A kind of blood vessel covered stent orthotopic fenestration positionerTechnical field
The present invention relates to technical field of medical instruments, more particularly, to a kind of blood vessel covered stent orthotopic fenestration positioner,Particularly to a kind of big-and-middle arteries overlay film frame orthotopic fenestration positioner such as sustainer.
Background technology
The disease such as the arrival with aging society and smoking, hypertension occurred frequently, sustainer Ectasia or interlayer diseaseThe generation becoming gets more and more, and must open chest or abdominal in the past, but recent overlay film frame windowing technology application, and obtain blood vesselSurgery and intervention being widely recognized as of educational circles, overlay film frame implantation is the current treatment very important means of big-and-middle artery, althoughSomewhat expensive, but be clinically still widely used.There is the use of nearly 1,000,000 in annual world wide, but in complicated diseaseBecome, such as relating to the reservation aspect of the important branch artery of overlay segment, but face adverse conditions, this kind of case worldwide all becomesDifficult point, a kind of selection is open surgery, and patient faces complication height, the high risk of the death rate；Other selection is to retain branchThe Minimally Interventional Therapy of the support windowing technology of blood vessel, it is to avoid the risk operated on；Employ following two opening in the world at presentWindow setting technique, but its application is all greatly limited because of technical problem and horizon problem etc. so as to can not be widely popularized.ThisWhile invention will make windowing technology simplify, be conducive to the wide popularization and application of windowing technology.
At present, the technology one being related to reservation bifurcated artery is the support of the custom-made for patient, designs when dispatching from the factoryMake the overlay film frame with bifurcated artery support, the cycle is long, probably need three months about, and operation easier is big, practicalProperty is poor；Another kind is that overlay film frame opens a window in the preoperative, needs the ct combining closely preoperative to image it is impossible to error, andAnd, need overlay film frame is sent back to support guiding intrathecal again after windowing, due to increased mark quoit etc., lead to backDifficulty, firmly damage after loopback support may, and then enter human body occur support to wreck and unexpected discharge may, occur calamitousConsequence, after opening a window, in art, operation needs good stereovision it is most likely that there is Poor fitness simultaneously, and then branch occursVascular occlusion is narrow and is unable to pairing etc. at all, and recent long-term effect is bad, makes patient face out abdomen if necessary and opens the danger such as chestOperation.
Content of the invention
The invention provides a kind of blood vessel covered stent orthotopic fenestration positioner, after magnetic absorption member pairing, guiding laser burnsBright punching or puncture needle method achieve and open a window in vivo, greatly simplify casing milling steps, reduce the requirement to technology and warpThe dependence tested, reduce operating difficulty and risk, saved operating time, it is to avoid device customizing, reduces operation simultaneouslyExpense, lowers individual burden and burden on society.The sequencing of windowing technology so as to become an only operation, rather than oneIndividual difficult point, this will make this windowing technology be conducive to worldwide promoting the use of.
The technical solution adopted in the present invention is:
A kind of blood vessel covered stent orthotopic fenestration positioner, comprising:
Pushing piece, described pushing piece is provided with first through hole, and the first end of described pushing piece is provided with the first magnetic absorption member, describedFirst magnetic absorption member is provided with the thread eye connecting with described first through hole；
Conveying sheath, described conveying sheath is provided with the second through hole, and the first end of described conveying sheath is provided with the second magnetic absorption member, describedSecond magnetic absorption member is provided with the third through-hole connecting with described second through hole, described first magnetic absorption member and described second magnetic absorption member magneticInhale and connect；
With the seal wire for conveying described first magnetic absorption member and described second magnetic absorption member.
Further, the side wall of described first magnetic absorption member is provided with described thread eye and groove, in described first magnetic absorption memberIt is additionally provided with fourth hole, described groove is connected with described fourth hole respectively with described thread eye.
Further, described groove and described thread eye are with regard to the setting substantially symmetrical about its central axis of described first magnetic absorption member.
Further, the first end of described pushing piece is provided with depression, and described first magnetic absorption member is detachably secured to described recessedIn falling into, and described thread eye is connected with described first through hole；
Second end of described pushing piece is provided with handle.
