CN1901964A - Treatment of vascular bifurcations - Google Patents
Treatment of vascular bifurcations Download PDFInfo
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- CN1901964A CN1901964A CNA2004800392553A CN200480039255A CN1901964A CN 1901964 A CN1901964 A CN 1901964A CN A2004800392553 A CNA2004800392553 A CN A2004800392553A CN 200480039255 A CN200480039255 A CN 200480039255A CN 1901964 A CN1901964 A CN 1901964A
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Abstract
Apparatus for treatment of a vascular bifurcation, where a first blood vessel (24) meets a second blood vessel (26). The apparatus includes a balloon (40, 90) for deployment at the vascular bifurcation. The balloon includes a first part (42, 94), which has a first inflation characteristic and is adapted to be deployed in the first blood vessel, and a second part (44, 92), which has a second inflation characteristic, different from the first inflation characteristic, and is adapted to be deployed in the second blood vessel.
Description
The cross reference of related application
The application requires the rights and interests of following patent application, the U.S. Provisional Patent Application 60/517,213 that on November 3rd, 1 submitted to, and the U.S. Provisional Patent Application 60/607,064 of JIUYUE in 2004 submission on the 2nd.Disclosing in the reference mode of these related applications comprises into the application.
Technical field
The present invention relates generally to the intubation of blood vessel, particularly relates to intravascular balloon and support.
Background technology
Endovascular stent is used for various uses, comprises the unobstructed blood vessel that makes obstruction.Usually, the support that is provided is to adopt form narrow, that tighten, is holding the sacculus that dwindles in support.Support and sacculus are fixed on the far-end of catheter.The doctor is inserted into lead in the blood vessel, catheter is slided on lead, thereby support is laid in position.Sacculus is inflated by the passage in the catheter subsequently, support is expanded so that be anchored in position, and keeps unobstructed blood vessel.In case support is inflated, sacculus will be reduced, and withdraw from from blood vessel together with catheter.
Sometimes be necessary to insert support in the position of wooden fork, wherein two blood vessels converge in this position.In this case, support must be inserted in such blood vessel, thereby this blood vessel will expand in some way and makes other blood vessel at wooden fork place can not blocked the injury of perhaps being performed the operation by support.The doctor who carries out operation must be also noted that, can not remove platelet from arbitrary blood vessel of wooden fork when handling.
Handle the difficulty of vascular bifurcations and generally acknowledge in the art, and proposed multiple solution.For example, United States Patent (USP) 6,361,544, disclosing in the reference mode of it comprises into the application, it has described a kind of support and catheter assembly that is used to handle wooden fork.Support described in the patent comprises the support that is applicable to side branch vessel, has the corresponding horn shape part in angle that constitutes with side branch vessel and main intersecting blood vessels place; Main intravascular stent has the hole with the register of side branch vessel; And Y shape support.The catheter assembly of side branch vessel and main blood vessel transmits than being used for, and accurately the couple of conductor of orientation and insertion support is more advanced.The Y shape catheter of a kind of pair of sacculus has also been described in the patent.
For example, at United States Patent (USP) 6,017,324,6,210,380 and 6,123,718, and the bifurcated balloon that is used for catheterization has also been described in the U.S. Patent application document 2003/0069561.Disclosing of these patents and patent application is to comprise into the application in the reference mode.
Summary of the invention
Embodiments of the invention provide and have been used for the novel sacculus that vascular bifurcations is handled, and utilize this sacculus, in the method for the regional implant frame of wooden fork.(employed here term " wooden fork " refers to the zone that two blood vessels cross, and comprises the aperture.) these methods allow doctors to lay support like a cork with very high accuracy.Sacculus also has such purposes, promptly reduces platelet and can be shed to probability in the blood flow at intra-operative.
In certain embodiments of the present invention, intravascular balloon comprises the two parts with different expansion characteristics.In other words, two parts of sacculus are configured to the given bulbs of pressure are made different responses.Usually, when sacculus expands at the vascular bifurcations place, sacculus two-part one of them be configured in the blood vessel, and another part is configured in another root blood vessel.
In certain embodiments, bifurcated balloon comprises main longitudinal component, has the radially outthrust that is positioned at precalculated position and angle place along the length of major part.Support is curled on sacculus usually.Support can have side opening, thereby makes that its radially outthrust passes the bracket side opening and stretches out when inflation.In one embodiment, side opening is covered by depression bar radially, and wherein these depression bars can open wide under the pressure effect of outthrust radially.The doctor uses outthrust that the side opening of support is alignd with the vascellum laterale at wooden fork place.In case support is correctly alignd in this way, sacculus will fully expand, and support is expanded, thereby be anchored in position, most desirably aligns with vascellum laterale.Sacculus is dwindled and withdraw from.
Perhaps, for example, in the sacculus angioplasty, can not rely on support and use sacculus, make in some blood vessels near the occluding vascular the wooden fork place unimpeded.In this case, the radially outthrust of the sacculus in the approaching side blood vessel still has following purposes, that is, aim at sacculus and prevent that near the platelet wooden fork place or the wooden fork place from coming off when a blood vessel expands therein.As mentioned above, when bifurcated balloon is used to make support to expand, also can provide this attendant advantages that prevents that platelet from coming off.
In other embodiments, sacculus comprises narrow interior section, is used for being inserted in the vascellum laterale at wooden fork place, and the collar, around an end of the narrow interior section of sacculus.The collar be configured to expand into compare with interior section than major diameter.During handling, the narrow of sacculus is inserted in the vascellum laterale, so the collar is placed in aperture place, and wherein vascellum laterale engages with main blood vessel at this place.The expansion of air bag is expanded interior section in vascellum laterale, and the diameter after wherein expanding is retained in the main blood vessel greater than the collar of vascellum laterale diameter.In one embodiment, the expansible collar is located thereby help operative doctor that support correctly is positioned at the aperture as the stop part with respect to the aperture.In another embodiment, sacculus is used to New-support is inserted in the vascellum laterale, and an end of its medium-height trestle extend into the main blood vessel from vascellum laterale, and by the collar be inflated compare with the support remainder than major diameter, so that cooperate with the aperture.
Therefore, provide the blood processor of vascular bifurcations according to embodiments of the invention, wherein first blood vessel and second blood vessel converge at the wooden fork place, and this device comprises the sacculus that is configured in the vascular bifurcations place, and this sacculus comprises:
First has first expansion characteristics, and is suitable for being configured in first blood vessel; And
Second portion has second expansion characteristics that is different from first expansion characteristics, and is suitable for being configured in second blood vessel.
In certain embodiments, second portion is suitable for when inflation radially outstanding from first.Usually, second portion is suitable for extending in second blood vessel after the sacculus demi-inflation, so that make the easier aligning vascular bifurcations of sacculus.
In one embodiment, second portion comprises fan fold, is suitable for launching after inflation, thereby second portion is extended in second blood vessel.In another embodiment, though sacculus is reduced, at least a portion of second portion is included within the first, and second portion is suitable for stretching out from first after inflation.In another embodiment, this device comprises contracting mechanism, and this mechanism is connected with second portion, so that make second portion to first's radial contraction after sacculus dwindles.
