CN113813091B - Support for reconstructing branch artery of aortic arch part in aortic arch intracavity repair operation - Google Patents
Support for reconstructing branch artery of aortic arch part in aortic arch intracavity repair operation Download PDFInfo
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- CN113813091B CN113813091B CN202111101191.7A CN202111101191A CN113813091B CN 113813091 B CN113813091 B CN 113813091B CN 202111101191 A CN202111101191 A CN 202111101191A CN 113813091 B CN113813091 B CN 113813091B
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- 210000002376 aorta thoracic Anatomy 0.000 title claims abstract description 38
- 210000001367 artery Anatomy 0.000 title claims abstract description 28
- 230000008439 repair process Effects 0.000 title claims abstract description 22
- 210000001168 carotid artery common Anatomy 0.000 claims abstract description 63
- 210000003270 subclavian artery Anatomy 0.000 claims abstract description 35
- 229920004933 Terylene® Polymers 0.000 claims abstract description 8
- 239000000463 material Substances 0.000 claims abstract description 8
- 239000005020 polyethylene terephthalate Substances 0.000 claims abstract description 8
- 238000009958 sewing Methods 0.000 claims description 2
- 230000017531 blood circulation Effects 0.000 abstract description 11
- 230000010412 perfusion Effects 0.000 abstract description 11
- 230000036770 blood supply Effects 0.000 abstract description 9
- 208000007474 aortic aneurysm Diseases 0.000 abstract description 8
- 210000001364 upper extremity Anatomy 0.000 abstract description 7
- 230000000302 ischemic effect Effects 0.000 abstract description 6
- 238000000034 method Methods 0.000 description 10
- 238000001356 surgical procedure Methods 0.000 description 9
- 210000000709 aorta Anatomy 0.000 description 7
- 238000005516 engineering process Methods 0.000 description 6
- 238000004873 anchoring Methods 0.000 description 5
- 208000014674 injury Diseases 0.000 description 5
- 206010002329 Aneurysm Diseases 0.000 description 4
- 201000008982 Thoracic Aortic Aneurysm Diseases 0.000 description 4
- 210000004204 blood vessel Anatomy 0.000 description 4
- 230000003902 lesion Effects 0.000 description 4
- 208000027418 Wounds and injury Diseases 0.000 description 3
- 230000008081 blood perfusion Effects 0.000 description 3
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- 238000011161 development Methods 0.000 description 3
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- 238000007792 addition Methods 0.000 description 2
- 210000000038 chest Anatomy 0.000 description 2
- 208000003457 familial thoracic 1 aortic aneurysm Diseases 0.000 description 2
- 238000002690 local anesthesia Methods 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 210000000115 thoracic cavity Anatomy 0.000 description 2
- 206010056346 Anastomotic haemorrhage Diseases 0.000 description 1
- 208000025494 Aortic disease Diseases 0.000 description 1
- 206010051093 Cardiopulmonary failure Diseases 0.000 description 1
- 206010008088 Cerebral artery embolism Diseases 0.000 description 1
- 208000009087 False Aneurysm Diseases 0.000 description 1
- 206010056559 Graft infection Diseases 0.000 description 1
- 206010033892 Paraplegia Diseases 0.000 description 1
- 208000007536 Thrombosis Diseases 0.000 description 1
- 238000002679 ablation Methods 0.000 description 1
- 230000032683 aging Effects 0.000 description 1
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- 210000002168 brachiocephalic trunk Anatomy 0.000 description 1
- 230000008859 change Effects 0.000 description 1
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- 238000001514 detection method Methods 0.000 description 1
- 235000005911 diet Nutrition 0.000 description 1
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- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 238000002692 epidural anesthesia Methods 0.000 description 1
- 238000011156 evaluation Methods 0.000 description 1
- 210000001105 femoral artery Anatomy 0.000 description 1
- 238000002695 general anesthesia Methods 0.000 description 1
- 239000007943 implant Substances 0.000 description 1
- 238000001802 infusion Methods 0.000 description 1
- 239000011229 interlayer Substances 0.000 description 1
- 201000010849 intracranial embolism Diseases 0.000 description 1
- 208000037906 ischaemic injury Diseases 0.000 description 1
- 238000002955 isolation Methods 0.000 description 1
- 230000007774 longterm Effects 0.000 description 1
- 210000003141 lower extremity Anatomy 0.000 description 1
- 239000012528 membrane Substances 0.000 description 1
- 210000005036 nerve Anatomy 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
Abstract
The invention relates to a stent for reconstructing a branch artery of an arch part in an aortic arch cavity repair operation, which comprises a stent main body, wherein the stent comprises a stent main body and a stent main body; the top end of the bracket main body is provided with a left common carotid artery fenestration and a left subclavian artery fenestration; the bottoms of the left common carotid artery fenestration and the left subclavian artery fenestration are respectively sewed with a left common carotid artery branch and a left common carotid artery branch which are in a trouser-tube shape through terylene materials; the left common carotid artery branch and the tail end of the left common carotid artery branch are both constructed by a woven bracket. The advantages are as follows: when the aortic aneurysm is used for treating the left common carotid artery and the left subclavian artery, the branch arteries of the arch part are rebuilt, the blood flow perfusion of the branch arteries is maintained, the blood supply condition of the head, neck and upper limbs is improved, and the ischemic complications of patients are reduced.
