CN102641164B - Branch type aortic stent vascular system - Google Patents

Branch type aortic stent vascular system Download PDF

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CN102641164B
CN102641164B CN201110039053.0A CN201110039053A CN102641164B CN 102641164 B CN102641164 B CN 102641164B CN 201110039053 A CN201110039053 A CN 201110039053A CN 102641164 B CN102641164 B CN 102641164B
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bifurcated artery
vessel
blood vessel
initiative pulse
artery
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CN102641164A (en
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舒畅
王暾
黎明
李全民
欧阳玉蓉
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Second Xiangya Hospital of Central South University
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Abstract

The invention discloses a kind of branch type aortic stent vascular system, comprise an initiative pulse support blood vessel and three bifurcated artery stented vessel, the stage casing of described initiative pulse support blood vessel is provided with depressed part, described depressed part is provided with three side openings, and described three bifurcated artery stented vessel are sub-packed in three side openings.This branch type aortic stent vascular system can completely cut off the aortic disease involving aortic arch and ascending aorta, the blood flow can rebuilding bifurcated artery, avoid customization support, can produce in batches and for emergency operation.

Description

Branch type aortic stent vascular system
Technical field
The present invention relates to initiative pulse support blood vessel system, particularly relate to branch type aortic stent vascular system.
Background technology
Aneurysm of thoracic aorta and dissection of aorta are the aortic diseases of serious threat patients ' lives safety.If treated not in time, the tumor body of aneurysm of thoracic aorta will increase, and cause breaking and death; Dissection of aorta is likely broken, and causes death, and meanwhile, dissection of aorta can cause bifurcated artery ischemia, occurs liver and kidney failure, paraplegia, the severe complications such as lower limb disorder.Under partial picture, aneurysm of thoracic aorta and dissection of aorta need Emergency surgical treatment.
Along with the development of intracavity technology, current chest intracavity aorta recovery technique (Thoracic Endovascualr Aortic Repair, TEVAR) has become treatment aneurysm of thoracic aorta and the main method of dissection of aorta.It puts into support in thoracic aorta, is completely cut off by aortic disease beyond support, and constraint blood flow passes through completely in support, thus reaches isolated pathological changes, the object of protection blood vessel.There is multiple initiative pulse support blood vessel both at home and abroad at present, in order to ensure that support fixedly secures endovascular, prevent blood flow to leak into support from the proximal part of support or distal end, the proximal part of the initiative pulse support blood vessel used at present and distal end need the anchorage zone of at least 15mm simultaneously.So when aneurysm of thoracic aorta or dissection of aorta are contiguous or when involving aortic branch arteries, support in the market, when treating it, by shutoff bifurcated artery in various degree, even cannot be treated by intracavity technology.
Have the aortic branch support of special customization abroad, its method is: the anatomic condition concrete according to patient, the initiative pulse support blood vessel of tubulose makes side opening, and the position of side opening is corresponding with bifurcated artery position; In operation, when initiative pulse support blood vessel being implanted aortic disease position, simultaneously by its side opening align fingers tremulous pulse, ensure that bifurcated artery blood flow is unobstructed, then implant small rack in bifurcated artery.But this kind of method shortcoming is a lot: first, stented vessel must customize by the anatomic morphological concrete according to patient especially, not can manufacture; Its two, customization support duration, can not be used for emergency operation; Its three, the support of the band side opening of this customization, when discharging in vivo, side opening must aim at the bifurcated artery involved, and then may cause bifurcated artery circulatory disorders and relevant complication, threat to life time serious if any deviation.
Summary of the invention
The technical problem to be solved in the present invention overcomes the deficiencies in the prior art, provides a kind of and can completely cut off the aortic disease involving aortic arch and ascending aorta, the blood flow can rebuilding bifurcated artery, avoids customizing support, can produce in batches and can be used for the branch type aortic stent vascular system of emergency operation.
For solving the problems of the technologies described above, the present invention by the following technical solutions:
A kind of branch type aortic stent vascular system, comprise an initiative pulse support blood vessel and three bifurcated artery stented vessel, the stage casing of described initiative pulse support blood vessel is provided with depressed part, and described depressed part is provided with three side openings, and described three bifurcated artery stented vessel are sub-packed in three side openings.