Further, described handle is provided with fifth hole, and described fifth hole is connected with described first through hole, described leadsThe axis of the axis, the axis of described first through hole and described fifth hole in silk hole overlaps.
Further, described handle is hexagon.
Further, one end of described second magnetic absorption member is detachably fixed with described conveying sheath and is connected, and described second leads toThe axis of the axis in hole and described third through-hole overlaps.
Further, described seal wire includes the first seal wire, the second seal wire and the 3rd seal wire；
The first end of described first seal wire sequentially passes through described thread eye, described fourth hole and described groove, and describedSecond end of one seal wire sequentially passes through described first through hole and described fifth hole；
The first end of described second seal wire passes through described third through-hole, and the second end of described second seal wire passes through described secondThrough hole；
Described 3rd seal wire is used for being placed through overlay film frame between described first magnetic absorption member and described second magnetic absorption memberFilm, and the blood vessel that achieves the goal.
Further, the first end bending of described conveying sheath is in the arc-shaped, and the radian at the second end of described conveying sheath is α,180 ° of 90 °≤α ＜；
Second end of described conveying sheath is provided with haemostatic valve.
Further, the material of described pushing piece is Nitinol；
The material of described conveying sheath is polytetrafluoroethylene (PTFE)；
The material of described first magnetic absorption member is iron or magnet；
The material of described second magnetic absorption member is magnet or iron.
Beneficial effects of the present invention:
1st, the present invention, using simply internal pairing technology, overlay film frame is sent into after human body, this device is placed on bloodAt the opening of pipe, and by magnetic mode, overlay film frame is positioned at the opening of purpose branch vessel, import puncture needle orAfter laser, overlay film frame is opened a window, follow-up operation includes inserting seal wire entrance purpose blood vessel, balloon expandable and placing in itSmall rack is to purpose blood vessel, so that blood flow smoothly enters purpose blood vessel and ensure that internal organs blood supply.
This device adopts simple method, and after magnetic absorption member pairing, the punching of guiding laser burn or puncture needle method are realShow and opened a window in vivo, greatly simplify casing milling steps, reduced the dependence of the requirement to technology and experience, reduce operationDifficulty and risk, have saved operating time, it is to avoid device customizing, reduce surgery cost simultaneously, lower individual burden and societyCan bear.The sequencing of windowing technology is so as to become an only operation, rather than a difficult point, and this will make this windowingTechnology is conducive to worldwide promoting the use of.
2nd, the first magnetic absorption member be detachably secured to depression in, increased the friction between the first magnetic absorption member and pushing piecePower so that both combine more firm, it is to avoid the malpractice causing because of both accidental separation in art, and first magnetic absorption memberMode of entrance easy to operate, be easy to and second magnetic absorption member magnetic connect.
3rd, the structure design of the first magnetic absorption member, facilitates intravasation, meets Diameter, facilitates simultaneously and has taken out guide workFirst seal wire, and the first seal wire still can stay in bifurcated artery, be easy to position；After windowing, enter purpose from window and move, when pulling out phase magnet device, due to the groove design in the first magnetic absorption member, the 3rd seal wire can be certainly for 3rd seal wire of arteries and veinsGroove skids off, and conveniently carries out next step operation.
4th, the first magnetic absorption member is provided with fourth hole, the second magnetic absorption member be provided with third through-hole so that the first magnetic absorption member andSecond magnetic absorption member, during magnetic, will not produce offset deviation on the contact surface of two magnetic absorption member, thus ensure that the 4thThe axis of the axis of through hole and third through-hole overlaps, and is easy to laser fiber or puncture needle burns and wears or pierce through positioned at the first magneticThe film of overlay film frame between part and the second magnetic absorption member, thus realize the purpose opening a window.
