing, downward sewing, and horizontal sewing. Therefore, the two embedded branch structures 4 can be combined according to the direction of the patient's blood vessels to form a double upward, downward sewing, or horizontal sewing. Combinations such as double downward, double horizontal, one upward and one downward, one horizontal and one upward, or one horizontal and one downward. The orientation of the two embedded branch structures 4 can be controlled by the second opening suture, or can be Through the size control of the empty membrane segment.

FIG. 4 is a schematic diagram of the first variable-height stent segment wrapped with an embedded branch coating in this embodiment after circumferential expansion. As shown in Figure 4, the first height-increasing bracket section 410 includes a first short edge 411 and a first high edge 412. All the first short edges and the first high edges are connected end to end in sequence and then connected to form a ring shape. A wavy bracket segment, and the lines connecting all vertices on at least one end of the bracket segment are on the same straight line. Among them, the number of the first short ribs 411 is 4-8, the number of the first high ribs 412 is 4-8, and all the first short ribs 411 are connected with all the first high ribs 412 in sequence. connection. Wherein, the edge height of the first short edge 411 is smaller than the edge height of the first high edge 412, and the edge height of the first short edge 411 is 2 mm to 10 mm, and the edge height of the first high edge 412 is 3mm～16mm.

Furthermore, the connecting lines of all the vertices on one end of the first height-increasing bracket section 410 are on the same straight line, that is, all the vertices of one end of the embedded branch structure 4 are provided with the first short edge and the first high edge. If they are on the same straight line, then this end is the second opening, and the other end (that is, the end where all the vertex lines are not on the same straight line, that is, the end where all the vertex lines are curves or polylines) is the embedded branch. The structure is provided with only one end of the first high edge as the first opening. Specifically, due to the difference in height between the first short rib 411 and the first high rib 412, the coating area in the embedded branch structure 4 near the first opening that is not supported by the first short rib 411 is an empty film section 415. As shown in Figure 4, when the first opening 400a of the embedded branch structure 4 is spliced with the window opening, it can be determined by adjusting the empty membrane section 415 above the first opening 400a to be spliced with the proximal side or the distal side of the window. The direction of the second opening 400b. The principle is: by retracting the distance between the second opening 400b and the corresponding side of the empty film section between the empty film section 415 and the proximal side or the distal side of the window during sewing, a small curved side close to the main body film is formed. 414, and a large curved side 413 opposite the small curved side 414. In this embodiment, the large curved side 413 is located in the area where all the first high edges 412 in the first height-increasing bracket section 410 are connected, and the small curved side 414 is located in the empty membrane section 415 . The small curved side 414 has a greater degree of curvature than the curved side 413 , which requires high flexibility of the embedded branch structure 4 . Therefore, in this embodiment, the empty film section 415 is used to form the small curved side 414 .

Please continue to refer to Figures 3a-3c and Figure 4. When the embedded branch structure 4 is sewn to the main body film, and the embedded branch structure 4 is sewn upward or downward, the third part of the embedded branch structure 4 An opening 400a is sewn at the opening of the film of the second film section. The second opening 400b of the embedded branch structure 4 can be a free end, or it can be covered by covering the embedded branch close to the second opening 400b. The part of the film 420 facing the main body coating is sewn on the main body coating of the second coating section to fix the second opening 400b of the embedded branch structure 4 on the coating of the second coating section. Specifically, , the embedded branch structure 4 is sewn on the main body coating of the second coating section. Further, the orientation of the second opening 400b is determined by the portion of the first opening 400a where the branch film is embedded (i.e., the empty film section 415) and the portion near the window. End-side or distal-side splicing to determine. Specifically, during sewing, the first opening 400a is sewn at the window opening of the film of the second film section. As shown in Figures 3a and 4, taking the second opening of the embedded branch structure 4 being sewn downward as an example, the first opening 400a of the embedded branch structure 4 corresponds to the window, and the empty film section 415 is located on the far end side of the window. , adopt the sewing method of the first height-increasing bracket segment as shown in Figure 4, that is: according to the direction requirements, at the first opening 400a, the area provided with the first high edge 412 corresponds to the far end side of the window, and only The empty film section 415 with the embedded branch coating 420 corresponds to the distal side of the window, and the first positioning ring structure is placed on the outer surface of the coating at the window; the embedded branch coating of the embedded branch structure 4 420 extends from the window opening to the outer surface of the second coating section, and covers the first positioning ring structure. By sewing, the embedded branch structure can be controlled by controlling the length of the empty film section 415 extending out of the window. The tilt angle is 4, which can ensure good compliance of the small curved side 414, and can also reduce the overall pressing size of the stent graft, thereby reducing the requirements of the stent graft on the diameter of the access blood vessel. When the embedded branch structure 4 is used with a ball-expanded stent graft or a self-expanding stent, since the empty membrane section 415 is not supported by the stent, the ball-expanded (expansion) size of the ball-expanded stent graft or self-expanding stent in the empty membrane section If it is larger, the ball-expanded stent graft or the self-expanding stent can be stuck between the first short edge 411 of the first height-increasing stent section and the first positioning ring structure.

