CN111227992A - Rapid Aortic Arch Stent Graft Perforation Kit with Reverse Traction - Google Patents
Rapid Aortic Arch Stent Graft Perforation Kit with Reverse TractionDownload PDFInfo
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Abstract
Translated fromChinese
Description
Translated fromChinese技术领域technical field
本发明涉及一种用于对人体主动脉弓腔内植入的覆膜支架目标部位快速逆行破膜的套件，所述套件总体上由三个管腔结构的配件构成，其中两个配件为单腔结构，一个配件为三腔结构。The invention relates to a kit for rapidly retrograde membrane perforation of a target site of a stent-graft implanted in a human aortic arch cavity. , and one accessory is a three-chamber structure.
背景技术Background technique
主动脉弓去分支技术是心血管外科微创治疗的重大进展之一，其成功的关键在于主动脉弓三分支的血运重建。Aortic arch debranching is one of the major advances in minimally invasive treatment of cardiovascular surgery, and the key to its success lies in the revascularization of the three branches of the aortic arch.
既往的覆膜支架预开窗技术、带单分支的主动脉覆膜支架以及烟囱技术等均不能满意解决术中快速精准定位和确保疗效等问题，预先进行主动脉弓分支血管旁路移植（搭桥），再用覆膜支架腔内隔绝的“杂交”治疗方式一定程度上增加了手术创伤、手术风险和患者的经济负担。The previous stent-graft pre-fenestration technology, aortic stent-graft with a single branch, and chimney technology cannot satisfactorily solve the problems of rapid and accurate intraoperative positioning and ensure the efficacy of the aortic arch branch blood vessel bypass grafting (bypass) in advance. The "hybrid" treatment method of intraluminal isolation with covered stents increases the surgical trauma, surgical risks and economic burden of patients to a certain extent.
主动脉弓覆膜支架“原位破膜”技术是近年来的新进展，由于至今还没有专用破膜设备，外科医生目前术中采用激光光纤、金属导丝等现有设备进行逆行破膜，这些装置的共同特点是效率低下，存在安全隐患。The "in situ membrane perforation" technology of aortic arch stent-graft is a new development in recent years. Since there is no dedicated membrane perforation device, surgeons currently use existing equipment such as laser optical fiber and metal guide wire to perform retrograde membrane perforation. These devices The common feature is inefficiency and security risks.
理论上，常温下大脑皮质能耐受完全缺血时间为3-4 分钟，超过此时限，大脑皮质将发生不可逆转的坏死。Theoretically, the cerebral cortex can tolerate complete ischemia for 3-4 minutes at room temperature, beyond this time limit, the cerebral cortex will undergo irreversible necrosis.
现有的上述破膜技术对血运重建过程冗长，一般难以在上述安全时间内完成，故多需要预先建立体外循环旁路或血管旁路以保障手术安全。The existing membrane perforation techniques are lengthy for the revascularization process, and are generally difficult to complete within the above-mentioned safe time. Therefore, an extracorporeal circulation bypass or a vascular bypass needs to be established in advance to ensure the safety of the operation.
此外，破膜的激光光纤或金属导丝头端并无有效保护装置，在破膜时可能导致支架对侧覆膜及血管壁损伤，激光还可能造成覆膜支架金属丝损伤、断裂、血液破坏、血栓形成等不良结果。In addition, there is no effective protection device for the end of the laser fiber or metal guide wire that ruptures the membrane, which may cause damage to the stent contralateral membrane and blood vessel wall when the membrane ruptures. , thrombosis and other adverse outcomes.
因此，临床上亟需一种能在瞬间快速精准逆行破膜、确保在大脑皮层耐受完全缺血的安全时间内恢复主动脉弓分支血管的有效血流灌注，同时确保支架结构完整、无副损伤的破膜装置。Therefore, there is an urgent need for a method that can rapidly and accurately retrograde membrane rupture in an instant, ensure that the effective blood perfusion of the branch vessels of the aortic arch can be restored within a safe time when the cerebral cortex can tolerate complete ischemia, and at the same time ensure that the stent structure is intact and free of side damage. Membrane rupture device.
