技术领域technical field
本发明涉及可植入血管领域，更为具体地说是指一种主动脉弓覆膜支架型血管。The present invention relates to the field of implantable blood vessels, and more specifically refers to an aortic arch stent-graft type blood vessel.
背景技术Background technique
胸主动脉瘤和主动脉夹层是严重威胁广大人民群众生命的灾难性疾病，未经积极治疗致残率、死亡率高。近年来，随着高血压、高血脂、高血糖、外伤发病率的增高，胸主动脉瘤和主动脉夹层的发病率显著升高。目前对此采用主动脉腔内支架修复术疗效好，并得到了飞速发展。但累及头臂干、左颈总动脉和左锁骨下动脉开口的主动脉弓动脉瘤、主动脉夹层一直是该治疗技术的难点。为了保证支架在主动脉内的牢固固定，同时防止血流从支架的近心端或远心端渗漏到支架外，目前使用的主动脉血管支架近心或远心端需要至少15mm的锚定区。当胸主动脉廇或主动脉夹层累及头臂干、左颈总动脉和左锁骨下动脉开口的主动脉弓时，目前市场上的支架在对其进行治疗时，将不同程度的封堵分支动脉，甚至无法通过腔内技术治疗。Thoracic aortic aneurysm and aortic dissection are catastrophic diseases that seriously threaten the lives of the general public. Without active treatment, the disability rate and mortality rate are high. In recent years, with the increase in the incidence of hypertension, hyperlipidemia, hyperglycemia, and trauma, the incidence of thoracic aortic aneurysm and aortic dissection has increased significantly. At present, the use of aortic endovascular stent repair has good curative effect and has been developed rapidly. However, aortic arch aneurysms and aortic dissection involving the brachiocephalic trunk, left common carotid artery, and left subclavian artery ostium have always been difficult points in this treatment technique. In order to ensure the firm fixation of the stent in the aorta and prevent the blood flow from leaking out of the stent from the proximal or distal end of the stent, currently used aortic stents require at least 15 mm of anchorage at the proximal or distal end district. When the thoracic aortic artery or aortic dissection involves the aortic arch at the opening of the brachiocephalic trunk, left common carotid artery, and left subclavian artery, the stents currently on the market will block the branch arteries to varying degrees, or even Cannot be treated by endoluminal techniques.
由于每个病人主动脉弓发出的3个分支血管：头臂干、左颈总动脉和左锁骨下动脉走行不尽相同，并且临床上主动脉弓及其分支血管走行变异发生率较高。主动脉弓发出2个分支如：右头臂干与左颈总动脉共干（13%），左颈总动脉由右头臂干发出（9%），少数人无头臂干动脉，主动脉弓直接发出4个分支：右锁骨下动脉、右颈总动脉、左颈总动脉、左锁骨下动脉。椎动脉直接从主动脉弓发出并不少见，这样主动脉弓发有出4个分支：头臂干、左颈总动脉、左锁骨下动脉、椎动脉（摘自单鸿主编的《临床血管解剖学介入放射学动脉图谱》）。一旦发生血管走行变异，支架与血管就不相匹配，就不能完成腔内修复治疗。国外有根据病人具体的解剖情况特别定制的主动脉分支支架。在手术中，将主动脉支架血管植入主动脉病变部位时要求同时将其侧孔对准分支动脉，保证分支动脉血流通畅，再在分支动脉中植入小支架。但是这种方法有以下缺点：1、支架要根据病人具体的解剖情况特别定制，费用高且不能批量生产；2、定制支架用时较长，不能用于急症手术病人；3、操作复杂，支架释放时要求各侧孔分别准确地对准受累及的分支动脉，如有偏差则可能导致分支动脉血流障碍，出现相应并发症，严重可危及生命。The three branch vessels from the aortic arch in each patient: the brachiocephalic trunk, the left common carotid artery, and the left subclavian artery have different routes, and clinically, the incidence of variation in the course of the aortic arch and its branches is relatively high. The aortic arch gives off 2 branches, such as: the right brachiocephalic trunk shares the trunk with the left common carotid artery (13%), the left common carotid artery originates from the right brachiocephalic trunk (9%), a few people have no brachiocephalic artery, and the aortic arch directly sends out 4 Branches: right subclavian artery, right common carotid artery, left common carotid artery, left subclavian artery. It is not uncommon for the vertebral artery to emanate directly from the aortic arch, so that the aortic arch has 4 branches: the brachiocephalic trunk, the left common carotid artery, the left subclavian artery, and the vertebral artery (from "Clinical Vascular Anatomy Interventional Radiology Artery" edited by Shan Hong) Atlas"). Once the variation of the course of the blood vessel occurs, the stent does not match the blood vessel, and the endovascular repair cannot be completed. Abroad, there are specially customized aortic branch stents according to the patient's specific anatomical conditions. During the operation, when the aortic stent is implanted into the lesion site of the aorta, it is required to align the side hole with the branch artery at the same time to ensure the smooth blood flow of the branch artery, and then implant a small stent in the branch artery. However, this method has the following disadvantages: 1. The stent needs to be specially customized according to the specific anatomical conditions of the patient, which is expensive and cannot be mass-produced; 2. The custom-made stent takes a long time and cannot be used for emergency surgery patients; 3. The operation is complicated and the stent is released. It is required that each side hole is accurately aligned with the affected branch artery. Any deviation may lead to blood flow disturbance in the branch artery and corresponding complications, which may be life-threatening in severe cases.
