Disclosure of Invention
The invention aims to provide an aortic stent-graft and an abdominal aortic stent-graft assembly, which at least solve the technical problem that a guide wire is difficult to be selected into a branch vessel when carrying out intra-cavity isolation treatment on aortic involvement branch vessel lesions (especially abdominal aortic involvement renal artery lesions) in the prior art.
In order to achieve the above purpose, the embodiment of the present invention adopts the following technical scheme:
in a first aspect, an embodiment of the present invention provides an aortic stent graft, comprising a main body stent graft and a built-in assembly.
The built-in assembly comprises a sleeve bracket and a preset catheter, wherein the main body tectorial membrane bracket, the sleeve bracket and the preset catheter are mutually parallel and are sequentially sleeved from outside to inside. The main body tectorial membrane support, the sleeve support and the side wall of each preset catheter are respectively provided with a side wall opening for the guide wire to be selected. The sleeve support is fixedly connected to the inner wall of the main body tectorial membrane support, and the side wall opening of the main body tectorial membrane support is at least partially overlapped with the side wall opening of the sleeve support. The inside guide chamber and the exchange chamber that keep apart each other that are equipped with of preset pipe, wherein, the guide chamber link up the axial both ends face of preset pipe, the exchange chamber link up the axial one end surface of preset pipe and the lateral wall opening of preset pipe.
In this embodiment, optionally, the sleeve stent comprises a stent and a covering film connected to the stent, the stent comprises a proximal stent and a distal stent, and the sidewall opening of the sleeve stent is located between the proximal stent and the distal stent. The part of the proximal stent closest to the side wall opening of the sleeve stent and the part of the distal stent closest to the side wall opening of the sleeve stent are a proximal stent ring and a distal stent ring respectively. The shape of the proximal support ring is the same as that of the distal support ring, the proximal support ring and the distal support ring respectively comprise a first arc support section and a second arc support section which are axisymmetric and are connected end to end at free ends, the proximal support ring and the distal support ring are symmetric with respect to a radial plane at the side wall opening of the sleeve support, and the contour line of the side wall opening of the sleeve support extends along the arc support sections where the proximal support ring and the distal support ring are butted.
Further optionally, the proximal stent further comprises a plurality of proximal body stent rings having the same shape as the proximal stent rings and being parallel to each other, and/or the distal stent rings further comprise a plurality of distal body stent rings having the same shape as the distal stent rings and being parallel to each other.
In this embodiment, optionally, the area of the side wall opening area of the sleeve stent is smaller than the area of the side wall opening area of the main body stent graft.
Further optionally, the projections of the sidewall opening regions of the sleeve stent onto the radial circumferential surface of the main body stent graft are all located inside the sidewall opening regions of the main body stent graft.
In this embodiment, optionally, a boss is disposed on a side wall of the preset catheter, and an opening on the side wall of the preset catheter is disposed on the boss.
In this embodiment, optionally, the aortic stent graft further comprises a rear release member that releasably circumferentially constrains the sleeve stent.
Further alternatively, the rear release member is a compression film sleeve with a release wire, the compression film sleeve is connected to the sleeve support at a point, the release wire circumferentially constrains the compression film sleeve to radially compress the sleeve support, and the release wire is retracted to open the compression film sleeve to release the sleeve support.
In a second aspect, an embodiment of the present invention provides an abdominal aortic stent-graft assembly comprising a branched stent-graft and an aortic stent-graft as described in any of the preceding embodiments.