发明内容SUMMARY OF THE INVENTION
因此，本发明的目的是提供这样的快速逆行破膜套件，所述快速逆行破膜套件中的快速逆行破膜系统可以在数秒钟内逆血流方向（逆行）对植入主动脉弓腔内覆膜支架的目标部位精准破膜，瞬间完成部分血运重建并在大脑皮质耐受完全缺血安全时间内完成后续的完全血运重建，整个手术过程将免除体外循环和其他血管旁路，不仅克服了现有技术的上述缺陷，而且简化手术操作，减少手术创伤，降低手术风险，提高手术安全性，同时减少患者的花费。Therefore, the object of the present invention is to provide such a rapid retrograde membrane perforation kit, the rapid retrograde membrane perforation system in the rapid retrograde membrane perforation kit can reverse the direction of blood flow (retrograde) within a few seconds to implant the intramedullary membrane in the aortic arch cavity The target site of the stent is precisely ruptured, and the partial revascularization can be completed in an instant, and the subsequent complete revascularization can be completed within the safe time when the cerebral cortex tolerates complete ischemia. The above-mentioned defects of the prior art also simplify the surgical operation, reduce the surgical trauma, reduce the surgical risk, improve the surgical safety, and reduce the cost of the patient at the same time.
本发明解决其技术问题所采用的技术方案是：根据需要在主动脉弓覆膜支架目标部位对应的主动脉弓分支血管内预先置入1-3只本发明套件中的快速逆行破膜系统，当主动脉弓覆膜支架完全释放、膨张后，利用本套件快速逆行破膜系统预置的袢状导丝环将覆膜支架反向牵引至破膜针针尖所在位置进行精准破膜，以达到瞬间部分血运重建以及在大脑皮质耐受完全缺血安全时间内完成后续血运完全重建的目标。The technical solution adopted by the present invention to solve the technical problem is as follows: as required, 1-3 pieces of the rapid retrograde membrane perforation system in the kit of the present invention are pre-placed in the branch blood vessels of the aortic arch corresponding to the target site of the aortic arch stent-graft. After the stent is completely released and expanded, use the loop-shaped guide wire loop preset by the rapid retrograde membrane perforation system of this kit to reversely pull the stent-graft to the position of the needle tip for precise membrane perforation, so as to achieve instant partial revascularization. And the goal of completing subsequent complete revascularization within a safe time to tolerate complete ischemia in the cerebral cortex.
所述快速逆行破膜套件总体上由具有三个管腔结构的配件构成，包括：（i）单腔结构的破膜针及其推送杆，所述单腔结构的破膜针及其推送杆用于对主动脉弓腔内覆膜支架的目标部位快速逆行破膜，并通过其管腔在破膜后向覆膜支架腔内迅速置入直径明显小于破口直径的硬导丝，(ii)三腔结构的输送鞘管，所述三腔结构的输送鞘管，被定尺寸和配置成可将上述单腔结构的破膜针及其推送杆和1根软导丝预置在其相应的管腔内，组装成快速逆行破膜系统，（iii）单腔结构的输送鞘管内芯，所述单腔结构的鞘管内芯被尺寸和配置成可预置在前述的三腔结构的输送鞘管内形成鞘-芯复合置入体，用于术中协助三腔输送鞘管沿血管内预置的硬导丝在低阻力、无损伤条件下送达预定部位。The rapid retrograde membrane rupture kit is generally composed of accessories with three lumen structures, including: (i) a single-lumen structure permeabilization needle and its push rod, the single-lumen structure of the membrane permeation needle and its push rod It is used for rapid retrograde perforation of the target site of the stent-graft in the aortic arch cavity, and rapid insertion of a rigid guide wire with a diameter significantly smaller than the diameter of the rupture through its lumen into the stent-graft lumen after membrane rupture, (ii) three The delivery sheath of the lumen structure, the delivery sheath of the three-lumen structure, is sized and configured so that the above-mentioned single-lumen structure permeation needle and its push rod and a soft guide wire can be preset in its corresponding tube Intraluminal, assembled into a rapid retrograde membrane rupture system, (iii) a single-lumen configuration delivery sheath core sized and configured to be pre-positioned within the aforementioned triple-lumen configuration delivery sheath A sheath-core composite implant is formed, which is used to assist the three-lumen delivery sheath tube pre-set along the blood vessel to reach the predetermined site under the condition of low resistance and no damage during the operation.