另外，申请公布号为CN102641164A的中国发明专利公开了一种分支型主动脉血管系统，包括一条主动脉支架血管和三条分支动脉支架血管，主动脉血管的中段设有凹陷部，凹陷部设有三个侧孔，三条分支动脉支架血管分装于三个侧孔内。该分支型主动脉血管系统虽然能隔绝累及主动脉弓部和升主动脉的主动脉病变、可重建分支动脉的血流、避免定制支架、可以批量生产并用于急诊手术，但该主动脉血管系统需要预留较大空间的凹陷部以适应分支动脉支架的弯曲和调整角度，否则分支动脉支架会严重扭曲、受压而血流不畅，然而，凹陷部的空间较大则其下部的主动脉支架空间相应的变窄，因此主动脉支架血流供应量必然受影响，尤其是头臂干，另外，对于一些血管走行较为特殊的患者，该类主动脉血管系统也无法适用。In addition, the Chinese invention patent with the application publication number of CN102641164A discloses a branched aortic vascular system, including an aortic stent vessel and three branched arterial stent vessels. Side holes, three branch arterial stent blood vessels are divided into three side holes. Although the branched aortic vascular system can isolate the aortic lesion involving the aortic arch and ascending aorta, rebuild the blood flow of the branch arteries, avoid customized stents, and can be mass-produced and used in emergency surgery, the aortic vascular system needs to be pre-prepared. Leave a larger space in the depression to adapt to the bending and adjustment of the angle of the branch artery stent, otherwise the branch artery stent will be severely twisted, compressed and blood flow will not be smooth. Corresponding narrowing, so the blood flow supply of the aortic stent will inevitably be affected, especially the brachiocephalic trunk. In addition, for some patients with special blood vessels, this type of aortic vascular system cannot be applied.
发明内容Contents of the invention
本发明提供一种主动脉弓覆膜支架型血管，以解决现有的支架血管存在上述不足等缺点。The present invention provides an aortic arch stent-graft type blood vessel to solve the above-mentioned shortcomings of the existing stent blood vessels.
本发明采用如下技术方案：The present invention adopts following technical scheme:
一种主动脉弓覆膜支架型血管，包括一主动脉支架血管和三条分支动脉支架血管，所述主动脉支架血管上开设一段凹陷部，所述凹陷部包括靠近近心端的左侧壁、远离近心端的右侧壁以及连接左、右侧壁的底壁，所述凹陷部的左侧壁和右侧壁中的其中一个侧壁开设两个开口，另一侧壁则开设一个或两个开口，每个开口内固定一段口径与开口相当的内烟囱支架，所述分支动脉支架血管分装于所述内烟囱支架内。An aortic arch stent-graft type blood vessel, comprising an aortic stent vessel and three branch arterial stent vessels, a section of depression is provided on the aortic stent vessel, and the depression comprises a left side wall near the proximal end and a left side wall away from the proximal end. The right side wall of the end and the bottom wall connecting the left and right side walls, one of the side walls of the left side wall and the right side wall of the recess is provided with two openings, and the other side wall is provided with one or two openings, A section of inner chimney support with a diameter equivalent to the opening is fixed in each opening, and the branch artery stent blood vessels are subpackaged in the inner chimney support.