When the embedded branch structure 4 is sewn to the main body coating, and the embedded branch structure 4 is sewn horizontally, the first opening of the embedded branch structure 4 is sewn to the coating of the second coating section. The opening of the window, that is to say, when the access point of the ball-expanded stent graft used is the distal end, the second opening 400b of the first heightening stent section 410 faces the distal end, reducing the pressing size of the stent graft. , for easy pressing and holding. At the same time, when used with the ball-expanded stent graft, when the ball-expanded stent graft is expanded in the inner cavity of the embedded branch structure, the ball-expanded stent graft has a larger expansion space in the empty membrane segment, thereby reinforcing the anchoring ball-expanded stent graft. Membrane stent to prevent displacement. When the approach of the ball-expanded stent graft used is the proximal end, the second opening 400b of the first heightening stent section faces the proximal end to achieve the same effect.

In other embodiments, when the renal artery runs substantially horizontally near the abdominal aorta, the embedded branch structure may include a contoured stent segment, an embedded branch coating and a first positioning ring structure, the embedded branch coating wrapping The equal height support section includes a plurality of equal height edges connected end to end.

The axial length of the embedded branch structure 4 is 2 mm to 18 mm, which can ensure the smooth blood flow of the renal artery and greatly avoid possible splicing when the main body 1 is spliced with the ball-expanding covered stent or self-expanding stent in vivo. Endoleak (i.e. type III endoleak).

As shown in Figure 5, the splicing part 2 includes a first splicing part 600 located at the proximal end and a second splicing part 700 located at the distal end. The first splicing part 600 is a tubular structure. The first splicing part 600 It is an integrated bifurcated structure, and the distal end of the first splicing part 600 is divided into two tubular leg structures from the proximal end to the distal end, namely the ipsilateral branch 621 and the contralateral branch 622, wherein the ipsilateral branch The axial length of 621 is longer, shorter, or the same as the axial length of the contralateral branch 622. The proximal end of the first splicing part 600 is connected to the distal end of the main body part 1 , and the distal end of the same side branch 621 is connected to the proximal end of the second splicing part 700 . The main body part 1 is located in the visceral area of the human aorta and is mainly used to provide sealing of the proximal end of the stent graft and to provide access for reconstruction of the visceral branches. The first splicing part 600 is located in the aneurysm cavity and is mainly used to provide a closed blood flow channel in the abdominal aortic aneurysm cavity to isolate the abdominal aortic aneurysm cavity. The second splicing part 700 is located at the distal end of the abdominal aortic aneurysm cavity and extends into the ipsilateral iliac artery of the patient. In this embodiment, the main body part 1, the first splicing part 600 and the second splicing part 700 are spliced together by suturing to form a whole stent graft. Compared with the intracorporeal splicing of ipsilateral iliac artery stents on the market, the sutured one-piece stent eliminates type III endoleak, reduces the economic cost and time cost of the operation, and at the same time, this splicing structure can achieve rapid delivery. , allowing patients to reduce waiting time as much as possible. The ipsilateral side is the side in the same direction as the entrance of the delivery system, and the contralateral side is the side opposite the ipsilateral side.

The first splicing part 600 includes a main body lower section 610, a bifurcation section 620 and a first splicing coating. The main body lower section 610 is provided at the proximal end of the bifurcation section 620, and the first splicing coating covers the main body lower section. 610 and bifurcated section 620, the proximal end of the first splicing coating is connected to the distal end of the main body coating of the main body part 1. The lower body section 610 includes at least one second equal-height bracket section 611 . The shape, diameter, and material of the second equal-height bracket section are the same as those of the first equal-height bracket section 310 . . The first splicing coating wraps at least one of the second equal-height bracket sections 611 .