In one aspect of the invention, this device comprises the radiopaque labelling at least a portion of second portion, and wherein this labelling is configured to allow show the aligning of sacculus with respect to wooden fork under the angiography perspective display.In one embodiment, the radiopaque labelling comprises the ring around second portion.
In another embodiment, this device comprises support, this support is installed in above the first of sacculus, and the expansion that is adapted to pass through sacculus is configured in first blood vessel, its medium-height trestle has radial opening, thereby allow to enter between first and second blood vessels, and wherein the second portion of sacculus is suitable for passing the radial opening of support and radially gives prominence to.Support can be suitable for the elution therapeutant.
In one aspect of the invention, expansion characteristics comprises compliance monitoring, so first and second parts of sacculus have compliance monitoring different, separately.In one embodiment, the sleeve pipe that the second portion of sacculus comprises is fixed on above the part of first of sacculus, so that suppress the compliance of this part in the first.
In certain embodiments, first and second blood vessels have distinctive first and second diameters, wherein first diameter is greater than second diameter, and when second portion was configured in second blood vessel, the first of sacculus was suitable for adopting the swell diameter greater than second diameter after inflation.In disclosed embodiment, when inflation, the first of sacculus is configured to the collar around the sacculus second portion.Usually, the first of sacculus comprises volution, and this volution is around the part in the sacculus second portion.
In certain embodiments, the first of sacculus is suitable for cooperating with the aperture after inflation.In one embodiment, this device comprises support, this support is installed in above the second portion of sacculus, and be suitable for being configured in second blood vessel by the expansion of sacculus, the near-end that support comprised is suitable for being inflated the size greater than second diameter, and the first of sacculus is suitable for making mount proximal end to expand, so that with respect to this near-end of aperture grappling.The near-end of support can comprise a plurality of depression bars, and these depression bars are configured to may expand to the size greater than second diameter.In another embodiment, the first of sacculus is suitable for when it expands as the retainer with respect to the aperture, so that help rack alignment in second blood vessel.
Usually, at least one in sacculus first and second parts has the inner chamber of break-through, to hold the lead that is used to dispose sacculus.In certain embodiments, just one of them of sacculus first and second parts has the inner chamber of break-through.First and second parts of sacculus are shared a common inflation mouth, perhaps can have different, inflation mouth separately.
According to embodiments of the invention, also provide the processing method of vascular bifurcations, wherein first blood vessel and second blood vessel converge at the wooden fork place, and this method comprises:
The sacculus that comprises first and second portion is provided, and wherein first has first expansion characteristics, and second portion has second expansion characteristics that is different from first expansion characteristics;
Sacculus is configured in the vascular bifurcations place, thereby first is configured in first blood vessel, and second portion is configured in second blood vessel; And
First and second parts of sacculus are expanded in first and second blood vessels.
According to embodiments of the invention, provide the blood processor of vascular bifurcations in addition, wherein first blood vessel and second blood vessel converge at the wooden fork place, and this device comprises:
Be configured in the sacculus at vascular bifurcations place, this sacculus comprises first and second portion, wherein first has first expansion characteristics, and be suitable for being configured in first blood vessel, and second portion has second expansion characteristics that is different from first expansion characteristics, and is suitable for being configured in second blood vessel; And
Catheter has the far-end that is connected with sacculus, and is suitable for passing first blood vessel, so that sacculus is configured in the wooden fork place.
According to embodiments of the invention, also provide the manufacture method of intravascular balloon, comprising:
The first that makes sacculus is so that there is first expansion characteristics; And
Make the sacculus second portion that is connected with first, so that second expansion characteristics that is different from first expansion characteristics is arranged.
In one embodiment, the step of making first and second parts of sacculus comprises by the injection moulding that utilizes the bifurcated mold and makes in first and second parts at least one.
In another embodiment, the step of making first and second parts of sacculus comprises by the blow molding that utilizes the bifurcated mold and makes in first and second parts at least one.The bifurcated mold can comprise flexible mold.Perhaps, making at least one step in first and second parts comprises and uses at least one suction pipe and band angle pin that material is directed in the bifurcated mold.
In another embodiment, the step of making first and second parts of sacculus comprises by the bifurcated mold is immersed in and makes first and second parts in the liquid polymers.
In addition or alternatively, the step of making first and second parts of sacculus comprises the first that makes sacculus, then Local treatment is carried out in a zone of first, so that the formation second portion.
In addition,, also provide intravascular stent, comprising according to embodiments of the invention:
Distal portions is suitable for being configured near the blood vessel of position, aperture given diameter, and expands in this blood vessel; And
Proximal part is suitable for relative aperture and expand into size greater than this given diameter, so that with respect to this proximal part of aperture grappling.
In one embodiment, the distal portions of support comprises that along the number of support periphery be the depression bar of first number, and the proximal part of support comprises that number is the depression bar of second number, and second number is greater than first number.In another embodiment, proximal part comprises a plurality of depression bars, and these depression bars are configured to outwardly-bent, so that cooperate with the aperture.In far-end and the proximal part at least one can be suitable for the elution therapeutant.
In addition, according to embodiments of the invention, also provide the blood processor of vascular bifurcations, wherein first blood vessel and second blood vessel converge at the wooden fork place, and this device comprises the sacculus that is configured in the vascular bifurcations place, and this sacculus comprises:
First is suitable for being configured in first blood vessel; And
Second portion is suitable for radially giving prominence to from first when inflation, so that make the easier aligning vascular bifurcations of sacculus.
In certain embodiments, this device comprises support, this support is installed in above the sacculus first, and be suitable for being configured in first blood vessel by the expansion of sacculus, its medium-height trestle has radial opening, thereby allow to enter between first and second blood vessels, and wherein the second portion of sacculus is suitable for passing the radial opening in the support and radially gives prominence to.In one embodiment, support comprises the depression bar above the radial opening, and wherein the second portion of sacculus is suitable for making depression bar outwardly open when inflation.
According to embodiments of the invention, also provide the blood processor of vascular bifurcations, first blood vessel and second blood vessel converge at the wooden fork place, wherein first and second blood vessels have distinctive first and second diameters, first diameter is greater than second diameter, this device comprises the sacculus that is configured in the vascular bifurcations place, and this sacculus comprises:
Interior section is suitable for being configured in second blood vessel; And
The collar around the interior section, when second portion was configured in second blood vessel, this collar was suitable for adopting the swell diameter greater than second diameter after inflation.
In certain embodiments, the collar is suitable for cooperating with the aperture after inflation.In one embodiment, this device comprises support, this support is installed in above the sacculus interior section, and be suitable for being configured in second blood vessel by the expansion of sacculus, the near-end that support comprised is suitable for being inflated the size greater than second diameter, and the collar is suitable for making mount proximal end to expand, so that with respect to this near-end of aperture grappling.In another embodiment, the collar is suitable for when being inflated as the retainer with respect to the aperture, so that help rack alignment in second blood vessel.