本破膜套件中所述的破膜针及其推送杆由两种不同的材质构成，空心破膜针为硬金属或类似材质，针体长度在8mm以内并与空心推送杆紧密粘合，推送杆无论什么材质，均具有一定硬度和顺应性，以便顺应血管走向，又能克服破膜针破膜时的阻力。The membrane permeation needle and its push rod described in this membrane permeation kit are composed of two different materials. The hollow membrane permeation needle is made of hard metal or similar material. The length of the needle body is within 8mm and is tightly bonded to the hollow push rod. No matter what material the rod is made of, it has a certain hardness and compliance, so as to conform to the direction of the blood vessel and overcome the resistance of the permeabilization needle when the membrane is ruptured.
本破膜套件中所述破膜针推送杆具有第一限位阻和第二限位阻，以限制破膜针破膜时刺入过深伤及主动脉弓覆膜支架对侧覆膜并伤及血管壁。The membrane permeation needle push rod in this membrane permeation kit has a first limit block and a second limit block, so as to limit the deep penetration of the permembrane needle and the injury to the opposite side of the aortic arch stent-graft when the membrane perforates the membrane. Vascular wall.
本破膜套件中所述的破膜针针尖的腔内有导向性隆凸，可以引导硬导丝植入时向希望方向进入主动脉弓覆膜支架腔内。There is a guiding protuberance in the cavity of the membrane permeation needle described in the membrane permeation kit, which can guide the rigid guide wire to enter the cavity of the aortic arch stent-graft in a desired direction when implanting.
本破膜套件中所述的破膜针呈圆锥状，以保证破膜快捷和破口直径明显大于随后置入的硬导丝直径，达到瞬间部分血运重建的目的。The membrane permeation needle described in this membrane perforation kit is in the shape of a cone, to ensure that the membrane perforation is quick and the diameter of the breach is significantly larger than the diameter of the subsequently inserted rigid guide wire, so as to achieve the purpose of instantaneous partial blood vessel reconstruction.
本破膜套件中所述的单腔结构的破膜针及其推送杆管腔内可允许硬导丝通过。The single-lumen structure of the membrane permeation needle and its push rod described in the membrane permeation kit can allow a hard guide wire to pass through the lumen.
本破膜套件中所述三腔结构的输送鞘管除了具有可通过破膜针及其推送杆的主体管腔及其出、入口之外，在两侧还有双侧管及其出、入口，允许1根软导丝从一侧穿入，另一侧穿出并固定，双侧管可被设计在鞘管外侧或腔内。In addition to the main lumen and its exit and entrance through which the membrane permeation needle and its push rod can pass through, the delivery sheath of the three-lumen structure in the membrane permeation kit also has double-sided tubes and its exit and entrance on both sides. , allowing a soft guide wire to be inserted from one side, and the other side to be pierced and fixed, and the bilateral tube can be designed on the outside of the sheath or in the lumen.
本破膜套件中所述的单腔结构的输送鞘管内芯除了具有可通过硬导丝的入口和出口外，被定尺寸和配置成可预置在输送鞘主体管腔内，其头端长度较输送鞘管更长并呈渐细的圆锥状，以利于输送鞘管在低阻力、无损伤条件下进入血管内的指定位置。In addition to having an inlet and an outlet that can pass through a rigid guide wire, the single-lumen structure of the delivery sheath core described in the membrane perforation kit is sized and configured to be pre-positioned in the lumen of the delivery sheath body, and the length of the head end is It is longer than the delivery sheath and has a tapered conical shape to facilitate the delivery sheath to enter the designated position in the blood vessel under low resistance and non-invasive conditions.
本破膜套件中所述呈圆锥状的输送鞘管内芯出口端根部一侧开有导丝环收纳槽，以利于三腔输送鞘预装的软导丝顺利进入血管内。A guide wire ring receiving groove is formed on the root side of the outlet end of the inner core of the conical delivery sheath described in the membrane perforation kit, so as to facilitate the smooth entry of the soft guide wire pre-installed in the three-lumen delivery sheath into the blood vessel.