上述底壁为向上弯曲的圆弧状，所述凹陷部的横截面为月牙形。The above-mentioned bottom wall is in the shape of an upward curved arc, and the cross-section of the concave part is crescent-shaped.
进一步地，上述内烟囱支架沿着背离凹陷部方向的主动脉支架血管侧壁延伸，内烟囱支架的外表面由第一血管膜包覆，其下部由两侧缝合于主动脉支架血管侧壁上的第二血管膜支撑固定，第二血管膜向内烟囱支架两端的外部延伸，其中，靠近凹陷部一端的第二血管膜垂直向上折合并缝合于主动脉支架血管侧壁，远离凹陷部一端的第二血管膜则倾斜向上折合并缝合于主动脉支架血管侧壁上，第二血管膜折合的两侧面开设有与内烟囱支架对应的缺口。Further, the inner chimney stent extends along the side wall of the aortic stent in a direction away from the depression, the outer surface of the inner chimney stent is covered by the first vascular membrane, and its lower part is sutured on both sides to the side wall of the aortic stent The second vascular membrane is supported and fixed, and the second vascular membrane extends to the outside of the two ends of the inner chimney stent, wherein the second vascular membrane at the end close to the depression is folded vertically upwards and sutured to the side wall of the aortic stent, and the second membrane at the end far away from the depression The second vascular membrane is obliquely folded upward and sutured on the side wall of the aortic stent, and the two sides of the folded second vascular membrane are provided with gaps corresponding to the inner chimney stent.
一种优选地实施方式，上述左侧壁与右侧壁均设有两个开口，所述开口分别并列分居于左、右侧壁顶端的两侧。In a preferred embodiment, the left side wall and the right side wall are both provided with two openings, and the openings are juxtaposed and separated on both sides of the top ends of the left and right side walls.
该支架型血管还包括一用于封堵其中一个内烟囱支架的血管封堵器和一条分支动脉支架血管，所述血管封堵器包括一撑起后的管径略大于所述内烟囱支架的支架，该支架外表壁由一血管膜包覆，支架内置有部分血管膜，支架两侧端的血管膜均设有一小孔。The stent-type blood vessel also includes a blood vessel occluder for blocking one of the inner chimney stents and a branch arterial stent vessel, and the blood vessel occluder includes a pipe diameter slightly larger than the inner chimney stent after being propped up. A stent, the outer wall of the stent is covered by a vascular membrane, a part of the vascular membrane is built in the stent, and the vascular membrane at both ends of the stent is provided with a small hole.
作为本方案的另一种实施方式，上述左侧壁开设两个开口，右侧壁开设一个开口，左侧壁的两个开口并排分居于左侧壁顶端的两侧，右侧壁的开口与其顶端内切。As another embodiment of this solution, the left side wall is provided with two openings, the right side wall is provided with one opening, and the two openings on the left side wall are arranged side by side on both sides of the top of the left side wall. Inscribed top.
本方案还有一种实施方式，即上述左侧壁开设两个开口，右侧壁开设一个开口，左侧壁的两个开口并排分居于左侧壁顶端的两侧，右侧壁的开口与其顶端内切。There is another embodiment of this solution, that is, two openings are opened on the left side wall, and one opening is opened on the right side wall. cut in.
上述主动脉支架血管和分支动脉支架血管均包括不锈钢支架和覆盖于该不锈钢支架上的管状膜，所述不锈钢支架选用具有良好生物相容性及支撑力的材料，包括镍基合金、钴基合金、316医用不锈钢、形状记忆合金或可降解或可降的高分子材料，所述管状膜为聚四氟乙烯膜、聚酯纤维膜、聚酰胺膜或聚丙烯膜。The above-mentioned aortic stent and branch arterial stent both include a stainless steel stent and a tubular membrane covering the stainless steel stent, and the stainless steel stent is selected from materials with good biocompatibility and supporting force, including nickel-based alloys and cobalt-based alloys. , 316 medical stainless steel, shape memory alloy or degradable or degradable polymer material, and the tubular membrane is polytetrafluoroethylene membrane, polyester fiber membrane, polyamide membrane or polypropylene membrane.