The front portion of described bifurcated artery stented vessel passes described side opening, and the rear portion of bifurcated artery stented vessel is provided with the fixed part strutted in umbrella shape, and the rear portion of bifurcated artery stented vessel is fixed by fixed part and initiative pulse support blood vessel.
The front portion of described bifurcated artery stented vessel is straight tube shape.
The caliber of described bifurcated artery stented vessel front portion reduces to distal end gradually from proximal part.
Described initiative pulse support blood vessel and bifurcated artery stented vessel are by artificial blood vessel and support composition.
Compared with prior art, the invention has the advantages that:
1, branch type aortic stent vascular system of the present invention, depressed part is provided with in the stage casing of initiative pulse support blood vessel, when initiative pulse support blood vessel is positioned at thoracic aorta, the depressed part in its stage casing is positioned aortic arch, side opening set by depressed part is towards the bifurcated artery of aortic arch, then initiative pulse support blood vessel is discharged, because initiative pulse support blood vessel stage casing is provided with depressed part, therefore in the side that the bifurcated artery of aortic arch sends, the space that one long and narrow is had between initiative pulse support blood vessel and aorta wall, owing to communicating with the side opening of initiative pulse support blood vessel and bifurcated artery opening while of above-mentioned long and narrow space, so initiative pulse support blood vessel upon discharge, can not shutoff bifurcated artery, avoid the risk of bifurcated artery ischemia, because above-mentioned long and narrow space avoids the risk of bifurcated artery ischemia, during initiative pulse support blood vessel location, its stage casing is only needed to be positioned aortic arch, side opening is towards bifurcated artery opening, and do not need to be aimed at completely by each side opening exactly each bifurcated artery opening, therefore significantly reduce operation technique difficulty, shorten operating time, due to the existence of above-mentioned long and narrow space, each side opening of initiative pulse support blood vessel does not need to aim at each bifurcated artery opening completely, therefore this initiative pulse support blood vessel does not need the anatomy customization concrete according to patient, avoid the time that customization support expends, and support can be produced in batches, can be applicable to emergency operation, due to the existence of above-mentioned long and narrow space, the seal wire that intracavitary therapy is used and conduit have enough working places, therefore after initiative pulse support blood vessel discharges in thoracic aorta, seal wire is by side opening and above-mentioned space, in quick feeding bifurcated artery, and implant bifurcated artery stented vessel, rebuild aortic arch three Main Branches artery blood flow passages, the pathological changes of aortic arch is completely cut off completely simultaneously beyond this cover branch type aortic stent vascular system, due to the existence of above-mentioned long and narrow space, after bifurcated artery stented vessel is implanted, even if the side opening of initiative pulse support blood vessel does not have the opening of align fingers tremulous pulse, bifurcated artery stented vessel also suitably can bend in above-mentioned long and narrow space, adjustment angle, can not cause the serious pressurized of bifurcated artery intravascular stent and inaccessible.Initiative pulse support blood vessel and bifurcated artery stented vessel are structure independently, so can according to the concrete condition of pathological changes, select initiative pulse support blood vessel and the bifurcated artery stented vessel of suitable dimension respectively, be combined into the stented vessel system of the most applicable a set of patient, avoid according to concrete anatomic condition customization support.This branch type aortic stent vascular system can completely cut off aortic disease effectively, simultaneously safety, rebuild the bifurcated artery of aortic arch easily, therefore can to perform the operation by alternative full Aortic arch replacement to a certain degree, avoid wound and the risk of open chest surgery; During installation, the leading portion of initiative pulse support blood vessel is positioned ascending aorta, as long as therefore Study on Ascending Aortic Lesions distance aortic valve and coronary ostium have certain distance, it can completely cut off by this branch type aortic stent vascular system effectively.
2, bifurcated artery stented vessel rear portion is provided with the fixed part strutted in umbrella shape, and bifurcated artery stented vessel can be made firmly to be connected with initiative pulse support blood vessel, to fit tightly, and significantly reduces the risk of leaking blood from connecting portion; Because bifurcated artery stented vessel rear portion have employed the design of " umbrella shape ", the side opening of initiative pulse support blood vessel can be slightly large compared with the opening of the bifurcated artery initial part of its correspondence, like this, when using bifurcated artery stented vessel to rebuild bifurcated artery blood flow, bifurcated artery stented vessel suitably can adjust position, make the para-position of itself and bifurcated artery more accurate, and the fixed part strutted in umbrella shape, also ensure that it can close the side opening of initiative pulse support blood vessel completely when suitably adjusting position, and can not cause leaking blood.