上述有益效果是通过本发明的鞘-芯复合置入体将本发明的三腔输送鞘管送达在主动脉弓三分支血管的任何一支或同时三个分支的开口处，取出鞘芯后再将本发明的破膜针及其推送杆预置在三腔输送鞘管主体管腔内，与双侧管内预置的软导丝一起共同组装成快速逆行破膜系统。The above beneficial effect is that the three-lumen delivery sheath of the present invention is delivered to any one of the three branches of the aortic arch or the openings of the three branches simultaneously through the sheath-core composite implant of the present invention, and the sheath core is taken out and then placed. The membrane perforating needle and its pushing rod of the present invention are preset in the lumen of the main body of the three-lumen delivery sheath tube, and are assembled together with the soft guide wires preset in the bilateral tubes to form a rapid retrograde membrane perforation system.
用三腔输送鞘管双侧管内的软导丝在主动脉腔内预先形成袢状导丝环，主动脉弓覆膜支架在该袢状导丝环内释放后牵拉软导丝即可将主动脉弓内已经膨张的覆膜支架反向牵引至破膜针针尖所在位置（输送鞘鞘口处），使针尖与目标处覆膜支架最大程度地接近并相互垂直，向覆膜支架方向推动快速逆行破膜系统破膜针推送杆的手柄即可瞬间完成对主动脉弓覆膜支架目标部位的精准破膜。A loop-shaped guide wire loop is pre-formed in the aortic cavity with the soft guide wire in the bilateral tube of the three-lumen delivery sheath, and the aortic arch stent-graft is released in the loop-shaped guide wire loop and the soft guide wire is pulled to insert the aortic arch into the aortic arch. The expanded stent-graft is reversely pulled to the position of the needle tip of the permeation needle (the mouth of the delivery sheath), so that the needle tip and the target stent-graft are as close to each other as possible and are perpendicular to each other, and the rapid retrograde rupture is pushed towards the stent-graft. The handle of the membrane system permeation needle push rod can instantly complete the precise membrane perforation of the target site of the aortic arch stent graft.
破膜后适当旋转破膜针针尖方向，将预置在快速逆行破膜系统内的硬导丝按希望的方向迅速送入主动脉弓覆膜支架腔内，后撤快速逆行破膜系统并退出破膜针及其推送杆后即可实现主动脉弓分支血管部分血运重建。After the membrane is ruptured, rotate the needle tip direction of the permeable membrane appropriately, and quickly send the rigid guide wire preset in the rapid retrograde membrane permeation system into the aortic arch stent-graft cavity in the desired direction, withdraw the rapid retrograde membrane permeation system and exit the membrane perforation Partial revascularization of the branch vessels of the aortic arch can be achieved after the needle and its push rod.
在此条件下，后续的破膜处扩张以及分支血管人工支架植入，实现主动脉弓分支血管的完全血运重建将不再面临任何障碍。Under this condition, the subsequent dilatation of the ruptured membrane and the implantation of artificial stents in the branch vessels will no longer face any obstacles to the complete revascularization of the branch vessels of the aortic arch.
附图说明Description of drawings
下面结合附图并举实例对本发明进一步说明。The present invention will be further described below with reference to the accompanying drawings and examples.
图1是人体主动脉弓示意图。Figure 1 is a schematic diagram of the human aortic arch.
图2是主动脉弓腔内覆膜支架置入后三分支血管血流中断示意图。Figure 2 is a schematic diagram of the blood flow interruption of the three branch vessels after the stent-graft in the aortic arch is implanted.
图3是本发明的套件所述的破膜针及其推送杆示意图。Figure 3 is a schematic diagram of the permeabilization needle and its push rod described in the kit of the present invention.
图4和图5是本发明的套件所述的两种形式的三腔输送鞘管示意图。Figures 4 and 5 are schematic views of two forms of the three-lumen delivery sheath described in the kit of the present invention.
图6是本发明的输送鞘管内芯示意图。6 is a schematic diagram of the inner core of the delivery sheath of the present invention.
