Coronary fistula covered stent and conveying system
Technical Field
The invention relates to the technical field of medical equipment, in particular to a coronary fistula covered stent and a delivery system.
Background
Coronary fistula (CAF) is a rare congenital vascular malformation that accounts for 0.27% -0.4% of congenital heart disease, and refers to the presence of abnormal branches of communication between coronary arteries and a certain cardiac cavity or great vessel, so that blood in coronary arteries can be shunted to the communicating cardiac cavity or great vessel through the branches of communication (fistula). When the blood shunt volume of the coronary fistula is large, the perfusion pressure of the coronary artery can be rapidly reduced, the local myocardial blood supply is affected, myocardial ischemia is caused, and angina and even myocardial necrosis can be generated. Prolonged shunting of coronary fistulas can also cause decreased cardiac function, ultimately leading to heart failure.
Currently, methods of treatment for coronary fistulas include surgical and medical interventions. The surgical treatment needs to be performed by opening the chest, has large surgical trauma, and is suitable for patients with heart diseases needing surgical treatment and patients with multiple fistulas and coronary fistula with complex anatomical structures.
Most coronary fistulas can be treated by medical intervention, with a therapeutic effect similar to surgery. The current major interventional treatment techniques include occluding coronary fistulas with a spring coil or the like, or covering the coronary ostia with a stent graft. The former is not easy to realize complete plugging, and has more required spring rings and high cost. The latter may simultaneously block the branches of the coronary arteries, artificially causing acute myocardial infarction.
Disclosure of Invention
The technical problem to be solved by the embodiment of the invention is to provide a covered stent for coronary fistula and a conveying system, which are simple to operate, accurate in positioning, low in price, safe and reliable, and can realize rapid occlusion of the coronary fistula.
In order to achieve the purpose, the invention discloses a coronary fistula covered stent which comprises a main body covered membrane and a metal bare stent, wherein the main body covered membrane is arranged on the metal bare stent, the metal bare stent is of a cylindrical structure, the main body covered membrane comprises a first covered membrane and a second covered membrane, the first covered membrane is of a cylindrical structure, the second covered membrane is of a funnel-shaped structure, the first covered membrane and the second covered membrane are integrally formed, so that a bullet-shaped structure is formed between the first covered membrane and the second covered membrane, the metal bare stent is provided with a covered membrane section and a bare stent section, and the first covered membrane tightly covers the covered membrane section of the metal bare stent, so that the metal bare stent forms the bullet-shaped coronary fistula covered stent.
Preferably, including main part tectorial membrane, the naked support of metal, the main part tectorial membrane set up in on the naked support of metal, the naked support of metal includes first support end, second support end, the first support end of the naked support of metal is circular structure, the diameter taper of second support end is funnel-shaped structure, the naked support of metal wholly is bullet shape structure, the naked support of metal has tectorial membrane section, naked support section, the main part tectorial membrane be with the outline assorted bullet shape structure of the naked support of metal, including first tectorial membrane, second tectorial membrane, first tectorial membrane closely cover in on the tectorial membrane section of the naked support of metal, the second tectorial membrane has support section and naked tectorial membrane section, the support section of second tectorial membrane closely cover in the second support of the naked support of metal is served.
Preferably, the bare metal stent comprises a plurality of metal rings, the metal rings are arranged at intervals along the axial direction, and a reinforcing rod is arranged between any two adjacent metal rings.
Preferably, the length of the metal bare stent is 14-24 mm, the diameter of the metal bare stent is 2-5 mm, the length of the bare stent section of the metal bare stent is 3-8 mm, and the length of the second covering film is 3-5 mm.
Preferably, the length of the metal bare stent is 16-28 mm, the length of the second stent end is 2-4 mm, the diameter of the first stent end is 2-5 mm, the length of the bare stent section of the metal bare stent is 3-8 mm, and the length of the second cover film is 3-5 mm.
Preferably, the invention further provides a conveying system of the coronary fistula covered stent, which is characterized by comprising a catheter and a balloon, wherein the balloon is arranged at the head end of the catheter, the tail end of the balloon is communicated with the catheter, a wire guide pipe is arranged inside one end of the catheter, which is adjacent to the balloon, the head end of the wire guide pipe penetrates through the catheter and extends outwards, so that the head end of the balloon is fixed on the wire guide pipe, the tail end of the catheter is provided with a liquid injection port communicated with the catheter, and the coronary fistula covered stent is tightly covered on the balloon.
Preferably, the guide wire pipe set up in the inside of pipe, the middle part lateral wall of pipe be provided with the seal wire export that the end of guide wire pipe is linked together, the head end of guide wire pipe be provided with the seal wire entry that the seal wire export is linked together.
Preferably, the length of the guide wire tube is 200-300 mm, the inner diameter is 0.3-0.4 mm, and the outer diameter is 0.35-1 mm.
Preferably, one end of the guide wire tube, which is adjacent to the guide wire inlet, is provided with a second film-coated mark point, and one end of the guide wire tube, which is not adjacent to the guide wire inlet, is provided with a first film-coated mark point and a bare stent section mark point.