Description
Technical Field
The invention relates to the technical field of medical appliances, in particular to a bracket for reconstructing a branch artery of an arch part in an aortic arch intracavity repair operation.
Background
Thoracic aortic aneurysms are serious vascular surgery aortic diseases that result in limited dilation of the aorta due to injury or lesions of the arterial wall. With the progress of the aging in China and the change of the dietary structure and the development of modern examination means, the detection rate of the thoracic aortic aneurysm is increased year by year.
Traditional surgical methods for treating thoracic aortic aneurysms include aortic aneurysm ablation and vascular graft prosthesis. For aneurysms involving the aortic arch, total arch replacement therapy is also required. Because of the great trauma of traditional open surgery, and the poor underlying condition of elderly patients, the mortality rate of elderly patients receiving traditional surgery is relatively high and there are a number of complications including anastomotic hemorrhage, pseudoaneurysms, spinal cord ischemic injuries and paraplegia, graft occlusion, graft infection, and the like.
Aortic endoluminal repair (endovascular aortic repair, EVAR) is a current new surgical procedure for treating aortic aneurysms by delivering a folded, vascular prosthesis membrane covered metallic stent into the aortic aneurysm lumen through a small incision in the femoral artery using a special infusion system, and securing the endoluminal implant to the normal arterial wall proximal to the aneurysm to isolate the aneurysm. Compared with the traditional open surgery, the EVAR has the following advantages: (1) EVAR avoids chest opening and extracorporeal circulation, thus greatly reducing surgical trauma; (2) The blood supply of viscera and lower limbs is fully ensured without clamping the aorta in the operation; (3) Most EVAR procedures are currently performed under local anesthesia, and a few under epidural anesthesia or general anesthesia, and are particularly useful for patients who combine severe cardiopulmonary insufficiency with other high risk factors. The thoracic aortic intracavity repair technology has been widely used for treating various diseases such as thoracic aortic aneurysm far from the left subclavian artery opening, and the advantages of minimally invasive, rapid and effective have prompted the technology to become the first choice for treatment.
The aortic arch is the upper arcuately curved portion of the aorta, transitioning to the descending aorta at the lower edge of the 4 th thoracic vertebrae. 3 larger arteries are sent out from the convex side of the bow and are divided into a innominate artery, a left common carotid artery and a left subclavian artery from right to left in sequence, so that the blood supply of the head, neck and upper limbs is maintained. However, the lesion of the aortic arch is involved in isolation of the lesion of the aortic arch and reconstruction of branch arteries on the arch, so that the application of the intracavity technology is greatly restricted.
