Integrated stent type artificial blood vessel

Abstract

The utility model provides an integrated stent-type artificial blood vessel which comprises an artificial blood vessel part comprising an artificial blood vessel main branch used for being arranged corresponding to an ascending aorta of a human body; the covered stent comprises a covered stent trunk and a left subclavian artery branch arranged beside the covered stent trunk and communicated with the covered stent trunk; the bendable connecting tube section is arranged between the artificial blood vessel part and the covered stent, the bendable connecting tube section comprises a main tube section and a side short tubular joint which is arranged on the side of the main tube section and communicated with the main tube section, and in the main blood flow direction of the artificial blood vessel, the near end of the main tube section is connected with the main branch of the artificial blood vessel; the far end of the main pipe section is connected with the near end of the artificial blood vessel main branch, and the axial height of the side short pipe-shaped connector is smaller than that of the left subclavian artery branch. The number of branch arteries needing to be dissociated in an operation is reduced, then dissociation anastomosis time is saved, circulation stopping time is shortened, protection on brain tissue is enhanced, and postoperative rehabilitation of a patient is facilitated.

Description

Technical Field

[0001] The present application relates to the technical field of artificial blood vessel medical devices, and in particular to an integrated stent-type artificial blood vessel. Background Art

[0002] Currently, traditional surgery for aortic dissection requires freeing the brachiocephalic trunk branches, left common carotid artery, and left subclavian artery. Under circulatory arrest, the covered stent is placed into the true lumen of the descending aorta. The covered stent is set separately from the four-branch artificial blood vessel. Therefore, the proximal end of the covered stent needs to be sutured to the distal end of the four-branch artificial blood vessel and the autologous aortic wall. Exposure is difficult, there is backflow interference during suturing, and the free suture space is limited, which increases the difficulty of anastomosis, thereby prolonging the circulatory arrest time and affecting the protection of brain tissue. In addition, the difficulty of surgical operation can easily lead to the risk of bleeding after anastomosis, prolonging the overall operation time, increasing the extracorporeal circulation time, and being detrimental to postoperative recovery. Utility Model Content

[0003] The present application provides an integrated stent-type artificial blood vessel, comprising:

[0004] The artificial blood vessel portion includes an artificial blood vessel main branch, which is used to correspond to the ascending aorta of the human body;

[0005] The stent graft comprises a stent graft trunk and a left subclavian artery branch arranged beside the stent graft trunk and connected to the stent graft trunk;

[0006] A flexible connecting tube segment is provided between the artificial blood vessel portion and the stent graft. The flexible connecting tube segment includes a main tube segment and a short side tubular connector provided beside the main tube segment and communicating with the main tube segment. In the main blood flow direction of the artificial blood vessel, the proximal end of the main tube segment is connected to the main trunk of the stent graft, and the distal end of the main tube segment is connected to the proximal end of the main branch of the artificial blood vessel. The axial height of the short side tubular connector is less than the axial height of the branch of the left subclavian artery.

[0007] The main pipe section is a tubular structure that can be bent and retracted in its own axial direction. An adjustment structure is provided on the outer periphery of the main pipe section, and the adjustment structure is used to adjust the axial length of the main pipe section.

[0008] The integrated stent-type artificial blood vessel provided by the present application has an integrated design in which the artificial blood vessel part and the covered stent are connected. This avoids the problem of difficult exposure caused by the need to suture the proximal end of the covered stent with the distal end of the four-branch artificial blood vessel and the wall of the native aorta. There is no need to anastomose the stent and the artificial blood vessel during surgery, which reduces the anastomosis time and avoids the risk of bleeding at the anastomosis site. The covered stent includes a branch of the left subclavian artery. After the native aorta is cut open in the area between the native left common carotid artery and the native left subclavian artery, the branch of the left subclavian artery can be inserted into the native left subclavian artery, avoiding the freedom of the native left subclavian artery during surgery and avoiding the need to anastomose a branch of the artificial blood vessel with the native left subclavian artery, thereby reducing operations and reducing operation time.

[0009] The integrated stent-type artificial blood vessel provided in the present application is also provided with a flexible connecting pipe segment, which is arranged between the artificial blood vessel portion and the stent graft. The main pipe segment on the flexible connecting pipe segment is flexible and can well adapt to the curved structure of the human aortic arch.

[0010] Moreover, the short tubular connector on the flexible connecting tube segment can be sutured with the covered stent pre-placed in the autologous left common carotid artery and / or the autologous brachiocephalic trunk to form a new artificial arterial branch. Based on the bendability of the main tube segment, it can be well adapted to the shape and structure of the curved arch of the human aorta, saving the steps required in existing aortic dissection surgery, such as resection and freeing of the brachiocephalic trunk artery, left common carotid artery or left subclavian artery and then suturing with artificial branch vessels. In general, the present application provides an integrated stent-type artificial blood vessel with a flexible connector, which can conform to the aortic morphology very well as a whole, avoiding problems such as necrosis and rupture of the aortic wall caused by postoperative binding and ligation. The integrated stent-type artificial blood vessel saves the number of free branch arteries required during surgery, thereby saving free anastomosis time, reducing circulatory arrest time, restoring systemic circulation as soon as possible, enhancing protection of brain tissue, reducing the risk of bleeding after anastomosis, shortening the overall operation time and extracorporeal circulation time, and facilitating the patient's postoperative recovery.

[0011] In some optional embodiments of the present application, the axial height of the short side tubular joint is 2 cm to 3 cm.

[0012] In some optional embodiments of the present application, the regulating structure includes:

[0013] There are multiple annular adjustment parts arranged at intervals along the axial direction of the main pipe section. Each annular adjustment part includes multiple radially outward protrusions, each of which is formed with a through hole. The opening direction of the through hole is the same as the axial direction of the main pipe section. The multiple radially outward protrusions of each annular adjustment part are arranged at intervals in the circumferential direction of the main pipe section.

[0014] In some optional embodiments of the present application, the regulating structure further includes:

[0015] There are multiple spacing adjustment lines, each of which passes through the through hole of the radially outward protruding part between at least two different annular adjustment parts. The axial length and / or bending angle of the main pipe section can be adjusted by tightening or loosening the spacing adjustment line.

[0016] In some optional embodiments of the present application, the plurality of radially outward protruding parts of each annular adjustment portion are arranged on the same plane in the circumferential direction of the main pipe section.