According to embodiments of the invention, provide the processing method of vascular bifurcations in addition, wherein first blood vessel and second blood vessel converge at the wooden fork place, and this method comprises:
The sacculus that comprises first and second portion is provided, and wherein first has first expansion characteristics, and second portion is suitable for radially giving prominence to from first when inflation;
Sacculus is configured near the vascular bifurcations, thereby first is configured in first blood vessel;
Near the vascular bifurcations sacculus is partly expanded, thereby make second portion leave first and radially outstanding;
The second portion of the sacculus of demi-inflation is alignd with second blood vessel; And
After with the second portion alignment, sacculus is fully expanded.
According to embodiments of the invention, also provide the processing method of vascular bifurcations, first blood vessel and second blood vessel converge at the wooden fork place, and wherein first and second blood vessels have distinctive first and second diameters, and first diameter is greater than second diameter, and this method comprises:
The sacculus that comprises the interior section and the interior section collar on every side is provided;
Sacculus is configured in the vascular bifurcations place, thereby interior section is configured in first blood vessel, and the collar is configured in second blood vessel; And
Make inflation, thereby make the collar expand into swell diameter, and cooperate with the aperture greater than second diameter.
Description of drawings
The present invention specifies by the embodiment that combines with accompanying drawing, will be understood more fully, wherein:
Fig. 1-the 3rd according to embodiments of the invention, is used in the consecutive steps of implantation process support being implanted to the support at the wooden fork place in the blood vessel and the side view of sacculus;
Fig. 4 is according to an alternative embodiment of the invention, is suitable for implantation in the sketch map of the support at wooden fork place;
Fig. 5-the 7th, according to an alternative embodiment of the invention, aim at and the consecutive steps of expansion process in align with wooden fork in the blood vessel and the sketch map of expansible sacculus therein;
Fig. 8 is according to embodiments of the invention, has the radially cross sectional view of the sacculus of outthrust;
Fig. 9 illustrates sketch map in the wooden fork that sacculus is inserted into blood vessel according to embodiments of the invention;
Figure 10 and 11 is illustrated in the consecutive steps that sacculus is inserted into the process in the vascular bifurcations according to embodiments of the invention, has radially outthrust and the radially sketch map of the sacculus of outthrust contracting mechanism;
Figure 12 is the sketch map according to the support of embodiments of the invention;
Figure 13 is the sketch map according to the intravascular balloon of embodiments of the invention;
Figure 14 and 15 is the sketch maps that are illustrated in the consecutive steps of the process of implant frame in the vascellum laterale at wooden fork place according to embodiments of the invention;
Figure 16 is the sketch map that the parts of intravascular balloon are shown according to an alternative embodiment of the invention;
Figure 17 is the sketch map according to the support of an alternative embodiment of the invention;
Figure 18 and 19 is the sketch maps that are illustrated in the consecutive steps of the process of implant frame in the blood vessel at wooden fork place according to an alternative embodiment of the invention.
The specific embodiment
Fig. 1 is the side view of support 20, and its medium-height trestle 20 is according to embodiments of the invention, is inserted in the blood vessel 24 of wooden fork position of blood vessel.Wooden fork is the point of blood vessel 24 and vascellum laterale 26 in this example.Blood vessel 24 is known as " main blood vessel " hereinafter, and this is that support 20 will be inserted in the wooden fork by it because it is such blood vessel.Usually, compare with vascellum laterale 26, main blood vessel has bigger diameter, and carries the blood of relatively large capacity.Generally speaking, in any case, principle of the present invention can be used to handle " main blood vessel " and " vascellum laterale " at wooden fork place, need not consider the relative dimensions of blood vessel.In other words, term " main blood vessel " and " vascellum laterale " are used for present patent application and claim, just for the convenience that illustrates and clear, should not be interpreted as making the scope of application of the embodiment of the invention to be limited in one or another kind of blood vessel.
Referring now to Fig. 2 and 3, they are according to embodiments of the invention, in the consecutive steps of implant frame, and the side view of the support 20 in the blood vessel 24.In step shown in Figure 2, sacculus 32 demi-inflations in the support 20, it is outstanding to make the radially outthrust 34 of sacculus pass the side opening of support.When making, handle by suitable sacculus, can make this radially outthrust be obedient to more than the main body of sacculus 32 in itself.(the manufacture method that hereinafter explanation be can be used for this purpose.) or, thereby radially the outthrust constraint that can only can not be subjected to support because it is arranged in aperture 28 is obedient to more.Usually, in step shown in Figure 2, the fluid course by in the catheter (not shown) that is used for inserting support makes inflation to low pressure, for example 1/4atm.Low pressure is enough to make radially outthrust expansion to pass side opening, but is not sufficient to make balloon body (in support) to cause that support itself expands.
Operative doctor is carried out following two steps, so that the side opening 28 of support 20 is alignd with vascellum laterale 26: support is around its longitudinal axis rotation, and support is along the lengthwise movement of axle.Usually, the doctor uses the radioscopy video picture of blood vessel and support or other irradiation image perspective display to obtain to help during these steps.In addition or alternatively, the outthrust 34 of sacculus can cause doctor's tactile feedback, the expression outthrust opening of approaching side blood vessel when.In certain embodiments, before the rotation step, the sacculus demi-inflation, as shown in Figure 2.In other embodiments, sacculus has just turned to the just demi-inflation later on of correct direction at support, and the outthrust of sacculus thereby mainly be used to the bracket side opening is vertically alignd with vascellum laterale.
In certain embodiments, by radiopaque fluid sacculus 32 is expanded, for example with the blended saline solution of suitable contrast agent.Operative doctor can be seen sacculus subsequently---especially, can under the radioscopy video picture, see the radially position of outthrust 34 of sacculus.Accurately be positioned near vascellum laterale 26 inlets at wooden fork place at the side opening 28 of support 20 before, the radially outthrust of sacculus will be compressed by the wall of main blood vessel 24 or endovascular platelet 30 parts at least.But, when the side opening of support by accurately on time, the doctor it will be appreciated that the radially outthrust of sacculus outwards expand in the vascellum laterale, as shown in Figure 2.
After using demi-inflation sacculus 32 that support 20 is accurately located, inflation is to total head, as shown in Figure 3.For example, the pressure in the sacculus can be added to about 1.5 at this moment to 2atm, and this pressure normally is enough to make support to expand.The radially outthrust 34 of sacculus further expands under the pressure that increases, and applies pressure to platelet in the wooden fork zone.The expansion of sacculus outthrust has two advantageous effects: between the phase of expansion of support, outthrust keeps bracket side opening 28 accurately to align with vascellum laterale 26 (1).(2) sacculus helps avoid breaking of vascellum laterale 26 walls, and avoids platelet 30 to come off from blood vessel wall when support expands.When the vascellum laterale wall breaks or platelet when coming off, may cause dangerous even fatal consequence subsequently.When the sacculus coverlet is private when bifurcated vessels is expanded, even do not having under the situation of support, these of bifurcated sacculus embolism resistance effect subsequently also is useful.