Brief description
Fig. 1 is the structural representation of pushing piece one embodiment of the present invention；
Fig. 2 is the structural representation of the present invention the first magnetic absorption member one embodiment；
Fig. 3 is the structural representation that the present invention conveys sheath one embodiment；
Fig. 4 is the structural representation of the present invention the second magnetic absorption member one embodiment；
Fig. 5 is the first state structural representation of one embodiment of the invention；
Fig. 6 is the second status architecture schematic diagram of one embodiment of the invention；
Fig. 7 is the third state structural representation of one embodiment of the invention；
Fig. 8 is the 4th status architecture schematic diagram of one embodiment of the invention.
Wherein: 1. pushing piece, 101. first through holes, 102. depressions, 103. handles, 104. fifth holes, 2. the first magneticPart, 21. thread eyes, 22. grooves, 23. fourth holes, 3. conveying sheath, 31. second through holes, 32. haemostatic valve, 4. the second magnetic absorption member,41. third through-holes, 5. the first seal wire, 6. the second seal wire, 7. the 3rd seal wire, 8. laser fiber, the 9. arteria renalis, 10. abdominal aortaKnurl, 11. overlay film frames.
Specific embodiment
For making the object, technical solutions and advantages of the present invention clearer, below in conjunction with the accompanying drawing of the present invention, provide toolThe description of body embodiment, but not as any restriction to the present invention.
Referring to Fig. 1 to Fig. 5, a kind of blood vessel covered stent orthotopic fenestration positioner, comprising: pushing piece 1, on pushing piece 1It is provided with first through hole 101, the first end of pushing piece 1 is provided with the first magnetic absorption member 2, and the first magnetic absorption member 2 is provided with and first through hole 101The thread eye 21 of connection, the second end of pushing piece 1 is provided with handle 103；Conveying sheath 3, conveying sheath 3 is provided with the second through hole 31, defeatedThe first end sending sheath 3 is provided with the second magnetic absorption member 4, and the second magnetic absorption member 4 is provided with the third through-hole 41 connecting with the second through hole 31, theOne magnetic absorption member 2 and the second magnetic absorption member 4 magnetic connect, and the second end of conveying sheath 3 is provided with haemostatic valve 32；With for conveying the first magneticPart 2 and the seal wire of the second magnetic absorption member 4.Wherein, the material of the first magnetic absorption member 2 is iron or magnet；The material of the second magnetic absorption member 4 is magneticIron or iron.
By the structure design of above-mentioned blood vessel covered stent orthotopic fenestration positioner, overlay film frame 11 is sent into human bodyAfterwards, this device is placed at the opening of blood vessel, and overlay film frame 11 is positioned at by purpose branch vessel by magnetic modeAt opening, after importing puncture needle or laser, overlay film frame 11 is opened a window, follow-up operation includes inserting seal wire 5 entrance purpose bloodPipe, balloon expandable simultaneously place small rack to purpose blood vessel, so that blood flow smoothly enters purpose blood vessel and ensure that internal organs in itBlood supply.
Referring to Fig. 1 and Fig. 2, in one kind preferably embodiment, the first magnetic absorption member 2 is provided with fourth hole 23, the first magneticThe side wall inhaling part 2 is provided with groove 22 and thread eye 21, and groove 22 is connected with fourth hole 23 respectively with thread eye 21, groove 22With thread eye 21 with regard to the first magnetic absorption member 2 setting substantially symmetrical about its central axis.Wherein, the first magnetic absorption member 2 is hollow cylinder, the first magneticThe length of part 2 is 3mm, and external diameter is 3mm, and internal diameter is 1.5mm, and wall thickness is 0.75mm；The width of groove 22 is 1.0mm；Thread eye21 aperture is 1.0mm, facilitates intravasation, meets Diameter, facilitates the first seal wire 5 having taken out impulse simultaneously,And first seal wire 5 still can stay in bifurcated artery, be easy to position；After windowing, enter the 3rd seal wire 7 of purpose artery from windowWhen pulling out phase magnet device, because the groove 22 in the first magnetic absorption member 2 designs, the 3rd seal wire 7 can be sliding from groove 22Go out, conveniently carry out next step operation.