Preferably, the structure of the balloon is bullet-shaped matched with the outer contour of the coronary fistula covered stent, the length of the cylindrical structure part of the balloon is 5-8 mm longer than that of the cylindrical structure part of the metal bare stent, and the length of the second covering film is 1-3 mm longer than that of the funnel-shaped structure part of the balloon.
Compared with the prior art, the invention has the beneficial effects that:
a bullet-shaped covered stent is prepared by specially designing the structure of the covered stent. When in use, the bullet-shaped covered stent is compressed on the balloon, the bullet-shaped covered stent and the balloon are delivered to a blood vessel part of a coronary fistula through the catheter under the guide wire mediation, the injection port at the tail end of the catheter is connected with a pressure pump to inject a contrast agent diluted by normal saline, the balloon is filled, the bullet-shaped covered stent can be fully opened because the balloon is in a bullet shape matched with the structure of the bullet-shaped covered stent, the covering membrane is in a bullet shape consisting of a cylinder shape and a funnel shape, the cylinder-shaped covering membrane of the bullet-shaped covered stent is tightly attached to an inner blood vessel membrane after being released, meanwhile, a naked stent section of the covered stent is directly and tightly attached to the inner wall of the blood vessel, the anchoring force is increased, the stent is prevented from shifting, the main blood flow of the coronary fistula can be blocked by the covering membrane outside the stent, the end opening at the funnel shape part is small, and platelets, cellulose and blood coagulation substances can be easily retained only by the guide wire tube, the thrombus plugging funnel-shaped film covering port is formed gradually, the effect of gradually and completely plugging the coronary artery fistula can be achieved, a machine body has a certain adaptation process, and the coronary artery fistula can be plugged accurately. When necessary, also can place the spring coil in bullet shape tectorial membrane support's infundibulate tectorial membrane port department with quick shutoff coronary artery fistula, because of infundibulate tectorial membrane port is little, can effectual reduction spring coil's use, reduce cost. The invention has the advantages of simple operation, accurate positioning, low price, safety and reliability, and is suitable for the occlusion of coronary fistula.
Drawings
FIG. 1 is a schematic view of a stent graft for coronary fistula according to an embodiment;
FIG. 2 is a schematic structural view of a coronary fistula stent graft delivery system;
FIG. 3 is a schematic view of a balloon;
FIG. 4 is a view of the coronary fistula stent graft delivery system of FIG. 2 in use after being inflated with a balloon;
FIG. 5 is a schematic view of a coronary fistula stent delivered to and retained in a coronary fistula vessel;
fig. 6 is a schematic structural view of a coronary fistula stent graft according to a second embodiment.
Detailed Description
In order to make the objects, technical solutions and advantages of the present invention more apparent, the present invention will be described in further detail with reference to fig. 1 to 6.
The first embodiment is as follows:
referring to fig. 1, a coronary artery fistula covered stent 1 comprises a main body covered stent 2 and a metal bare stent 3, wherein the main body covered stent 2 is arranged on the metal bare stent 3, the metal bare stent 3 is of a cylindrical structure, the metal bare stent 3 comprises a plurality of metal rings 33, the plurality of metal rings 33 are arranged at intervals along the axial direction, and a reinforcing rod 34 is arranged between any two adjacent metal rings 33.
The main part tectorial membrane 2 includes first tectorial membrane 21, second tectorial membrane 22, first tectorial membrane 21 is cylindrical structure, second tectorial membrane 22 is the infundibulate structure, integrated into one piece between first tectorial membrane 21 and the second tectorial membrane 22 makes first, second tectorial membrane 21, form bullet shape structure between 22, the second tectorial membrane port of infundibulate structure is little, only accessible wire guide pipe to easily make platelet, cellulose and blood coagulation material to be detained, form the port of thrombus shutoff second tectorial membrane gradually.
The bare metal stent 3 is provided with a covering membrane section 31 and a bare stent section 32, the first covering membrane 21 tightly covers the covering membrane section 31 of the bare metal stent 3, the bare metal stent section 32 of the bare metal stent 3 has no covering membrane, the bare metal stent section 32 without the covering membrane can be directly and tightly attached to the inner wall of a blood vessel, the anchoring force is increased, the covered coronary fistula stent is prevented from displacing, the length of the bare metal stent 3 is 14-24 mm, the diameter of the bare metal stent 3 is preferably 20mm, the diameter of the bare metal stent 3 is 2-5 mm, the diameter of the bare metal stent 3 is preferably 3mm, the length of the bare metal stent section 32 of the bare metal stent 3 is 3-8 mm, the length of the second covering membrane 22 is preferably 5mm, the length of the second covering membrane 22 is 3-5 mm, the diameter of the bare metal stent 3 is preferably 4mm, and the bare metal stent 3 forms a bullet-shaped covered coronary fistula stent 1, which is beneficial for plugging the blood vessel.