In case support fully expands, sacculus 32 will be reduced, withdraw from from blood vessel then, and support 20 is stayed original position.(certainly, lead 22 also will withdraw from.) make the radially outthrust 34 of sacculus enough little, thereby make it after dwindling, under the situation that is not bonded to autochthonous risk, pass bracket side opening 28 and withdraw.As above pointed, outthrust has the expansion characteristics that is different from sacculus 32 remainders usually, so that make easier the carrying out of above described difference expansion process.For example, outthrust 34 can be by flexible and stiff relatively material is made, thereby applying high pressure so that support when expanding, prevents the outthrust excessive expansion.
Fig. 4 is the sketch map according to the support 35 of an alternative embodiment of the invention.Side opening 36 quilts that support 35 is had radially depression bar 37 initially seal.In case support 35 is properly oriented in vascular bifurcations, the sacculus radially expansion of outthrust (this is not shown) will make in the depression bar 37 outwardly open approaching side blood vessels, thereby support the aperture.Sacculus is reduced subsequently, and withdraws from.
Fig. 5 and 6 is sacculus 40 insertion and the aligned side views according to the wooden fork place of embodiments of the invention diagram blood vessel 24 and 26.Sacculus 40 can use with support, this with aforesaid embodiment in the same, perhaps as illustrated in Figures 5 and 6, can be used alone.Sacculus comprise main body 42 and by radiopaque labelling 46 around radially outthrust 44.Sacculus also will be designed under the situation of the help of lead in not having vascellum laterale 26 in this case, is inserted in the wooden fork zone by the catheter 48 above the lead 22.Perhaps, as the additional of lead 22 in the blood vessel 24 or substitute, lead can be inserted in the vascellum laterale 26, and perhaps sacculus can not be inserted into the wooden fork place under the situation by lead.
In one embodiment, labelling 46 comprises the coil around outthrust 44.For example, coil can comprise super-elastic shape memory alloy, Nitinol for example, and it is manufactured into can not have to make coil have the compression shape shown in Fig. 5 and 6 usually under the situation of external force.Usually, coil is embedded in the balloon material.Perhaps, coil can be positioned at the inboard or the outside of outthrust 44.Outthrust 44 can be the shape of fan fold, has a plurality of folds as accordion.For outthrust 44 is alignd with vascellum laterale 26, operative doctor will use suitable perspective display system, and for example the fluoroscope of angiography system or other type is observed the wooden fork zone.The perspective display system is aligned, so that the plane of delineation is parallel to comprise two blood vessels 24 at wooden fork place and 26 paper, the just page among Fig. 5 and 6.In Fig. 5, outthrust 44 does not also align with vascellum laterale 26, and therefore labelling 46 shows as ellipse in angiographic image.The doctor rotates catheter 48 till the register of outthrust 44 and blood vessel 26, and as shown in Figure 6, labelling 46 shows as straight line thereupon.
Fig. 7 is the sacculus 40 expansible side views that illustrate in the wooden fork.With the same among other embodiment described herein, sacculus is to come expansible by injecting suitable fluid by catheter 48.The bulbs of pressure are launched outthrust 44, thereby expand in the vascellum laterale 26.Therefore, labelling 46 expands, thereby the circle of coil is separated from each other.Finish in operation, and after sacculus dwindled, coil was withdrawn into its original form, with main body 42 tractions of outthrust 44 to sacculus 40, thereby makes its easier disengaging human body.
Perhaps, align with wooden fork 26, can use other instrument to come to make marks as outthrust 34 or 44 in order to make outthrust 34 or 44.For example, labelling 46 can comprise that one or more wire loops are to replace coil.In addition alternatively, can in the balloon wall in wooden fork zone, embed radiopaque pigment or dyestuff.In one embodiment, labelling 46 is drawn together the radiopaque pigment ring that contains outthrust 46 bottom peripheries, and this pigment ring will have under angiography and above-mentioned coil similar in appearance.In addition alternatively, outthrust 44 can comprise center cavity, is used for holding lead, as what will illustrate among the next embodiment.
Fig. 8 is the sketch map according to the sacculus 50 of an alternative embodiment of the invention.Sacculus 50 comprises main body 54 and outthrust 52 radially, this with aforesaid embodiment in the same.But in this case, before sacculus 50 expanded in wooden fork, radially outthrust 52 was reversed, thereby is comprised in the main body 54.In this structure, radially outthrust is reversed, so it shows as depression, rather than outthrust.Radially the top end of outthrust 52 has opening 64, thereby the interior pipe (this is not shown) that allows to comprise lead passes radially in the outthrust approaching side blood vessel 26.The main body 54 of sacculus 50 can comprise extra inner chamber (not shown), is used for holding another root lead in the main blood vessel.Just as previously pointed out, sacculus 50 can be used for handling vascular bifurcations being with or without under the situation of additional body.
Fig. 9 is the side view according to the wooden fork of the blood vessel 24 of embodiments of the invention and 26, shows sacculus 50 and is configured in the wooden fork.Catheter 56 is used for disposing sacculus 50, and it comprises the interior pipe 58 of the opening 64 that passes outthrust 50 top ends.In the embodiment shown in fig. 9, the main body 54 of sacculus 50 is on the catheter far-end is installed in blind end 60.Perhaps, the top end of main body 54 can be opened holding lead, this with aforesaid embodiment in the same.For sacculus 50 is inserted into the wooden fork place, lead 62 at first is inserted into blood vessel 26 by blood vessel 24, as shown in FIG..Be in (as shown in Figure 8) under the deflated state at sacculus 50, catheter 56 is advanced onto in the wooden fork zone by lead 62 subsequently, so that pipe 58 enters into vascellum laterale 26 in making, and end 60 remains in the main blood vessel 24.Then, the expansion of sacculus 50 makes outthrust 52 be expansion structure shown in Figure 9 from the outside upset of the initial position in the main body shown in Figure 8 54.
Alternatively, as shown in Figure 5 and Figure 6, have the sacculus of the outthrust that do not overturn, for example, can be inserted into via lead and expand by the mode shown in Fig. 9.
Figure 10 and 11 illustrates according to embodiments of the invention to can be used to help the radially sketch map of the mechanism 70 of the use after-contraction of outthrust 52.Figure 10 shows in the outthrust 52 of punctured position and mechanism 70, and Figure 11 shows outthrust and mechanism at expanding position.Though mechanism 70 here is illustrated with sacculus 50, kindred organization can be suitable for using with the radially outthrust of other type as described herein.
Figure 12 is according to embodiments of the invention, is suitable for implantation in the sketch map of the support 80 in the wooden fork place vascellum laterale.Support 80 is designed to cooperate with the aperture, as what hereinafter will illustrate.With the same in other embodiments, support 80 comprises suitable biocompatible material, can elution be accompanied by the medical treatment material of implantation process.Support 80 comprises the distal part 82 of conventional configurations and the near-end of being made up of depression bar 84, and wherein these depression bars 84 can outwards be out of shape being fit to the shape in aperture, as following shown in Figure 15.Usually, depression bar can bandy angle up to 90 °.But, during transmitting support, comprise that the entire bracket of depression bar 84 is retained as contraction structure by vascular system, in the whole length range of support, have the diameter of approximately constant.