The built-in assembly at least comprises a group of side wall openings which correspond to any side wall opening of the main body tectorial membrane bracket;
The main body covered stent is conveyed to an abdominal aorta, the side wall opening of the main body covered stent is aligned with the renal artery opening, a main guide wire is conveyed in the proximal direction along the guide cavity of the preset guide tube, the preset guide tube and the main guide wire are simultaneously pushed in the proximal direction, the main guide wire is caught from the proximal end to penetrate through the preset guide tube from the proximal end, the main guide wire is withdrawn, a branch guide wire is penetrated from the proximal end to the exchange cavity of the preset guide tube, the preset guide tube and the branch guide wire are pushed in the distal direction, when the side wall opening of the preset guide tube reaches the renal artery opening position, the side wall opening of the preset guide tube is aligned with the renal artery opening, the preset guide tube is fixed, the branch guide wire is continuously pushed, the branch guide wire smoothly enters into a side renal artery to finish the guide wire super-selection of the side renal artery, and then the preset guide tube is sent into a renal artery stent conveyer along the branch guide wire, and the side renal artery is withdrawn, and the branch covered stent is implanted into the side renal artery.
In the abdominal aorta covered stent assembly provided by the embodiment of the invention, optionally, the built-in assembly comprises two groups, and the two groups of built-in assemblies respectively correspond to two side wall openings of the main body covered stent.
The embodiment of the invention at least has the following beneficial effects:
The aortic tectorial membrane stent provided by the embodiment of the invention can be applied to the pathological change treatment operation of the aortic involvement branch vessel, the aortic tectorial membrane stent is implanted into the aorta under the guidance of the guide wire, and then the other guide wire is accurately and rapidly super-selected into the branch vessel under the restraint and guide action of the built-in component, and the branch tectorial membrane stent is implanted along the guide wire. Compared with the prior art, the aortic stent graft can effectively and rapidly select the branch guide wire into the branch vessel by the combined action of the sleeve stent and the preset catheter in the built-in component, ensure that the guide wire is more selected accurately, and can control the proximal opening of the implanted branch stent graft to face the proximal opening of the aortic stent graft by utilizing the restraint of the sleeve stent graft, so as to ensure that the blood flow perfusion of the branch vessel is good.
Because the abdominal aortic stent graft assembly provided by the embodiment of the invention comprises the aortic stent graft provided by the first aspect, the abdominal aortic stent graft assembly provided by the embodiment of the invention can achieve all the beneficial effects achieved by the aortic stent graft provided by the first aspect.
Specifically, in the embodiment of the invention, the "and/or" means that the "and/or" first feature before the "and/or" second feature after the "are/is included in the following specific setting modes (1) only the first feature is set, no second feature is set, (2) only the second feature is set, no first feature is set, and (3) the first feature and the second feature are set simultaneously.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings that are needed in the description of the embodiments or the prior art will be briefly described, and it is obvious that the drawings in the description below are some embodiments of the present invention, and other drawings can be obtained according to the drawings without inventive effort for a person skilled in the art.
FIG. 1 is an elevation view of the overall structure of an aortic stent graft provided in an embodiment of the present invention;
FIG. 2 is a schematic illustration of the relationship between the inner assembly and the main body stent graft in the main body stent graft proximal region of the main body stent graft shown in FIG. 1;
FIG. 3 is a side view of the aortic stent graft according to the embodiment of the present invention, showing the mating relationship between a sleeve stent and an aortic stent graft;
FIG. 4 is a partial cross-sectional view of a fitting relationship between a sleeve stent and an aortic stent-graft in an aortic stent-graft according to an embodiment of the present invention;
FIG. 5 is a schematic view showing the structure of the lumen of an optional pre-catheter in the aortic stent graft according to the embodiment of the present invention;
FIG. 6 is a schematic view showing the structure of the lumen of a pre-catheter of another alternative configuration in an aortic stent graft according to an embodiment of the present invention;
FIG. 7 is a diagram showing a fitting structure of a sleeve stent and a preset catheter in a circumferentially constrained state of a release member after the sleeve stent is installed in an aortic stent graft according to an embodiment of the present invention;
Fig. 8 is a schematic diagram of an implantation step of an abdominal aortic stent graft assembly according to an embodiment of the present invention;
fig. 9 is a schematic diagram of a second implantation step of the abdominal aortic stent graft assembly according to the embodiment of the present invention;
Fig. 10 is a schematic diagram of a third implantation step of the abdominal aortic stent graft assembly according to the embodiment of the present invention;
FIG. 11 is a schematic diagram showing a fourth step of implanting an abdominal aortic stent graft assembly according to an embodiment of the present invention;
FIG. 12 is a schematic view of the final state of implantation of the abdominal aortic stent graft assembly according to the embodiment of the present invention;
Fig. 13 is a schematic view of the proximal region of the abdominal aortic stent graft assembly of fig. 12, showing the relationship of the branched stent graft to the sleeve stent.