图7是本发明的将输送鞘管内芯安置在三腔输送鞘主体管腔中形成鞘-芯复合置入体并沿硬导丝走行的示意图。7 is a schematic view of the present invention, where the inner core of the delivery sheath is placed in the lumen of the three-lumen delivery sheath body to form a sheath-core composite implant and run along the rigid guide wire.
图8是本发明的破膜针及其推送杆和硬导丝预置在双侧管内已经安置好软导丝的三腔输送鞘主体管腔中，组装成为快速逆行破膜系统的示意图。Figure 8 is a schematic diagram of the present invention's membrane permeation needle, its push rod and hard guide wire pre-installed in the main lumen of the three-lumen delivery sheath with the soft guide wire installed in the bilateral tubes, and assembled into a rapid retrograde membrane perforation system.
图9是将本发明的2个快速逆行破膜系统安置在主动脉弓三分支中的右无名动脉和左颈总动脉管腔内，输送鞘双侧管中的软导丝在主动脉弓腔内形成袢状导丝环的示意图。Figure 9 shows that the two rapid retrograde membrane perforation systems of the present invention are placed in the lumen of the right innominate artery and the left common carotid artery in the three branches of the aortic arch, and the soft guide wires in the bilateral tubes of the delivery sheath form a loop in the lumen of the aortic arch. Schematic of the guide wire loop.
图10是安置在主动脉弓三分支中的右无名动脉和左颈总动脉管腔内的2个本发明的快速逆行破膜系统将主动脉弓腔内覆膜支架反向牵引至套件破膜针针尖所在部位并进行快速逆行破膜过程的示意图。Figure 10 shows two rapid retrograde membrane permeation systems of the present invention placed in the lumen of the right innominate artery and the left common carotid artery in the three branches of the aortic arch to reverse the traction of the stent-graft in the aortic arch cavity to the location of the needle tip of the set permeation needle And a schematic diagram of the rapid retrograde membrane rupture process.
在图1中，描绘的是人体主动脉弓（26），其具有三个重要的头颈干分支开口：右无名动脉开口（29）、左颈总动脉开口（30）和左锁骨下动脉开口（31），与主动脉弓相连的是升主动脉（28）、主动脉瓣（27）和降主动脉（32），图中箭头指向为头颈部正常供血的方向。In Figure 1, the human aortic arch (26) is depicted with three important branch openings of the head and neck trunk: the right innominate artery opening (29), the left common carotid artery opening (30), and the left subclavian artery opening (31) , connected to the aortic arch are the ascending aorta (28), the aortic valve (27), and the descending aorta (32).
图2显示如图1中已经显示的人体主动脉弓（26）以及在其内释放覆膜支架（33）后主动脉弓头颈干三分支血管开口（29，30，31）血流被完全隔断的情形（箭头所指处），若持续时间超过3 - 4分钟，大脑皮层将发生不可逆转的坏死，故必须在其对应部位（以下简称“目标部位”）的主动脉弓腔内覆膜支架（33）局部快速逆行破膜，以恢复头颈干血管分支的血液供应。Figure 2 shows the aortic arch (26) of the human body as already shown in Figure 1 and the situation in which the blood flow of the three branch vessels (29, 30, 31) of the head and neck trunk of the aortic arch is completely blocked after the stent-graft (33) is released within it (arrows). If it lasts for more than 3-4 minutes, irreversible necrosis of the cerebral cortex will occur, so the stent graft in the aortic arch (33) at its corresponding site (hereinafter referred to as the "target site") must be rapidly retrograde locally The membrane is ruptured to restore the blood supply to the branches of the head and neck trunk.