Figure 13 is according to embodiments of the invention, is used for the sketch map of the interior sacculus of handling 90 of blood vessel in wooden fork zone.Sacculus is designed to cooperate with the aperture at wooden fork place.Sacculus 90 for example can be used for, and implant frame 80 is as what hereinafter will describe.Perhaps, sacculus 90 can place an order in the situation that does not have support and be solely used in the processing of vascular bifurcations.Sacculus shown in the figure is its abundant expansion structure; During transmitting sacculus by vascular system, sacculus normally dwindles.
Now will be with reference to Figure 14 and 15, they are according to the side view in the vascular bifurcations zone of embodiments of the invention, show the step of utilizing sacculus 90 implant frame 80 in vascellum laterale 26.This implantation process can be used for any wooden fork in fact, but it is particularly useful from aperture, more aortic wooden fork place for handling, for example from the coronary artery wooden fork of ascending aorta.As shown in figure 14, the support 80 of contraction state is installed in above the sacculus 90 that dwindles, and is crimped onto above the sacculus, so the near-end of support is stretched over the interior section 92 of sacculus and above the collar 94 far-ends.Support is to transmit by the catheter in the guiding catheter above the lead 98 97 96, and wherein lead 98 has passed in the main blood vessel 24 approaching side blood vessels 26.In this embodiment, sacculus 90 has center cavity, and the distal openings that is used for holding lead is arranged in the chamber.Even when sacculus fully expands, center cavity also can allow in the vascellum laterale 26 blood flow through the chamber.
In case support 80 is arranged in the appropriate location of vascellum laterale 26, the collar 94 of the height compliance monitoring of sacculus 90 can demi-inflation, makes the collar expand into the diameter of diameter greater than vascellum laterale 26.Operative doctor can promote catheter 96 forward in distal direction in this step, so that the collar 94 is cooperated with the aperture.This cooperation is guaranteed that support 80 is accurately positioned in and is suitable for expansible position.Perhaps, sacculus 90 can be designed and be operable to make the collar 94 expansion only interior section 92 and support 80 has been configured in the vascellum laterale 26 and expand therein after carry out.
At last, as shown in figure 15, sacculus 90 fully expands, and makes sacculus present shape shown in Figure 13.Interior section 92 outwards promotes the distal part 82 of support 80 to widen blood vessel 26.Simultaneously, the collar 94 launches depression bar 84 with respect to the aperture, thereby supports the aperture, and helps with the support grappling in position.Sacculus 90 dwindles then, and by using catheter 96, withdraws from from human body by blood vessel 24.
Figure 16 is the side view according to sacculus 100 structures of optional embodiment of the present invention.Sacculus 100 comprises partly is obedient to distal part 102 and is obedient to portions of proximal 104 fully.Distal part 102 has telescopic shape, is installed in above the portions of proximal 104, then by gummed or use heat for example or the fusion of ultrasonic energy is fixed in position.After sacculus 100 expands, the near-end of portions of proximal 104 (in the upper right side of Figure 16) will expand into compare with far-end than major diameter, this diameter is subjected to the restriction of distal part 102.Therefore, sacculus 100 will present shape shown in Figure 13.In other words, distal part 102 defines the interior section of sacculus, and portions of proximal 104 defines the collar.Sacculus 100 thereby can be used for replace above and hereinafter described process in sacculus 90.Other sacculus design with difference compliance can be used for this purpose similarly, and is considered within the scope of the invention.
Figure 17 is the sketch map according to the support 110 of the optional embodiment of the present invention.Support 110 can be used for replacing the support 80 in the said process.With the same in other embodiments, support 110 comprises suitable biocompatible material, can elution be accompanied by the therapeutant of implantation process.
Figure 18 and 19 is the side views in vascular bifurcations zone, shows according to embodiments of the invention, utilizes sacculus 122 to be implanted into the step of support 120 at vascellum laterale 26.Sacculus 122 is similar to sacculus 90 in design, as above shown and explanation.But as shown in figure 18, the support 120 of contraction state is installed in above the sacculus 122 that dwindles in this case,, and be crimped onto above the sacculus, so that support is only extended to above the sacculus interior section 124, and not can with previous embodiment in the same, extend to above the sacculus collar 126.Support 120 is to be sent in the vascellum laterale 26, as shown in figure 18 by the catheter 96 above guiding catheter 97 inside conductors 98.
Utilizing known method in this area that the support in the orifice area of wooden fork is accurately aimed at, is the task of a difficulty, needs to use radio opaque markers so that operative doctor can be seen backing positions usually.Yet sacculus 122 makes the doctor that the support 120 in the orifice area is accurately aimed at.For this purpose, the doctor is expanded the collar 126, as shown in figure 19.The doctor promotes catheter 96 in distal direction then, so that interior section 124 (its medium-height trestle 120 curls in the above) is moved forward in the approaching side blood vessel 26.The expansible collar is as mechanical stopping piece, advanced in the distally of support and stops at its desired location, just in time in vascellum laterale 26.Doctor's expansion of interior section 124 that is through with subsequently is so that expand the appropriate location of support 120 in vascellum laterale.
The same with sacculus 90, sacculus 122 has center cavity, and the distal openings that is used for holding lead 98 is arranged in the chamber.Even when sacculus fully expands, center cavity also can allow in the vascellum laterale 26 blood flow through the chamber.
Can make ins all sorts of ways makes above-mentioned sacculus:
A) utilize and to have the outthrust top end of opening or sealing (whether the distally top end that depends on sacculus has opening, normally is used for holding lead, and bifurcated mold as described in the text) carries out injection moulding.The sacculus raw material of liquid, powder or other form is preheated, and is injected in the mold.After material had been deposited in the mold, it was cooled, and presented suitable net shape.
B) use the bifurcated mold to carry out blow molding.Piped sacculus raw material is placed in the mold (heating or under indoor temperature).Using gases, water or other material make this tube swelling then, so as to apply intrinsic pressure, this intrinsic pressure geometry that pipe is shaped as mold.
C) use bifurcated mold and suction nozzle to carry out blow molding.Method described in this method and the earlier paragraphs is similarly, has increased by suction nozzle to apply suction tube material is pulled into the expection outthrust shape that is limited by the blowing mould shape.
D) use and to have movably inner band angle pin the bifurcated mold of (as applying the additional of suction or substituting) to carry out blow molding, thereby the tube material in the guiding mold is so that form the outthrust of expection.
E) use the flexible mold of bifurcated to carry out blow molding.Be used for forming sacculus radially the mould portion of outthrust can stretch and shrink, for example to form the outthrust of type shown in Fig. 9.
F) use liquid polymers and bifurcated sacculus model to flood.In order to form the sacculus shown in Fig. 8, for example, a branch (being used for forming radially outthrust) of model can be retracted back in the model, so model presents cylindrical shape.Under the state that retractible branch stretches, the sacculus model is immersed in the bucket that comprises liquid polymers, and wherein polymer is attached on the surface.From bucket, shift out the band coating model then, and place dry.After polymer hardening and stablizing, the regracting branch is retracted back in the model, so that sacculus can be shifted out.
