201032788 六、發明說明： 【發明所屬之技術領域】 ： 本發明係一種有關於血管支架之技術領域，尤指一種可達有 : 效簡化手術過程'節省手術時間與提高手術成功率等功效之血管 支架裝置及其使用方法。 【先前技術】 習用的血管吻合技術領域中，血管的點對端吻合（end t〇-side anastomosis)以及端對端吻合（end_t〇_end © anastomosis)為基本之技術技巧，縫合的技術包括連續縫合 (continuous suture)以及間斷吻合（interrupted suture)，但不論是哪種吻合，都無法避免吻合處狹窄 (anastomosis stricture)的問題，造成這種現象的最常見原 因包括手術技術不佳（technical error)以及因手術所引起的繼 發性血管内皮受損所導致的内皮不正常增生，而這兩個引起吻合 處狹窄的原因即使是技巧純熟的醫師亦無法完全避免。 先刖技術的相關文獻中有提出新的血管吻合術，避免習用的 ®針扎傷害血管，造成長期的内膜受傷狹窄，相關文獻包括小血管 的應用雷射或其他熱能作吻合、各種不同的血管夾作吻合、各種 不同的新式吻合裝置或是用組織黏膠作吻合等多種方式，但仍然 存在諸多的問題，實缺乏一可簡易使用、安全、快速、可靠且便 宜可取代習用血管吻合方式出現。 在現今的臨床經驗中，血管支架已廣泛的應用在治療血管狹 乍或動脈瘤的病灶上，而其置放技巧在現今臨床應用上以達成 熟。此外，在2008年五月的Ann Vase Surg中由Wu. CY et al提出利用血管支架（end〇vascular stent)處理醫源性血管 201032788 受損（iatrogen i , . vascular injury)之技巧進一步啟發了血 管支架的應用。 月參閱第九圖所不’習用的血管支架（140)的兩端外徑 係相等，無法依受體的血管大小作轉，使訂相當不便。 另外’請參閱第十圖所示，習用的人卫血管（1 5〇)係概 長條狀S用的人工灰管（丄5 〇)的一端係與受體的一動脈 ^ )相勿0連接，習用的人工血管（150)的另端係與 Ο201032788 VI. Description of the invention: [Technical field of invention]: The present invention relates to the technical field of vascular stents, and more particularly to a blood vessel which can effectively simplify the surgical procedure, save operation time and improve surgical success rate. Stent device and method of use thereof. [Prior Art] In the field of conventional vascular anastomosis, end-to-end anastomosis and end-to-end anastomosis (end_t〇_end © anastomosis) are basic technical techniques, and suturing techniques include continuous Continuous suture and interrupted suture, but no matter what kind of anastomosis, the problem of anastomasis stricture cannot be avoided. The most common causes of this phenomenon include technical error. And the abnormal proliferation of the endothelium caused by secondary vascular endothelium damage caused by surgery, and the two causes of anastomotic stenosis can not be completely avoided even by skilled physicians. A new vascular anastomosis has been proposed in the literature on sputum technology to avoid the use of conventional needles to damage blood vessels, resulting in long-term intimal injury and stenosis. Related literature includes the application of small blood vessels to laser or other thermal energy for anastomosis, various Vascular clips for anastomosis, a variety of new anastomotic devices or tissue glue for anastomosis, but there are still many problems, there is a lack of easy to use, safe, fast, reliable and cheap to replace the traditional vascular anastomosis appear. In today's clinical experience, vascular stents have been widely used to treat lesions in vascular stenosis or aneurysms, and their placement techniques are used in today's clinical applications to achieve maturity. In addition, the technique of treating iatrogenic i. The application of the bracket. Referring to the ninth figure, the vascular stent (140) of the conventional use has the same outer diameter at both ends, and cannot be rotated according to the size of the blood vessel of the recipient, making the order quite inconvenient. In addition, please refer to the figure shown in the tenth figure. The artificial vascular tube (1 5〇) is a kind of artificial ash tube (丄5 〇) for the strip S, and one end of the artificial ash tube (丄5 〇) is not associated with the receptor. Connection, the other end of the artificial blood vessel (150)
的靜脈（1 7 0)相吻合連接。惟，在臨床經驗上，習用 的人工血管（1 5◦)因為其形狀與構造上的設計不佳，導致容 易&成Ag出口的狹窄’進而導致▲栓的形成，其原因經分析有 下列幾點其疋做手術縫線吻合時對血管内皮的傷害誘發内皮 増生血小板之凝集以及後續血栓的生成。其二是因血流震顫在 吻合處形成涡流而引起血栓的形成。其三是因為植人的人工血管 (1 5 0 )與吻合處血管的軟硬度（c〇mpliance)不同造成吻 〇處狹窄引起血栓生成。綜上所述，習用血管的吻合方法習用 血管支架（140)與習用人工血管（150)、结構仍存在有諸 多的問題與缺失，實有改良之必要。 【發明内容】 欲解決之技術問題點：先前技術的相關文獻中有提出新的金 &吻〇術，避免習用的針札傷害血管，造成長期的内膜受傷狹 窄，相關文獻包括小血管的應用雷射或其他熱能作吻合、各種不 同的血管夾作吻合、各種不同的新式吻合裝置或是用組織黏膠作 吻合與血管支架的應用等多種方式，惟，習用的血管吻合方法容 易因手術技術不佳（technical error)以及因手術所引起的繼發 性血管内皮受損所導致的内皮不正常增生，導致手術失敗等，習 201032788 用的血管支架的兩端外徑係相等，無法依受體的血管大小作選 擇，使用上相當不便，此外，習用的人工血管因為其形狀與構造 : 上的設計不佳，導致容易造成血管出口的狹窄，進而導致血栓的 . 形成，由此可知，習用血管支架的使用方法、習用血管支架與習 用人工血管結構仍存在有諸多的問題與缺失。 解決問題的技術特點：提供一種血管支架裝置，係包括：一 血管支架，該血管支架係為一自膨式（self-expand able)血管支 架，該血管支架内側包覆有不透水之包膜（membrane)，該血管 〇 支架係包括一前半段與一後半段，該前半段與該後半段口徑係可 以相等，或是該前半段的口徑大於該後半段的口徑，或是該後半 段的口徑大於該前半段的口徑，藉以可適用於不同大小的血管吻 合連接使用；該血管支架的該前半段與該後半段之間設有一條狀 標記，做為釋放時的辨識，該條狀標記約略位於該血管支架的中 段位置處，在未釋放前，該企管支架係縮於一血管鞘（sheath) 中，該血管鞘係為透明材質，未釋放時，可以從該血管鞘外直視 到該血管支架的位置及該條狀標記，藉此手術定位置放時，只要 ® 將該血管鞘往後退，該血管支架即會自動撐張，藉以將所欲吻合 的兩段血管緊緊卡住連結，穩固地吻合連接兩段受體血管。 其中，該血管支架裝置更可連接一人工血管，該人工血管係 包括一吻合動脈段與一吻合靜脈段；其中，該吻合動脈段的一端 係用以與受體的一動脈相吻合連接；該吻合靜脈段的兩端係透過 該血管支架來與受體的一靜脈進行彼此口徑相對地撐張卡住連 接，該吻合動脈段的另端係連通於該吻合靜脈段，該吻合靜脈段 與該吻合動脈段相接處具有可避免血栓形成的一平順膨大袖口 部。 5 201032788 其中，該吻合動脈段係較長於該吻合靜脈段。 其中，該吻合動脈段與該吻合靜脈段係為一體成型的結構。 : 其中，該人工血管係概呈τ形狀。 . 其中，該吻合動脈段與該吻合靜脈段係相交形成一銳角側與 一鈍角側，該平順膨大袖口部係鄰近於該鈍角側。 另外本發明血管支架裝置之使用方法，關於端對端的部分， 係依序包括下列步驟： 找出受體之血管； ® 完成欲吻合血管之血管控制以及受端血管之血管控制； 將血管導針刺入血管並以肝素稀釋溶液使其鼓脹； 利用C型血管直徑測量器（C-shape vessel sizer)作血管 直徑測量，並依據測量結果選擇對應受體血管之也管支架裝置， 該血管支架裝置係包括一企管支架，該血管支架内側包覆有不透 水之包膜（membrane )，該血管支架係包括一前半段與一後半 段，該前半段與該後半段口徑係可以相等，或是該前半段的口徑 大於該後半段的口徑，或是該後半段的口徑大於該前半段的口 ® 徑，藉以可適用於不同大小的受體血管吻合連接使用；該血管支 架的該前半段與該後半段之間設有一條狀標記，做為釋放時的辨 識，該條狀標記約略位於該血管支架的中段位置處，在未釋放 前，該血管支架係縮於一血管鞘（sheath)中，該血管鞘係為透明 材質，未釋放時，可以從該血管鞘外直視到該血管支架的該條狀 標記； 將該血管支架套入於一導絲，於欲吻合血管處先以導針建立 導絲之路徑，欲吻合血管可為人工血管或自體血管的移植物 (autogenous transplant)，經導針穿入導絲置入一受端血管 6 201032788 中，藉此，將該血管支架順著該導絲滑入該受端血管中；以及， 透過透明的該血管鞘係可直視到該血管支架的該條狀標記， ； 當該條狀標記位於該欲吻合血管與該受端血管之間時，即將該血 . 管鞘退後而釋出該血管支架，該血管支架係可自膨撐張完成吻合 動作，藉以將該欲吻合血管與該受端血管緊緊卡住連結。 