The bifurcated section 620 includes a wavy elliptical ring stent section 623. The radial cross section of the proximal end of the elliptical ring stent section 623 is circular, and the radial cross section of the distal end is oval, and the elliptical ring stent section 623 Both the major axis and the minor axis of the radial cross section of the stent segment 623 gradually decrease from the proximal end to the distal end, so as to make the bifurcation of the bifurcated segment 620 smooth. The diameter, material and shape of the stent section of the ipsilateral branch 621 and the stent section of the contralateral branch 622 are all the same. The stent section of the contralateral branch 622 adopts a constant height stent, so that the diameter of the contralateral branch 622 is The diameter is fixed diameter design, which can better match the contralateral iliac artery branches. The use of stent segments is used to establish contralateral iliac artery blood flow after splicing; the stent segment of the ipsilateral branch 621 also uses a constant height stent, so that the radial diameter of the ipsilateral branch 621 is a fixed diameter design, so that the second splicing The parts 700 are connected with equal diameters, thereby facilitating mass production of the second splicing part 700 .

The proximal end of the second splicing part 700 is connected to the distal end of the same side branch 621. Furthermore, the proximal end of the coating of the second splicing part 700 is sewn to the third distal end of the same side branch 621. A splicing film is applied. The second splicing part 700 includes a first equal diameter section 710, a transition section 720 and a second equal diameter section 730 that are connected in sequence along the axial direction. The proximal end of the first equal diameter section 710 is connected to the distal end of the same side branch 621. end, the proximal end of the transition section 720 is connected to the distal end of the first equal diameter section 710, the distal end of the transition section 720 is connected to the proximal end of the second equal diameter section 730, the bracket section of the first equal diameter section 710 and The stent sections of the second equal-diameter section 730 are all equal-height stents and have a wavy annular structure. The diameter of the stent section of the first equal-diameter section 710 is the same as the diameter of the stent section of the branch on the same side, and the second equal-diameter section The diameter of 730 is larger than the diameter of the first equal-diameter section 710, and the stent section of the transition section 720 is a variable-diameter stent, so that the diameter of the transition section 720 gradually increases from the proximal end to the distal end. The diameter of the second equal diameter section 730 is equal to the diameter of the distal end of the transition section 720. Specifically, the diameter of the second equal diameter section 730 is 6 mm to 28 mm, and the length is 20 mm to 180 mm. The second equal diameter section 730 is used to fit the second splicing portion 700 to the wall of the diseased blood vessel, and is also used to seal the distal end of the second equal diameter section 730 . The sum of the lengths of the ipsilateral branch 621 , the first equal diameter section 710 , the transition section 720 and the second equal diameter section 730 is greater than the opposite side branch 622 .

Please continue to refer to Figure 2. The proximal end of the main body coating is provided with two developing points to realize the position calibration of the proximal end of the stent graft under rays. The developing points are respectively an O-shaped developing point 142 and an 8-shaped developing point 141. , the O-shaped developing points 142 and 8-shaped developing points 141 are evenly distributed along the proximal circumferential direction of the main body coating.

In this embodiment, an 8-shaped developing point 141 and three O-shaped developing points 142 are provided at the proximal end of the main body coating, and the spacing between each developing point is the same (the angle between each developing point is 90°), and the 8-shaped developing point 141 is arranged on the same side or the opposite side of the stent graft, and the three O-shaped developing points 142 are arranged in the other three directions.

In order to realize the beam diameter function of the stent graft, the stent graft also includes a beam diameter structure 500, which is provided on the main body stent and the main body coating. The beam diameter structure 500 includes a plurality of beam diameter coils 510 and a plurality of suture coils 520. The beam diameter coils 510 are made of PTFE, PET or ultra-high resolution. Made of soft polymer materials with good biocompatibility such as polyethylene. The beam diameter coil 510 circumferentially surrounds the second variable-height bracket segment and/or the first equal-height bracket segment, that is, each bracket segment (for example, the second variable-height bracket segment, the first equal-height bracket segment, the third At least one of a variable-height bracket section, a second equal-height bracket section, a bracket section of the lower body section, etc.) has at least two beam diameter coils 510 . In this embodiment, each stent segment has two beam diameter coils 510. The two beam diameter coils 510 can overlap or be arranged at intervals along the axial direction of the covered stent, and the beam diameter coils 510 can be set in the edge or at any position at the vertex of the bracket segment, and can be set according to actual needs. One end of the two beam diameter coils 510 can start from the same point or different points in opposite directions, and "hug" the bracket segment in the circumferential direction. After the two beam diameter coils 510 "hug" the bracket segment in the circumferential direction, the main body guide The wire passes through the other ends of the two beam diameter coils to constrain the stent segments in the radial direction to achieve the beam beam effect. In this embodiment, the two beam diameter coils 510 are arranged at intervals and are respectively arranged at the vertices of the proximal end and/or the distal end of each stent segment.