The icons are 100-sidewall opening, 1-body stent graft, 2-sleeve stent, 21-proximal stent, 211-proximal stent ring, 212-proximal body stent ring, 22-distal stent, 221-distal stent ring, 222-distal body stent ring, 3-pre-catheter, 31-guide lumen, 32-exchange lumen, 33-boss, 4-branch stent graft, 51-main guide wire, 52-branch guide wire.
Detailed Description
For the purpose of making the objects, technical solutions and advantages of the embodiments of the present invention more apparent, the technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings in the embodiments of the present invention, and it is apparent that the described embodiments are some embodiments of the present invention, but not all embodiments of the present invention. The components of the embodiments of the present invention generally described and illustrated in the figures herein may be arranged and designed in a wide variety of different configurations.
Thus, the following detailed description of the embodiments of the invention, as presented in the figures, is not intended to limit the scope of the invention, as claimed, but is merely representative of selected embodiments of the invention. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.
It should be noted that like reference numerals and letters refer to like items in the drawings, and thus once an item is defined in one drawing, no further definition or explanation thereof is necessary in subsequent drawings.
In describing the present invention, it should be noted that:
Unless specifically stated or limited otherwise, the terms "disposed," "mounted," "connected," and "connected" are to be construed broadly, and may be, for example, fixedly connected, detachably connected, or integrally connected, or may be directly connected, or may be indirectly connected through intervening media, or may be in communication between two elements. The specific meaning of the above terms in the present invention will be understood in specific cases by those of ordinary skill in the art.
The terms "proximal," "distal," "axial," "radial," "inner," "outer," and the like refer to an orientation or positional relationship based on that shown in the drawings, or that is conventionally put in place when the inventive product is used, merely to facilitate description of the invention and to simplify description, and do not indicate or imply that the devices or elements referred to must have a particular orientation, be constructed and operated in a particular orientation, and therefore should not be construed as limiting the invention.
The terms "first," "second," and the like, are used merely for distinguishing between descriptions, and not for indicating a total number, or a relative position in time and/or space, and are not to be construed as indicating or implying relative importance.
In the following, some embodiments of the present invention will be described in detail with reference to the accompanying drawings, in which an inflow end of blood flow is a proximal end of a stent, and an outflow end of blood flow is a distal end of the stent after the stent is implanted in a patient. The following examples and features of the various alternative implementations of the examples may be combined with one another without conflict.
Example 1
The present embodiment provides an aortic stent graft, referring to fig. 1 to 5, which includes a main body stent graft 1 and a built-in assembly. The built-in assembly comprises a sleeve support 2 and a preset catheter 3, wherein the main body tectorial membrane support 1, the sleeve support 2 and the preset catheter 3 are mutually parallel and are sequentially sleeved from outside to inside, side wall openings 100 for over-selection of guide wires are respectively formed in the side walls of the main body tectorial membrane support 1, the sleeve support 2 and the preset catheter 3, the sleeve support 2 is fixedly connected to the inner wall of the main body tectorial membrane support 1, the side wall openings 100 of the main body tectorial membrane support 1 are at least partially overlapped with the side wall openings 100 of the sleeve support 2, a guide cavity 31 and an exchange cavity 32 which are mutually isolated are formed in the preset catheter 3, the guide cavity 31 penetrates through two axial end faces of the preset catheter 3, and the exchange cavity 32 penetrates through one axial end surface of the preset catheter 3 and the side wall opening 100 of the preset catheter 3.