The first end of pushing piece 1 is provided with depression 102, and the first magnetic absorption member 2 is detachably secured to be recessed in 102, and thread eye21 are connected with first through hole 101.Handle 103 is provided with fifth hole 104, and fifth hole 104 is connected with first through hole 101, leadsThe axis of the axis, the axis of first through hole 101 and fifth hole 104 in silk hole 21 overlaps.First magnetic absorption member 2 detachableIt is fixed in depression 102, increased the frictional force between the first magnetic absorption member 2 and pushing piece 1 so that both combine more firmly, keep awayExempt from the malpractice causing because of both accidental separation in art, and the mode of entrance of the first magnetic absorption member 2 is easy to operate, is easy toConnect with the second magnetic absorption member 4 magnetic.Wherein, pushing piece 1 is open circles mast, and external diameter is 3.0mm, and internal diameter is 1.0mm, and length is1020～150cm；The radian of depression 102 is matched with the radian of the side wall of the first magnetic absorption member 2, and the first magnetic absorption member 2 is pastedIn depression 102；Rotary handle 103 is hexagon, a length of 20mm, a diameter of 10mm, and hexagon increases for rotating handThe revolving part of handle and the frictional force of rotary handle, when adjusting the direction of pushing piece 1 it is therefore prevented that the revolving part of rotary handle and rotationChange hands handle relatively to slide such that it is able to conveniently adjust the direction of simultaneously control pushing piece 1；Pushing piece 1 adopts Nitinol material, withFirst magnetic absorption member 2 does not produce magnetic effect, it is to avoid pushing piece 1 is interacted because of magnetic force with the first magnetic absorption member 2.
Referring to Fig. 3 and Fig. 4, in one kind preferably embodiment, one end of the second magnetic absorption member 4 is detachably solid with conveying sheath 3Fixed connection is it is preferable that the second magnetic absorption member 4 is pasted in the first end of conveying sheath 3；When the second magnetic absorption member 4 and the first magnetic absorption member 2When magnetic connects, the axis of the axis, the axis of fourth hole 23 and third through-hole 41 of the second through hole 31 overlaps.Wherein,Second magnetic absorption member 4 is hollow cylinder, and the length of the second magnetic absorption member 4 is 10mm, and external diameter is 3mm, and internal diameter is 1.5mm, and wall thickness is0.75mm；Conveying sheath 3 adopts polytetrafluoroethylene (PTFE) material, using the characteristic of polytetrafluoroethylene (PTFE) material, by the second end of conveying sheath 3End bending is in the arc-shaped, and the radian at the second end of conveying sheath 3 is α, and 180 ° of 90 °≤α ＜, preferably radian are 90 °, and conveySecond end of sheath 3 is long 100～150cm, the long sheath of wide 5f, and 5f is 5*0..33mm；The first end of conveying sheath 3 be long by 1030～The long sheath of 140cm, and the end of conveying sheath 3 first end is provided with haemostatic valve 32.
By the design of the hollow-core construction of above-mentioned first magnetic absorption member 2 and the second magnetic absorption member 4 so that the first magnetic absorption member 2 and secondMagnetic absorption member 4, during magnetic, will not produce offset deviation on the contact surface of two magnetic absorption member, thus ensure that fourth holeThe axis of 23 axis and third through-hole 41 overlaps, and is easy to laser fiber 8 or puncture needle burns and wears or pierce through positioned at the first magneticInhale the film of overlay film frame 11 between part 2 and the second magnetic absorption member 4, thus realizing the purpose opening a window.
In one kind preferably embodiment, seal wire includes the first seal wire 5, the second seal wire 6 and the 3rd seal wire 7；First seal wire 5First end sequentially pass through thread eye 21, fourth hole 23 and groove 22, the second end of the first seal wire 5 sequentially passes through first through hole101 and fifth hole 104；The first end of the second seal wire 6 passes through third through-hole 41, and the second end of the second seal wire 6 passes through second to lead toHole 31；3rd seal wire 7 is used for being placed through the film of overlay film frame 11 between the first magnetic absorption member 2 and the second magnetic absorption member 4, and reachesPurpose blood vessel.