[0017] In the axial direction of the main pipe section, the multiple radially outward protruding parts in all the annular adjustment parts are aligned into multiple rows to form a plurality of axial adjustment units.

[0018] In some optional embodiments of the present application, each spacing adjustment line adopts a U-shaped routing method to pass through at least two annular adjustment parts and pass through two axial adjustment units. The U-shaped bottom of the spacing adjustment line is set toward the distal end of the main pipe section, and the two free ends of the spacing adjustment line are set toward the proximal end of the main pipe section.

[0019] In some optional embodiments of the present application, the integrated stent-type artificial blood vessel further includes:

[0020] An anti-reflux cap is arranged around the periphery of the connection between the main branch and the main pipe section of the artificial blood vessel, with the cap opening of the anti-reflux cap facing the flexible connecting pipe section;

[0021] The brim of the anti-reflux hat is cylindrical, or

[0022] The brim of the anti-reflux cap is in a truncated cone shape, and the diameter of the bottom end of the brim of the anti-reflux cap close to the main pipe section is larger than the diameter of the top end of the brim of the anti-reflux cap close to the main pipe section.

[0023] In some optional embodiments of the present application, the proximal diameter of the stent graft trunk is larger than the distal diameter of the main tube segment;

[0024] The ratio of the proximal diameter of the covered stent trunk to the distal diameter of the main tube segment ranges from 1.06 to 1.9.

[0025] In some optional embodiments of the present application, the trunk of the stent graft is conical, and the distal diameter of the trunk of the stent graft is smaller than the proximal diameter of the trunk of the stent graft.

[0026] In some optional embodiments of the present application, the integrated stent-type artificial blood vessel further includes:

[0027] The reducing connection part is arranged between the main tube section and the coated stent trunk. The proximal end of the reducing connection part is connected to the distal end of the main tube section and the radial size of the first connection matches. The distal end of the reducing connection part is connected to the proximal end of the coated stent trunk and the radial size of the second connection matches. The radial size of the second connection is larger than the radial size of the first connection.

[0028] In some optional embodiments of the present application, at least one step is formed on the axial outer peripheral wall of the variable diameter connection portion in the main blood flow direction of the artificial blood vessel.

[0029] In some optional embodiments of the present application, a single side short tubular joint is provided;

[0030] The artificial blood vessel part also includes an artificial brachiocephalic trunk branch and a perfusion branch which are arranged beside the main branch of the artificial blood vessel and communicated with the main branch of the artificial blood vessel.

[0031] In some optional embodiments of the present application, in the main blood flow direction of the artificial blood vessel, the artificial brachiocephalic trunk branch and the perfusion branch are arranged on opposite sides of the main branch of the artificial blood vessel.

[0032] In some optional embodiments of the present application, the side short tubular joint includes a first side short tubular joint and a second side short tubular joint, and the bendable connecting pipe section includes a coated short tubular stent corresponding to either the first side short tubular joint or the second side short tubular joint.

[0033] In some optional embodiments of the present application, the artificial blood vessel part is also provided with a spare blood vessel branch, which is arranged on the main branch of the artificial blood vessel and is connected to the main branch of the artificial blood vessel. In the main blood flow direction of the artificial blood vessel, the spare blood vessel branch and the left subclavian artery branch are arranged on the same side of the main blood flow direction of the artificial blood vessel.

[0034] In some optional embodiments of the present application, an anti-reflux ring is provided on the outer periphery of the proximal end where the short tubular joint is connected to the main pipe section.

[0035] In some optional embodiments of the present application, multiple fixed lines are preset along the circumference of the anti-reflux ring. BRIEF DESCRIPTION OF THE DRAWINGS

[0036] Figure 1 Schematic diagram of the same type of aortic dissection;

[0037] Figure 2 Schematic diagram of the anatomical structure of the human aorta;

[0038] Figure 3 This is a schematic diagram of the partial structure of the integrated stent-type artificial blood vessel provided in Example 1 of the present application;

[0039] Figure 4 This is a schematic diagram of adjusting the axial length of the main pipe section through the adjustment structure in Example 1 of the present application;

[0040] Figure 5 This is a schematic diagram of the integrated stent-type artificial blood vessel provided in Example 1 being placed in a patient after surgery;

[0041] Figure 6This is a schematic diagram of the partial structure of the integrated stent-type artificial blood vessel provided in Example 2 of the present application;

[0042] Figure 7 This is a schematic diagram of the integrated stent-type artificial blood vessel provided in Example 2 or Example 3 being placed in a patient during surgery.

[0043] Description of reference numerals:

[0044] Artificial blood vessel part-1; artificial blood vessel main branch-11; perfusion branch-12; artificial brachiocephalic trunk branch-13;

[0045] Covered stent-2; Covered stent trunk-21; Left subclavian artery branch-22; Covered short tubular stent-23; First covered short tubular stent-231; Second covered short tubular stent-232;

[0046] Bendable connecting pipe section-3; main pipe section-31; side short tubular joint-32; first side short tubular joint-321; second side short tubular joint-322;

[0047] Anti-reflux hat-4; brim-41;

[0048] Reducer-5; proximal end of the reducer-51; distal end of the reducer-52; step-53;

[0049] Artificial left common carotid artery branch-6;

[0050] Fixation line-7; Anti-reflux coil-8; Spare vascular branch-9;

[0051] Annular adjustment portion 10; radially outward protrusion 101; through hole 102; spacing adjustment line 103; axial adjustment unit 104;

[0052] The main blood flow direction of the artificial blood vessel is X;

[0053] Axial height of the short tubular joint - H1;

[0054] Axial height of the left subclavian artery branch trunk - H2;

[0055] First regulation area-A; second regulation area-B. DETAILED DESCRIPTION

[0056] The following will be combined with the Figures 1 to 7 The technical solution of this application is described in detail.

