A kind of anastomosis system of novel blood vessel and intravascular stent
Technical field
The present invention relates to artificial blood vessels to be placed in technical field, specially a kind of identical system of novel blood vessel and intravascular stent
System.
Background technique
Acute Aortic Dissecting Aneurysm is disease most commonly seen and dangerous in Acute aortic syndromes, although due to
Early diagnosis and timely surgery are handled, and clinical prognosis has been obtained greatly improvement, improves, but the death rate of its early stage
And long term re-treatm ent rate is still very high.Conventional aortic interlayer is there are two types of more commonly used classifying method: Stanford parting and
Debakey parting.For Standford parting, no matter which position interlayer originates from, as long as involving aorta ascendens, person is known as A
Type;Interlayer is originating from descending thoracic aorta and does not involve aorta ascendens person is known as Type B.Debakey divides dissecting aneurysm of aorta
For three types: I type, dissecting aneurysm of aorta is originating from aorta ascendens and involves abdominal aorta;II type, dissecting aneurysm of aorta
It is confined to aorta ascendens;Type III, dissecting aneurysm of aorta originate from descending thoracic aorta, and not involving abdominal aorta downwards, person claims
For IIIA, involving abdominal aorta, person is known as IIIB.StanfordA type is equivalent to DebakeyI type and II type, StanfordB type phase
When in DebakeyIII type.
And acute Stanford A type dissecting aneurysm of aorta is the acute disease of a life-threatening, in initial 24 of falling ill
~48h, the death rate can increase by 1%~2% per hour.Untreated person, the death rate is about 75% when falling ill 2 weeks, 1 Nian Shike high
Up to 91%.Based on this, world wide has been built consensus, and emergency surgery operation is to treat Stanford A type dissection of aorta only
One effective method.Although Surgical technique and preoperative, postoperative care make moderate progress, since the state of an illness is critical, operation is complicated,
The case fatality rate of Stanford A type dissection of aorta is still higher, up to 10%~25%.If early stage can be to acute Stanford
A dissecting aneurysm of aorta is effectively assessed, and sufficient preparation is carried out, then can reduce its death rate.
Stanford A type Aortic Dissection is complicated, different art formulas should be selected according to lesion, marfan's syndrome is simultaneously
Hair active interlayer and dissection of aorta involve aortic root, coronary artery and severe aortic valve incompetence person are caused to use
Bentall operation;Dissection of aorta involve aorta petal, sinus portion can the person's of reparation row David operation.The person that involves aorta ascendens merely
It need only row aorta ascendens displacement technique.Park etc. points out the acute Stanford A type aorta clamp for involving aortic arch
Layer, the full bow displacement technique+bracket elephant trunk technique of row are only correct effective treatment methods.2003, professor Sun Lizhong was first in state
Inside start the treatment that interlayer is carried out using Betall art or aorta ascendens displacement+full Aortic arch replacement+bracket " trunk " operation.
The characteristics of art formula, is using four bifurcated artificial blood vessels and bracket " trunk " technology.Bend entirely using four bifurcated artificial blood vessel rows and sets
It changes, after completion active distal arteries and veins coincide under Deep Hypothermia Circulatory Arrest, selective ascending venography venous, can be inserted through branch artificial blood vessel
Enter arterial cannulation and restore lower part of the body blood perfusion, greatly reduces and stop circulation time.The great advantage of bracket " trunk " is selected to exist
Have self-expanding characteristic in the artificial blood vessel of belt supporting frame, can not only sealing blood vessels inner membrance cut, make be pressurized true chamber obtain maximum
The expansion of limit, while can also squeeze, eliminate false chamber and be attached onto the wall structures torn again, realize vascular wall
It rebuilds.
But three branch vessels need to kiss with innominate artery, left common carotid artery, left subclavian artery respectively in Four branches aortic graft
It closes, vessel trunk proximal end need to coincide with aorta ascendens notch, need to distally coincide with trunk bracket proximal segment, previous anastomotic is more, can lead
It causes:
1. modus operandi is complicated, external time, operating time, Deep Hypothermia Circulatory Arrest time and brain guard time extend, hand
The art death rate, nervous system and other complication increased significantly;
2. previous anastomotic is more so that relatively easy bleeding, anthemorrhagic difficulty in art, postoperative hemorrhage amount is big in art, to increase death
Rate.