图3显示是本发明套件中的单腔破膜针及其推送杆（21），所述的单腔破膜针及其推送杆（21）包括破膜针（1）、破膜针出口（2）、破膜针尖腔内导向性隆突（3）、推送杆末端形成的第一限位阻（4）、破膜针推送杆（5）及其第二限位阻（6）、推送杆手柄（7）和推送杆入口（8），由于破膜针及其推送杆整体上是一个管腔结构，故可允许其沿硬导丝（9）进入血管内，也可在破膜后通过推送杆入口（8）向破膜针出口（2）所在的主动脉弓覆膜支架腔内置入硬导丝（9）。Figure 3 shows the single-lumen permeation needle and its push rod (21) in the kit of the present invention. The single-lumen permeation needle and its push rod (21) comprise the permeate needle (1), the permeation needle outlet (21). 2), the guiding protuberance in the tip cavity of the membrane permeation needle (3), the first limit resistance formed at the end of the push rod (4), the permeation needle push rod (5) and its second limit resistance (6), push The rod handle (7) and the push rod inlet (8), because the permeation needle and the push rod are a lumen structure as a whole, they can be allowed to enter the blood vessel along the hard guide wire (9), and can also be used after the membrane rupture. A rigid guide wire (9) is inserted into the lumen of the stent-graft of the aortic arch where the outlet of the permeation needle (2) is located through the inlet of the push rod (8).
图4和图5描绘的是套件中两种形式的三腔输送鞘管（22），所述的三腔输送鞘管（22）除了有主体管腔入口（11）和出口（12）外，还包括双侧管（10）的入口（13）、出口（14）和导丝固定栓（15），三腔输送鞘管（22）的双侧管（10）管腔内可允许1根软导丝（16）从一侧进入，另一侧引出（图中箭头方向）后被导丝固定栓（15）固定，导丝在进出双侧管远端处形成袢状导丝环（34）。根据不同设计，双侧管（10）可位于主体管腔外（图4）或主体管腔内（图4）。Figures 4 and 5 depict two forms of the three-lumen delivery sheath (22) in the kit. In addition to the main lumen inlet (11) and the outlet (12), the three-lumen delivery sheath (22), It also includes the inlet (13), the outlet (14) and the guide wire fixing plug (15) of the bilateral tube (10). The guide wire (16) enters from one side, and is drawn out from the other side (in the direction of the arrow in the figure) and then fixed by the guide wire fixing bolt (15). . Depending on the design, the bilateral tube (10) can be located outside the main body lumen (Fig. 4) or inside the main body lumen (Fig. 4).
图6显示的是本发明套件中的单腔输送鞘管内芯（23），所述的单腔输送鞘管内芯（23）除了有可以通过硬导丝（9）的管腔入口（17）、出口（18）外，其芯体（20）呈圆柱体，直径与前述三腔输送鞘（22）主体管腔内径相当，出口（18）端长度超过三腔输送鞘管（22）主体管腔长度并呈渐细的圆椎状，在圆锥体的底部一侧开有导丝环收纳槽（19）。Fig. 6 shows the inner core (23) of the single lumen delivery sheath in the kit of the present invention, except that the inner core (23) of the single lumen delivery sheath has a lumen inlet (17) through which a rigid guide wire (9) can pass, Outside the outlet (18), the core (20) is cylindrical, and the diameter is equivalent to the inner diameter of the main body lumen of the three-lumen delivery sheath (22), and the length of the end of the outlet (18) exceeds the main body lumen of the three-lumen delivery sheath (22). The length is tapered in the shape of a cone, and a guide wire ring receiving groove (19) is opened on one side of the bottom of the cone.
图7描述的是由单腔输送鞘内芯（23）和三腔输送鞘（22）组装成的鞘--芯复合置入体（24），所述的鞘--芯复合置入体（24）可以将三腔输送鞘管（22）双侧管（10）内预置的软导丝（16）远端形成的袢状导丝环（34）暂时收紧在单腔输送鞘内芯的导丝环收纳槽（19）内。Figure 7 depicts a sheath-core composite implant (24) assembled from a single-lumen delivery sheath core (23) and a three-lumen delivery sheath (22). The sheath-core composite implant ( 24) The loop-shaped guide wire loop (34) formed at the distal end of the soft guide wire (16) preset in the double-sided tube (10) of the triple-lumen delivery sheath tube (22) can be temporarily tightened on the inner core of the single-lumen delivery sheath. inside the guide wire ring receiving groove (19).