The on-arch branch reconstruction technique is divided into a branch removing technique and an intra-arch branch cavity reconstruction according to whether the branch opening position is changed or not. The arch debranching technique bypasses or indexes and rebuilds the upper arch artery through surgery, and creates an anchoring area for intracavity repair. However, the debranching technique requires multiple vascular anastomoses, which increases the risk of complications such as cerebral embolism and nerve plexus injury, and is difficult for some high-risk patients to tolerate. In recent years, the intracavitary treatment technique for reconstructing the aortic arch is a hot spot studied by scholars at home and abroad. The application of various intracavity treatment techniques avoids open chest surgery, further reduces the trauma of the surgery, and initially shows great advantages in aortic arch lesion treatment. However, the prior multi-cavity internal operation technology such as parallel bracket technology, windowing technology and the like is still applied to super-indication, lacks long-term evaluation results and evidence-based medical evidence, and has great limitation in wide clinical application. The development of new endoluminal therapeutic devices for reconstructing aortic arch is a future development direction.
Chinese patent literature: CN201320567853.4, filing date 2013.09.13, patent name: an endoluminal stent releaser. An endoluminal stent releaser is disclosed which delivers and releases stents into the lumen of a human vessel and belongs to medical devices. The main structure of the releaser is a release wire and catheter assembly.
Chinese patent literature: CN200520005218.2, filing date 2005.03.02, patent name: a split stent-type vessel for use in an ascending aorta and aortic arch endoluminal prosthesis. The split type bracket type blood vessel for the ascending aorta and aortic arch intracavity repair is composed of three modules, wherein a trunk part of a second module is sleeved with a short arm branch of a first module; the third thin end of the module is sleeved with the short arm branch of the second module. The stent type blood vessel is suitable for the intracavity repair of ascending aorta, aortic arch aneurysm and interlayer. The operation can be performed under local anesthesia, surgical operation assistance is not needed, the operation wound is reduced to the minimum, and the blood supply of important branch vessels of the aortic arch part is ensured through designing branches.
An endoluminal stent releaser in the above patent document CN201320567853.4, wherein the endoluminal stent releaser delivers the stent into the target artery in a simple and reliable manner, the length of the releaser is suitable for operation in the surgical procedure, the possible damage of the releaser to the arterial vessel is avoided, the possible operation difficulty caused by the releaser is reduced, the safety and reliability of treatment are improved, and the endoluminal stent releaser is particularly suitable for repairing the branch artery of the aortic arch by adopting an interventional method in aortic arch artificial vessel replacement surgery, and is safe and reliable to use; and patent literature: the split type stent type blood vessel for the ascending aorta and aortic arch intracavity repair in CN200520005218.2 effectively plays a role of fixing the stent and preventing the stent from shifting by the stent which is positioned in the aortic arch branch blood vessel. And the common complications of internal leakage of the stent, thrombosis in the stent and stenting of the stent are reduced by design. And the multi-part markers can facilitate the positioning in operation. However, there is no report on a stent for reconstructing a branch artery of an aortic arch in an aortic arch intracavity repair operation for reducing ischemic complications of a patient by reconstructing the branch artery of the arch, maintaining blood perfusion of the branch artery, improving blood supply conditions of the head, neck and upper limbs when the aortic aneurysm involves the left common carotid artery and the left subclavian artery.
In view of the foregoing, there is a need for a stent for reconstructing a branch artery of an aortic arch in an aortic arch intracavity repair procedure for reducing ischemic complications in patients by reconstructing the branch artery of the arch, maintaining blood perfusion of the branch artery, improving blood supply to the head and neck and upper limbs, and reducing the left common carotid artery and the left subclavian artery.
Disclosure of Invention
The invention aims to overcome the defects of the prior art and provide a stent for reconstructing a branch artery of an arch part in an aortic arch intracavity repair operation, which is used for reconstructing the branch artery of the arch part when aortic aneurysm affects the left common carotid artery and the left subclavian artery, maintaining blood flow perfusion of the branch artery, improving the blood supply condition of the head, neck and upper limbs and reducing ischemic complications of patients.
In order to achieve the above purpose, the technical scheme adopted by the invention is as follows:
a stent for reconstructing a branch artery of an arch part in an aortic arch cavity repair operation, which comprises a stent main body; the top end of the bracket main body is provided with a left common carotid artery fenestration and a left subclavian artery fenestration; the bottoms of the left common carotid artery fenestration and the left subclavian artery fenestration are provided with left common carotid artery branches and left common carotid artery branches; the left common carotid artery branch and the tail end of the left common carotid artery branch are both constructed by a woven bracket.