The aortic stent graft provided by the embodiment can be applied to the pathological change treatment operation of the aortic involvement branch vessels, the aortic stent graft is implanted into the aorta under the guidance of the guide wire, and then the other guide wire is accurately and rapidly super-selected into the branch vessels under the restraint and guide actions of the built-in component, and the branch stent graft is implanted along the guide wire. The following describes in more detail the implantation method of the aortic stent graft and the functional effects that can be achieved by using the aortic stent graft in a lesion treatment operation of abdominal aorta with renal artery as an example:
When in implantation, the main body covered stent 1 is combined with a branch covered stent to form an abdominal aortic covered stent component, and referring to fig. 8 to 13, in the first step, as shown in fig. 8, the main body covered stent 1 is implanted into the abdominal aorta by a conveyor through femoral artery puncture so that the side wall opening 100 of the main body covered stent is aligned with the renal artery opening; the method comprises the steps of (1) delivering a main guide wire 51 along a guide cavity 31 of a preset catheter 3 in the carotid artery direction (the proximal direction) as shown in fig. 9, simultaneously advancing the preset catheter 3 and the main guide wire 51 in the carotid artery direction (the proximal direction), thirdly, penetrating the preset catheter 3 out of a carotid artery by capturing the main guide wire 51 through a capturing device as shown in fig. 10, withdrawing the main guide wire 51 from the guide cavity 31 of the preset catheter 3, penetrating a branch guide wire 52 from the proximal side into an exchange cavity 32 of the preset catheter 3 to finish guide wire exchange, and fourthly, pushing the preset catheter 3 and the branch guide wire 52 in the distal direction as shown in fig. 11, rotating the preset catheter 3 to enable a side wall opening 100 of the preset catheter 3 to be aligned with a renal artery opening, fixing the preset catheter 3, continuing to push the branch guide wire 52 to smoothly enter a renal artery on one side, and delivering the branch guide wire 52 into the renal artery stent 4 after the side of the renal artery stent is withdrawn from the side of the preset catheter 3. The second and subsequent steps are repeated to implant a branch stent-graft 4 in the other renal artery, and the final implanted state of the abdominal aortic stent-graft assembly is shown in fig. 12 and 13.
In the above operation steps, during the process of selecting the branch guide wire 52 into the renal artery, the sleeve stent 2 can restrict the trend of the preset catheter 3 within a certain range, and meanwhile, the shape of the exchange cavity 32 of the preset catheter 3 is controlled, so that the direction of the branch guide wire 52 when penetrating out of the exchange cavity 32 is approximately perpendicular to the axis of the preset catheter 3, and the branch guide wire 52 is more accurately selected into the renal artery.
In summary, compared with the prior art, the aortic stent graft provided in this embodiment, through the combined action of the sleeve stent 2 and the preset catheter 3 in the built-in component, can effectively and rapidly super-select the branch guide wire into the branch vessel, ensure that the guide wire is super-selected more accurately, and can utilize the constraint of the sleeve stent 2 to control the proximal opening of the implanted branch stent graft to face the proximal opening of the aortic stent graft, and ensure that the blood flow of the branch vessel is well perfused.