更进一步地，上述内烟囱支架包括复数段等间距分布的不锈钢小管架及一管状膜，所述不锈钢小管架由所述管状膜连接而成，其中，排列在并列两个开口的内烟囱支架的不锈钢小管架相互错开排列。相邻两不锈钢小管架的间距大于不锈钢小管架的长度。Furthermore, the above-mentioned inner chimney support includes a plurality of stainless steel small tube frames distributed at equal intervals and a tubular film, and the stainless steel small tube frames are formed by connecting the tubular films, wherein the inner chimney support with two openings arranged side by side The stainless steel small tube racks are arranged in a staggered manner. The distance between two adjacent stainless steel tubule racks is greater than the length of the stainless steel tubule racks.
再进一步地，位于开口处与主动脉支架血管相切的内烟囱支架上及位于凹陷部左、右侧壁顶端最高点的主动脉支架血管上均设有一显影标记，两个相邻的内烟囱支架在开口相切的部位也设有显影标记，所述显影标记为支架本身的固有成分，或具有良好的生物相容性及不透X射线特性的材料。Furthermore, a developing mark is provided on the inner chimney stent that is tangent to the aortic stent at the opening and on the highest point of the aortic stent at the top of the left and right side walls of the depression. Two adjacent inner chimneys The stent is also provided with a developing mark at the tangential part of the opening, and the developing mark is an inherent component of the stent itself, or a material with good biocompatibility and X-ray-opaque properties.
由上述对本发明结构的描述可知，和现有技术相比，本发明具有如下优点：As can be seen from the above description of the structure of the present invention, compared with the prior art, the present invention has the following advantages:
1、本发明的支架型血管，在其凹陷部的左、右侧壁设有三个或四个开口，并与内烟囱支架相通，分支动脉支架血管从几个内烟囱支架选择最优的路线植入到三个主要分支动脉血流通道，不需要根据患者具体的解剖情况定制。本发明的主动脉支架血管和分支动脉支架血管为分别独立的结构，适用于各种正常及走形变异的血管，可以根据病变的具体情况，分别选择合适尺寸的主动脉支架血管和分支动脉支架血管，组合成一套最适合患者的支架血管系统，避免定制支架，可以批量生产，并有效节省时间与操作容易的功效。1. The stent-type blood vessel of the present invention is provided with three or four openings on the left and right side walls of its depression, and communicates with the inner chimney stent, and the branch artery stent blood vessel selects the optimal route from several inner chimney stents to plant It enters the three main branch arterial blood flow channels, and does not need to be customized according to the specific anatomy of the patient. The aortic stent vessel and branch arterial stent vessel of the present invention are independent structures, and are suitable for various normal and deformed blood vessels. According to the specific conditions of the disease, the aortic stent vessel and branch arterial stent of appropriate size can be selected respectively. Blood vessels are combined into a set of stent vascular systems that are most suitable for patients, avoiding custom-made stents, and can be mass-produced, which effectively saves time and is easy to operate.