Summary of the invention
The purpose of the present invention is to provide the anastomosis systems of a kind of novel blood vessel and intravascular stent, to solve above-mentioned background
It is proposed in technology: a kind of anastomosis system of novel blood vessel and intravascular stent, including branch's artificial blood vessel's group, scaffold artificial's blood
Pipe group exempts from suture ring and identical buckle device, and the main body of the branch artificial blood vessel group is the main body artificial blood vessel of tubular structure, and
In the fixed main split artificial blood vessel for being communicated with tubular structure in the upper end of main body artificial blood vessel, the main split artificial blood vessel's is upper
There are three branch vessels for the fixed connection in end;
The main body of the stent-graft group is the rack body blood vessel of tubular structure, and in rack body blood vessel
Wall fixing sleeve is equipped with the intravascular stent of reticular structure, is arranged with inner core in the intravascular stent, the rack body blood vessel it is outer
Side ring is laid with the cableties of cyclic structure to being arranged with bracing wire in bracing wire, the outside of the rack body blood vessel and
It wears in cableties equipped with wire drawing;
It is arranged in the right end port of the main body artificial blood vessel and exempts from suture ring, the main body for exempting from suture ring is ring junction
The ring set of structure, and it is laid in the outer circle of ring set the rollet of annular trough body structure, the main body artificial blood vessel right end
The outer sheath of port is equipped with the buckle device that coincide, and the buckle device that coincide fastens with suture ring is exempted from, the main body of the identical buckle device
For the fastening ring of ring structure, notch is offered on the wall body for fastening ring, the upper end of the notch and fastening ring
Outside is fixed with the upper fixed block of boss structure, and is laid with the locking belt of strip structure, institute in the side of upper fixed block
The two sides for stating locking belt are laid with the Elastic buckle of boss structure, the lower end of the notch and fix in the outside for fastening ring
Lower fixing sleeve equipped with trough body structure, and locking belt is mutually worn with lower fixing sleeve and is matched.
Preferably, three branch vessels of the fixed connection in upper end of the main split artificial blood vessel are respectively innominate artery
Branch artificial blood vessel, left common carotid artery branch artificial blood vessel and left subclavian artery branch artificial blood vessel, the innominate artery point
The diameter of branch artificial blood vessel is 12mm, length 10cm, and the diameter of the left common carotid artery branch artificial blood vessel is 10mm, length
For 10cm, the diameter of the left subclavian artery branch artificial blood vessel is 8mm, length 10cm.
Preferably, main body artificial blood vessel, main split artificial blood vessel and people from main split in the branch artificial blood vessel group
The material of three branch vessels of work vessel end is polyester material, and main body artificial blood vessel is bend pipe structure.
Preferably, the diameter of the main split artificial blood vessel is 20mm, and the length of main split artificial blood vessel is 2cm.
Preferably, the material of the rack body blood vessel is polyester material, and the intravascular stent is specially W-shaped Nitinol
The diameter of metallic support, the rack body blood vessel is identical as the diameter of main body artificial blood vessel.
Preferably, the material of the inner core is plastic material, and the rear end of the inner core is fixedly connected with handle, and in inner core
Front end be fixedly connected with the seeker of cone structure.
Preferably, the quantity of the rollet is equal with the quantity of decorative pattern boss, and rollet and decorative pattern boss phase
Buckle.
Preferably, the material of the ring set is hardmetal, and the material for fastening ring is elastic metallic.
Compared with prior art, the beneficial effects of the present invention are: structure of the invention setting rationally, functional, have with
Lower advantage:
1. simplifying operating procedure by using the present invention, operating difficulty is reduced, and then make external time, operating time, depth
Hypothermia circulatory arrest time and brain guard time greatly shorten, and reduce operative mortality rate, at the same reduce nervous system and other
The incidence rate of complication;
2. in the present invention, previous anastomotic is less, and by buckle device and the fastening for exempting from suture ring of coincideing, reduces bleeding
Probability thereby reduces the death rate, greatly improves the probability of success of operation.
Detailed description of the invention
Fig. 1 is structure of the invention axis side view;
Fig. 2 is the half-sectional structure axis side view of the present invention;
Fig. 3 is partial structurtes enlarged diagram at A in Fig. 2;
Fig. 4 is the half-sectional topology view of stent-graft;
Fig. 5 is partial structurtes enlarged view at B in Fig. 4;
Fig. 6 is that the half-sectional topology view after inner core is removed in stent-graft;
Fig. 7 is partial structurtes enlarged view at C in Fig. 6;
Fig. 8 is the stent-graft release conditions topology view removed after seal wire and bracing wire;
Fig. 9 is to exempt to suture annulate shaft side structure view;
Figure 10 is the buckle device axis side structure view that coincide.
