Endoprosthesis for a total vascular exclusion of the liver

Abstract

Improved endoprosthesis (100) for a total vascular exclusion of the liver (120), to be used in most critical surgical operations like in example in major hepatectomy and in hepatic trauma with relevant venous damage, characterized in that comprising: an endovenous catheter (101), having the shape of a cylinder extended longitudinally, and being flexible in the transversal direction in order to beinserted preferably from the femoral vein or saphena vein (114), directed to the inferior caval vein (102); said endovenous catheter (101) having a diameter in the order of the inner diameter of the same femoral vein or saphena vein (114); a self-expanding sheet (103), rolled around itself and fixed at the distal part (133) of said endovenous catheter (101), characterized in that: said sheet (103)is achieved by using a shape memory alloy, having two states: a first state having a shape rolled around itself (131a), called martensite, associated to a first temperature T1, and a second state having an expanded shape (131 b), called austenite, associated to a second temperature T2, - said endoprosthesis (100) comprises means of heat generation and / or transmission, between said endovenous catheter (101) and said self-expanding sheet (103), and means of respective warming up or cooling down of said sheet (103); at said second temperature T2, the self-expanding sheet (103) changes its shapeand achieves automatically the expanded shape (131 b), adapting itself perfectly to the surface of the caval vein, maintaining therefore the function of blood flowing back to the heart; at said firsttemperature T1, the self-expanding sheet (103) changes its shape and achieves automatically the shape rolled around itself (131a), facilitating its reinsertion into the distal part (133) of said endovenous catheter (101), so that, under control of an operator, the endovenous catheter (101) is firstly installed by insertion from the femoral vein or saphena vein (114) directed to the caval vein, with the self-expanding sheet (103) placed in the caval tract of the upper hepatic veins; then, said mechanism of radial expansion of said self-expanding sheet (103) is activated so that the lateral walls bond and close the holes connecting the upper hepatic veins (113) to the inferior caval vein (102); therefore, the device permits the blood to flow inside the same self-expanding sheet (103) preventing at the same time a return of blood to the liver (120); in such a way, with a simultaneous Pringle maneuver that stops the blood going to the liver (120), a total vascular exclusion of the liver (120) is achieved.

Description

technical field [0001] The present invention relates to a medical device represented by an improved endoprosthesis, which is a temporary venous transfemoral or transoccult device for total hepatic blood flow occlusion of the liver. [0002] This device is a modification of the endoprosthesis for total hepatic occlusion of the liver described in European patent EP 2851015, which has the same applicant as the present application and has been granted. Background technique [0003] It is well known that endoprostheses are particularly well suited for use in most critical surgical procedures involving the liver, such as in major hepatectomies and in hepatic trauma with injury to the superior vena cava. [0004] In effect, this device represents an internal and temporary intravenous bypass that permits the normal function of the vena cava to return blood to the heart and at the same time permits the thinning of the liver with simultaneous Pringle maneuver Whole hepatic blood flow...

AI Technical Summary

Problems solved by technology

[0012] First, the transmission of rotational motion over distance relative to the longitudinal axis is particularly complex from a technical point of view in devices placed after the patient's curved arteriovenous conformation

[0013] Then, the diameter of the vein changes along the venous endoluminal path, so the insertion and installation of the endovascular device is very difficult

Also, considering that the endoprosthesis will be inserted inside some very fragile and sensitive structures, potentially causing very serious injuries inside the patient, making the surgical intervention very complex and putting the patient at high risk, it will be very difficult to manage

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