2、本结构支架型血管能安全、有效隔绝累及主动脉弓和升主动脉病变，适用范围广，支架释放程序简单。只要升主动脉病变距离主动脉瓣和冠状动脉开口有一定距离，这种主动脉弓覆膜支架型血管系统都能将其有效地隔绝，同时安全、方便地重建主动脉弓部的分支动脉，可替代全主动脉弓置换手术，避免了开胸手术的创伤和风险。由于分支动脉支架血管是从凹陷部左、右侧壁植入至各个分支动脉血流通道，因此，该支架无需将开口与各分支动脉血流通道一一对准，主动脉支架血管定位在胸主动脉时，很容易将主动脉弓分支动脉的开口定位于凹陷部左、右侧壁之间。主动脉支架血管和主动脉壁之间有一个月牙形空间，由于上述月牙形空间同时与内烟囱支架开口和分支动脉开口相通，所以主动脉支架血管在释放后，不会封堵分支动脉，避免了分支动脉缺血的风险。由于上述月牙形空间的存在，腔内治疗时导丝和导管具有足够的操作空间，通过内烟囱支架开口经月牙形空间，快速送入分支动脉内，并植入分支动脉支架血管，重建主动脉弓部三个主要分支动脉血流通道，从而将累及主动脉弓部的病变完全隔绝在这套主动脉支架血管系统以外，其操作较为简单，具有手术成功率高、且术后并发症少等优点。2. The stent-type blood vessel with this structure can safely and effectively isolate lesions involving the aortic arch and ascending aorta, has a wide range of applications, and has a simple stent release procedure. As long as the ascending aortic lesion has a certain distance from the aortic valve and coronary artery opening, this aortic arch stent-graft vascular system can effectively isolate it, and at the same time reconstruct the branch arteries of the aortic arch safely and conveniently, which can replace the whole aortic arch Replacement surgery avoids the trauma and risks of open-chest surgery. Since the branch arterial stent is implanted from the left and right side walls of the depression to each branch arterial blood flow channel, the stent does not need to align the opening with each branch arterial blood flow channel one by one, and the aortic stent is positioned on the chest In the case of the aorta, it is easy to locate the openings of the branches of the aortic arch between the left and right walls of the depression. There is a crescent-shaped space between the aortic stent vessel and the aortic wall. Since the above-mentioned crescent-shaped space communicates with the opening of the inner chimney stent and the opening of the branch artery at the same time, the aortic stent vessel will not block the branch artery after release, avoiding risk of branch artery ischemia. Due to the existence of the above-mentioned crescent-shaped space, the guide wire and catheter have sufficient operating space during endovascular treatment. They are quickly sent into the branch artery through the opening of the inner chimney stent through the crescent-shaped space, and the branch artery stent is implanted to reconstruct the aortic arch. The three main branch arterial blood flow channels completely isolate the lesions involving the aortic arch from the aortic stent vascular system. The operation is relatively simple, and it has the advantages of high success rate of operation and few postoperative complications.
3、该结构支架型血管的主动脉支架血管与分支血管支架之间通过内烟囱支架相连接，两支架之间有足够长的锚定区，稳定性好，不易发生内瘘。本发明创造性地将内烟囱支架置于主动脉支架血管内并成为其结构的一部分，是对现有烟囱技术的进一步发展，既增加了锚定区，重建分支血流的优点，又摒弃了现有烟囱支架位于主动脉覆膜支架外被挤压变形及主体主动脉覆膜支架较易发生内瘘的缺点。国内外目前的主动脉弓开窗支架主体与分支支架之间锚定范围窄，与本发明相比稳定性较差，较易发生内瘘和支架移位。3. The aortic stent vessel and the branch vessel stent of the stent-type vessel are connected through an inner chimney stent, and there is a sufficiently long anchoring area between the two stents, which has good stability and is not prone to internal fistula. The present invention creatively places the inner chimney stent in the aortic stent vessel and becomes a part of its structure, which is a further development of the existing chimney technology. There are disadvantages that the chimney stent is squeezed and deformed outside the aortic stent-graft and the main body aortic stent-graft is prone to internal fistula. The current domestic and foreign aortic arch fenestrated stents have a narrow anchoring range between the main body and the branch stents, and are less stable than the present invention, and are more prone to internal fistula and stent displacement.
4、该结构支架型血管，头臂干及左颈总动脉分支血流通道可优选从近心端一侧植入分支动脉支架血管，其血流量供应充足，更符合人体生理，凹陷部下方的主动脉支架血管的血流仅供应左锁骨下动脉及降主动脉。4. With the structure of stent-type blood vessels, the blood flow channel of the brachiocephalic trunk and the branch of the left common carotid artery can preferably be implanted from the proximal side of the branch arterial stent vessel. The blood flow supply is sufficient, which is more in line with human physiology. The blood flow of the aortic stent vessel only supplies the left subclavian artery and the descending aorta.
5、排列在并列两个开口的内烟囱支架的不锈钢小管架相互错开排列，两个内烟囱支架的小管架压缩时恰好处于对方间隔空间内，即可压缩成小体积形状，便于操作。5. The small stainless steel tube racks arranged in the inner chimney brackets of two parallel openings are arranged in a staggered manner, and the small tube racks of the two inner chimney brackets are just in the space between each other when compressed, and can be compressed into a small volume shape, which is easy to operate.