3, the front portion of bifurcated artery stented vessel is the similar taper tubular design that the design of straight tube shape or caliber reduce to distal end gradually from proximal part, providing multiple choices, being applicable to the bifurcated artery pathological changes of different anatomic form for rebuilding bifurcated artery.
Accompanying drawing explanation
Fig. 1 is position, the side perspective view of initiative pulse support blood vessel of the present invention;
Fig. 2 is the normotopia perspective view of initiative pulse support blood vessel of the present invention;
Fig. 3 is the structural representation (leading portion is the design of straight tube shape) of bifurcated artery stented vessel of the present invention;
Fig. 4 is the structural representation (leading portion is the design of similar taper tubular) of bifurcated artery stented vessel of the present invention;
Fig. 5 is the structural representation after initiative pulse support blood vessel discharges in thoracic aorta;
Fig. 6 is after initiative pulse support blood vessel discharges in thoracic aorta, then in innominate artery the initial segment, place the structural representation that a bifurcated artery stented vessel rebuilds innominate artery;
Fig. 7 is that initiative pulse support blood vessel discharges in thoracic aorta, after innominate artery gives the reconstruction of bifurcated artery stented vessel, then in left common carotid artery the initial segment, places the schematic diagram that a bifurcated artery stented vessel rebuilds left common carotid artery;
Fig. 8 is that initiative pulse support blood vessel discharges in thoracic aorta, after innominate artery and left common carotid artery give the reconstruction of bifurcated artery stented vessel respectively, then in left subclavian artery the initial segment, place the schematic diagram that a bifurcated artery stented vessel rebuilds left subclavian artery.
In figure, each label represents:
1, initiative pulse support blood vessel; 11, depressed part; 12, side opening; 13, leading portion; 14, stage casing; 15, back segment; 2, bifurcated artery stented vessel; 21, fixed part; 22, anterior; 23, rear portion; 3, thoracic aorta; 4, innominate artery; 5, left common carotid artery; 6, left subclavian artery; 7, long and narrow space.
Detailed description of the invention
Fig. 1 to Fig. 8 shows a kind of branch type aortic stent vascular system embodiment of the present invention, this stented vessel system comprises an initiative pulse support blood vessel 1 and three bifurcated artery stented vessel 2, initiative pulse support blood vessel 1 and bifurcated artery stented vessel 2 are by artificial blood vessel and support composition, the stage casing 14 of initiative pulse support blood vessel 1 is provided with depressed part 11, depressed part 11 is provided with three side openings 12, article three, bifurcated artery stented vessel 2 is sub-packed in three side openings 12, when initiative pulse support blood vessel 1 is positioned at thoracic aorta 3, by the corresponding aortic arch of depressed part 11 in its stage casing 14, side opening 12 set by depressed part 11 is towards the bifurcated artery of aortic arch, then initiative pulse support blood vessel 1 is discharged, because initiative pulse support blood vessel 1 stage casing 14 is provided with depressed part 11, therefore in the side that the bifurcated artery of aortic arch sends, a long and narrow space 7 is had between initiative pulse support blood vessel 1 and aorta wall, owing to communicating with the side opening 12 of initiative pulse support blood vessel 1 and bifurcated artery opening while of above-mentioned long and narrow space 7, so initiative pulse support blood vessel 1 upon discharge, can not shutoff bifurcated artery, avoid the risk of bifurcated artery ischemia, because above-mentioned long and narrow space 7 avoids the risk of bifurcated artery ischemia, when initiative pulse support blood vessel 1 is located, its stage casing 14 is only needed to be positioned aortic arch, side opening 12 is towards bifurcated artery opening, and do not need to be aimed at completely by each side opening 12 exactly each bifurcated artery opening, therefore significantly reduce operation technique difficulty, shorten operating time, due to the existence of