With continued reference to fig. 1-5, in the aortic stent graft provided in this embodiment, the sleeve stent 2 preferably comprises a stent and a stent graft attached thereto, the stent comprising a proximal stent 21 and a distal stent 22, with a sidewall opening 100 of the sleeve stent 2 located between the proximal stent 21 and the distal stent 22. The proximal stent 21 and distal stent 22 are proximal stent ring 211 and distal stent ring 221, respectively, at the location closest to the sidewall opening 100 of the sleeve stent 2 and closest to the sidewall opening 100 of the sleeve stent 2. The proximal and distal stent rings 211, 221 are identical in shape, and in particular, referring to fig. 2 and 4, the proximal and distal stent rings 211, 221 comprise first and second arcuate stent sections, respectively, which are axisymmetric and free end-to-end, i.e., the proximal and distal stent rings 211, 221 each form a "fishmouth" like shape, and the proximal and distal stent rings 211, 221 are symmetric about a radial plane at the sidewall opening 100 of the sleeve stent 2, i.e., the proximal and distal stent rings 211, 221 form a set of "reverse stents" in the axial direction, the contour line of the sidewall opening 100 of the sleeve stent 2 extending along the arcuate stent sections where the proximal and distal stent rings 211, 221 abut, i.e., the proximal and distal stent rings 211, 221 axially snap-together to form the "fishmouth" like sidewall opening 100. In this structure, the proximal stent ring 211 and the distal stent ring 221 are used to profile-support the sidewall opening 100 of the sleeve stent 2, so as to prevent the sidewall opening 100 from being pinched during the delivery process or under the influence of blood flow, and keep the sidewall opening 100 of the sleeve stent 2to have a larger guide wire threading area all the time, thereby further ensuring that the branch guide wires 52 can be quickly selected.
In the preferred structure of the sleeve stent 2, it is further preferred that the proximal stent 21 further comprises a plurality of proximal body stent rings 212 having the same shape as the proximal stent rings 211 and being parallel to each other, and/or the distal stent ring 221 further comprises a plurality of distal body stent rings 222 having the same shape as the distal stent rings 221 and being parallel to each other. Thereby, the sleeve stent 2 is formed into a structure of a plurality of stent rings in a 'fish mouth' shape and a coating film connected to the stent rings, under which, when the sleeve stent 2 is radially compressed, each stent ring can reach a smaller compressed diameter than the conventional Z-shaped stent ring, so as to further reduce the delivery diameter of the delivery device, thereby being more beneficial to the delivery of the aortic stent graft by the delivery device and reducing the damage to the blood vessel of a patient in the delivery process.
Further, in the aortic stent graft provided in the present embodiment, it is preferable that the area of the side wall opening 100 of the sleeve stent 2 is smaller than the area of the side wall opening 100 of the main stent graft 1, and it is further preferable that the projections of the side wall opening 100 of the sleeve stent 2 on the radial circumferential surface of the main stent graft 1 are all located inside the side wall opening 100 of the main stent graft 1. Accordingly, the branch guide wire 52 can be ensured to be penetrated out of the side wall opening 100 of the main body covered stent 1 only by penetrating out of the side wall opening 100 of the sleeve stent 2, the phenomenon that the branch guide wire 52 is blocked against the peripheral area of the side wall opening 100 of the main body covered stent 1 after penetrating out of the side wall opening 100 of the sleeve stent 2 when the branch guide wire 52 is over-selected is avoided, the over-selection efficiency of the branch guide wire 52 is further improved, and the sealing performance of the main body covered stent 1 is not damaged.
For stent forms of the main body stent graft 1, including but not limited to a plurality of Z-shaped stent rings, wherein, in the region of the side wall opening 100 of the main body stent graft 1, preferably as shown in FIGS. 1 and 3, for two Z-shaped stent rings axially adjacent to the side wall opening 100 of the main body stent graft 1, the peak height and peak width of the portion of at least one Z-shaped stent ring adjacent to the side wall opening 100 is smaller than the peak height and peak width of other regions in the circumferential direction of the Z-shaped stent ring to accommodate the side wall opening 100 without reducing the distance between the two Z-shaped stent rings, ensuring that the main body stent graft 1 has higher radial support force.