此外，本發明中血管支架裝置之使用方法，關於端對側的部 分，係依序包括下列步驟： 找出受體之血管； ® 完成第一受端血管之血管控制以及第二受端血管之血管控 制； 將血管導針刺入血管並以肝素稀釋溶液使其鼓脹； 利用C型血管直徑測量器（C-shape vessel sizer)作血 管直徑測量，並依據測量結果選擇對應受體血管之血管支架裝 置，該血管支架裝置係包括一血管支架，該企管支架内側包覆有 不透水之包膜（membrane)，該血管支架係包括一前半段與一後 半段，該前半段與該後半段口徑係可以相等，或是該前半段的口 〇 徑大於該後半段的口徑，或是該後半段的口徑大於該前半段的口 徑，藉以可適用於不同大小的受體血管吻合連接使用；該血管支 架的該前半段與該後半段之間設有一條狀標記，做為釋放時的辨 識，該條狀標記約略位於該血管支架的中段位置處，在未釋放 前，該血管支架係縮於一血管鞘（sheath)中，該血管鞘係為透 明材質，未釋放時，可以從該血管鞘外直視到該血管支架的該條 狀標記； 將第一導絲的末端穿過導針，將該第一導絲放入一第一受端 血管中，該人工血管係套於該第一導絲上，該人工血管具有一吻 201032788 該吻合靜脈 合靜脈段，該吻合靜脈段具有一第一端與一第二端 毕又係靠於該第一受端血管； I督支架係滑入 將一第一血管支架套入該第一導絲，該第_ 該第一受端血管内； 透過透明的該血管鞘係可直視到該第一血管 兮木兮政UL加 乏架的該條狀標 5己，备該條狀標記位於該人工血管的該吻合靜脈段的該第一端與 該第一受端血管之間時，即將該血管鞘退後而釋出該第一血管支 ΟThe veins (1, 70) are consistent with the connection. However, in clinical experience, conventional artificial blood vessels (15 ◦) have a poor design due to their shape and structure, resulting in easy & stenosis into the Ag outlet, which in turn leads to the formation of ▲ suppositories. At the same time, the injury to the vascular endothelium caused by surgical suture anastomosis induces agglutination of endothelium-producing platelets and subsequent thrombus formation. The second is the formation of blood clots due to the formation of eddy currents in the anastomosis due to blood flow tremor. The third reason is that the artificial blood vessel (1 150) and the softness (c〇mpliance) of the blood vessel in the anastomosis cause thrombus formation due to stenosis at the kiss. In summary, the conventional method of anastomosis of blood vessels has a variety of problems and defects in the use of vascular stents (140) and conventional artificial blood vessels (150), and it is necessary to improve them. SUMMARY OF THE INVENTION Technical Problem to Be Solved: In the related literature of the prior art, a new gold & kiss scorpion technique is proposed to avoid the use of needles to damage blood vessels, resulting in long-term intimal injury and stenosis, and related literature includes small blood vessels. Application of laser or other thermal energy for anastomosis, various blood vessel clamps for anastomosis, various new anastomosis devices or application of tissue glue for anastomosis and vascular stents, but the conventional method of vascular anastomosis is easy to operate The technical error and the abnormal proliferation of the endothelium caused by the injury of the secondary vascular endothelium caused by surgery, leading to surgical failure, etc., the end of the vascular stent used in 201032788 is equal, unable to accept The size of the blood vessel of the body is chosen, and it is quite inconvenient to use. In addition, the conventional artificial blood vessel has a shape and structure: the design is poor, which leads to the narrowing of the blood vessel outlet, which leads to the formation of blood clots. There are still many problems in the use of vascular stents, conventional vascular stents and conventional artificial vascular structures. Missing. Technical feature of the problem: a vascular stent device is provided, comprising: a blood vessel stent, which is a self-expandable blood vessel stent, and the inner side of the blood vessel stent is covered with an impervious envelope ( Membrane), the vascular stent comprises a first half and a second half, the first half and the second half may be equal, or the first half has a larger diameter than the second half, or the second half The diameter of the first half is larger than that of the first half, so that it can be applied to different sizes of vascular anastomosis; a strip mark is arranged between the first half and the second half of the blood vessel support, and the strip is marked as a release. Located at a mid-section of the vascular stent, the vascular stent is squashed in a sheath that is transparent when not released, and can be viewed directly from the vascular sheath when not released. The position of the stent and the strip mark, so that when the surgical position is placed, as long as the vascular sheath is retracted, the vascular stent will automatically stretch, so as to kiss The two vessels jammed tightly coupled, firmly connected to two receptor vascular anastomosis. Wherein, the vascular stent device is further connected to an artificial blood vessel, the artificial blood vessel system comprising an anastomotic artery segment and an anastomotic vein segment; wherein one end of the anastomotic artery segment is used for anastomosis with an artery of the receptor; The two ends of the anastomotic venous segment are connected to the venous support of the receptor through a vascular stent, and the other end of the anastomotic artery segment is connected to the anastomotic venous segment, and the anastomotic venous segment is The junction of the anastomotic arteries has a flattened cuff that prevents thrombus formation. 5 201032788 wherein the anastomotic artery segment is longer than the anastomotic vein segment. Wherein, the anastomotic artery segment and the anastomotic vein segment are integrally formed. : The artificial blood vessel system has a τ shape. Wherein the anastomotic artery segment intersects the anastomotic segment to form an acute angle side and an obtuse angle side, the flattened cuff portion being adjacent to the obtuse angle side. In addition, the method of using the vascular stent device of the present invention, in the end-to-end portion, comprises the following steps: finding the blood vessel of the receptor; completing the vascular control of the blood vessel to be anastomosed and controlling the blood vessel of the receiving blood vessel; Pierce the blood vessel and dilute the solution with heparin to swell; use a C-shape vessel sizer for blood vessel