In figure: 1, branch artificial blood vessel group;2, stent-graft group;3, exempt from suture ring;4, coincide buckle device;101, main
Body artificial blood vessel;102, main split artificial blood vessel;103, innominate artery branch artificial blood vessel;104, left common carotid artery branch is artificial
Blood vessel;105, left subclavian artery branch artificial blood vessel;201, rack body blood vessel;202, intravascular stent;203, inner core;204,
Cableties;205, wire drawing;206, handle;207, seeker;208, bracing wire;301, ring set;302, rollet;401, ring is fastened;
402, decorative pattern boss;403, upper fixed block;404, lower fixing sleeve;405, locking belt;406, Elastic buckle.
Specific embodiment
Following will be combined with the drawings in the embodiments of the present invention, and technical solution in the embodiment of the present invention carries out clear, complete
Site preparation description, it is clear that described embodiments are only a part of the embodiments of the present invention, instead of all the embodiments.It is based on
Embodiment in the present invention, it is obtained by those of ordinary skill in the art without making creative efforts every other
Embodiment shall fall within the protection scope of the present invention.
Please refer to Fig. 1 to Figure 10, the present invention provides a kind of technical solution: a kind of novel blood vessel and intravascular stent coincide
System, including branch artificial blood vessel organize 1, stent-graft group 2, exempt from suture ring 3 and identical buckle device 4, branch artificial blood vessel
The main body of group 1 is the main body artificial blood vessel 101 of tubular structure, and fixation is communicated with tubulose in the upper end of main body artificial blood vessel 101
The main split artificial blood vessel 102 of structure, there are three branch vessels for the fixed connection in the upper end of main split artificial blood vessel 102, wherein leading
The diameter range of body artificial blood vessel 101 is between 26mm-32mm, specially tetra- kinds of specifications of 26mm, 28mm, 30mm and 32mm, because
Within this range for Most patients aorta diameter, the length of main body artificial blood vessel 101 is 15cm;
The main body of stent-graft group 2 is the rack body blood vessel 201 of tubular structure, and in rack body blood vessel 201
Inner wall fixing sleeve be equipped with the intravascular stent 202 of reticular structure, be arranged with inner core 203, rack body blood vessel in intravascular stent 202
201 outside circumferential direction is arranged with bracing wire 208, and the cableties 204 of cyclic structure, rack body blood are laid in bracing wire 208
It the outside of pipe 201 and wears in cableties 204 equipped with wire drawing 205;
It is arranged in the right end port of main body artificial blood vessel 101 and exempts from suture ring 3, the main body for exempting from suture ring 3 is ring structure
Ring set 301, and be laid in the outer circle of ring set 301 rollet 302 of annular trough body structure, main body artificial blood vessel
The outer sheath of 101 right end ports is equipped with the buckle device 4 that coincide, and the buckle device 4 that coincide fastens with suture ring 3 is exempted from, and coincide buckle device 4
Main body be ring structure fastening ring 401, fasten and offer notch on the wall body of ring 401, the upper end of notch and fastening
The outside of ring 401 is fixed with the upper fixed block 403 of boss structure, and is laid with strip knot in the side of upper fixed block 403
The locking belt 405 of structure, the two sides of locking belt 405 are laid with the Elastic buckle 406 of boss structure, the lower end of notch and are detaining
The outside of cyclization 401 is fixed with the lower fixing sleeve 404 of trough body structure, and locking belt 405 is worn with lower 404 phase of fixing sleeve and matched, when
After decorative pattern boss 402 is buckled with 302 phase of rollet, the length adjustment by shrinking lower 404 internal locking band 405 of fixing sleeve is coincide
Buckle device 4 and the clamping level for exempting from suture ring 3.
Further, three branch vessels of the fixed connection in the upper end of main split artificial blood vessel 102 are respectively unknown dynamic
Arteries and veins branch artificial blood vessel 103, left common carotid artery branch artificial blood vessel 104 and left subclavian artery branch artificial blood vessel 105, it is unknown
The diameter of arterial branch artificial blood vessel 103 is 12mm, length 10cm, and the diameter of left common carotid artery branch artificial blood vessel 104 is
10mm, length 10cm, the diameter of left subclavian artery branch artificial blood vessel 105 is 8mm, length 10cm.