[0057] Figure 1This is a schematic diagram of aortic dissection of the same type. The annual incidence of aortic dissection ranges from 7.9 to 16 cases per 100,000 person-years. It is categorized as Stanford type A or B, depending on the location of the rupture. Stanford type A aortic dissection (TAAD) is approximately twice as common as Stanford type B aortic dissection (TBAD). Without prompt treatment, the 24-hour mortality rate can reach 50%. For TAAD, current guidelines recommend early open surgical repair of the aortic rupture. However, open surgery often requires a midline thoracotomy and deep hypothermic circulatory arrest. Currently, traditional surgery for type A aortic dissection requires freeing the autologous brachiocephalic trunk branches, left common carotid artery, and left subclavian artery (that is, the above three need to be cut off and then sutured with the implanted artificial blood vessels). Under circulatory arrest, the covered stent is placed into the true lumen of the descending aorta. The covered stent is separated from the four-branch artificial blood vessel (including the main branch of the artificial blood vessel, the artificial brachiocephalic trunk branch, the artificial left carotid artery branch, and the artificial perfusion branch). Therefore, the proximal end of the covered stent needs to be sutured with the distal end of the four-branch artificial blood vessel and the autologous aortic wall. Exposure is difficult, and there is backflow interference during suturing. In addition, the free suture space is limited, which increases the difficulty of anastomosis, thereby prolonging the circulatory arrest time and affecting the protection of brain tissue. In addition, the difficulty of surgical operation can easily lead to the risk of bleeding after anastomosis, prolonging the overall operation time, increasing the extracorporeal circulation time, and being unfavorable for postoperative recovery.

[0058] Figure 2 The figure is a schematic diagram of the anatomical structure of the human aorta. Figure 2 It can be seen that the aorta is mainly arch-shaped, including the ascending aorta and the descending aorta, the innominate artery (connected to the right subclavian artery and the right common carotid artery, the innominate artery can also be called the autologous brachiocephalic trunk branch), the left common carotid artery and the left subclavian artery formed on the greater curvature side of the aortic arch.

[0059] The integrated stent-type artificial blood vessel provided in this application includes:

[0060] The artificial blood vessel portion 1 includes an artificial blood vessel main branch 11, which is used to correspond to the ascending aorta of the human body;

[0061] The stent graft 2 includes a stent graft trunk 21 and a left subclavian artery branch 22 disposed beside the stent graft trunk 21 and communicating with the stent graft trunk 21;

[0062] The flexible connecting pipe section 3 is arranged between the artificial blood vessel part 1 and the coated stent 2. The flexible connecting pipe section 3 includes a main pipe section 31 and a short tubular joint 32 arranged beside the main pipe section 31 and connected to the main pipe section 31. In the main blood flow direction X of the artificial blood vessel, the proximal end of the main pipe section 31 is connected to the main branch 11 of the artificial blood vessel, and the distal end of the main pipe section 31 is connected to the proximal end of the coated stent main trunk 21. The axial height H1 of the short tubular joint is less than the axial height H2 of the left subclavian artery branch.

[0063] It should be noted that the proximal ends of various structures in the integrated stent-type artificial blood vessel in the embodiment of the present application are the blood inflow ends under normal autologous conditions, and the distal ends of various structures are the blood outflow ends under normal autologous conditions.

[0064] The integrated stent-type artificial blood vessel provided by the present application has an integrated design in which the artificial blood vessel portion 1 and the coated stent 2 are connected. This avoids the problem of difficult exposure caused by the need to suture the proximal end of the coated stent 2 with the distal end of the four-branch artificial blood vessel and the wall of the native aorta. There is no need to anastomose the stent and the artificial blood vessel during surgery, which reduces the anastomosis time and avoids the risk of bleeding at the anastomosis site. The coated stent 2 includes a left subclavian artery branch trunk 22. After the native aorta is cut open in the area between the native left common carotid artery and the native left subclavian artery, the left subclavian artery branch trunk 22 can be inserted into the native left subclavian artery, avoiding the freedom of the native left subclavian artery during surgery and avoiding the need to anastomose a branch of the artificial blood vessel with the native left subclavian artery again, thereby reducing operations and reducing surgical time.

[0065] The integrated stent-type artificial blood vessel provided in the present application is further provided with a flexible connecting pipe section 3, which is arranged between the artificial blood vessel portion 1 and the covered stent 2. The main pipe section 31 on the flexible connecting pipe section 3 is flexible and can well adapt to the curved structure of the human aortic arch.

[0066] Moreover, the short tubular connector 32 on the flexible connecting tube segment can be sutured with the covered stent pre-placed in the autologous left common carotid artery and / or the autologous brachiocephalic trunk to form a new artificial arterial branch. Based on the bendability of the main tube segment 31, it can be well adapted to the shape and structure of the curved arch of the human aorta, thus saving the steps required in existing aortic dissection surgery, such as resection and freeing of the brachiocephalic trunk artery, left common carotid artery or left subclavian artery and then suturing with artificial branch vessels. In general, the present application provides an integrated stent-type artificial blood vessel with a flexible connector, which can conform to the aortic morphology very well as a whole, avoiding problems such as long-term postoperative tearing. The integrated stent-type artificial blood vessel saves the number of free branch arteries required during surgery, thereby saving free anastomosis time, reducing circulatory arrest time, restoring systemic circulation as soon as possible, enhancing protection of brain tissue, reducing the risk of bleeding after anastomosis, shortening the overall operation time and extracorporeal circulation time, and facilitating the patient's postoperative recovery.

[0067] [Example 1]

[0068] like Figure 3 As shown, the integrated stent-type artificial blood vessel provided by the present application includes:

[0069] The artificial blood vessel portion 1 includes an artificial blood vessel main branch 11, which is used to correspond to the ascending aorta of the human body;

[0070] The stent graft 2 includes a stent graft trunk 21 and a left subclavian artery branch 22 disposed beside the stent graft trunk 21 and communicating with the stent graft trunk 21;

[0071] The flexible connecting pipe section 3 is arranged between the artificial blood vessel part 1 and the coated stent 2. The flexible connecting pipe section 3 includes a main pipe section 31 and a short tubular joint 32 arranged beside the main pipe section 31 and connected to the main pipe section 31. In the main blood flow direction X of the artificial blood vessel, the proximal end of the main pipe section 31 is connected to the main branch 11 of the artificial blood vessel, and the distal end of the main pipe section 31 is connected to the proximal end of the coated stent main trunk 21. The axial height H1 of the short tubular joint is less than the axial height H2 of the left subclavian artery branch trunk; the main pipe section is a tubular structure that can be retracted and bent in its own axial direction, and an adjustment structure is provided on the periphery of the main pipe section, which is used to adjust the axial length of the main pipe section.