diameter measurement, and select a corresponding stent blood vessel according to the measurement result, the stent device The utility model comprises an enterprise stent, the inner side of the blood vessel stent is covered with a water-tight membrane, the blood vessel stent comprises a first half section and a second half section, and the first half section and the second half section can be equal to each other, or The diameter of the first half is larger than the diameter of the second half, or the diameter of the second half is larger than the diameter of the first half, so that it can be applied to different sizes of the recipient vascular anastomosis; the first half of the stent is A strip mark is provided between the second half as the identification at the time of release, and the strip mark is located approximately at the middle of the blood vessel support. Before being released, the vascular stent is contracted in a sheath which is a transparent material, and when not released, the strip can be directly viewed from the vascular sheath to the stent; The stent is inserted into a guide wire, and the guide wire is established by the guide needle at the end of the blood vessel to be anastomosed. The blood vessel to be anastomosed may be an artificial blood vessel or an autogenous transplant, and the guide needle is inserted into the guide wire. Inserting into a recipient vessel 6 201032788, whereby the stent is slid into the recipient vessel along the guidewire; and the strip of the stent is directly visible through the transparent sheath of the vessel When the strip mark is located between the blood vessel to be anastomosis and the blood vessel of the receiving end, the blood vessel sheath is retracted to release the blood vessel stent, and the blood vessel stent can be self-expanding to complete the anastomosis action, thereby The blood vessel to be anastomosed and the blood vessel of the receiving end are tightly engaged. In addition, in the method of using the vascular stent device of the present invention, the end-to-side portion includes the following steps: finding the blood vessel of the recipient; ® completing the blood vessel control of the first receiving end vessel and the second receiving end vessel Vascular control; the vascular guide needle is inserted into the blood vessel and the heparin diluted solution is used to swell; the C-shape vessel sizer is used for blood vessel diameter measurement, and the blood vessel stent corresponding to the recipient blood vessel is selected according to the measurement result. The vascular stent device comprises a vascular stent, and the inner side of the vascular stent is covered with a watertight membrane, the vascular stent comprising a first half and a second half, the first half and the second half It may be equal, or the diameter of the first half of the mouth is larger than the diameter of the second half, or the diameter of the second half is larger than the diameter of the first half, so that it can be applied to different sizes of recipient vascular anastomosis; A strip mark is provided between the first half and the second half as an identification during release, the strip mark is located approximately in the stent At the segment position, before being released, the vascular stent is contracted in a sheath which is a transparent material, and when not released, the vascular sheath can be directly viewed from the vascular sheath to the strip of the vascular stent Marking; passing the end of the first guide wire through the guide needle, the first guide wire is placed in a first receiving end blood vessel, the artificial blood vessel is sleeved on the first guide wire, the artificial blood vessel has a kiss 201032788 The anastomosis venous segment has a first end and a second end and is reliant on the first receiving end vessel; the I scaffold slides into the first vascular stent into the first a guide wire, the first _ the first end of the blood vessel; the transparent vascular sheath can directly view the strip 5 of the first vascular 兮 兮 UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL UL When the first end of the anastomotic vein segment of the artificial blood vessel is between the first end and the first end vessel, the blood vessel sheath is retracted to release the first vessel branch
架，該第-血管支架係可自膨撐張完成吻合動作，藉以將該吻合 靜脈段的該第一端與該第一受端血管緊緊卡住連結； 同樣地，再將第二導絲的末端穿過—導針，將該第二導絲放 入-第二受端血管中，該人工血管係套於該第二導絲上該吻合 靜脈段係靠於該第二受端血管； 將-第二血管支架套入該第二導絲’該第二血管支架係滑入 該第二受端血管内；以及， 透過透明的該血管鞘係可直視到該第二血管支架的該條狀標 記，當該條狀標記位於該人工血管的該吻合靜脈段的該第二端與 該第二受端血管之間時，將該血管鞘退後而釋出該第二血管支 架，該第二血管支架係可自膨撐張完成吻合動作，藉以將談吻合 靜脈段的該第二端與該第二受端血管緊緊卡住連結。 其中，該人工蠱管更包括一吻合動脈段；其中，該吻合動脈 段的/端係用以與受體的一動脈相吻合連接；該吻合動脈段的另 端係速通於該吻合靜脈段，該吻合靜脈段與該吻合動脈段相接處 具有玎避免也栓形成的一平順膨大袖口部。 其中，該吻合動脈段係較長於該吻合靜脈段。 其中，該吻合動脈段與該吻合靜脈段係為一體成型的結構。 8 201032788 其中，該人工血管係概呈τ形狀。 其中，該吻合動脈段與該吻合靜脈段係相交形成一銳角側與 ： 一鈍角側，該平順膨大袖口部係鄰近於該鈍角側。 . 另外，本發明係提供一種血管支架裝置，係包括：一血管支 架，該血管支架係為一自膨式（self-expandable)血管支架，該 血管支架内側包覆有不透水之包膜（membrane)，該血管支架係 包括一第一段與一第二段，該第一段係與一人工血管的一端預先 地進行口徑相對地固接結合，該第二段係用以與所欲吻合的一受 ® 體血管緊緊卡住連結。 其中，該血管支架的該第一段係與該人工血管為一體成型的 結構。 對照先前技術之功效： 一、 本發明中血管支架裝置之使用方法，不僅可不受手術技術不 佳（technical error)的影響，也可大幅減少因手術所引 起的繼發性血管内皮受損所導致的内皮不正常增生，這在對 擁有洗腎屢管需要長期洗腎的病人而言，可以有效減少接受 手術的時間以及因吻合處狹窄所帶來再次手術之機會。 二、 本發明對醫師而言，手術方式變得更簡單，而其臨床成果也 變得更可靠，更可提高手術的成功率。 三、 本發明係利用企管支架裝置來執行血管間之吻合術，由於不 需要縫針縫線刺激破壞血管，使得手術進行更容易，且能有 效節省手術時間，而且因為沒有吻合血管之縫線針孔，不會 刺激内膜增生，可長期性地有效避免與解決習用吻合後之血 管狹窄等問題。 