Further, the main body artificial blood vessel 101 in branch artificial blood vessel group 1, main split artificial blood vessel 102 and main point
The material of three branch vessels of 102 end of branch artificial blood vessel is polyester material, and main body artificial blood vessel 101 is bend pipe knot
Structure, this makes entire branch artificial blood vessel group 1 have good elasticity.
Further, the diameter of main split artificial blood vessel 102 is 20mm, and the length of main split artificial blood vessel 102 is
2cm, it is too short in this way convenient for providing sufficient space for blocking artificial blood vessel, it is not easy clamp, it is too long to be then easy bending.
Further, the material of rack body blood vessel 201 is polyester material, has rack body blood vessel 201 good
Elasticity, intravascular stent 202 be specially W-shaped Nitinol metallic support, when wire drawing 205 along rack body blood vessel 201 outer wall from
After pulling out in cableties 204, the bracing wire around rack body blood vessel 201 is unclamped rapidly, and bound intravascular stent 202 obtains at this time
Rack body blood vessel 201 can be propped up automatically after release, the diameter of rack body blood vessel 201 is straight with main body artificial blood vessel's 101
Diameter is identical.
Further, the material of inner core 203 is plastic material, and the rear end of inner core 203 is fixedly connected with handle 206, and
The front end of inner core 203 is fixedly connected with the seeker 207 of cone structure, and the front end that this structure is conducive to inner core 203 is imported into
In descending aorta.
Further, the quantity of rollet 302 is equal with the quantity of decorative pattern boss 402, and rollet 302 and decorative pattern
402 phase of boss buckle, by the fastening of rollet 302 and decorative pattern boss 402 so that exempting from suture ring 3 and identical buckle device 4 tightly
Tight is fixed together.
Further, the material of ring set 301 is hardmetal, and the material for fastening ring 401 is elastic metallic, and this structure makes
Must exempt from suture ring 3 and identical buckle device 4 all has stronger support strength.
Inner core 203: first importeding into the lumen of stent-graft group 2 by working principle, and bracing wire 208 is looped around branch
The outside of frame body blood vessel 201 tightens rack body blood vessel 201, then uses wire drawing 205 through the cableties in bracing wire 208
204, adjusting bracket artificial blood vessel group 2 is in trunk shape, this process is completed by producer;
In the course of surgery, the aorta ascendens for cutting off lesion leads the seeker 207 of the front end of stent-graft group 2
Enter to after descending aorta, pull out wire drawing 205, and then open the release of intravascular stent 202, inner core 203 is then extracted out, with identical button
Device 4 fastens active distal arteries and veins on exempting from suture ring 3, according to the elasticity of aorta size adjusting fitting buckle device 4, in turn
Complete the installation of stent-graft group 2;
Then innominate artery branch artificial blood vessel 103 and left common carotid artery branch artificial blood vessel 104 are fit to nothing respectively
On name artery and left common carotid artery, left subclavian artery branch artificial blood vessel 105 coincide at left subclavian artery as needed,
Block main split artificial blood vessel 102, left common carotid artery branch artificial blood vessel 104 and left subclavian artery branch artificial blood vessel 105
Respectively by 103 blood supply of innominate artery branch artificial blood vessel, to increase the time that bilateral cerebral is perfused in art, nerveous system in art is reduced
System damage, while also correspondingly reducing operating time;
Finally 101 proximal end of main body artificial blood vessel and active proximal arteries and veins root are sutured, open exhaust, after listening circulation, hemostasis
Terminate operation.
Row bends the patient of displacement full when for acute type A aortic dissection, can effectively be simplified by using the present invention
Operation shortens operating time and Deep Hypothermia Circulatory Arrest time, improves the perfusion of art midbrain, reduces previous anastomotic quantity in art, to drop
The low incidence of Anastomotic bleeding event, postoperative nerve system and cardiovascular complications.
It although an embodiment of the present invention has been shown and described, for the ordinary skill in the art, can be with
A variety of variations, modification, replacement can be carried out to these embodiments without departing from the principles and spirit of the present invention by understanding
And modification, the scope of the present invention is defined by the appended.