As a preferable technical scheme, the left common carotid artery branch and the left common carotid artery branch are made of terylene materials, are of a trouser-leg structure, and are connected with the bottoms of the left common carotid artery fenestration and the left subclavian artery fenestration in a sewing mode.
The invention has the advantages that:
1. the aortic stent top fenestration is designed to cover the left common carotid artery and the left subclavian artery by designing a top large fenestration.
2. The left common carotid artery branch is designed by windowing the bracket, the trouser leg branch is constructed by terylene material, and the blood flow perfusion of the left common carotid artery is rebuilt.
3. The left subclavian artery branch is designed by windowing the bracket, the trouser leg branch is constructed by terylene materials, and the blood flow perfusion of the left subclavian artery is rebuilt.
4. The stent fenestration designs a left common carotid artery branch end braided stent to provide a proximal anchoring region for the left common carotid artery, reestablishing blood perfusion for the left common carotid artery.
5. The stent fenestration designs a left subclavian artery branch end braided stent to provide a proximal anchoring zone for the left subclavian artery, reestablishing blood flow perfusion for the left subclavian artery.
Drawings
Fig. 1 is a schematic view of the appearance structure of a stent for reconstructing a branch artery of an aortic arch part in an aortic arch intracavity repair operation.
Fig. 2 is an internal view schematically showing a stent for reconstructing a branch artery of an arch portion in an aortic arch intracavity repair operation according to the present invention.
Detailed Description
The invention is further described below with reference to examples and with reference to the accompanying drawings.
Reference numerals and components referred to in the drawings are as follows:
1. bracket body 2 left common carotid artery fenestration
3. Left subclavian artery fenestration 4. Left common carotid artery branch
5. Left common carotid artery branch
Example 1
Referring to fig. 1-2, fig. 1 is a schematic view showing the external appearance and structure of a stent for reconstructing a branch artery of an aortic arch in an aortic arch cavity repair operation according to the present invention, and fig. 2 is a schematic view showing the internal appearance of a stent for reconstructing a branch artery of an aortic arch in an aortic arch cavity repair operation according to the present invention. A stent for reconstructing a branch artery of an arch part in an aortic arch cavity repair operation, which comprises a stent main body 1; the top end of the bracket main body 1 is provided with a left common carotid artery fenestration 2 and a left subclavian artery fenestration 3; the bottoms of the left common carotid artery fenestration 2 and the left subclavian artery fenestration 3 are respectively sewed with a left common carotid artery branch 4 and a left common carotid artery branch 5 which are in a trouser-leg shape through terylene materials; the tail ends of the left common carotid artery branch 4 and the left common carotid artery branch 5 are both constructed by a woven bracket.
It should be noted that: the top end of the bracket main body 1 is provided with two windows of a left common carotid artery and a left subclavian artery, which can respectively cover the left common carotid artery and the left subclavian artery; the bottoms of the left common carotid artery fenestration 2 and the left subclavian artery fenestration 3 are respectively sewed with a left common carotid artery branch 4 and a left common carotid artery branch 5 which are in a trouser-tube shape through terylene materials and can be respectively used for reconstructing blood flow perfusion of the left common carotid artery and reconstructing blood flow perfusion of the left subclavian artery so as to improve the blood supply condition of the head, the neck and the upper limbs; the tail ends of the left common carotid artery branch 4 and the left common carotid artery branch 5 are designed by a woven bracket, so that the proximal anchoring areas of the left common carotid artery and the left subclavian artery can be respectively provided, the blood flow perfusion of the left common carotid artery and the left subclavian artery can be rebuilt, and the ischemic complications of patients can be reduced.