四、 本發明可有效且穩固地吻合連接兩血管成一連續管路，並可 9 201032788The first vascular stent can be self-expanded to complete the anastomosis action, whereby the first end of the anastomotic venous segment is tightly engaged with the first receiving end vessel; likewise, the second guide wire is further The distal end is passed through a guide pin, and the second guide wire is placed in the second receiving end vessel, and the artificial blood vessel is sleeved on the second guide wire, and the anastomotic vein segment is anchored to the second receiving end vessel; Inserting a second vascular stent into the second guidewire', the second vascular stent is slid into the second recipient vessel; and, through the transparent vascular sheath, the strip of the second stent is directly viewable a mark, when the strip mark is located between the second end of the anastomotic venous segment of the artificial blood vessel and the second end vessel, the vascular sheath is retracted to release the second vascular stent, the first The second vascular stent system can perform anastomosis action by self-expanding, so that the second end of the anastomosis venous segment is tightly engaged with the second receiving end vessel. Wherein, the artificial fistula further comprises an anastomotic segment; wherein the end of the anastomotic segment is connected to an artery of the recipient; the other end of the anastomotic segment is connected to the anastomotic segment The anastomosis venous segment and the anastomotic artery segment have a flattened cuff portion that avoids the formation of a plug. Wherein the anastomotic artery segment is longer than the anastomotic vein segment. Wherein, the anastomotic artery segment and the anastomotic vein segment are integrally formed. 8 201032788 wherein the artificial blood vessel system has a τ shape. Wherein the anastomotic artery segment intersects the anastomotic venous segment to form an acute angle side and an obtuse angle side, the flattened cuff portion being adjacent to the obtuse angle side. In addition, the present invention provides a vascular stent device, comprising: a blood vessel stent, which is a self-expandable blood vessel stent, and the inner surface of the blood vessel stent is covered with a watertight membrane (membrane). The vascular stent comprises a first segment and a second segment, the first segment being fixedly coupled to the end of an artificial blood vessel in advance, the second segment being used to match the desired One is subject to the body's blood vessels tightly stuck. Wherein the first segment of the vascular stent is integrally formed with the artificial blood vessel. Compared with the efficacy of the prior art: 1. The method of using the vascular stent device of the present invention can not only be affected by the technical error, but also can greatly reduce the damage caused by the secondary vascular endothelium caused by the operation. The abnormal proliferation of the endothelium can effectively reduce the time of surgery and the chance of reoperation due to the narrowing of the anastomosis in patients who have long-term dialysis for dialysis. Second, the present invention is simpler for the physician, and the clinical results are more reliable, and the success rate of the surgery can be improved. 3. The present invention utilizes an enterprise management stent device to perform an anastomosis between blood vessels. Since needle stitching is not required to stimulate the destruction of blood vessels, the operation is easier, and the operation time can be effectively saved, and because there is no needle hole for anastomotic blood vessels. It does not stimulate the intimal hyperplasia, and can effectively avoid problems such as narrowing of the blood vessels after the anastomosis. Fourth, the invention can effectively and stably match the two blood vessels into a continuous pipeline, and 9 201032788
可便利地進行血管接合，可以有效便利手術之進行。 應用在人工血管或自體血管間的吻合。 本發明中的血管支架裝置係的兩端口徑 前半段大或後半段大，可以依受艚的&The vascular engagement can be conveniently performed, and the operation can be effectively facilitated. Application of anastomosis between artificial blood vessels or autologous blood vessels. The two-port diameter of the vascular stent device of the present invention is large in the front half or large in the second half, and can be relied upon &
避免血栓之形成，有效維持血f之長期暢通並減少血检清除 術等相關手術所衍生的醫療浪費，有效降低醫療成本。 有關本發明所採用之技術、手段及其功效，兹舉—較佳實施 例並配合圖切細㈣如后，相信本發明上述之目的、構造及其 特徵，當可由之得一深入而具體的瞭解。 、 【實施方式】 請參閱第- A圖至第六圖所示，本發明係提供一種血管支架 裝置，係包括：-血管支架（1〇)，該血管支架（10)係為 一自膨式（self-expandable)血管支架，該血管支架（J 〇 )内 側包覆有不透水之包膜（membrane)(圖中未示），該血管支架 (10)係包括一前半段與一後半段，該前半段與該後半段口徑 係可以相等，或是該前半段的口徑大於該後半段的口徑或是談 後半段的口徑大於該前半段的口徑，藉以可適用於不同大小的血 管吻合連接使用；該血管支架（丄〇 )的該前半段與該後半段之 間设有一條狀橾記（i i)，做為釋放時的辨識，該條狀標記 (1 1 )約略位於該血管支架（丄〇)的中段位置處，在未釋放 前，該血管支架（1 0 )係縮於一血管鞠（sheath)中，該血管鞘 201032788 '、為透月材質纟釋放時，可以從該血管稍外直視到該企管支架 (10)的位置及該條狀標記（1 1 )，藉此手術定位置放時，、 :只要將該血管勒往後退，該金管支架（1〇)即會自動撑張，藉 :以將所欲吻合的兩段血管緊緊卡住連結，_地吻合連接兩段受 體血管。 其中’該血管支架裝置更可連接一人工血管（40)，該人 工血管（4 〇)係包括-吻合動脈段（4丄）與—吻合靜脈段 (42);其中’㈣合動脈段（41)的—端係用以與受體的 -動脈相吻合連接；該吻合靜脈段（4 2)的兩端係透過該血管 支架（10)來與受體的一靜脈進行彼此口徑相對地撐張卡住連 接，該吻合動脈段（4 1 )的另端係連通於該吻合靜脈段（4 2)，該吻合靜脈段（4 2)與該吻合動脈段（4卫）相接處具 有可避免企栓形成的一平順膨大袖口部（4 3 )。 其中，該吻合動脈段（4 1 )係較長於該吻合靜脈段（4 2 ) ° 其中，該吻合動脈段（4 1 )與該吻合靜脈段（4 2)係為 一艘成型的結構。_ 其中，該人工血管（40)係概呈T形狀。 其中’該吻合動脈段（4 1 )與該吻合靜脈段（4 2)係相 交形成一銳角側與一鈍角侧，該平順膨大袖口部（4 3 )係鄰近 於該鈍角側。 