The suture coil 520 is a hollow coil sewn on the main body coating of the main body part and the first splicing coating of the second equal-height stent section, and its diameter is 0.5 mm to 2 mm. The suture coil 520 is disposed at the vertex of the distal end of each stent segment (i.e., vertex A), the vertex of the proximal end (ie, vertex A'), or on the edge. When the suture coils 520 are disposed on the edges of each stent segment, two suture coils 520 can be disposed on each edge, and the two suture coils are equally spaced from their corresponding nearest vertices; one suture coil can also be disposed on each edge. 520, the suture coil 520 is located at the midpoint of the edge, that is, the distance between it and the vertices on both sides is equal, or is located at the vertex of the distal end of the second variable-height stent segment and/or the first equal-height stent segment. , on the proximal vertex. The A vertex is the trough of each stent segment, and the A’ vertex is the crest of each stent segment.

In this embodiment, the beam diameter coil 510 is inserted into the suture coil, and passes through the suture coil at the overlapping positions of all suture coils and stent segments before surrounding the stent segment, so that the suture coil 520 is at the A vertex, A' Each bracket segment is fixed to the covering film wrapping it at the vertex or edge. The structure is simple and easy to operate and has a reliable effect. Adopting this structure can effectively avoid the stent segment being unable to spring out due to the wire nodes being stuck during release. The beam diameter coil 510 is restricted after passing through the suture coil 520 and can only move in the circumferential direction to ensure the stability of the beam diameter. By adjusting the length of the beam diameter coil, the ratio of the beam diameter can be adjusted from 40% to 90% of the nominal diameter.

It needs to be said that the beam diameter coil 510 and the suture coil 520 need to be avoided when encountering the openings and windows. That is, the beam diameter coil 510 cannot block the opening of the superior mesenteric artery window 3 and the embedded branch structure on the main body coating. Therefore, the second positioning ring structure of the superior mesenteric artery window 3 and the second positioning ring structure of the embedded branch structure 4 On a certain positioning ring structure, the suture coil 520 fixes the beam diameter coil 510 on the outside of the superior mesenteric artery window 3 and the embedded branch structure 4. The number of suture coils on the superior mesenteric artery window 3 and the embedded branch structure can be 1 to 4 respectively.

The second variable-height bracket sections 210 and 220, the first equal-height bracket section 310, the first variable-height bracket section 410, the second equal-height bracket section 611, the bracket section of the lower body section 610, and the bracket section of the bifurcated section 620 The material of the bracket and the second splicing part 700 are all nickel-titanium, cobalt-chromium alloy or 316 stainless steel, and the shape is annular and wavy. The main body coating, embedded branch coating, main body lower section coating, bifurcation section coating and second splicing section 700 coating are all made of polymer soft materials with good biocompatibility, which can make the stent The segments form a closed inner cavity in the axial direction.

To sum up, the present invention provides a stent graft, which is used to connect and communicate the main body part with the renal artery through two of the fenestrations; and each of the embedded branch structures is connected to one of the fenestrations. connected, the two embedded branch structures are located in the inner cavity of the main body, and the orientation of the embedded branch structures is consistent with the opening of the renal artery, so as to control the blood flow out of the opening of the renal artery. It plays a drainage role and follows the natural direction of blood flow, making it closer to the original blood vessel shape of the human body. It also reduces the compliance requirements for the ball-expanded stent graft or self-expanding stent used to ensure that the ball-expanded stent graft is used. Or the good long-term patency rate of self-expanding stents also greatly avoids possible internal leakage when the embedded branch structure is spliced with the ball-expanded covered stent or self-expanding stent in vivo.