above-mentioned long and narrow space 7, the side opening 12 of initiative pulse support blood vessel 1 does not need complete align fingers arterial ostium, therefore this initiative pulse support blood vessel 1 does not need the anatomy customization concrete according to patient, avoid the time that customization support expends, and support can be produced in batches, can be applicable to emergency operation, due to the existence of above-mentioned long and narrow space 7, the seal wire that intracavitary therapy is used and conduit have enough working places, therefore after initiative pulse support blood vessel 1 discharges in thoracic aorta 3, seal wire is sent in each bifurcated artery fast by side opening 12 and above-mentioned long and narrow space 7, and implant bifurcated artery stented vessel 2, rebuild aortic arch three Main Branches artery blood flow passages, the pathological changes of aortic arch is completely cut off completely simultaneously beyond this cover branch type aortic stent vascular system, due to the existence of above-mentioned long and narrow space 7, after bifurcated artery stented vessel 2 is implanted, even if the side opening 12 of initiative pulse support blood vessel 1 does not have the opening of align fingers tremulous pulse, bifurcated artery stented vessel 2 also suitably can bend in above-mentioned long and narrow space 7, adjustment angle, can not cause the serious pressurized of bifurcated artery stented vessel 2 and inaccessible.Initiative pulse support blood vessel 1 and bifurcated artery stented vessel 2 are structure independently, so can according to the concrete condition of pathological changes, select initiative pulse support blood vessel 1 and the bifurcated artery stented vessel 2 of suitable dimension respectively, be combined into the stented vessel system of the most applicable a set of patient, it also avoid according to concrete anatomic condition customization support simultaneously.Branch type aortic stent vascular system of the present invention can completely cut off aortic disease effectively, safely, rebuild the bifurcated artery of aortic arch easily simultaneously, therefore can perform the operation by alternative full Aortic arch replacement to a certain degree, avoid wound and the risk of open chest surgery, during installation, the leading portion 13 of initiative pulse support blood vessel 1 is positioned ascending aorta, as long as therefore Study on Ascending Aortic Lesions distance aortic valve and coronary ostium have certain distance, pathological changes can completely cut off by branch type aortic stent vascular system of the present invention effectively.
In the present embodiment, bifurcated artery stented vessel 2 front portion 22 passes side opening 12, rear portion 23 is provided with the fixed part 21 strutted in umbrella shape, the rear portion 23 of bifurcated artery stented vessel 2 is fixed by fixed part 21 and initiative pulse support blood vessel 1, the fixed part 21 strutted in umbrella shape can make bifurcated artery stented vessel 2 firmly be connected with initiative pulse support blood vessel 1, fit tightly, and significantly reduces the risk of leaking blood from connecting portion; Rear portion 23 due to bifurcated artery stented vessel 2 have employed the design of " umbrella shape ", the side opening 12 of initiative pulse support blood vessel 1 can be slightly large compared with the opening of the bifurcated artery initial part of its correspondence, like this, when using bifurcated artery stented vessel 2 to rebuild bifurcated artery blood flow, bifurcated artery stented vessel 2 suitably can adjust position, make the para-position of itself and bifurcated artery more accurate, and the fixed part 21 strutted in umbrella shape, also ensure that it can close the side opening 12 of initiative pulse support blood vessel 1 completely when suitably adjusting position, and can not cause leaking blood.
In the present embodiment, bifurcated artery stented vessel 2 anterior 22 is straight tube shape.The pipe diameter determing of bifurcated artery stented vessel 2 front portion 22 can be become reduce gradually to distal end from proximal part in addition, provide multiple choices for rebuilding bifurcated artery, being applicable to the bifurcated artery pathological changes of different anatomic form.