G) carry out after the main chamber of blow molding with the formation sacculus, the Local treatment of carrying out the desired location place under the convenient pressure condition is to form side-prominent thing.Local treatment can comprise for example heat treatment, ultrasound wave radiation or chemical treatment.
Other manufacture method those technical staff in this area will be conspicuous.
Though the accompanying drawing in this patent application illustrates some special construction of vascular bifurcations, support and sacculus, these structures only are illustrated as an example.Based on optional structure those technical staff in this area of the principle of the invention will be conspicuous.For example, among some embodiment shown in the figure, vascular bifurcations (and sacculus) has "T"-shaped shape, and wooden fork and sacculus are " Y " shapes in other embodiments.Should be understood that among these embodiment each all not only goes for the wooden fork of T-shape and " Y " type, and go for more complicated shape according to the blood vessel structure of being discussed.Although some sacculus shown in the figure is configured to be adapted to pass through lead and inserts, sacculus (and be used for catheter that they are inserted) also can optionally be configured to be suitable for do not operate under the situation of lead having, if perhaps suitable, be suitable for using the insertion of two or more leads.The radially outthrust of sacculus or portions of proximal also can be made as and the isolating independent chamber of main part, as what above mentioned, also can be by different channel expansion, and if needs are arranged, can be expanded to the pressure different with the sacculus major part.
Therefore should be understood that the above embodiments are cited as an example, the present invention is not limited to that institute above is special to be shown and the content of description.On the contrary, scope of the present invention comprises above described various combination of features and recombinant, and their change and correction, wherein those of skill in the art will expect these changes and correction after reading above-mentioned explanation, and they are not disclosed in the prior art.
Claims (82)
1. the blood processor of a vascular bifurcations, wherein first blood vessel and second blood vessel converge at this wooden fork place, and this device comprises the sacculus that is configured in the vascular bifurcations place, and this sacculus comprises:
First has first expansion characteristics, and is suitable for being configured in described first blood vessel; And
Second portion has second expansion characteristics that is different from described first expansion characteristics, and is suitable for being configured in described second blood vessel.
2. device according to claim 1 is characterized in that, described second portion is suitable for when described inflation radially outstanding from described first.
3. device according to claim 2 is characterized in that, described second portion is suitable for extending in described second blood vessel after described sacculus demi-inflation, so that make the easier aligning vascular bifurcations of described sacculus.
4. device according to claim 2 is characterized in that described second portion comprises fan fold, and it is suitable for launching after described inflation, thereby described second portion is extended in described second blood vessel.
5. device according to claim 2, it is characterized in that, when described sacculus was reduced, at least a portion of described second portion was included within the described first, and wherein said second portion is suitable for stretching out from described first after described inflation.
6. device according to claim 2 is characterized in that, also comprises contracting mechanism, and this mechanism is connected with described second portion, so that make described second portion towards described first radial contraction after described sacculus dwindles.
7. device according to claim 2, it is characterized in that, the radiopaque labelling that also comprises at least a portion that is arranged in described second portion, wherein this labelling is configured to allow show the aligning of described sacculus with respect to described wooden fork under the angiography perspective display.
8. device according to claim 7 is characterized in that, described radiopaque labelling comprises the ring around described second portion.
9. device according to claim 2, it is characterized in that, also comprise support, this support is installed in above the described first of described sacculus, and be suitable for being configured in described first blood vessel by the expansion of described sacculus, wherein said support has radial opening, thus allow to enter described first and described second blood vessel between, and the described second portion of wherein said sacculus is suitable for passing the described radial opening of described support and radially outstanding.
10. device according to claim 9 is characterized in that described support is suitable for the elution therapeutant.
11. device according to claim 1 is characterized in that, described expansion characteristics comprises compliance monitoring, and therefore described first and second parts of described sacculus have compliance monitoring different, separately.
12. device according to claim 11 is characterized in that, the described second portion of described sacculus comprises sleeve pipe, and this sleeve pipe is fixed on above the part of described first of described sacculus, so that suppress the compliance of this part in the described first.
13. device according to claim 1, it is characterized in that, described first and second blood vessels have distinctive first and second diameters, wherein said first diameter is greater than described second diameter, and wherein when described second portion was configured in described second blood vessel, the described first of described sacculus was suitable for having the swell diameter greater than described second diameter after described inflation.
14. device according to claim 13 is characterized in that, when described inflation, the described first of described sacculus is configured to around the collar of the described second portion of described sacculus.
15. device according to claim 14 is characterized in that, the described first of described sacculus comprises volution, and this volution is around the part in the described second portion of described sacculus.
16. device according to claim 13 is characterized in that, the described first of described sacculus is suitable for cooperating with an aperture after described inflation.
17. device according to claim 16, it is characterized in that, also comprise support, this support is installed in above the described second portion of described sacculus, and be suitable for being configured in described second blood vessel by the expansion of described sacculus, described support comprises near-end, and this near-end is suitable for being inflated the size greater than described second diameter, and the described first of wherein said sacculus is suitable for making described mount proximal end to expand, so that with respect to this near-end of described aperture grappling.
18. device according to claim 17 is characterized in that, the near-end of described support comprises a plurality of depression bars, and these depression bars are configured to may expand to the size greater than described second diameter.
19. device according to claim 17 is characterized in that, described support is suitable for the elution therapeutant.
20. device according to claim 16, it is characterized in that, also comprise support, this support is installed in above the described second portion of described sacculus, and be suitable for being configured in described second blood vessel by the expansion of described sacculus second portion, and the described first of wherein said sacculus is suitable for as the retainer with respect to described aperture, so that help described support at the described second endovascular aligning when expanding.
21. device according to claim 20 is characterized in that, described support is suitable for the elution therapeutant.
22. each the described device according among the claim 1-21 is characterized in that at least one in first and second parts of described sacculus has the inner chamber of break-through, to hold the lead that is used to dispose described sacculus.
23. device according to claim 22 is characterized in that, one of them of first and second parts that is described sacculus has the inner chamber of described break-through.
24. each the described device according among the claim 1-21 is characterized in that, described first and second parts of described sacculus are shared a common inflation mouth.
25. each the described device according among the claim 1-21 is characterized in that, described first and second parts of described sacculus have inflation mouth independent, separately.
26. the processing method of a vascular bifurcations, wherein first blood vessel and second blood vessel converge at this wooden fork place, and this method comprises:
The sacculus that comprises first and second portion is provided, and wherein first has first expansion characteristics, and second portion has second expansion characteristics that is different from described first expansion characteristics;
Described sacculus is configured in described vascular bifurcations place, thereby described first is configured in described first blood vessel, and described second portion is configured in described second blood vessel; And
Described first and second parts of described sacculus are expanded in described first and second blood vessels.
27. method according to claim 26 is characterized in that, described second portion is suitable for when described inflation radially outstanding from described first.
28. method according to claim 27, it is characterized in that, the step of the described sacculus of described configuration comprises partly expands described sacculus, thereby make described second portion leave described first and radially outstanding, and before making described sacculus complete expansion, use described second portion to make the sacculus alignment of described demi-inflation.