The operation principle of the present invention is as follows:
Angiographic image passes through digitized processing, unwanted tissue image is deleted, an artery-sparing image,This technology is called DSA, i.e. digital subtraction angiography, abbreviation dsa.It is characterized in figureAs clear, high resolution, to observing vascular lesion, the positioning measurement of hemadostewnosis, diagnose and PCI provides reallyStereo-picture, is that various PCIs provide necessary requirement.Dsa is the inspection method of aneurysm most worthy.
Referring to Fig. 5 to Fig. 8, taking the abdominal aneurvsm 10 of the arteria renalis 9 as a example, by dsa equipment operation and control this enforcementApplication in surgical procedure for the blood vessel covered stent 11 orthotopic fenestration positioner of example, specifically used method is as follows:
1st, left side arteria brachialis is cut, the first seal wire 5 is sent into, along arteria brachialis, axillary artery, subclavian artery, sustainerBow, descending aorta etc. reach abdominal aorta, and seal wire 5 is inserted left (or right) arteria renalis 9；
2nd, the first end of the first seal wire 5 is sequentially passed through thread eye 21, fourth hole 23 and groove 22, along the first seal wire 5First magnetic absorption member 2 is sent into arteria brachialis, and along the first seal wire 5, first magnetic absorption member 2 is pushed to left (or right) kidney with pushing piece 1 and moveArteries and veins 9, rotary handle 103, the direction of adjustment the first magnetic absorption member 2, any one end be aligned left (or right) kidney of the first magnetic absorption member 2 is movedThe sustainer direction of arteries and veins 9 opening, that is, overlay film frame 11 direction, and ensure that the first magnetic absorption member 2 and the second magnetic absorption member 4 canMagnetic coordinates, and pushing piece 1 is fixing；
3rd, again femoral artery is cut, send into overlay film frame 11, discharge after reaching purpose blood vessel, by overlay film frame 11 by theOne magnetic absorption member 2 is pressed in left (or right) arteria renalis 9；Second seal wire 6 is sent into by the common iliac artery branch through overlay film frame 11 again, theThe first end of two seal wires 6 passes through the second through hole 31 and third through-hole 41, and by the effect of the second seal wire 6 by the of conveying sheath 3Two ends stretch, and are easy to convey sheath 3 and move in intravascular, along the second seal wire 6 by convey sheath 3 and the second magnetic absorption member 4 deliver to left (orRight) near the arteria renalis 9, withdraw from the second seal wire 6, thus eliminating the second seal wire 6 active force is stretched to conveying sheath 3, convey sheath 3The second end bend in the presence of its own elastic force, so that the third through-hole 41 of the second magnetic absorption member 4 and the first magnetic absorption member 2Fourth hole 23 relatively, make by rotation conveying sheath 3 that second magnetic absorption member 4 moves closer to the first magnetic absorption member 2 and magnetic connects,Now by laser fiber 8 or puncture needle, the first end through conveying sheath 3 is delivered to the second end of conveying sheath 3, and burning to wear or pierce through is located atBetween first magnetic absorption member 2 and the second magnetic absorption member 4, the film (as opening a window) of overlay film frame 11, withdraws from laser fiber 8 or puncture needle,Send into the 3rd seal wire 7 and by by the film worn or pierce through that burns, the 3rd seal wire 7 reaches left (or right) arteria renalis through overlay film frame 119, after fixing, remove pushing piece 1, the first magnetic absorption member 2, conveying sheath 3 and the second magnetic absorption member 4 successively, be re-fed into sacculus and be used for expandingAt windowing, expand window diameter, then a small rack is sent at windowing, after release, main artery blood flow can enter along small rackEnter the arteria renalis 9, windowing completes.Can be stopped blooding by the haemostatic valve 32 being arranged on conveying sheath 3 in surgical procedure, in case bloodThe generation of the contingencies such as tracheal rupture, massive haemorrhage.
The present invention is not limited to above-mentioned preferred forms, and those skilled in the art can draw under the enlightenment of the present inventionOther various forms of products, however, making any change in its shape or structure, every have same as the present application or phaseApproximate technical scheme, is within the scope of the present invention.