Further, the first height-increasing stent segment and the embedded branch coating located in the first high-edge connection area serve as the large curved side of the embedded branch structure, and there are no The embedded branch coating supported by the first short rib serves as the small curved side of the embedded branch structure, and the small curved side is located at the first opening, so that the first short rib avoids the First to speak. The design of the first variable-height stent section of the present invention can ensure good compliance of the small curved side; the small curved side can strengthen the anchorage of the ball-expanded stent graft or self-expanding stent used, and at the same time reduce the overall pressure of the stent graft. size, thereby reducing the requirements for the diameter of the access vessel.

Further, the splicing of the main body part, the first splicing part and the second splicing part, as well as the window and window opening and embedded branch structures are centrally arranged in the main body, so that the main body can be designed according to needs, and the first splicing part and the second splicing part can be mass-produced without special customization, making the preparation of the first splicing part and the second splicing part difficult. It can be quickly distributed and delivered, which greatly shortens the waiting time for wearing. The ipsilateral branch can directly reconstruct the ipsilateral iliac artery blood flow. Compared with the ipsilateral iliac artery stent in vivo splicing on the market, this problem is eliminated. Type III endoleak also reduces the economic cost and time cost of surgery.

In addition, it should be noted that, unless otherwise specified or pointed out, the terms "first", "second" and "third" in the specification are only used to distinguish various components, elements, steps, etc. in the specification, rather than to It is used to express the logical relationship or sequential relationship between various components, elements, steps, etc.

It can be understood that although the present invention has been disclosed above in preferred embodiments, the above embodiments are not intended to limit the present invention. For any person familiar with the art, without departing from the scope of the technical solution of the present invention, they can use the technical content disclosed above to make many possible changes and modifications to the technical solution of the present invention, or modify it into equivalent changes. Example. Therefore, any simple modifications, equivalent changes, and modifications made to the above embodiments based on the technical essence of the present invention without departing from the content of the technical solution of the present invention still fall within the protection scope of the technical solution of the present invention.

Claims

A covered stent is characterized in that it includes a main body, the main body includes a covered section and two embedded branch structures, the covered section is provided with two windows, and the two windows are used for The main body part is connected with the renal artery; each of the embedded branch structures is respectively arranged at one of the window openings and is connected to the window opening, and both of the embedded branch structures are located on the main body part. in the inner cavity of the renal artery, and the orientation of the embedded branch structure is consistent with the opening orientation of the renal artery.
The stent graft according to claim 1, wherein the embedded branch structure is disposed in the inner cavity of the stent graft and is an axially penetrating tubular structure having a first opening and a second opening, The embedded branch structure includes a first variable-height bracket segment and an embedded branch coating. The embedded branch coating wraps the first variable-height bracket segment, and the embedded branch coating at the first opening is fixed. at said window opening.
The stent graft of claim 1, wherein the embedded branch structure is an axially penetrating tubular structure having a first opening and a second opening, and the first opening is connected to the corresponding opening. Windows are connected;

When the opening of the renal artery is toward the proximal end of the main body, the second opening is provided toward the proximal end of the main body; when the opening of the renal artery is toward the distal end of the main body, the second opening is disposed toward the distal end of the main body part; or, when the opening of the renal artery is oriented perpendicular to the axial direction of the main body part, the second opening is disposed horizontally.
The stent graft of claim 1, wherein the embedded branch structure is an axially penetrating tubular structure having a first opening and a second opening, and the embedded branch structure includes a first height-increasing The stent segment, the embedded branch coating and the first positioning ring structure, the embedded branch coating wraps the first variable height stent segment, the embedded branch coating at the first opening and the first positioning ring structure The ring structure is fixed at the opening.
The covered stent according to claim 2, characterized in that:

The first height-increasing bracket section includes at least two first short ribs and at least two first high ribs. All the first short ribs are connected in sequence and then connected with all the first high ribs in sequence to form a ring. Wave-shaped structure, wherein the edge height of the first short edge is smaller than the edge height of the first high edge;

The embedded branch structure is provided with the first short edge and one end of the first high edge as the second opening, and the embedded branch structure is provided with only one end of the first high edge as the second opening. First opening;