图8显示的是组装完成的快速逆行破膜系统（25），由单腔结构的破膜针及其推送杆（21）及其预置在管腔中的硬导丝（9）、三腔结构的输送鞘管（22）及其预置在其双侧管（10）内的软导丝（16）共同组成，软导丝（16）从双侧管（10）的一侧进入，沿箭头所指方向从另一侧引出后被导丝固定栓（15）固定。Figure 8 shows the assembled rapid retrograde membrane permeation system (25), which consists of a single-lumen permeation needle and its push rod (21) and a rigid guide wire (9) preset in the lumen, three-lumen The structured delivery sheath (22) and the soft guide wire (16) preset in the bilateral tube (10) are composed together, and the soft guide wire (16) enters from one side of the bilateral tube (10), along the The direction indicated by the arrow is drawn out from the other side and fixed by the guide wire fixing bolt (15).
图9描述的是同时在主动脉弓三分支的右无名动脉（29）和左颈总动脉（30）中各预置1个本发明的快速逆行破膜系统（25），将一侧被导丝固定栓（15）固定的软导丝（16）按箭头所指的方向向三腔输送鞘管（22）内推进，使其在主动脉弓腔内预先形成袢状导丝环（34），随后从股动脉置入的硬导丝（35）从该袢状导丝环（34）中穿过的情形。Fig. 9 depicts the right innominate artery (29) and the left common carotid artery (30) of the three branches of the aortic arch at the same time each preset with a rapid retrograde membrane rupture system (25) of the present invention, and one side is fixed by a guide wire The soft guide wire ( 16 ) fixed by the plug ( 15 ) is advanced into the three-lumen delivery sheath ( 22 ) in the direction indicated by the arrow, so that a loop-like guide wire loop ( 34 ) is pre-formed in the aortic arch cavity, and then the guide wire loop ( 34 ) is preformed in the aortic arch cavity. The arterially placed rigid guide wire (35) is passed through the looped guide wire loop (34).
图10描述的是本发明的2个快速逆行破膜系统（25）在主动脉弓的右无名动脉（29）和左颈总动脉（30）中同时或先后完成对主动脉弓腔内覆膜支架（33）目标部位破膜的过程，当覆膜支架（33）沿经股动脉置入的硬导丝（35）抵达主动脉弓的预定部位并完全释放后，把一侧被导丝固定栓（15）固定的软导丝（16）按箭头所指的方向向三腔输送鞘管（22）外牵拉，即可将其原先在主动脉弓腔内形成的袢状导丝环（34）收紧并将已经膨胀的覆膜支架（33）逆破膜针穿刺方向反向牵引至破膜针（1）针尖所在部位，此时，破膜针（1）与覆膜支架（33）目标部位最大程度地接近并相互垂直，将快速逆行破膜系统（25）推送杆手柄（7）向覆膜支架（33）方向推进至图3描述的第一限位阻（4）和第二限位阻（6）处，即可在瞬间快速完成对覆膜支架（32）目标部位的精准破膜。Figure 10 depicts the two rapid retrograde membrane perforation systems (25) of the present invention in the right innominate artery (29) and the left common carotid artery (30) of the aortic arch to simultaneously or sequentially complete the stent graft (33) in the aortic arch cavity. In the process of membrane rupture of the target site, when the stent graft (33) reaches the predetermined part of the aortic arch along the rigid guide wire (35) placed through the femoral artery and is completely released, one side is fixed by the guide wire fixing plug (15). The soft guide wire (16) is pulled to the outside of the three-lumen delivery sheath (22) in the direction indicated by the arrow, and the loop-shaped guide wire loop (34) originally formed in the aortic arch cavity can be tightened and expanded. The stent-graft (33) is pulled in the reverse direction against the puncture direction of the per-membrane needle to the position where the needle tip of the per-membrane needle (1) is located. perpendicular to each other, push the push rod handle (7) of the rapid retrograde membrane rupture system (25) in the direction of the stent graft (33) to the first limit block (4) and the second limit block (6) described in Figure 3 , the precise membrane rupture of the target site of the stent graft (32) can be completed in an instant.