附图说明Description of drawings
图1为本发明结构示意图；Fig. 1 is a structural representation of the present invention;
图2为本发明实施例一俯视图；Fig. 2 is a top view of Embodiment 1 of the present invention;
图3为图2中A向剖视放大图；Fig. 3 is an enlarged cross-sectional view of A direction in Fig. 2;
图4为本发明内烟囱支架包覆第二血管膜的结构示意图；Fig. 4 is a schematic structural view of the inner chimney stent of the present invention coated with a second blood vessel membrane;
图5为本发明血管封堵器的结构示意图；Fig. 5 is a schematic structural view of the vascular occluder of the present invention;
图6为本发明支架型血管在胸主动脉中释放，三条分支血管予以分支动脉血管后的结构示意图；Fig. 6 is a schematic diagram of the structure of the stent-type blood vessel of the present invention after being released in the thoracic aorta, and three branch vessels are branched into arteries;
图7为本发明实施例二的俯视图；7 is a top view of Embodiment 2 of the present invention;
图8为本发明实施例三的俯视图。Fig. 8 is a top view of Embodiment 3 of the present invention.
具体实施方式Detailed ways
下面参照附图说明本发明的具体实施方式。Specific embodiments of the present invention are described below with reference to the accompanying drawings.
实施例一Embodiment one
参照图1和图6，一种主动脉弓覆膜支架型血管，包括一主动脉支架血管1和三条分支动脉支架血管2，其中分支动脉支架血管2的前部为直筒型设计或管径自近心端向远心端逐渐减小。主动脉支架血管1上开设一段凹陷部11，凹陷部11包括靠近近心端的左侧壁111、远离近心端的右侧壁112以及连接左、右侧壁111、112的底壁113，底壁113为向上弯曲的圆弧状，左侧壁111与右侧壁112均设有两个开口12，开口12分别并列分居于左、右侧壁111、112顶端的两侧。Referring to Fig. 1 and Fig. 6, an aortic arch stent graft type blood vessel comprises an aortic stent vessel 1 and three branch arterial stent vessels 2, wherein the front part of the branch arterial stent vessel 2 is a straight cylindrical design or the diameter of the vessel is proximal to the heart It gradually decreases towards the distal end. The aortic stent vessel 1 is provided with a section of depression 11, the depression 11 includes a left side wall 111 close to the proximal end, a right side wall 112 away from the proximal end, and a bottom wall 113 connecting the left and right side walls 111, 112, the bottom wall 113 is an arc shape bent upwards. Both the left side wall 111 and the right side wall 112 are provided with two openings 12 .
参照图2、图3及图4，每个开口12内固定一段口径与开口12相当的内烟囱支架13，分支动脉支架血管2分装于内烟囱支架13内。内烟囱支架13沿着背离凹陷部11方向的主动脉支架血管1方向延伸，内烟囱支架13的外表面由第一血管膜包覆，其下部由两侧缝合于主动脉支架血管1侧壁上的第二血管膜14支撑固定，第二血管膜14向内烟囱支架13两端的外部延伸，其中，靠近凹陷部11一端的第二血管膜14垂直向上折合并缝合于主动脉支架血管1侧壁，远离凹陷部11一端的第二血管膜14则倾斜向上折合并缝合于主动脉支架血管1侧壁上，第二血管膜14折合的两侧面开设有与内烟囱支架13对应的缺口。为了便于分支动脉支架血管2的植入及血流的顺畅，第二血管膜14倾斜面与其对应的内烟囱支架13的底部成钝角设计。Referring to Fig. 2, Fig. 3 and Fig. 4, a section of inner chimney stent 13 having a diameter equivalent to that of the opening 12 is fixed in each opening 12, and the branch arterial stent blood vessels 2 are subpackaged in the inner chimney stent 13. The inner chimney stent 13 extends along the direction of the aortic stent vessel 1 away from the direction of the recess 11, the outer surface of the inner chimney stent 13 is covered by the first vascular membrane, and its lower part is sutured on the side wall of the aortic stent vessel 1 by both sides The second vascular membrane 14 is supported and fixed, and the second vascular membrane 14 extends to the outside of the two ends of the inner chimney stent 13, wherein the second vascular membrane 14 near the end of the recessed part 11 is folded vertically upwards and sutured to the side wall of the aortic stent vessel 1 The second vascular membrane 14 at the end away from the depression 11 is obliquely folded upward and sutured on the side wall of the aortic stent 1 , and the folded sides of the second vascular membrane 14 are provided with notches corresponding to the inner chimney stent 13 . In order to facilitate the implantation of the branch artery stent vessel 2 and smooth blood flow, the inclined surface of the second vessel membrane 14 is designed to form an obtuse angle with the bottom of the corresponding inner chimney stent 13 .