The stent for reconstructing the branch artery of the arch part in the aortic arch intracavity repair operation is characterized in that the top end of the stent main body is provided with two windows of the left common carotid artery and the left subclavian artery, and the left common carotid artery and the left subclavian artery can be respectively covered; the left common carotid artery branch and the left common carotid artery branch which are in a trouser-tube shape are respectively sewn at the bottoms of the left common carotid artery fenestration and the left subclavian artery fenestration through terylene materials and can be respectively used for reconstructing blood flow perfusion of the left common carotid artery and reconstructing blood flow perfusion of the left subclavian artery so as to improve the blood supply condition of the head, the neck and the upper limbs; the left common carotid artery branch and the tail end of the left common carotid artery branch are designed by a woven bracket, so that the proximal anchoring areas of the left common carotid artery and the left subclavian artery can be respectively provided, the blood flow perfusion of the left common carotid artery and the left subclavian artery can be rebuilt, and the ischemic complications of patients can be reduced.
The foregoing is merely a preferred embodiment of the present invention and it should be noted that modifications and additions to the present invention may be made by those skilled in the art without departing from the principles of the present invention and such modifications and additions are to be considered as well as within the scope of the present invention.
Claims (1)
1. The bracket for reconstructing the branch artery of the arch part in the aortic arch cavity repair operation is characterized by comprising a bracket main body; the top end of the bracket main body is provided with a left common carotid artery fenestration and a left subclavian artery fenestration; the bottoms of the left common carotid artery fenestration and the left subclavian artery fenestration are provided with left common carotid artery branches and left common carotid artery branches; the left common carotid artery branch and the tail end of the left common carotid artery branch are all constructed through a woven bracket, and the left common carotid artery branch are made of terylene materials, are of a trouser-leg structure, and are connected with the bottoms of the left common carotid artery fenestration and the left subclavian artery fenestration in a sewing mode.
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202111101191.7A CN113813091B (en) | 2021-09-18 | 2021-09-18 | Support for reconstructing branch artery of aortic arch part in aortic arch intracavity repair operation |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202111101191.7A CN113813091B (en) | 2021-09-18 | 2021-09-18 | Support for reconstructing branch artery of aortic arch part in aortic arch intracavity repair operation |
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| Publication Number | Publication Date |
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| CN113813091A CN113813091A (en) | 2021-12-21 |
| CN113813091B true CN113813091B (en) | 2023-04-25 |
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Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2002076346A1 (en) * | 2001-03-23 | 2002-10-03 | Hassan Tehrani | Branched aortic arch stent graft |
| CN2817766Y (en) * | 2005-03-02 | 2006-09-20 | 郭伟 | Separated standing blood vessel for prosthesis of aorta ascendens and aortic arches cavity |
| CN102641164A (en) * | 2011-02-16 | 2012-08-22 | 舒畅 | Branching type aortal vascular stent system |
| CN206414369U (en) * | 2016-08-15 | 2017-08-18 | 于存涛 | A kind of arch of aorta direct-view stented vessel with branch stent blood vessel |
| CN209075049U (en) * | 2018-05-24 | 2019-07-09 | 武汉大学人民医院（湖北省人民医院） | Novel compositions type aortic arch bracket |
Family Cites Families (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP6129867B2 (en) * | 2011-12-06 | 2017-05-17 | エイオールティック イノベーションズ エルエルシーＡｏｒｔｉｃ Ｉｎｎｏｖａｔｉｏｎｓ Ｌｌｃ | Intravascular aortic repair device and method of use thereof |
-
2021
- 2021-09-18 CN CN202111101191.7A patent/CN113813091B/en active Active
Patent Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2002076346A1 (en) * | 2001-03-23 | 2002-10-03 | Hassan Tehrani | Branched aortic arch stent graft |
| CN2817766Y (en) * | 2005-03-02 | 2006-09-20 | 郭伟 | Separated standing blood vessel for prosthesis of aorta ascendens and aortic arches cavity |
| CN102641164A (en) * | 2011-02-16 | 2012-08-22 | 舒畅 | Branching type aortal vascular stent system |
| CN206414369U (en) * | 2016-08-15 | 2017-08-18 | 于存涛 | A kind of arch of aorta direct-view stented vessel with branch stent blood vessel |
| CN209075049U (en) * | 2018-05-24 | 2019-07-09 | 武汉大学人民医院（湖北省人民医院） | Novel compositions type aortic arch bracket |
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| CN113813091A (en) | 2021-12-21 |
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