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Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN115363817A (en)* | 2022-08-31 | 2022-11-22 | 范卫东 | Assembled aortic endoluminal stent and left subclavian artery in situ fenestration system and method |
| CN116350912A (en)* | 2023-04-04 | 2023-06-30 | 武汉大学人民医院（湖北省人民医院） | A kind of vascular sheath and its equipment for endovascular repair of thoracic aorta |
| CN118526248A (en)* | 2024-07-24 | 2024-08-23 | 归创通桥医疗科技股份有限公司 | Tectorial membrane support rupture of membranes device |
| CN119302785A (en)* | 2023-07-06 | 2025-01-14 | 深圳市英耐特医疗科技有限公司 | Conveying device and conveying system |
Citations (9)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6042588A (en)* | 1998-03-03 | 2000-03-28 | Scimed Life Systems, Inc | Stent delivery system |
| US20040225233A1 (en)* | 2003-05-09 | 2004-11-11 | Frankowski Brian J. | Magnetic guidewires |
| CN102046112A (en)* | 2008-06-11 | 2011-05-04 | 安吉奥米德医药技术有限责任两合公司 | Catheter delivery device |
| CN105832447A (en)* | 2016-05-27 | 2016-08-10 | 杨威 | Covered stent for aortic dissection surgery, delivery device and use method thereof |
| CN106214287A (en)* | 2016-08-24 | 2016-12-14 | 杨威 | Dissection of aorta operation overlay film frame, conveyer device and using method |
| CN106725643A (en)* | 2016-06-22 | 2017-05-31 | 苏州茵络医疗器械有限公司 | For the membrane-repturing device of Endovascular operation |
| US20180092650A1 (en)* | 2016-09-30 | 2018-04-05 | Vascular Solutions, Inc. | Methods for facilitating revascularization of occlusion |
| WO2018207542A1 (en)* | 2017-05-11 | 2018-11-15 | 株式会社 京都医療設計 | Stent supply device |
| CN209574962U (en)* | 2018-11-28 | 2019-11-05 | 刘健 | Quickly arcus haemalis overlay film frame rupture of membranes external member with reversed traction function |
- 2018
- 2018-11-28CNCN201811469767.3Apatent/CN111227992B/enactiveActive
Patent Citations (9)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6042588A (en)* | 1998-03-03 | 2000-03-28 | Scimed Life Systems, Inc | Stent delivery system |
| US20040225233A1 (en)* | 2003-05-09 | 2004-11-11 | Frankowski Brian J. | Magnetic guidewires |
| CN102046112A (en)* | 2008-06-11 | 2011-05-04 | 安吉奥米德医药技术有限责任两合公司 | Catheter delivery device |
| CN105832447A (en)* | 2016-05-27 | 2016-08-10 | 杨威 | Covered stent for aortic dissection surgery, delivery device and use method thereof |
| CN106725643A (en)* | 2016-06-22 | 2017-05-31 | 苏州茵络医疗器械有限公司 | For the membrane-repturing device of Endovascular operation |
| CN106214287A (en)* | 2016-08-24 | 2016-12-14 | 杨威 | Dissection of aorta operation overlay film frame, conveyer device and using method |
| US20180092650A1 (en)* | 2016-09-30 | 2018-04-05 | Vascular Solutions, Inc. | Methods for facilitating revascularization of occlusion |
| WO2018207542A1 (en)* | 2017-05-11 | 2018-11-15 | 株式会社 京都医療設計 | Stent supply device |
| CN209574962U (en)* | 2018-11-28 | 2019-11-05 | 刘健 | Quickly arcus haemalis overlay film frame rupture of membranes external member with reversed traction function |
Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN115363817A (en)* | 2022-08-31 | 2022-11-22 | 范卫东 | Assembled aortic endoluminal stent and left subclavian artery in situ fenestration system and method |
| CN116350912A (en)* | 2023-04-04 | 2023-06-30 | 武汉大学人民医院（湖北省人民医院） | A kind of vascular sheath and its equipment for endovascular repair of thoracic aorta |
| CN119302785A (en)* | 2023-07-06 | 2025-01-14 | 深圳市英耐特医疗科技有限公司 | Conveying device and conveying system |
| CN118526248A (en)* | 2024-07-24 | 2024-08-23 | 归创通桥医疗科技股份有限公司 | Tectorial membrane support rupture of membranes device |
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|---|---|
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