In the embedded branch structure, the coating area near the first opening without the first short rib support is an empty film section. The direction of the second opening is determined by the embedded branch coating provided at the first opening. The empty membrane segment is determined by splicing with the proximal side or distal side of the window.
The stent graft of claim 5, wherein the portion of the embedded branch graft located at the second opening and facing the main body is connected to the main body.
The stent graft of claim 1, wherein the axial length of the embedded branch structure is 2 mm to 18 mm.
The covered stent according to claim 1, wherein the covered section includes a window, the window is axially spaced apart from the two opening windows, and the window is used to make the main body part Connected with the superior mesenteric artery.
The covered stent according to claim 8, wherein the covered section includes a main body stent and a main body coating, and the main body coating covers the main body stent and makes the distal end of the main body stent extend along the A closed inner cavity is formed in the axial direction, and the main body bracket includes two second height-increasing bracket segments and at least one first equal-height bracket segment, and the two second height-increasing bracket segments are arranged symmetrically along the radial direction of the main body bracket. At the proximal end of the main body stent, all the first equal-height stent segments are arranged in sequence at axial intervals at the distal end of the main body stent, and the window is located between the two second variable-height stent segments. On the main body coating, the window is provided on the main body coating covering the first equal height bracket section or the second variable height bracket section.
The stent graft of claim 9, wherein the second height-increasing stent section includes two second short ribs and a plurality of second high ribs, and all the second short ribs are connected in sequence with each other respectively. All the second high edges connected in sequence are connected to form an annular wavy structure, the edge height of the second short rib is smaller than the edge height of the second high edge, and the window is located along the axial direction between the two said between the second short edges of the second heightening bracket section.
The covered stent according to claim 9, characterized in that the first equal-height stent section is formed by a plurality of equal-length prisms connected end to end to form an annular wavy structure; and the windows are located at two adjacent prisms. between them, and the two windows are circumferentially located on the main body covering of the same first equal-height bracket section. on the film, or the two said windows are circumferentially located on the main body covering film of the different first equal-height bracket segments; or the two said windows are circumferentially located on the main body covering covering the second height stent segment The main body of the stent segment is covered with film.
The stent graft of claim 9, wherein the embedded branch structure is an axially penetrating tubular structure having a first opening and a second opening, and the first opening and the second opening of the embedded branch structure are The second openings are each provided with a first positioning ring structure, and the window is provided with a second positioning ring structure. The first positioning ring structure at the first opening is located outside the main body coating, and the second positioning ring structure is provided at the second opening. The first positioning ring structure at the opening is located inside the main body coating, and the second positioning ring structure is located outside the main body coating.
The stent graft of claim 12, wherein the second positioning ring structure and the first positioning ring structure each include a supporting wire and a developing wire, the supporting wire is annular, and the developing wire is wrapped around On the support wire or the developing wire and the support wire are arranged in parallel.
The stent graft according to claim 9, further comprising a beam diameter structure, the beam diameter structure is arranged on the main body stent and the main body coating, and the beam diameter structure includes a beam diameter coil and a suture. Coil, the beam diameter coil circumferentially surrounds the second variable height stent section and/or the first equal height stent section, and the suture coil is arranged on the second variable height stent section and/or the first equal height stent section On the distal apex, proximal apex or edge of the stent segment.
The stent graft of claim 14, wherein the suture coils are arranged on the edges, and two suture coils are arranged on each edge, and the two suture coils are at corresponding distances from each other. The spacing between the nearest vertices is equal; or, one suture loop is provided on each edge, and the suture loop is located at the midpoint of the edge.
The stent graft of claim 9, wherein the main body further includes a bare section, the distal end of the bare section is connected to the proximal end of the main body graft, and the bare section is axially connected to The proximal end portions of the main body supports overlap.
The stent graft of claim 16, wherein the bare section includes a stent ring and a barb structure located at the proximal end of the stent ring, the barb structure includes a barb and a barb handle, The distal end of the barb handle is connected to the stent ring, the proximal end of the barb handle is connected to the proximal end of the barb, the distal end of the barb is everted away from the axis of the stent ring, and the The angle between the barb and the axis of the bracket ring is 10° to 70°.
The stent graft according to claim 1, further comprising a splicing part spliced at the distal end of the main body part, the splicing part including a first splicing part, the first splicing part The proximal end is connected to the distal end of the main body part.
The stent graft of claim 18, wherein the splicing part further includes a second splicing part, the distal end of the first splicing part has an ipsilateral branch and a contralateral branch, and the second splicing part The proximal end is connected to the ipsilateral branch and is used to establish the ipsilateral iliac artery blood flow, and the contralateral branch is used to establish the contralateral iliac artery blood flow after splicing.