When implementing operation, three bifurcated artery stented vessel 2 are used for rebuilding innominate artery 4, left common carotid artery 5 and left subclavian artery 6 respectively.Select the suitable initiative pulse support blood vessel 1 in thoracic aorta 3 cross section of leading portion 13 and back segment 15 weeks footpaths and corresponding position week footpath, select the bifurcated artery stented vessel 2 that 22 weeks footpaths, front portion are suitable with all footpaths of corresponding each bifurcated artery.As shown in Figure 5, during thoracic aorta endovascular stent vascular repair of being expert at operation, initiative pulse support blood vessel 1 is positioned at release after in thoracic aorta 3, initiative pulse support blood vessel 1 leading portion 13 is positioned at ascending aorta, stage casing 14 is positioned at aortic arch, and back segment 15 is positioned at descending aorta.Depressed part 11 side of initiative pulse support blood vessel 1 is towards aortic arch bifurcated artery opening.Depressed part 11 weeks footpaths due to initiative pulse support blood vessel 1 are less than the Zhou Jing of thoracic aorta 3 corresponding position, therefore between initiative pulse support blood vessel 1 and aorta wall, have a long and narrow space 7, this long and narrow space 7 communicates with three side openings 12 of initiative pulse support blood vessel 1, and is connected with the opening of innominate artery 4, left common carotid artery 5, left subclavian artery 6.As shown in Figure 6, select the bifurcated artery stented vessel 2 that size is suitable, by the seal wire of transluminal operation by initiative pulse support blood vessel 1 side opening 12 foremost and long and narrow space 7, stretch in innominate artery 4, again bifurcated artery stented vessel 2 is introduced, guided by seal wire, discharge after being positioned the nearly heart portion of innominate artery 4, rebuild the blood flow of innominate artery 4.The fixed part 21 of bifurcated artery stented vessel 2 struts in initiative pulse support blood vessel 1 in " umbrella shape ", ensure that the firm connection of initiative pulse support blood vessel 1 and bifurcated artery stented vessel 2 and fits tightly, and avoids the risk that connecting portion leaks blood.As shown in Figure 7, select the bifurcated artery stented vessel 2 that size is suitable, by the method identical with rebuilding innominate artery 4, the middle side opening 12 of bifurcated artery stented vessel 2 from initiative pulse support blood vessel 1 being stretched out, rebuilding the blood flow of left common carotid artery 5.As shown in Figure 8, select the bifurcated artery stented vessel 2 that size is suitable, by the method identical with rebuilding innominate artery 4, the side opening 12 of bifurcated artery stented vessel 2 from initiative pulse support blood vessel 1 rearmost end being stretched out, rebuilding the blood flow of left subclavian artery 6.After branch type aortic stent vascular system discharges in vivo completely, the pathological changes of thoracic aorta 3 is completely cut off completely beyond branch type aortic stent vascular system of the present invention, makes blood flow be limited to pass through in initiative pulse support blood vessel system.
Above-mentioned just preferred embodiment of the present invention, not does any pro forma restriction to the present invention.Although the present invention discloses as above with preferred embodiment, but and be not used to limit the present invention.Any those of ordinary skill in the art, when not departing from technical solution of the present invention scope, can utilize the technology contents of above-mentioned announcement to make many possible variations and modification to technical solution of the present invention, or being revised as the Equivalent embodiments of equivalent variations.Therefore, every content not departing from technical solution of the present invention, according to the technology of the present invention essence to any simple modification made for any of the above embodiments, equivalent variations and modification, all should drop in the scope of technical solution of the present invention protection.

Claims (5)

1. a branch type aortic stent vascular system, comprise an initiative pulse support blood vessel (1) and three bifurcated artery stented vessel (2), it is characterized in that: the stage casing (14) of described initiative pulse support blood vessel (1) is provided with depressed part (11), described depressed part (11) is provided with three side openings (12), and described three bifurcated artery stented vessel (2) are sub-packed in three side openings (12).
2. branch type aortic stent vascular system according to claim 1, it is characterized in that: the front portion (22) of described bifurcated artery stented vessel (2) passes described side opening (12), the rear portion (23) of bifurcated artery stented vessel (2) is provided with the fixed part (21) strutted in umbrella shape, and the rear portion (23) of bifurcated artery stented vessel (2) is fixed by fixed part (21) and initiative pulse support blood vessel (1).
3. branch type aortic stent vascular system according to claim 2, is characterized in that: the front portion (22) of described bifurcated artery stented vessel (2) is straight tube shape.
4. branch type aortic stent vascular system according to claim 2, is characterized in that: the caliber of described bifurcated artery stented vessel (2) anterior (22) reduces to distal end gradually from proximal part.
5. branch type aortic stent vascular system according to any one of claim 1 to 4, is characterized in that: described initiative pulse support blood vessel (1) and bifurcated artery stented vessel (2) are by artificial blood vessel and support composition.
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