Referring to fig. 2-4, the invention further provides a conveying system of a coronary fistula covered stent 1, the conveying system comprises a catheter 4 and a balloon 5, the balloon 5 is arranged at the head end of the catheter 4, a guide wire tube 6 is arranged inside one end of the catheter 4 adjacent to the balloon, the head end of the guide wire tube 6 penetrates through the catheter 4 and extends outwards, the head end of the balloon 5 is fixed on the guide wire tube 6, a liquid injection port 71 communicated with the tail end of the catheter 4 is arranged at the tail end of the catheter 4, the tail end of the balloon 5 is communicated with the catheter 4, the structure of the balloon 5 is in a bullet shape matched with the outer contour of the coronary fistula covered stent 1, the coronary fistula covered stent 1 is tightly covered on the balloon 5, the length of a cylindrical structure part of the balloon 5 is 5-8 mm longer than that of the metal bare stent 3, in the embodiment, 6mm is preferred, the length of the second covering film 22 is 1-3 mm longer than that of a funnel-shaped structure part of the balloon 5, in the embodiment, the diameter of the balloon 5 is preferably 2mm, so that the balloon can sufficiently support the coronary fistula covered stent 1 without causing deformation of the port of the second covered membrane 22, the side wall of the middle part of the catheter 4 is provided with a guide wire outlet 61 communicated with the tail end of the guide wire tube 6, and the head end of the guide wire tube 6 is provided with a guide wire inlet communicated with the guide wire outlet.
The length of the guide wire tube 6 is 200 mm and 300mm, the inner diameter is 0.3-0.4 mm and the inner diameter is 0.35mm, the outer diameter is 0.35-1 mm and the outer diameter is 0.5 mm.
Referring to fig. 1-5, a medical metal guide wire enters a guide wire tube 6 through a guide wire inlet and passes out of a guide wire outlet, and a catheter 4 sends a coronary fistula covered stent 1 and a balloon 5 into a specified position in a blood vessel under the mediation of the guide wire; then, injecting a contrast agent diluted by normal saline into the injection port 71 through a pressure pump, injecting the contrast agent diluted by the normal saline into the balloon 5 along the catheter 4, filling the balloon 5, gradually expanding the balloon 5 along with the injection of the contrast agent to restore to a bullet shape, thereby fully expanding the coronary fistula covered stent 1, then withdrawing the contrast agent, retracting and withdrawing the balloon, so that the coronary fistula covered stent 1 stays at a specified position in a blood vessel, the first covering membrane 21 of the coronary fistula covered stent 1 is tightly attached to the inner membrane of the blood vessel, meanwhile, the uncovered bare stent section 32 of the coronary fistula covered stent 1 is directly and tightly attached to the inner wall of the blood vessel, increasing anchoring force, preventing stent displacement, retaining blood platelets, cellulose and blood coagulation substances through the second covering membrane 22 of the coronary fistula covered stent 1, thereby gradually forming thrombus and completely blocking the port of the second covering membrane 22 with a funnel-shaped structure to achieve the effect of blocking the coronary fistula, avoiding abnormal connection between the blood vessel and the heart chamber or the thoracic cavity.
One end of the guide wire tube 6 adjacent to the guide wire inlet is provided with a second tectorial membrane mark point 62, one end of the guide wire tube 6 not adjacent to the guide wire inlet is provided with a first tectorial membrane mark point 63 and a naked support section mark point 64, and the coronary fistula tectorial membrane support can be better placed at a proper position in the operation process by marking the positions of the main tectorial membrane and the coronary fistula tectorial membrane support.
Example two:
referring to fig. 6, the covered stent for coronary fistula comprises a main body covered membrane 2 and a metal bare stent 3, wherein the main body covered membrane 2 is arranged on the metal bare stent 3, the metal bare stent 3 comprises a first stent end 35 and a second stent end 36, the first stent end 35 is of a circular structure, the diameter of the second stent end 36 is gradually reduced to be of a funnel-shaped structure, the metal bare stent 3 is of an overall bullet-shaped structure, and the metal bare stent 3 is provided with a membrane covered section 31 and a bare stent section 32; the main body coating 2 is bullet-shaped and matched with the outer contour of the metal bare stent 3, and comprises a first coating 21 and a second coating 22, wherein the first coating 21 is of a cylindrical structure, the second coating 22 is of a funnel-shaped structure, the first coating 21 and the second coating 22 are integrally formed, and the second coating 22 is provided with a stent section 23 and a bare coating section 24; the first covering film 21 is tightly covered on the covering film section 31 of the metal bare stent 3, and the stent section 23 in the second covering film 22 is tightly covered on the second stent end 36, so that the metal bare stent 3 can fully support the main body covering film 2, and the plugging of the blood vessel is more stable.
The length of the metal bare stent 3 is 16-28 mm, wherein the length of the second stent end is 2-4 mm, the diameter of the first stent end 35 is 2-5 mm, the length of the bare stent section 32 of the metal bare stent 3 is 3-8 mm, and the length of the second coating 22 is 3-5 mm.
The bare metal stent 3 includes a plurality of metal rings 33, the plurality of metal rings 33 are arranged at intervals in the axial direction, and a reinforcing rod 34 is arranged between any two adjacent metal rings 33.
It should be understood that the above-mentioned embodiments are merely illustrative of the technical concept and features of the present invention, and are not intended to limit the scope of the present invention, which is defined by the following claims.