另外本發明中該血管支架裝置之使用方法，其中，關於端對 端的部分（如第一 A、一 B、二、三圖所示）’係依序包括下列 步驟： (al )找出受體之血管； 11 201032788 / (bl)完成欲吻合血管（7 0)之血管控制以及受端血管 (80)之灰管控制； ()將血g導針刺入血管並以肝素稀釋溶液使其鼓服； ⑷）利用C型血管直#測量器（c —si·) (2 0)作血管直徑測量（如第二圖所示），並依據測量結果選 擇對應受體血管之血管支架裝置，該企管支架裝置係包括一血管 ❹ ❹ 支架（60)，該血管支架（6〇)内側包覆有不透水之包膜 (membi'ane)該i管支架（6 Q )係包括—前半段與一後半 段’該前半段與該後半段〇徑係可以相等或是該前半段的口徑 一“乂後半段的口检，或是該後半段的口徑大於該前半段的口 /藉X可適用於不同大小的受體▲管吻合連接使用；該血管支 架（6 0)的該則半段與該後半段之間設有—條狀標記，做為釋 放時的辨識’該條狀標記約略位於該血管支架（60)的中段位 置處，在未釋放前，該血管支架（6 〇 )係縮於_血管賴 (sheath)巾，敍管㈣、為透，未釋放時，可以從該血管 勒外直視到該血管支架（60)的該條狀標記； (el)將該血管支架（6〇)套入於一導絲（3〇),該導 絲（3〇)的末端穿過一導針（50)，承吻合血管（7〇)可 為人工血管或自體血管的移植物（aut〇gen〇us加物⑹， 將該導絲（3 0)放入-受端血管（8〇)中，藉此，將該血管 支架（6 Q)順著該導絲（3 G)滑人該受端血管（8 ◦)中； 以及， (fi)透過透㈣敍管鞘係可直視到該▲管支架（6 〇 ) 的該條狀標記’當該條狀標記位於該欲吻合▲管（7 〇)與該受 端血管（8 0)之間時’即將該血管鞘退後而釋出該血管支： 12 201032788 (60)，該血管支架（6〇)係可自膨撐張完成吻合動作，藉 以將該欲吻合血管（70)與該受端血管（80)緊緊卡住^ 此外，本發明中該血管支架裝置之使用方法， 序包括下列步驟： 對侧的部分（如第一 A、一 B、二、四、五 ：關於端 五〜、圖所不），係依 (a2)找出受體之血管； (b2)元成第一受端血管（1 〇 〇 )之血管控制以及第二受 ❹端血管（110)之血管控制； (c2)將血管導針刺入血管並以肝素稀釋溶液使其鼓脹； (d2 )利用c型血管直徑測量器（C shape sizer) ( 2 〇 )作血管直制量，並依據測量結果選擇對應受 體血g之血管支架裝置，該血管支架裝置係包括—血管支架該 血管支架内側包覆有不透水之包膜（瞻以繼），該血管支架係 c括前半段與-後半段，該料段與該後半段口徑係可以相 等或疋該别半段的口徑大於該後半段的口捏或是該後半段的 © 口徑大於該前半段的時，藉以可適用於不同大+的受體血管吻 :連接使用，該*管支架的該前半段與該後半段之間設有一條狀 &»己Μ為釋放時的辨識，該條狀標記約略位於該血管支架的中 段位置處，在未釋放前，該血管支架係縮於一血管勒（sheath) 中該血s勒係為透明材質，未釋放時，可以從該血管勒外直視 到該血管支架的該條狀標記； (e2)將第—導絲的末端穿過—導針，將該第—導絲放入一 第又端血官（1 中，並利用一人工血管（4 0 )套於該 第-導絲上，該人工血管（4〇)具有一吻合靜脈段（42)， 13 201032788 該吻合靜脈段（42)具有一第一端（421)與—第二端（4 2 2)，該吻合靜脈段（4 2)係靠於該第-受端血管（1〇 0 ); (f2)將一第—血·管支架（Θ 0 )套入該第一導絲，該第一 血管支架（9 0)係滑入該第-受端血管（1〇〇)内； (g2)透過透明的該血㈣係可直制該第—血管支架（9 0)的該條狀標記，當該條狀標記位於該人卫 ❹ ❹ 吻合靜脈段（42)帽-端（421)與該第_受〇 = (1 0 0 )之間時’即將該血管勒退後而釋出該第—血管支架 (90) ’該第-血管支架（9Q)係可自膨撐張完成吻合動 作’藉以將該吻合靜脈段（4 2)的該第—端（4 2 ι )與該第 一受端血管（1 〇 〇)緊緊卡住連結； (⑻同樣地，再將第二導絲的末端穿過—導針，將該第二 導絲放入一第二受端血管（1 1 〇)中，該人工血管（4 〇)係 套於該第二導絲上，該吻合靜脈 t (110) ; 42)係靠於該第二受端血 (⑴將一第二血管支架（120)套入該第二導絲 二血管支架⑴0)係滑入該第二受端血管（11〇)内：以 及， (12)透過透㈣該血管鞘係可直視到該第二血管支架（工 2 0)的該條狀標記，當該條狀標記位於該人卫血 該吻〇靜脈段（42)的该第二端（4 2 2 )與該第二受端血管 (1 1 0)之間時，將該血管稍退後而釋出該第二血 20) ’該第二血管支架（12〇)係可 吻 作，藉以將該吻合靜脈段"2 )的該 ㈣口動 第一端（4 2 2)與該第 201032788 二受端血管（1 1 ο)緊緊卡住連結。 其中’該人工血管（4 〇)更包括一吻合動脈段（4 1); : 其中，該吻合動脈段（4 1 )的一端係用以與受體的一動脈相吻 ; 合連接；該吻合動脈段（41)的另端係連通於該吻合靜脈段 (4 2)，該吻合靜脈段（4 2)與該吻合動脈段（4 1 )相接 處具有可避免血栓形成的一平順膨大袖口部（43)。 其中，該吻合動脈段（4 1 )係較長於該吻合靜脈段（4 2 )。 ® 其中，該吻合動脈段（4 1 )與該吻合靜脈段（4 2 )係為 一體成型的結構。 其中，該人工金管（4 0)結構係概呈τ形狀。 其中，該吻合動脈段（4 1)與該吻合靜脈段（4 2)係相 交形成一銳角侧與一鈍角側，該平順膨大袖口部（4 3)係鄰近 於該鈍角側。 另外，請參閱第七、八圖所示，本發明係提供一種血管支架 裝置（131、132) ’係包括：一血管支架，該血管支架係 n 為一自膨式（self-expandable)血管支架，該血管支架内側包 覆有不透水之包膜（membrane) ’該血管支架係包括一第一段 (1311、1321)與一第二段（1312、1322)， 該第一段（1 3 1 1、1 3.2 1)係與一人工血管（13 13、 1 3 2 3 )的一端預先地進行口徑相對地固接結合，該第二段 (1312、1322)係透過一導絲（1314、1324) 來與所欲吻合的一受體血管緊緊卡住連結，因此該血管支架可實 施於人工血管的各端、兩端或三端皆實施等，其中該血管支架的 該第一段（1 3 1 1 )係與該人工血管（1 3 1 3)為一體▲型 15 201032788 的結構，透過血管支架與人工血管已經預先一體成型結合，藉以 不用利用條狀標記對準，即可便利地進行血管接合。 ： 總結而言，該血管支架裝置主要有兩種應用使用方法，其一 . 為端對端（end-to-end)的吻合方法，為兩段管之端對端吻 合，係先將導絲放入欲作吻合金管之受端血管中，另一段欲吻合 之企管（可為人工血管或自體血管的移植物（autogenous transplant)) 係套於導絲上，將吻合用血管支架 (anastomosis device)順著導絲滑入承接的該受端血管中。 ® 由透明的該血管鞘中可直視到該血管支架的該條狀標記，當該條 狀標記位於兩段血管之間時，則為正確位置，此時將該血管鞘退 後，而釋放出自膨的該血管支架，藉以完成吻合。 其二為端對側（end-to-side)的吻合方法，係先將導絲放入 欲吻合血管之受端血管之中，另一段欲吻合之預先成型的T型人 工血管套於導絲上，將人工血管的該吻合靜脈段先作吻合，因此 人工血管的位置係為該吻合靜脈段朝向欲吻合的血管。 首先，本發明中血管支架裝置之使用方法，不僅可不受手術 技術不佳（technical error)的影響，也可大幅減少因手術所引 起的繼發性血管内皮受損所導致的内皮不正常增生，這在對擁有 洗腎屢管需要長期洗腎的病人而言，可以有效減少接受手術的時 間以及因吻合處狹窄所帶來再次手術之機會。其次，本發明對醫 師而言，手術方式變得更簡單，而其臨床成果也變得更可靠，更 可提高手術的成功率。再者，本發明係利用血管支架裝置來執行 血管間之吻合術，由於不需要縫針縫線刺激破壞血管，使得手術 進行更容易，且能有效節省手術時間，而且因為沒有吻合血管之 縫線針孔，不會刺激内膜增生，可長期性地有效避免與解決習用 16 201032788 吻合後之血管狹窄等問題。 另外，本發明可有效且穩固地吻合連接兩血管成一連續管 • 路，並可應用在人工金管或自體企管間的吻合。此外，本發明中 . 的血管支架裝置係的兩端口徑係可以相等，也可以前半段大或後 半段大，可以依受體的血管大小作選擇，使用上更加便利。此 外，本發明中的血管支架裝置的該血管支架的該第一段係與該人 工血管為一體成型的結構，藉以不用利用條狀標記對準，即可便 利地進行血管接合，可以有效便利手術之進行。最後，本發明中 © 的人工血管係採一體成型的三向構形設計，可有效避免血栓之形 成，有效維持血管之長斯暢通並減少企栓清除術等相關手術所衍 生的醫療浪費，有效降低醫療成本。 前文係針對本發明之可行實施例為本發明之技術特徵進行具 體說明；惟，熟悉此項技術之人士當可在不脫離本發明之精神與 原則下對本發明進行變更與修改，而該等變更與修改，皆應涵蓋 於如下申請專利範圍所界定之範疇中。 【圖式簡單說明】 〇 第一 Α圖：係本發明實施例之血管支架立體外觀示意圖。 第一 B圖：係本發明實施例之另一血管支架立體示意圖。 第二圖：係本發明實施例之C型血管直徑測量器測量示意 圖。 第三圖··係本發明實施例之端對端吻合示意圖。 第四圖：係本發明實施例之端對側吻合動作示意圖。 第五圖：係本發明實施例之端對側吻合另一動作示意圖。 第六圖：係本發明實施例之端對側吻合動作後示意圖。 第七圖：係本發明實施例之另一血管支架實施示意圖。 17 201032788 第八圖：係本發明實施例之再一血管支架實施示意圖 第九圖：係習用血管支架立體外觀示意圖。 第十圖：係習用人工血管立體外觀示意圖。 【主要元件符號說明】 •習用部份· (1 4 0)血管支架 (1 5 0)人工金管 (1 6 0 )動脈 (1 7 0)靜脈 •本發明部份· Ο (1〇)血管支架 (1 1 )條狀標記 (2 0) C型血管直徑測量器 (3 0)導絲 (40)人工血管 (4 1 )吻合動脈段 (4 2)吻合靜脈段 (4 2 1 )第一端 (4 2 2 )第二端 (4 3)平順膨大袖口部 (5 0)導針 (60)血管支架 (7 0 )欲吻合血管 (8 0)受端血管 (9 0)第一血管支架 (1 0 0)第一受端企管 ❹ （1 1 0)第二受端血管 (12◦)第二血管支架 (1 3 1 )血管支架裝置 (1 3 1 1 )第一段 (1312)第二段 (1 3 1 3)人工血管 (1314)導絲 (1 3 2)企管支架裝置 (1 3 2 1 )第一段， (1 3 2 2 )第二段 (1 3 2 3 )人工血管 (1 3 2 4 )導絲 18Avoid the formation of blood clots, effectively maintain the long-term smoothness of blood f and reduce the medical waste caused by related operations such as blood test and removal, and effectively reduce medical costs. With regard to the techniques, means and efficiencies of the present invention, it is believed that the above-described objects, structures and features of the present invention can be obtained from To understanding. [Embodiment] Referring to Figures -A to 6 , the present invention provides a blood vessel stent device comprising: - a blood vessel stent (1), the blood vessel stent (10) is a self-expanding type (self-expandable) a blood vessel stent, the inner side of the blood vessel stent (J 〇) is covered with a watertight membrane (not shown), and the blood vessel stent (10) includes a first half and a second half. The first half and the second half of the caliber can be equal, or the cavities of the first half are larger than the caliber of the second half or the caliber of the second half is larger than the caliber of the first half, so that it can be applied to different sizes of vascular anastomoses. a sputum (ii) is provided between the first half of the vascular stent and the second half, and is