继续参照图2和图4，内烟囱支架13包括复数段等间距分布的不锈钢小管架131及一管状膜132，不锈钢小管架131由管状膜132连接而成，其中，排列在并列两个开口12的内烟囱支架13的不锈钢小管架131相互错开排列。相邻两不锈钢小管架131的间距大于不锈钢小管架131的长度，两个内烟囱支架13的错开排列距离恰好为相邻两不锈钢小管架131的间距与不锈钢小管架131的长度之差。Continuing to refer to Fig. 2 and Fig. 4, the inner chimney bracket 13 includes a plurality of sections of equally spaced stainless steel tubules 131 and a tubular membrane 132, the stainless steel tubules 131 are formed by connecting the tubular membranes 132, wherein two openings 12 are arranged in parallel. The stainless steel tubule frames 131 of the inner chimney support 13 are arranged in a staggered manner. The distance between two adjacent stainless steel small tube racks 131 is greater than the length of the stainless steel small tube racks 131, and the staggered arrangement distance of the two inner chimney supports 13 is just the difference between the distance between two adjacent stainless steel small tube racks 131 and the length of the stainless steel small tube racks 131.
参照图5，该支架型血管还包括一用于封堵其中一个内烟囱支架13的血管封堵器15，血管封堵器15包括一撑起后的管径略大于内烟囱支架13的支架151，该支架151外表壁由一血管膜152包覆，支架151内置有部分血管膜，支架两侧端的血管膜152均设有一小孔153，当然也可用现有其他血管封堵器来封堵。参照图6，对于一些血管走形正常即有三条分支的患者，三条分支动脉支架血管2从四个内烟囱支架13选择最优的路线植入到三个主要分支动脉血流通道中，其中，头臂干分支血流通道可优选从近心端一侧植入分支动脉支架血管2，另外一个内烟囱支架13则由血管封堵器15封堵阻止血流通过；对于血管走形特殊有四条分支血管的，则增加一条分支动脉支架血管2；另外，若只有两条分支血管的患者，则可从凹陷部11左右侧内烟囱支架13各植入一条分支动脉支架血管2，另外两个内烟囱支架13则由另一条分支动脉支架血管2相通连接。Referring to Fig. 5, the stent-type blood vessel also includes a blood vessel occluder 15 for blocking one of the inner chimney stents 13, and the blood vessel occluder 15 includes a stent 151 whose pipe diameter is slightly larger than that of the inner chimney stent 13 when propped up. The outer wall of the stent 151 is covered by a vascular membrane 152, the stent 151 is built with a part of the vascular membrane, the vascular membrane 152 at both ends of the stent is provided with a small hole 153, of course other existing vascular occluders can also be used to block. Referring to FIG. 6 , for some patients with normal blood vessel shape that has three branches, the three branch arterial stent vessels 2 are implanted into the three main branch arterial blood flow channels by selecting the optimal route from the four inner chimney stents 13 , wherein, Brachiocephalic branch blood flow channels can preferably be implanted with branch arterial stent vessels 2 from the proximal side, and the other inner chimney stent 13 is blocked by a vessel occluder 15 to prevent blood flow from passing through; If there are branch vessels, add a branch artery stent vessel 2; in addition, if there are only two branch vessels, one branch artery stent vessel 2 can be implanted from the left and right inner chimney stents 13 of the depression 11, and the other two inner chimney stents can be implanted. The chimney stent 13 is communicated with another branch arterial stent vessel 2 .