[0072] Figure 3 For the sake of convenience, the left extension of the artificial blood vessel main branch 11 is not shown. Figure 5 Instructions in .

[0073] In some optional embodiments of the present application, the axial height of the short side tubular joint is 2 cm to 3 cm.

[0074] In some optional embodiments of the present application, the regulating structure includes:

[0075] Multiple annular adjustment parts 10 are arranged at intervals along the axial direction of the main pipe section. Each annular adjustment part 10 includes multiple radially outward protrusions 101. The radially outward protrusions are formed with through holes 102. The opening direction of the through holes 102 is the same as the axial direction of the main pipe section. The multiple radially outward protrusions 101 of each annular adjustment part 10 are arranged at intervals in the circumferential direction of the main pipe section.

[0076] In some optional embodiments of the present application, the regulating structure further includes:

[0077] There are multiple spacing adjustment lines 103, each spacing adjustment line 103 is passed through the through hole 102 of the radially outward protruding part 101 between at least two different annular adjustment parts 10, and the axial length and / or bending angle of the main pipe section are adjusted by tightening or loosening the spacing adjustment line 103.

[0078] In some optional embodiments of the present application, the plurality of radially outward protruding parts 101 of each annular adjustment portion 10 are arranged on the same plane in the circumferential direction of the main pipe section.

[0079] In the axial direction of the main pipe section, the multiple radially outward protruding parts 101 in all the annular adjustment portions 10 are aligned into multiple rows to form a plurality of axial adjustment units 104 .

[0080] In some optional embodiments of the present application, each spacing adjustment line 103 adopts a U-shaped routing method to pass through at least two annular adjustment parts 10 and pass through two axial adjustment units 104, the U-shaped bottom of the spacing adjustment line 103 is set toward the distal end of the main pipe section, and the two free ends of the spacing adjustment line 103 are set toward the proximal end of the main pipe section.

[0081] In these embodiments, Figure 3 As shown, when the axial length and / or bending angle of the main tube segment need to be adjusted, the operator can grasp the two free ends of the spacing adjustment wire 103 and pull the spacing adjustment wire 103 toward the proximal end of the main tube segment, thereby shortening the portion of the main tube segment corresponding to the U-shaped alignment of the spacing adjustment wire 103. When the spacing adjustment wire 103 is in a relaxed state, the operator can stretch the main tube segment axially to increase its axial length, as the main tube segment is a flexible, axially retractable tubular structure.

[0082] Figure 4 The diagram illustrates the use of multiple spacing adjustment wires 103 on a main pipe section to adjust the overall axial length of the main pipe section. Tightening all spacing adjustment wires 103 in the same direction, i.e., when the spacing adjustment wires 103 are tightened, shortens the axial length of the main pipe section. When all spacing adjustment wires 103 are loosened, the overall axial length of the main pipe section returns to its original length.

[0083] There are many examples of winding the spacing adjustment wire 103 between two different annular adjustment parts 10 , as long as the axial length and / or bending angle of the main pipe section can be adjusted by tightening or loosening the spacing adjustment wire 103 .

[0084] The integrated stent-type artificial blood vessel also includes:

[0085] The anti-reflux cap 4 is arranged around the periphery of the connection between the artificial blood vessel main branch 11 and the main pipe section 31 , and the cap opening of the anti-reflux cap 4 faces the flexible connecting pipe section 3 .

[0086] In some specific examples, the anti-reflux cap 4 and the artificial blood vessel part 1 are made of the same material.

[0087] In some specific examples, the brim 41 of the anti-reflux cap 4 is cylindrical.

[0088] In some specific examples, the brim 41 of the anti-reflux cap 4 is truncated cone-shaped, and the bottom diameter of the brim 41 of the anti-reflux cap 4 close to the main pipe section 31 is larger than the top diameter of the brim 41 of the anti-reflux cap 4 close to the main pipe section 31.

[0089] In some specific examples, the proximal diameter of the stent graft trunk 21 is larger than the distal diameter of the main tube section 31 .

[0090] In some specific examples, the ratio of the proximal diameter of the stent graft trunk 21 to the distal diameter of the main tube section 31 is in the range of 1.06 to 1.9;

[0091] In some specific examples, the proximal diameter of the stent graft trunk 21 is 32 mm to 45 mm;

[0092] In some specific examples, the distal end diameter of the main tube section 31 is 24 mm to 30 mm.

[0093] In some specific examples, the stent graft trunk 21 is cone-shaped, and the distal diameter of the stent graft trunk 21 is smaller than the proximal diameter of the stent graft trunk 21 .

[0094] In some specific examples, the diameter of the distal end of the stent graft trunk 21 differs from the diameter of the proximal end of the stent graft trunk 21 by 6 mm to 8 mm.

[0095] In some specific examples, the integrated stent-type artificial vascular further includes:

[0096] The reducing connection part 5 is arranged between the main tube section 31 and the coated stent trunk 21. The proximal end 51 of the reducing connection part is connected to the distal end of the main tube section 31 and the radial dimension of the first connection matches. The distal end 52 of the reducing connection part 5 is connected to the proximal end of the coated stent trunk 21 and the radial dimension of the second connection matches. The radial dimension of the second connection is larger than the radial dimension of the first connection.

[0097] In some specific examples, in the main blood flow direction X of the artificial blood vessel, at least one step 3 is formed on the axial outer peripheral wall of the diameter-reducing connecting portion 5 .

[0098] In some specific examples, the short side tubular connector 32 is provided singly, and the coated short tubular stent 23 is also provided singly accordingly. The short side tubular connector 32 and the coated short tubular stent 23 are connected to form an artificial left common carotid artery branch 6.

[0099] In some specific examples, the main tube section 31 is a tubular structure that is flexible and retractable in its axial direction. In some examples, the main tube section 31 is integrally formed with the main branch 11 of the artificial blood vessel in the artificial blood vessel portion 1, and both are made of artificial blood vessel materials. In other examples, the main tube section 31 and the main branch 11 of the artificial blood vessel in the artificial blood vessel portion 1 are formed separately and connected by suture.

[0100] In some specific examples, the artificial blood vessel portion 1 further includes an artificial brachiocephalic trunk branch 13 and a perfusion branch 12 which are arranged beside the artificial blood vessel main branch 11 and communicated with the artificial blood vessel main branch 11 .