identified as a release, and the strip (1 1 ) is located approximately in the vascular stent (丄) At the middle position of the 〇), before the blood is released, the vascular stent (10) is contracted in a sheath, and the vascular sheath 201032788' can be slightly removed from the blood vessel when it is released. Directly view the position of the business tube bracket (10) and the strip The mark (1 1 ), when the position is released by the operation, as long as the blood vessel is retracted, the gold tube bracket (1〇) will automatically stretch, by: to tight the two segments of the blood vessel to be fitted Tightly stuck to the joint, _ ground anastomosis to connect the two receptor blood vessels. Wherein the vascular stent device is further connected to an artificial blood vessel (40), the artificial blood vessel (4 〇) system includes an anastomotic artery segment (4丄) and an anastomosis vein segment (42); wherein the '(four) artery segment (41) The end-to-end is used to anastomosically connect to the receptor-arterial artery; the two ends of the anastomotic venous segment (42) are permeable to each other through a vascular stent (10) and a vein of the recipient Jamming the connection, the other end of the anastomotic segment (4 1 ) is connected to the anastomotic segment (42), and the anastomosis segment (42) is avoidable at the junction of the anastomotic segment (4) A flat and swollen cuff formed by the plug (4 3 ). Wherein, the anastomotic artery segment (4 1 ) is longer than the anastomotic segment (4 2 ) ° , wherein the anastomotic segment (4 1 ) and the anastomotic segment (42) are a formed structure. _ wherein the artificial blood vessel (40) is substantially T-shaped. Wherein the anastomotic artery segment (4 1 ) intersects the anastomotic segment (42) to form an acute angle side and an obtuse angle side, and the flattened cuff portion (43) is adjacent to the obtuse angle side. Further, in the present invention, the method of using the vascular stent device, wherein the end-to-end portion (as shown in the first A, B, B, and III) sequentially comprises the following steps: (al) finding the receptor The blood vessels; 11 201032788 / (bl) complete the vascular control of the blood vessel (70) and the gray tube control of the end vessel (80); () puncture the blood g needle into the blood vessel and dilute the solution with heparin to make it (4)) using a C-type blood vessel straight measuring device (c-si·) (20) for blood vessel diameter measurement (as shown in the second figure), and selecting a blood vessel stent device corresponding to the recipient blood vessel according to the measurement result, The vascular stent device comprises a vascular iliac crest (60), the inner side of the vascular stent (6 〇) is covered with a watertight envelope (membi'ane), and the i-tube stent (6 Q) includes a first half and a first The second half of the 'the first half and the second half of the diameter can be equal or the first half of the diameter of the first half of the mouth of the mouth of the second half of the mouth, or the second half of the mouth is larger than the first half of the mouth / borrow X can be applied to Different sizes of receptors ▲ tube anastomosis connection; the half of the vascular stent (60) A strip-like mark is provided between the second half of the segment as the identification at the time of release. The strip-shaped mark is located approximately at the middle position of the blood vessel support (60), and the blood vessel support (6 inch) is contracted before being released. In the _vascular sheath (sheath) towel, the tube (four), transparent, when not released, the strip can be directly viewed from the blood vessel to the stent (60); (el) the stent (6) Inserted into a guide wire (3〇), the end of the guide wire (3〇) passes through a guide pin (50), and the anastomotic blood vessel (7〇) can be an artificial blood vessel or an autologous blood vessel graft (aut 〇gen〇us addition (6), the guide wire (30) is placed in the end vessel (8〇), whereby the vascular stent (6 Q) is slid along the guide wire (3 G) The end vessel (8 ◦); and, (fi) through the permeable (four) stalk sheath can directly see the strip mark of the ▲ tube holder (6 〇) when the strip mark is located in the tube (7 〇) and the end vessel (80) when the vascular sheath is retracted to release the vascular branch: 12 201032788 (60), the vascular stent (6 〇) can be self-expanding Anastomotic action Thereby, the blood vessel (70) to be anastomosed and the blood vessel (80) are tightly clamped. Further, in the method of using the blood vessel stent device of the present invention, the sequence includes the following steps: a part on the opposite side (such as the first A, One B, two, four, five: about the end five ~, the figure does not), according to (a2) to find the blood vessels of the receptor; (b2) the vascular control of the first end of the blood vessel (1 〇〇) and (2) vascular control of the second sacral vessel (110); (c2) puncturing the vascular needle into the blood vessel and diluting the solution with heparin; (d2) using a c-shaped blood vessel diameter gauge (C shape sizer) (2 〇 According to the measurement result, the vascular stent device corresponding to the recipient blood g is selected, and the vascular stent device comprises a blood vessel stent, and the inner side of the blood vessel stent is covered with an impervious envelope (and the succession). The vascular stent system includes a first half segment and a second half