29. method according to claim 27, it is characterized in that, described second portion comprises fan fold, and wherein makes the step of described first and second demi-inflations comprise the described fan fold of expansion, thereby described second portion is extended in described second blood vessel.
30. method according to claim 27, it is characterized in that, when described sacculus is reduced, at least a portion of described second portion is included within the described first, and wherein makes the step of described first and second demi-inflations that described second portion is stretched out from described first.
31. method according to claim 27 is characterized in that, also is included in to make described second portion towards described first radial contraction after described sacculus dwindles.
32. method according to claim 27, it is characterized in that, a radiopaque labelling is placed at least a portion of described second portion, and the step of wherein said configuration sacculus is included in uses described labelling under the angiography perspective display, so that manifest the aligning of described sacculus with respect to described wooden fork.
33. method according to claim 32 is characterized in that, described radiopaque labelling comprises the ring around described second portion.
34. method according to claim 27, it is characterized in that, also comprise support is installed in above the described first of described sacculus, wherein said support has radial opening, with allow to enter described first and described second blood vessel between, wherein make the step of described first and second demi-inflations of described sacculus comprise that the expansion by described sacculus is configured in described support in described first blood vessel, this makes the described second portion of described sacculus pass the described radial opening of described support and radially is projected in second blood vessel.
35. method according to claim 34 is characterized in that, described support is suitable for the elution therapeutant.
36. method according to claim 26 is characterized in that, described expansion characteristics comprises compliance monitoring, and therefore described first and second parts of described sacculus have compliance monitoring different, separately.
37. method according to claim 36, it is characterized in that, the described second portion of described sacculus comprises sleeve pipe, and described sleeve pipe is fixed on above the part of described first of described sacculus, so that suppress the compliance of this part in the described first.
38. method according to claim 26, it is characterized in that, described first and second blood vessels have distinctive first and second diameters, wherein said first diameter is greater than described second diameter, and the step of described first and second demi-inflations of described sacculus comprised make described first to expand into swell diameter greater than described second diameter.
39., it is characterized in that when the described first of described sacculus expanded, the described first of described sacculus was configured to around the collar of the described second portion of described sacculus according to the described method of claim 38.
40., it is characterized in that the described first of described sacculus comprises volution according to the described method of claim 39, this volution is around the part in the described second portion of described sacculus.
41., it is characterized in that the step of described configuration sacculus comprises and is positioned to make the described first of described sacculus to cooperate with the aperture described sacculus according to the described method of claim 38 after described inflation.
42. according to the described method of claim 41, it is characterized in that, also comprise support is installed in above the described second portion of described sacculus, wherein make the step of described first and second demi-inflations of described sacculus comprise expansion by the described second portion of described sacculus, described support is configured in described second blood vessel, while is by the expansion of the described first of described sacculus, make the near-end of described support expand into size, so that with respect to the described near-end of described aperture grappling greater than described second diameter.
43., it is characterized in that the described near-end of described support comprises a plurality of depression bars according to the described method of claim 42, and wherein make the expansible step of described near-end comprise the described depression bar of expansion.
44., it is characterized in that described support is suitable for the elution therapeutant according to the described method of claim 42.
45. according to the described method of claim 41, it is characterized in that, comprise also support is installed in above the described second portion of described sacculus that the step of wherein locating described sacculus comprises:
After the described first that makes described sacculus expand into swell diameter, described support is aligned on the described second portion of described sacculus in described second blood vessel, so that the described first that makes described sacculus is as the retainer with respect to described aperture; And
After described second portion alignment, the described second portion of described sacculus is expanded, so that described support is configured in described second blood vessel with described sacculus.
46., it is characterized in that described support is suitable for the elution therapeutant according to the described method of claim 45.
47. according to each the described method among the claim 26-46, it is characterized in that, the step of described configuration sacculus comprises passes inner chamber at least one of described first and second parts of described sacculus with lead, and with described sacculus by conductor configurations at the vascular bifurcations place.
48., it is characterized in that one of them of described first and second parts that is described sacculus has the inner chamber of break-through according to the described method of claim 47.
49., it is characterized in that the described step of described first and second demi-inflations of sacculus that makes comprises two parts expansion that makes described sacculus by total inflation mouth according to each described method among the claim 26-46.
50., it is characterized in that the described step of described first and second demi-inflations of sacculus that makes comprises described first and second demi-inflations that make described sacculus by inflation mouth independent, separately according to each described method among the claim 26-46.
51. the blood processor of a vascular bifurcations, wherein first blood vessel and second blood vessel converge at this wooden fork place, and this device comprises:
Be configured in the sacculus at vascular bifurcations place, this sacculus comprises first and second portion, wherein first has first expansion characteristics, and be suitable for being configured in described first blood vessel, and second portion has second expansion characteristics that is different from described first expansion characteristics, and is suitable for being configured in described second blood vessel; And
Catheter has the far-end that is connected with described sacculus, and is suitable for passing described first blood vessel, so that described sacculus is configured in described wooden fork place.
52. the manufacture method of an intravascular balloon comprises:
Make the first of described sacculus so that have first expansion characteristics; And
Make the second portion of the described sacculus that is connected with described first, so that have second expansion characteristics that is different from described first expansion characteristics.
53., it is characterized in that the step of the described second portion of described making sacculus comprises described second portion is made into wooden fork from described first according to the described method of claim 52.
54. according to the described method of claim 52, it is characterized in that, the described second portion of described sacculus is made into makes described first form the collar when the described inflation around described second portion.
55., it is characterized in that described first and second expansion characteristics comprise the first and second different compliance monitorings respectively according to the described method of claim 52.
56., it is characterized in that the step of the described second portion of described making sacculus comprises sleeve pipe is fixed on above the part in the described sacculus first, so that suppress the compliance of this part in the described first according to the described method of claim 55.
57. according to the described method of claim 52, it is characterized in that, also comprise support is installed in described first and second parts of described sacculus above at least one.
58., it is characterized in that the step of described first and second parts of described making sacculus comprises by the injection moulding that utilizes the bifurcated mold makes in described first and second parts at least one according to the described method of claim 52.
59., it is characterized in that the step of described first and second parts of described making sacculus comprises by the blow molding that utilizes the bifurcated mold makes in described first and second parts at least one according to the described method of claim 52.
60., it is characterized in that described bifurcated mold comprises flexible mold according to the described method of claim 59.
61., it is characterized in that the step of at least one in described making first and second parts comprises uses at least one suction pipe and band angle pin that material is directed in the described bifurcated mold according to the described method of claim 59.
62., it is characterized in that the step of described first and second parts of described making sacculus comprises by the bifurcated mold is immersed in makes described first and second parts in the liquid polymers according to the described method of claim 52.
63. according to the described method of claim 52, it is characterized in that, the step of described first and second parts of described making sacculus comprises the described first that makes described sacculus, then Local treatment is carried out in a zone of described first, so that form described second portion.
64. an intravascular stent comprises:
Distal portions is suitable for being configured near the blood vessel of position, aperture given diameter, and expands in this blood vessel; And
Proximal part is suitable for relative aperture and is inflated size greater than described given diameter, so that with respect to the described proximal part of described aperture grappling.