[0101] In some specific examples, in the main blood flow direction X of the artificial blood vessel, the artificial brachiocephalic trunk branch 13 and the perfusion branch 12 are arranged on opposite sides of the main branch 11 of the artificial blood vessel.

[0102] Figure 5 This is a schematic diagram of the integrated stent-type artificial blood vessel provided in Example 1 being placed in a patient during surgery. Figure 5 The regulatory structure is hidden in the middle.

[0103] In some specific treatment scenarios, the integrated stent-type artificial blood vessel provided in Example 1 of the present application is used to treat patients with aortic dissection.

[0104] Routine disinfection and draping were performed, and the internal jugular vein, right dorsalis pedis artery and radial artery were pierced. The right femoral artery was freed, and the right axillary artery was kept aside. The chest was opened and the brachiocephalic artery (i.e. Figure 2 The innominate artery in the suspensory pericardium.

[0105] After heparinization, the right femoral and right axillary arteries were selected, and extracorporeal circulation was established with a caesarean cannula. After transfer, cooling was performed, the aorta was clamped, the ascending aorta was dissected, the thrombus was cleared, and the left and right coronary arteries were perfused. The heart was stopped, and the aortic root was treated (if the dissection involved the valve or coronary artery, a David, Bentall, or Wheat procedure was performed first). The aorta was lined with a 1-cm wide graft and secured with 5-0 prolene sutures. The temperature was lowered to 32°C, and an ice cap was applied to the brain. Arrest the circulation and perfuse the brain with 5 ml / kg of blood through the right axillary artery. (An assistant has previously prepared this new type of stent-vascular graft and pre-placed three 5-0 prolene sutures equidistantly at the root of the left common carotid artery. Depending on the aortic morphology, if placement is difficult, a small part can be cut along the long axis of the aorta until the conditions for stent placement are met. First, the main trunk of the covered stent 21 is placed, followed by the branch trunk of the left subclavian artery 22. After complete release, the adjustment structure is adjusted according to the distance between the patient's left subclavian artery and the left common carotid artery to ensure that the artificial left common carotid artery branch 6 corresponds to the position of the left common carotid artery. (Preoperatively, according to the imaging results, a suitable covered short tubular stent 23 (optional bent rod Viabahn) is prepared to match the left common carotid artery. During the operation, the bent rod Viabahn is connected to the short tubular connector 32 to form an artificial left common carotid artery branch. 6), then insert the artificial left common carotid artery branch 6, suspend and fix it with a pre-set line at the root (you can leave it untied and tie it after the circulation is restored to shorten the circulatory arrest time), suture the longitudinally opened aortic wall (you can tighten the aortic edge wall according to the artificial blood vessel, or use the left atrial appendage clamp), and after exhausting, use a blocking clamp to block the brachiocephalic trunk (innominate artery) and the left common carotid artery, and suture the anti-reflux cap 4 and the proximal end of the aortic arch continuously. After suturing, briefly stop the circulation and exhaust the air, then move the blocking clamp to the proximal end of the anti-reflux cap 4 for blocking. Restore circulation again. Rewarm, and suture the proximal end of the main branch of the artificial blood vessel and the aortic root continuously. The heart is restored to beat, and finally the artificial brachiocephalic trunk branch 13 is sutured continuously with the proximal end of the brachiocephalic trunk (also known as the innominate artery), check for bleeding, give acupuncture, neutralize with protamine, remove the machine, stop bleeding, place a guide tube, and close the chest as usual.

[0106] During the operation, due to the bending performance of the flexible connecting tube section 3, the stent graft 2 can be quickly inserted first and then the entire artificial blood vessel part 1 can be inserted, reducing the need to free the branch arteries connected to the side of the aorta (such as the brachiocephalic artery, the left carotid artery and the left subclavian artery). The insertion time of the integrated stent-type artificial blood vessel is greatly improved, and the circulation can be quickly restored. The conical setting of the stent graft trunk 21 conforms to the structure of the human aorta, and the proximal end of the stent graft trunk 21 is more in line with the diameter of the aorta, fits well with the aortic wall, and reduces false lumen reflux.

[0107] The design of the anti-reflux cap 4: on the one hand, it can block the backflow of blood from the false lumen of the dissection; on the other hand, the setting of the anti-reflux cap 4 can increase the suture area with the native aortic wall, thereby increasing the space for anastomosis operation and reducing the difficulty of anastomosis. The anti-reflux cap 4 is used to anastomose with the aortic wall to avoid the general direct ligation and binding of the artificial blood vessel and the covered stent 2 to the aortic wall, which leads to aortic compression ischemia and necrosis, thereby avoiding long-term necrosis and detachment of the aortic wall and improving the patient's quality of life after surgery. The design of the anti-reflux cap 4 greatly simplifies the processing steps and processing time of the anastomosis between the integrated stent-type artificial blood vessel and the aortic arch, and can make the proximal blockade of the anti-reflux cap 4 restore the systemic circulation as soon as possible, thereby achieving multiple circulatory arrest times, enhancing the protection of brain tissue, reducing the risk of post-anastomotic bleeding, shortening the overall operation time and extracorporeal circulation time, and facilitating the patient's postoperative recovery.

[0108] The left subclavian artery branch trunk 22 has a high degree of fit with the patient's own left subclavian artery and can also play an anti-reflux role.

[0109] The axial height of the artificial left common carotid artery branch trunk 6 is greater than the axial height of the left subclavian artery branch trunk 22. Considering that the proximal end of the left common carotid artery has no branches, designing the artificial left common carotid artery branch trunk 6 with a higher axial height can increase the anti-reflux effect of the stent anchor area. In addition, the root of the artificial left common carotid artery branch trunk 6 (i.e., the proximal end where the short tubular connector is connected to the main tube section 31) is designed with an anti-reflux coil 8 to further reduce reflux. The multiple fixed lines 7 (in some examples, three sutures) pre-installed on the root anti-reflux coil can be used for fixation when the angle of the artificial left common carotid artery branch trunk 6 deviates from the human left common carotid artery, preventing the artificial blood vessel from twisting and narrowing during subsequent use, which seriously affects the blood supply of the left common carotid artery. The pre-installed fixed line 7 can prevent dissection from tearing the left common carotid artery.