上述主动脉支架血管1和分支动脉支架血管2均包括不锈钢支架和覆盖于该不锈钢支架上的管状膜，其中不锈钢支架采用具有良好生物相容性、化学稳定性和机械、物理性能的医用不锈钢合金圈，如镍基合金、钴基合金、316医用不锈钢、形状记忆合金或可降解或可降的高分子材料；而管状膜为聚四氟乙烯膜、聚酯纤维膜、聚酰胺膜或聚丙烯膜。另外，参照图3，位于开口12处与主动脉支架血管1相切的内烟囱支架13上及位于凹陷部11左、右侧壁111、112顶端最高点的主动脉支架血管1上均设有一显影标记16，另外，另个相邻的内烟囱支架13在开口12相切的部位也设有显影标记16，所述显影标记为支架本身的固有成分，或具有良好的生物相容性及不透X射线特性的材料。The above-mentioned aortic stent vessel 1 and branch arterial stent vessel 2 both include a stainless steel stent and a tubular membrane covering the stainless steel stent, wherein the stainless steel stent is made of a medical stainless steel alloy with good biocompatibility, chemical stability and mechanical and physical properties Rings, such as nickel-based alloys, cobalt-based alloys, 316 medical stainless steel, shape memory alloys, or degradable or degradable polymer materials; and tubular membranes are polytetrafluoroethylene membranes, polyester fiber membranes, polyamide membranes or polypropylene membrane. In addition, referring to FIG. 3 , on the inner chimney stent 13 tangent to the aortic stent vessel 1 at the opening 12 and on the aortic stent vessel 1 at the highest point of the left and right side walls 111 and 112 of the recess 11, a Developing marks 16, in addition, another adjacent inner chimney support 13 is also provided with developing marks 16 at the position tangential to the opening 12, and the developing marks are inherent components of the support itself, or have good biocompatibility and non-toxicity. X-ray transparent material.
实施例二Embodiment two
参照图7，本实施例与实施例一基本相同，其主要区别在于凹陷部11的右侧壁112开设一个开口12，该开口与右侧壁112顶端内切，本实施方式相对于实施例一的适用范围较小和选择性较窄，主要用于主动脉血管分支不增加的患者，该实施例不必使用实施例一中的血管封堵器15，减少手术工序。Referring to Fig. 7, this embodiment is basically the same as Embodiment 1, the main difference is that the right side wall 112 of the recessed part 11 has an opening 12, and the opening is inscribed with the top of the right side wall 112. Compared with Embodiment 1, this embodiment The scope of application is small and the selectivity is relatively narrow, and it is mainly used for patients with no increase in aortic blood vessel branches. This embodiment does not need to use the blood vessel occluder 15 in Embodiment 1, which reduces the operation process.
实施例三Embodiment Three
参照图8，该实施例与实施例二的不同之处在于凹陷部11的左侧壁111开设两个开口12，而右侧壁112开设一个开口12。Referring to FIG. 8 , the difference between this embodiment and the second embodiment is that the left side wall 111 of the recess 11 defines two openings 12 , and the right side wall 112 defines one opening 12 .
上述仅为本发明的具体实施方式，但本发明的设计构思并不局限于此，凡利用此构思对本发明进行非实质性的改动，均应属于侵犯本发明保护范围的行为。The above is only a specific embodiment of the present invention, but the design concept of the present invention is not limited thereto, and any non-substantial changes made to the present invention by using this concept should be an act of violating the protection scope of the present invention.
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201210558648.1ACN102973303B (en) | 2012-12-21 | 2012-12-21 | Aortic-arch covered stent-graft vessel |
| Application Number | Priority Date | Filing Date | Title |
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| CN201210558648.1ACN102973303B (en) | 2012-12-21 | 2012-12-21 | Aortic-arch covered stent-graft vessel |
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| CN102973303A CN102973303A (en) | 2013-03-20 |
| CN102973303Btrue CN102973303B (en) | 2015-02-04 |
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| CN201210558648.1AActiveCN102973303B (en) | 2012-12-21 | 2012-12-21 | Aortic-arch covered stent-graft vessel |
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| TR01 | Transfer of patent right | Effective date of registration:20220124 Address after:200032 No. 136, Xuhui District Medical College, Shanghai Patentee after:ZHONGSHAN HOSPITAL, FUDAN University Address before:362002 Room 102, building B, Chongfu commercial building, No.1 Chongfu Road, Licheng District, Quanzhou City, Fujian Province Patentee before:Chen Hongwei |