segment, the material segment and the second half segment diameter system may be equal or the other half segment has a larger diameter than the second half segment or the latter half has a larger diameter than the first half segment. At the time, it can be applied to different large + receptor vascular kisses: use a strip between the front half of the tube holder and the second half is identified as a release, the strip mark being located approximately at the middle of the stent, before being released The blood vessel is contracted in a sheath, and the blood stalk is a transparent material. When not released, the strip can be directly viewed from the vessel to the strip of the vessel stent; (e2) the first guide wire The end of the through-guide pin, the first guide wire is placed in a second end of the blood (1, and an artificial blood vessel (40) is placed on the first guide wire, the artificial blood vessel (4〇 Having an anastomotic venous segment (42), 13 201032788 The anastomotic venous segment (42) has a first end (421) and a second end (42 2), the anastomotic segment (42) resting on the a first-accepting blood vessel (1〇0); (f2) a first blood-tube stent (Θ 0) is inserted into the first guide wire, and the first blood vessel support (90) is slid into the first-acceptance Within the end vessel (1〇〇); (g2) through the transparent blood (4) line, the strip-shaped marker of the first-vessel stent (90) can be directly produced, and when the strip-shaped marker is located in the person's defending ❹ anastomosis When the cap (42) between the cap (42) and the _ _ 〇 = (1 0 0 ) is 'retracted from the blood vessel to release the first vascular stent (90) 'the first vascular stent (9Q) is capable of self-expanding to complete the anastomotic action' by which the first end (4 2 ι ) of the anastomotic venous segment (42) is tightly engaged with the first receiving end vessel (1 〇〇) (8) Similarly, the end of the second guide wire is passed through the guide pin, and the second guide wire is placed in a second end vessel (1 1 〇), the artificial blood vessel (4 〇) sleeve On the second guidewire, the anastomotic vein t (110); 42) is dependent on the second recipient blood ((1) inserts a second stent (120) into the second guidewire stent (1) 0) Sliding into the second receiving vessel (11〇): and, (12) transmitting through the vascular sheath, the strip of the second vessel stent (working 20) can be directly viewed as the strip When the marker is located between the second end (4 2 2 ) of the venous venous segment (42) of the person and the second receiving end vessel (1 1 0), the blood vessel is slightly retracted to release the Second blood 20) 'The second blood vessel stent (12〇) is a kiss The first end (4 2 2) of the (4) mouth movement of the anastomotic vein segment "2 is tightly engaged with the second end vessel (1 1 ο) of the 201032788. Wherein the artificial blood vessel (4 〇) further comprises an anastomotic artery segment (4 1); wherein: one end of the anastomotic artery segment (4 1 ) is used to kiss an artery of the recipient; The other end of the arterial segment (41) is connected to the anastomotic segment (42), and the anastomotic segment (42) and the anastomotic segment (4 1) have a smooth cuff that avoids thrombus formation. Department (43). Wherein the anastomotic segment (4 1 ) is longer than the anastomotic segment (42). ® wherein the anastomotic segment (4 1 ) and the anastomotic segment (42) are integrally formed. Wherein, the artificial gold tube (40) structure is generally in the shape of τ. Wherein the anastomotic artery segment (4 1) intersects the anastomotic vein segment (42) to form an acute angle side and an obtuse angle side, and the flattened cuff portion (43) is adjacent to the obtuse angle side. In addition, as shown in the seventh and eighth figures, the present invention provides a vascular stent device (131, 132) 'system comprising: a blood vessel stent, the blood vessel stent n is a self-expandable blood vessel stent The inner side of the blood vessel stent is covered with a watertight membrane. The blood vessel stent includes a first segment (1311, 1321) and a second segment (1312, 1322), the first segment (1 3 1 1, 1 3.2 1) is fixedly coupled to one end of an artificial blood vessel (13 13 , 1 3 2 3 ) in a relative manner, and the second section (1312, 1322) is transmitted through a guide wire (1314, 1324). The vascular stent can be implemented at the end, the two ends or the three ends of the artificial blood vessel, and the first segment of the vascular stent (1) 3 1 1 ) is integrated with the artificial blood vessel (1 3 1 3) ▲ type 15 201032788 structure, through the vascular stent and the artificial blood vessel have been integrally formed in advance, so that it can be conveniently carried out without alignment with the strip mark Vascular junction. In summary, the vascular stent device has two main application methods. One is an end-to-end anastomosis method, which is an end-to-end anastomosis of the two-stage tube. Put into another blood vessel that is to be anastomosed to the gold tube, and another tube to be anastomosed (which may be an artificial blood vessel or an autogenous transplant) is placed on the guide wire, and the anastomosis device will be used for anastomosis. Sliding along the guide wire into the receiving end vessel. ® The strip mark of the vascular stent can be directly viewed from the transparent vascular sheath. When the strip mark is located between the two vessels, it is