Referring to fig. 6, in the aortic stent graft provided in this embodiment, optionally and preferably, a boss 33 is provided on a side wall of the preset catheter 3, and a side wall opening 100 of the preset catheter 3 is provided on the boss 33, which can prolong the effective length of the exchange cavity 32 of the preset catheter 3, so that a part of the boss 33 is selected into a branch vessel, and the guiding effect of the branch vessel on the branch guide wire 52 is enhanced.
In addition, referring to fig. 7, in the aortic stent graft provided in this embodiment, optionally and preferably, the aortic stent graft further includes a rear release member which circumferentially binds the sleeve stent 2 in a releasable manner. The back release has various optional structural forms including, but not limited to, using a compression film sleeve with a release wire, the compression film sleeve is connected to the sleeve support 2 at a point, the release wire circumferentially restrains the compression film sleeve to radially compress the sleeve support 2, the compression film sleeve is opened by withdrawing the release wire to release the sleeve support 2, or the binding wire is directly used for tying a slip knot, circumferentially winding the sleeve support 2, and withdrawing the binding wire, so that the sleeve support 2 is released. Before the branch guide wire 52 is selected, the sleeve bracket 2 is always in a state of being circumferentially restrained by the rear release piece and radially compressed, so that the restraint and guide functions on the preset catheter 3 are better played, and when the branch guide wire 52 is selected, the rear release piece is released to open the sleeve bracket 2.
Example two
The present embodiment provides an abdominal aortic stent graft assembly, referring to fig. 8 to 13, which includes a branch stent graft 4 and an aortic stent graft provided in any one of the alternative embodiments of the embodiment.
The two radially symmetrical side walls of the main body tectorial membrane bracket 1 are respectively provided with side wall openings 100, and the built-in component at least comprises a group which corresponds to any side wall opening 100 of the main body tectorial membrane bracket 1.
During the delivery, the main body covered stent 1 is delivered to the abdominal aorta, the side wall opening 100 of the main body covered stent 1 is aligned with the renal artery opening, the main guide wire 51 is delivered along the guide cavity 31 of the preset guide tube 3 in the proximal direction, the preset guide tube 3 and the main guide wire 51 are simultaneously pushed in the proximal direction, the main guide wire 51 is caught from the proximal end to penetrate the preset guide tube 3 from the proximal end, the main guide wire 51 is withdrawn, the branch guide wire 52 is penetrated from the exchange cavity 32 of the preset guide tube 3 from the proximal end side, the preset guide tube 3 and the branch guide wire 52 are pushed in the distal direction, when the side wall opening 100 of the preset guide tube 3 reaches the position of the renal artery opening, the preset guide tube 3 is rotated to align the side wall opening 100 of the preset guide tube 3 with the renal artery opening, the preset guide tube 3 is fixed, the branch guide wire 52 is continuously pushed, the branch guide wire 52 smoothly enters one side renal artery to finish the guide wire super-selection of the side renal artery, and then the preset guide tube 3 is withdrawn, the branch guide wire 52 is sent into the renal artery stent conveyer along the branch guide wire 52, and the branch covered stent 4 is implanted into the side renal artery.
Alternatively, the above-mentioned built-in components include two sets, and the two sets of built-in components correspond to the two sidewall openings 100 of the main body stent graft 1, respectively.
The more specific use mode and the beneficial effects that can be realized of the abdominal aorta covered stent assembly provided by the embodiment can be obtained by referring to the first embodiment.
It should be noted that the above embodiments and the optional embodiments thereof in the present specification are only for illustrating the technical solution of the present invention and not for limiting the same, and although the present invention has been described in detail with reference to the above embodiments, it should be understood by those skilled in the art that the technical solution described in the foregoing optional embodiments may be modified or some or all of the technical features may be equivalently replaced, and these modifications or substitutions do not make the essence of the corresponding technical solution deviate from the scope of the technical solution of the embodiments of the present invention, and in addition, it is emphasized again that the features of the embodiments and the optional embodiments in the present specification may be mutually combined without conflict.