[0110] The provision of the flexible connecting tube section 3 can facilitate the folding of the integrated stent-type artificial blood vessel, is beneficial to the preservation of the integrated stent-type artificial blood vessel and facilitates the priority release of the artificial left subclavian artery branch 22, further facilitates the implantation of the artificial left common carotid artery branch 6 and the artificial brachiocephalic trunk branch 13 and further leaves sufficient space for the above two to match with the human autologous branch artery, further improves the matching degree between the relative position and angle of the artificial left common carotid artery branch 6 and the artificial brachiocephalic trunk branch 13 and the relative position and angle of the common carotid artery and the brachiocephalic artery in the actual individual, improves the fault tolerance of the integrated stent-type artificial blood vessel and the human body's own aortic structure differences, and improves the compatibility of the integrated stent-type artificial blood vessel with more patients.

[0111] The design of the anti-reflux ring can further reduce reflux bleeding. When the reflux bleeding is severe, it is convenient to sew the artificial blood vessels and autologous blood vessels from the outside.

[0112] The artificial blood vessel main branch 11 and main tube section 31 have relatively small diameters, ensuring that the artificial blood vessel main branch 11 meets the requirements for matching the valve annulus or sinus junction, while the proximal diameter of the covered stent main trunk 21 needs to be increased to limit false lumen regurgitation. The provision of step 3 on the reducer 5 satisfies the different diameter requirements of the proximal end 51 and distal end 52 of the reducer 5. Based on the principle that the flow rate slows as the cross-sectional area of ​​blood flowing through increases, and the principle of blocking false lumen regurgitation, the provision of step 3 can limit and mitigate false lumen regurgitation.

[0113] The transition step 3 from the stent graft trunk 21 to the main tube segment 31: This design avoids the limitation of the stent graft trunk 21 diameter due to the proximal diameter requirement of the graft portion 1, which could prevent the stent graft trunk 21 from being matched with a suitable stent graft trunk 21 at the distal aortic arch to limit false lumen regurgitation. This design allows the selection of a proximal graft trunk 11 and main tube segment 31 with a suitable diameter, without limiting the stent graft trunk 21 diameter, thus better preventing false lumen regurgitation.

[0114] [Example 2]

[0115] like Figure 6 As shown, the difference between this embodiment 2 and the above embodiment 1 is that:

[0116] The side short tubular joint 32 includes a first side short tubular joint 321 and a second side short tubular joint 322. No coated short tubular stent is provided. The coated short tubular stent is only selected to be connected to the side short tubular joint during surgery.

[0117] [Example 3]

[0118] In this embodiment, the side short tubular joint 32 includes a first side short tubular joint 321 and a second side short tubular joint 322, and the coated short tubular stent 23 includes a coated short tubular stent corresponding to either the first side short tubular joint 321 or the second side short tubular joint 322. When the first side short tubular joint 321 is provided with a coated short tubular stent, it is referred to as the first coated short tubular stent 231 provided corresponding to the first side short tubular joint 321. When the second side short tubular joint 322 is provided with a coated short tubular stent, it is referred to as the second coated short tubular stent 232 provided corresponding to the second side short tubular joint 322. In this embodiment, the side short tubular joint that is not provided with a coated short tubular stent is then connected to the coated short tubular stent selected during surgery to form an artificial branch. This embodiment is not shown in the figures.

[0119] After the operation is completed, the first side short tubular joint 321 and the first coated short tubular stent 231 are connected to form an artificial brachiocephalic trunk branch 13, and the second side short tubular joint 322 and the second coated short tubular stent 232 are connected to form an artificial left common carotid artery branch 6. The artificial brachiocephalic trunk branch 13 and the artificial left common carotid artery branch are arranged on the same side of the main blood flow direction X of the artificial blood vessel.

[0120] The main pipe section 31 is a tubular structure that is telescopically bendable in its own axial direction.

[0121] In some optional embodiments of the present application, the first coated short tubular stent 231 is a balloon expandable stent, and the second coated short tubular stent 232 is a Viabahn stent.

[0122] In some optional embodiments of the present application, the artificial blood vessel part 1 is also provided with a spare blood vessel branch 9, which is arranged on the main branch 11 of the artificial blood vessel and is connected to the main branch 11 of the artificial blood vessel. In the main blood flow direction X of the artificial blood vessel, the spare blood vessel branch 9 and the artificial brachiocephalic trunk branch 13 are arranged on the same side of the main blood flow direction X of the artificial blood vessel.

[0123] like Figure 6 As shown, the adjustment structures of Examples 2 and 3 are divided into two adjustment regions. The first adjustment region A is located between the artificial brachiocephalic trunk 13 and the artificial left common carotid artery branch 6; the second adjustment region B is located between the artificial left common carotid artery branch 6 and the proximal end of the stent graft trunk 21. In the first adjustment region A, multiple U-shaped spacing adjustment lines 103 are provided along the main tube section 31, while in the second adjustment region B, multiple U-shaped spacing adjustment lines 103 are provided along the main tube section 31.

[0124] Figure 7 This is a schematic diagram of the integrated stent-type artificial blood vessel provided in Example 2 or Example 3 being placed in a patient during surgery. Figure 7 The regulatory structure is hidden in the middle.

[0125] In some specific treatment scenarios, the integrated stent-type artificial blood vessel provided in Example 2 or Example 3 of the present application is used to treat patients with aortic dissection.

[0126] Routine disinfection and draping were performed, and the internal jugular vein, right dorsalis pedis artery and radial artery were pierced. The right femoral artery was freed, and the right axillary artery was reserved. The chest was opened and part of the brachiocephalic artery (i.e. Figure 2 The innominate artery in the cervical spine is then suspended. The brachiocephalic artery at this location must be occluded to prevent blood from flowing back into the aorta via the axillary artery cannulation, potentially rendering the procedure inoperable. The brachiocephalic artery is superficial and easily freed, and only a portion of the vessel is freed for vascular occlusion.