the correct position, and the vascular sheath is retracted and released. The vascular stent is swelled to complete the anastomosis. The second is an end-to-side anastomosis method, in which the guide wire is placed in the end vessel of the blood vessel to be anastomosed, and the other pre-formed T-shaped artificial blood vessel to be anastomosed is placed on the guide wire. In the above, the anastomotic vein segment of the artificial blood vessel is first anastomosed, so the position of the artificial blood vessel is such that the anastomotic vein segment faces the blood vessel to be anastomosed. First, the method of using the vascular stent device of the present invention can not only be affected by the technical error, but also can greatly reduce the abnormal proliferation of the endothelium caused by the secondary vascular endothelium damage caused by the surgery. This can effectively reduce the time of surgery and the chance of reoperation due to the narrowing of the anastomosis in patients who have long-term dialysis for dialysis. Secondly, the present invention is simpler for the surgeon, and the clinical results are more reliable, and the success rate of the surgery can be improved. Furthermore, the present invention utilizes a vascular stent device to perform an anastomosis between blood vessels, since the needle stitch is not required to stimulate the destruction of the blood vessel, the operation is easier, and the operation time can be effectively saved, and since the needle is not anastomosed The hole does not stimulate the intimal hyperplasia, and can effectively avoid problems such as vascular stenosis after the use of the 16 201032788. In addition, the present invention can effectively and stably bridge the two blood vessels into a continuous tube and can be applied to the anastomosis between the artificial gold tube or the self-contained tube. Further, the two-port diameter system of the vascular stent device of the present invention may be equal, or may be large in the first half or large in the second half, and may be selected according to the size of the blood vessel of the receptor, and is more convenient to use. In addition, the first segment of the blood vessel stent of the blood vessel stent device of the present invention is integrally formed with the artificial blood vessel, so that the blood vessel joint can be conveniently performed without alignment with the strip mark, which can effectively facilitate the operation. Go on. Finally, the artificial vascular system of the present invention adopts an integrated three-way configuration design, which can effectively prevent the formation of blood clots, effectively maintain the long-term smoothness of the blood vessels, and reduce the medical waste derived from related operations such as the suture removal surgery, and is effective. Reduce medical costs. The foregoing is a description of the technical features of the present invention, and the present invention can be modified and modified without departing from the spirit and scope of the present invention. And modifications should be covered in the scope defined by the scope of the patent application below. BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a schematic view showing the stereoscopic appearance of a blood vessel stent according to an embodiment of the present invention. Figure B is a perspective view of another blood vessel stent according to an embodiment of the present invention. Second Fig.: A schematic view of a C-type blood vessel diameter measuring device according to an embodiment of the present invention. The third figure is a schematic diagram of the end-to-end anastomosis of the embodiment of the present invention. The fourth figure is a schematic diagram of the end-to-side anastomosis action of the embodiment of the present invention. Fig. 5 is a schematic view showing another action of the end-to-side anastomosis of the embodiment of the present invention. Fig. 6 is a schematic view showing the end-to-side anastomosis action of the embodiment of the present invention. Fig. 7 is a schematic view showing the implementation of another blood vessel stent according to an embodiment of the present invention. 17 201032788 The eighth figure is a schematic diagram of the implementation of another blood vessel stent according to an embodiment of the present invention. FIG. 9 is a schematic view showing the stereoscopic appearance of a conventional blood vessel stent. Figure 10: Schematic diagram of the stereoscopic appearance of artificial blood vessels. [Main component symbol description] • Conventional part · (1 4 0) Vascular stent (1 50) Artificial gold tube (1 60) Artery (170) vein • Part of the invention · Ο (1〇) vascular stent (1 1 ) strip mark (2 0) C-type blood vessel diameter measuring device (30) guide wire (40) artificial blood vessel (4 1 ) anastomotic artery segment (4 2) anastomosis vein segment (4 2 1 ) first end (4 2 2) second end (4 3) flattened cuff (5 0) guide needle (60) blood vessel stent (70) to anastomosis blood vessel (80) recipient blood vessel (90) first blood vessel stent ( 1 0 0) The first segment of the first tube (1 1 0), the second tube (12 ◦), the second tube stent (1 3 1 ), the vascular stent device (1 3 1 1 ), the first segment (1312), the second Segment (1 3 1 3) artificial blood vessel (1314) guide wire (1 3 2) management stent device (1 3 2 1 ) first segment, (1 3 2 2 ) second segment (1 3 2 3 ) artificial blood vessel ( 1 3 2 4) Guide wire 18