65. according to the described support of claim 64, it is characterized in that, the described distal portions of described support comprises that along the number of described support periphery be the depression bar of first number, and the described proximal part of wherein said support comprises that number is the described depression bar of second number, and second number is greater than first number.
66., it is characterized in that described proximal part comprises a plurality of depression bars according to the described support of claim 64, these depression bars are configured to outwardly-bent, so that cooperate with described aperture.
67., it is characterized in that at least one in described far-end and the proximal part is suitable for the elution therapeutant according to each described support among the claim 64-66.
68. the blood processor of a vascular bifurcations, wherein first blood vessel and second blood vessel converge at this wooden fork place, and this device comprises the sacculus that is configured in described vascular bifurcations place, and this sacculus comprises:
First is suitable for being configured in described first blood vessel; And
Second portion is suitable for radially giving prominence to from described first when described inflation, so that make the described vascular bifurcations of the easier aligning of described sacculus.
69. according to the described device of claim 68, it is characterized in that, also comprise support, this support is installed in above the described sacculus first, and be suitable for being configured in described first blood vessel by the expansion of described sacculus, wherein said support has radial opening, enter between described first and second blood vessels allowing, and the described second portion of wherein said sacculus is suitable for passing described radial opening in the described support and radially outstanding.
70., it is characterized in that described support comprises the depression bar above the described radial opening according to the described device of claim 69, and the described second portion of wherein said sacculus is suitable for making described depression bar outwardly open when described inflation.
71. according to each described device among the claim 68-70, it is characterized in that, the radiopaque labelling that also comprises at least a portion that is arranged in described second portion, wherein said labelling are configured to allow to manifest described sacculus aligning with respect to described wooden fork under the angiography perspective display.
72. the blood processor of a vascular bifurcations, wherein first blood vessel and second blood vessel converge at this wooden fork place, wherein said first and second blood vessels have distinctive first and second diameters, described first diameter is greater than described second diameter, this device comprises the sacculus that is configured in described vascular bifurcations place, and this sacculus comprises:
Interior section is suitable for being configured in described second blood vessel; And
Around the collar of described interior section, when described second portion was configured in described second blood vessel, this collar was suitable for having the swell diameter greater than described second diameter after described inflation.
73., it is characterized in that the described collar comprises volution according to the described device of claim 72, this volution is around the part of the described interior section of described sacculus.
74., it is characterized in that the described collar is suitable for cooperating with the aperture according to claim 72 or 73 described devices after described inflation.
75. according to the described device of claim 74, it is characterized in that, also comprise support, this support is installed in above the interior section of described sacculus, and be suitable for being configured in described second blood vessel by the expansion of described sacculus, described support comprises near-end, and described near-end is suitable for being inflated the size greater than described second diameter, and the wherein said collar is suitable for making described mount proximal end to expand, so that with respect to the described near-end of described aperture grappling.
76. according to the described device of claim 74, it is characterized in that, also comprise support, this support is installed in above the interior section of described sacculus, and be suitable for being configured in described second blood vessel by the expansion of the second portion of described sacculus, and the wherein said collar is suitable for when being inflated as the retainer with respect to described aperture, so that help described support at the described second endovascular aligning.
77. the processing method of a vascular bifurcations, wherein first blood vessel and second blood vessel converge at this wooden fork place, and this method comprises:
The sacculus that comprises first and second portion is provided, and wherein first has first expansion characteristics, and second portion is suitable for radially giving prominence to from described first when described inflation;
Described sacculus is configured near the described vascular bifurcations, thereby described first is configured in described first blood vessel;
Near the described vascular bifurcations described sacculus is partly expanded, thereby make described second portion leave described first and radially outstanding;
The described second portion of the described sacculus of demi-inflation is alignd with described second blood vessel; And
After with described second portion alignment, described sacculus is fully expanded.
78. according to the described method of claim 77, it is characterized in that, also comprise support is installed in above the described sacculus first, wherein said support has radial opening, thereby allow to enter between described first and second blood vessels, wherein make the adequately expanded step of described sacculus comprise that the expansion by described sacculus is configured in described support in described first blood vessel, this described radial opening that described second portion of described sacculus is passed in the described support radially extends in described second blood vessel.
79., it is characterized in that described support comprises the depression bar above the radial opening according to the described method of claim 78, and the described second portion that the adequately expanded step of described sacculus is comprised make described sacculus radially depression bar open outwardly with respect to the aperture.
80. the processing method of a vascular bifurcations, wherein first blood vessel and second blood vessel converge at this wooden fork place, and wherein said first and second blood vessels have distinctive first and second diameters, and described first diameter is greater than described second diameter, and this method comprises:
The sacculus that comprises interior section and center on the collar of interior section is provided;
Described sacculus is configured in described vascular bifurcations place, thereby described interior section is configured in described first blood vessel, and the described collar is configured in described second blood vessel; And
Make described inflation, thereby make the described collar expand into swell diameter, and cooperate with the aperture greater than described second diameter.
81. 0 described method according to Claim 8, it is characterized in that, also comprise support is installed in above the interior section of described sacculus, the step that wherein disposes described sacculus comprises described support is configured in described second blood vessel, and the expansion of wherein said sacculus makes the described collar that described mount proximal end is expand into size greater than described second diameter, so that with respect to the described near-end of described aperture grappling.
82. 0 described method is characterized in that according to Claim 8, also comprises support is installed in above the interior section of described sacculus, the step that wherein disposes described sacculus comprises:
After making the described collar expand into described swell diameter, described support is aligned on the interior section of the described second endovascular described sacculus, therefore the described collar is as the retainer with respect to described aperture; And
After interior section alignment, the described second portion of described sacculus is expanded, so that described support is configured in described second blood vessel with described sacculus.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US51721303P | 2003-11-03 | 2003-11-03 | |
| US60/517,213 | 2003-11-03 | ||
| US60/607,064 | 2004-09-03 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN1901964A true CN1901964A (en) | 2007-01-24 |
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ID=37657508
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CNA2004800392553A Pending CN1901964A (en) | 2003-11-03 | 2004-11-02 | Treatment of vascular bifurcations |
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| Country | Link |
|---|---|
| CN (1) | CN1901964A (en) |
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN107334562A (en) * | 2016-04-28 | 2017-11-10 | 美敦力心血管股份有限公司 | Implantable medical device delivery system |
| CN107951603A (en) * | 2017-12-18 | 2018-04-24 | 上海脉全医疗器械有限公司 | A kind of biodegradable stent system for crotch branch vessel |
-
2004
- 2004-11-02 CN CNA2004800392553A patent/CN1901964A/en active Pending
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN107334562A (en) * | 2016-04-28 | 2017-11-10 | 美敦力心血管股份有限公司 | Implantable medical device delivery system |
| CN107334562B (en) * | 2016-04-28 | 2021-07-20 | 美敦力心血管股份有限公司 | Implantable medical device delivery system |
| CN107951603A (en) * | 2017-12-18 | 2018-04-24 | 上海脉全医疗器械有限公司 | A kind of biodegradable stent system for crotch branch vessel |
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