[0127] After heparinization, the right femoral artery and right axillary artery are selected, and a caesarean cannula is used to establish extracorporeal circulation. After the transfer, the patient is cooled down in parallel, the aorta is blocked, the ascending aorta is opened, the thrombus is cleared, the left and right coronary arteries are perfused, and the heart is stopped. If the dissection involves the valve or coronary artery, David, Bentall or wheat surgery must be performed first, the temperature is lowered to 32℃, and an ice cap is applied to the brain. Arrest the circulation and perfuse the brain with 5 ml / kg via the right axillary artery. (Prior to this, the assistant prepared the integrated stent-type artificial blood vessel provided in this embodiment, and pre-placed three 5-0 prolene sutures at the root of the left common carotid artery. Depending on the morphology of the aorta, if the placement is difficult, a small part can be cut along the long axis of the aorta until the conditions for stent placement are met. First, the main trunk of the covered stent 21 is placed, and then the left subclavian artery branch trunk 22 is placed. After complete release, the first adjustment area of ​​the adjustment structure is adjusted according to the distance between the patient's left subclavian artery and the left common carotid artery to ensure that the artificial left common carotid artery branch trunk 6 corresponds to the position of the left common carotid artery (preoperatively, according to the imaging results, a suitable covered short tubular stent 23 (optional bent rod Viabahn) is prepared to match the left common carotid artery. During the operation, the bent rod Viabahn is connected to the short tubular connector 32 to form an artificial left common carotid artery branch trunk 6). Then, the artificial left common carotid artery branch trunk 6 is placed, and the anti-reflux device is used. The fixed line 7 preset on the ring 8 suspends and fixes the artificial left common carotid artery branch 6 on the patient's own aorta. After a brief pause in circulation and exhaust, the blocking clamp is used to block the proximal end of the autologous left common carotid artery branch and the longitudinal incision of the aorta to restore circulation, and the artificial brachiocephalic trunk branch 13 is inserted. The balloon is used to expand the brachiocephalic trunk to fit well with the brachiocephalic trunk to avoid backflow of blood. After insertion, the second adjustment area of ​​the adjustment structure is adjusted according to the innominate artery and the left common carotid artery, so that the artificial brachiocephalic trunk branch 13 and the autologous brachiocephalic trunk (innominate artery) are aligned in position. Suture the longitudinally cut aortic wall (the aortic wall can be sutured and tightened according to the diameter of the artificial blood vessel to ensure the fit between the artificial blood vessel and the aortic wall), suture the brim 41 of the anti-reflux cap 4 to the proximal end of the aortic arch continuously, and resume circulation again after exhausting. Rewarm, and suture the proximal end of the artificial blood vessel main branch 11 to the aortic root continuously. Check for bleeding, give acupuncture, neutralize with protamine, remove the machine, stop bleeding, place a guide tube, and close the chest as usual.

[0128] After implantation, first covered short-tube stent 231 is a balloon-expandable stent (e.g., the Gore VBX covered stent 2). This balloon-expandable stent can be expanded according to the diameter of the brachiocephalic artery (innominate artery), ensuring a complete fit between the first covered short-tube stent 231 and the brachiocephalic artery to prevent reflux. A balloon of appropriate diameter is selected for balloon expansion. Three 5-0 prolene fixation sutures 7 (i.e., the sutures 7 pre-installed on the anti-reflux coil 8) at the base of the artificial brachiocephalic branch 13 are sutured and secured to the native brachiocephalic artery. In these examples, the first coated short tube stent 231 is a balloon-expandable stent. Due to the different anatomical morphologies and distribution angles of the three branches of the brachiocephalic artery, the left common carotid artery, and the left subclavian artery in the aortic arch, an integrated stent-type artificial blood vessel is generally first implanted from the left subclavian artery. When the artificial brachiocephalic branch 13 is subsequently implanted, in order to improve the universality of the integrated stent-type artificial blood vessel to the aortas of patients with different aortic dissections, a balloon-expandable stent is used to enable the artificial brachiocephalic branch 13 to have a larger range of movement angles to adapt to the brachiocephalic arteries on different human aortas. After the artificial brachiocephalic branch 13 is adapted to the angles of the brachiocephalic arteries on different human aortas, a suitable balloon is selected according to the diameter for balloon expansion to adapt the diameters of the two.

[0129] In other examples, if the angle deviation of the artificial brachiocephalic trunk branch 13 when it is implanted into the person's own artificial brachiocephalic artery is large, the first side short tubular connector 321 and the first coated short tubular stent 231 are connected to form the artificial brachiocephalic trunk branch 13, which is ligated and discarded, and the spare vascular branch 9 is used to be implanted into the person's own artificial brachiocephalic artery.

[0130] The brim 41 of the anti-reflux cap 4 is continuously sutured to the proximal end of the aortic arch. After suturing, the circulation is briefly paused to allow for ventilation, and the clamp is then moved to the proximal end of the anti-reflux cap 4 for occlusion. Circulation is restored. Rewarming is performed, and the proximal end of the main branch of the artificial blood vessel 11 is continuously sutured to the aortic root (aligning the annulus or sinus-tubular junction). The heart is re-beaten, bleeding is checked, additional stitches are given, the ventilator is removed, and the chest is closed as usual.

[0131] During the operation, due to the bending performance of the flexible connecting tube section 3, the stent graft 2 can be quickly inserted first and then the entire artificial blood vessel part 1 can be inserted, reducing the need to free the branch arteries connected to the side of the aorta (such as the brachiocephalic artery, the left carotid artery and the left subclavian artery). The insertion time of the integrated stent-type artificial blood vessel is greatly improved, and the circulation can be quickly restored. The conical setting of the stent graft trunk 21 conforms to the structure of the human aorta, and the proximal end of the stent graft trunk 21 is more in line with the diameter of the aorta, fits well with the aortic wall, and reduces false lumen reflux.

[0132] The design of the anti-reflux cap 4: on the one hand, it can block the backflow of blood from the false lumen of the dissection; on the other hand, the setting of the anti-reflux cap 4 can increase the suture area with the native aortic wall, thereby increasing the space for anastomosis operation and reducing the difficulty of anastomosis. The anti-reflux cap 4 is used to anastomose with the aortic wall to avoid the compression of the aortic wall when the artificial blood vessel and the covered stent 2 are directly sutured to the aortic wall, thereby avoiding long-term necrosis and detachment of the aortic wall and improving the patient's quality of life after surgery. The design of the anti-reflux cap 4 greatly simplifies the processing steps and processing time of the anastomosis between the integrated stent-type artificial blood vessel and the aortic arch, and can make the proximal blockade of the anti-reflux cap 4 restore the systemic circulation as soon as possible, thereby achieving multiple circulatory arrest times, enhancing the protection of brain tissue, reducing the risk of bleeding after anastomosis, shortening the overall operation time and extracorporeal circulation time, and facilitating the patient's postoperative recovery.

