A combined device for reconstructing aortic arch and three-branch covered stent graft

Abstract

The invention discloses a combined device for reconstructing the aortic arch and a three-branched stent-graft vessel, which includes three artificial vessel components: ① a section of straight cylindrical artificial aortic vessel (1), the artificial aortic vessel (1) includes a main Arterial adventitia (7) and aortic stent (8), the distal part (8a) of the aortic stent (8) is designed integrally with the outer vascular membrane, and the proximal part (8b) can be After the bare stent is released, ② the small stent vessel (2), the small stent vessel (2) includes the small stent vessel adventitia (9) and the small stent intravascular stent (10), the small stent intravascular stent (10 ) head part (10a) is designed integrally with the adventitia (9a) at the top part of the small stent vessel adventitia (9), and the tail part (10b) is designed with the lower end part adventitia of the small stent vessel adventitia (9) (9b) separate design, ③ a section of straight pipe (11). Using this vascular component can quickly reconstruct the aortic arch and three branch vessels. Even if the branch vessels have large variations, the original normal vessel shape can still be maintained to the greatest extent. It is suitable for various branched vessels with a wide range of applications and avoids customized stents , can be produced in batches, effectively reduce surgical trauma, and significantly simplify surgical operations.

Description

technical field [0001] The invention relates to the field of implantable stent blood vessels, and relates to a covered stent assembly that can be used to reconstruct the three branches of the aortic arch. Background technique [0002] Thoracic aortic aneurysm and aortic dissection are serious lesions that seriously threaten the lives of the general public. Without active treatment, the natural disability rate and mortality rate are high. In recent years, with the increase in the incidence of hypertension, hyperlipidemia, hyperglycemia, and trauma, the incidence of thoracic aortic aneurysm and aortic dissection has increased significantly. Currently, aortic arch replacement under direct vision is still the only option for aortic lesions involving the proximal ascending aorta and aortic arch. At present, the most mature aortic arch replacement operation requires artificial blood vessels to replace the diseased blood vessels under deep hypothermic circulatory arrest, and anast...

AI Technical Summary

Problems solved by technology

[0003] Since the three branch vessels from the aortic arch in each patient: the innominate artery, the left common carotid artery and the left subclavian artery run differently, the distance between the openings of the three branch vessels, the arrangement angle, and the diameter of each branch vessel are different. , so that the shape of the three-branched blood vessels in the combined arch is very different, and it is impossible to completely match the arch blood vessels of different patients through a prefabricated stent blood vessel

Once the stent vessel does not match the target vessel, endovascular repair cannot be completed well

[0004] At present, the three-branched stent-graft vessel that is tried to be used in open surgery is only reported by Chen Liangwan’s group in China. The three-branched stent vessel they designed has obvious disadvantages: ①The three-branched vessels in the human body have large differences in course and diameter, The combined three-branch vascular system varies greatly. The stent blood vessels used by Chen Liangwan’s team are blood vessels with fixed branches, which cannot be completely prefabricated to match the stents of various blood vessel conditions, and the occurrence of endoleaks is high.

②The three branches are fixed with the main stent vessel. When implanting, the three branches and the main vessel must be placed at the same time. The operation is difficult and the branch vessels are easy to be damaged

However, this stent cannot completely prefabricate three-branch vessels of different calibers, and when the position of the branch opening varies greatly, the blood vessels at the opening are easily twisted and compressed, and the vascular membrane of the branch vessels on the greater curvature is not supported by a stent, and internal fistulas are prone to occur in the vascular lesions of the greater curvature

It is difficult to accurately place the three-branch vessels, especially when the branch variation is large, it will affect the blood flow of the branch vessels and the lumen of the main vessel

[0008] The application publication number is CN 108403255 A, a novel arch stent system and its application method, including cross-arch main body stent and branch stent, the size of the branch stent can be pre-determined before operation, but for patients with type A aortic dissection, Due to the pressure of the true lumen of the blood vessel, the size of the true lumen cannot be measured according to the image before operation, so it is difficult to accurately select the size of the main stent. If the main stent is selected after circulatory arrest and three branches are made, the time of circulatory arrest will be significantly increased , increased surgical risk

In addition, in the implementation of this invention, when the stent is implanted, the main blood vessel and the three branches must be inserted simultaneously, which is difficult to operate and easily damages the blood vessel.

At the same time, the stent vessel at the proximal end of the device needs to be clamped after implantation, and the vessel containing the metal stent inside the clamp is likely to deform the stent and damage the target vessel outside the vessel, and it is difficult to perform further anastomosis at the proximal end of the clamped vessel operate

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