[0133] The left subclavian artery branch trunk 22 has a high degree of fit with the patient's own left subclavian artery and can also play an anti-reflux role.

[0134] The axial height of the artificial left common carotid artery branch trunk 6 is greater than the axial height of the left subclavian artery branch trunk 22. The axial height of the artificial left common carotid artery branch trunk 6 is also greater than the axial height of the artificial brachiocephalic trunk 13. Considering that there are no branches at the proximal end of the left common carotid artery, designing the artificial left common carotid artery branch trunk 6 to have a higher axial height can increase the anti-reflux effect of the stent anchor area. In addition, the root of the artificial left common carotid artery branch trunk 6 (i.e., the proximal end where the short tubular connector is connected to the main pipe section 31) is designed with an anti-reflux coil 8 to further reduce the reflux situation. The multiple fixed lines 7 (in some examples, three sutures) pre-installed on the root anti-reflux coil can be used for fixation when the angle of the artificial left common carotid artery branch trunk 6 deviates from the human left common carotid artery, so as to prevent the artificial blood vessel from twisting and narrowing during subsequent use, which seriously affects the blood supply of the left common carotid artery. The pre-installed fixed line 7 can prevent the dissection from tearing the left common carotid artery in reverse.

[0135] The provision of the flexible connecting tube section 3 can facilitate the folding of the integrated stent-type artificial blood vessel, is beneficial to the preservation of the integrated stent-type artificial blood vessel and facilitates the priority release of the artificial left subclavian artery branch 22, further facilitates the implantation of the artificial left common carotid artery branch 6 and the artificial brachiocephalic trunk branch 13 and further leaves sufficient space for the above two to match with the human autologous branch artery, further improves the matching degree between the relative position and angle of the artificial left common carotid artery branch 6 and the artificial brachiocephalic trunk branch 13 and the relative position and angle of the common carotid artery and the brachiocephalic artery in the actual individual, improves the fault tolerance of the integrated stent-type artificial blood vessel and the human body's own aortic structure differences, and improves the compatibility of the integrated stent-type artificial blood vessel with more patients.

[0136] The design of the anti-reflux ring can further reduce reflux bleeding. When the reflux bleeding is severe, it is convenient to sew the artificial blood vessels and autologous blood vessels from the outside.

[0137] The variable diameter connection part 5 is provided with a step 3 to ensure that the artificial blood vessel main branch 11 meets the needs and matches the valve ring or sinus tube junction. The artificial blood vessel main branch 11 has a smaller diameter, and avoids the inability to match a suitable stent at the distal end of the aortic arch to limit the false lumen reflux of the artificial blood vessel main branch 11.

[0138] The transition step from the main stent to the graft (3 sections): This design avoids the problem of limiting stent diameter selection due to proximal graft diameter requirements, which can prevent false lumen regurgitation in the distal aortic arch. This design allows for the selection of a proximal graft with an appropriate diameter without limiting the diameter of the main stent graft (2), thereby better preventing false lumen regurgitation.

[0139] In general, the current traditional surgical procedures for aortic dissection, especially the existing surgical procedures for type A aortic dissection, require the brachiocephalic artery, left common carotid artery and left subclavian artery to be freed, and the covered stent and the four-branch artificial blood vessel are set separately, which all lead to long circulatory arrest time and easy backflow. The integrated stent-type artificial blood vessel provided in the embodiment of the present application greatly reduces the number of branch arteries required to be freed in aortic dissection surgery, especially type A aortic dissection surgery, avoids the risk of bleeding during anastomosis, and the integrated stent-type artificial blood vessel has a high degree of compatibility with the human aorta. The use of the integrated stent-type artificial blood vessel provided in the embodiment of the present application can revolutionize the current surgical procedures for type A aortic dissection. It greatly reduces the operation time, simplifies the operation, improves the success rate of the operation, and expands the number of high-risk patients who cannot tolerate surgery. In the embodiment of the present application, an adjustment structure is further provided on the main section, so that during the process of the integrated stent-type artificial blood vessel being implanted into the human body, the position of each branch artery of the aortic arch (forming the innominate artery, left common carotid artery and left subclavian artery) is more aligned, thereby improving the efficiency and quality of implantation.

[0140] The above description is merely a specific embodiment of the present application, but the scope of protection of the present application is not limited thereto. Any changes or substitutions that can be easily conceived by a person skilled in the art within the technical scope disclosed in this application should be included in the scope of protection of the present application. Therefore, the scope of protection of the present application should be based on the scope of protection of the claims.

Claims

1. An integrated stent-type artificial blood vessel, characterized in that: include: The artificial blood vessel portion includes an artificial blood vessel main branch, wherein the artificial blood vessel main branch is configured to correspond to the ascending aorta of the human body; The stent graft comprises a stent graft trunk and a left subclavian artery branch arranged beside the stent graft trunk and connected to the stent graft trunk; a flexible connecting tube segment, disposed between the artificial blood vessel portion and the covered stent, comprising a main tube segment and a short side tubular joint disposed beside the main tube segment and communicating with the main tube segment; in the main blood flow direction of the artificial blood vessel, the proximal end of the main tube segment is connected to the main branch of the artificial blood vessel, and the distal end of the main tube segment is connected to the proximal end of the covered stent trunk; the axial height of the short side tubular joint is less than the axial height of the branch of the left subclavian artery; The main pipe section is a tubular structure that can be bent and retracted in its own axial direction. An adjustment structure is provided on the outer periphery of the main pipe section, and the adjustment structure is used to adjust the axial length of the main pipe section.

2. The integrated stent-type artificial blood vessel according to claim 1, characterized in that: The axial height of the side short tubular joint is 2 cm to 3 cm.

3. The integrated stent-type artificial blood vessel according to claim 1, characterized in that: The regulating structure comprises: A plurality of annular adjustment parts are arranged at intervals along the axial direction of the main pipe section, each of the annular adjustment parts includes a plurality of radially outward protrusions, and the radially outward protrusions are formed with through holes. The opening direction of the through holes is the same as the axial direction of the main pipe section. The plurality of radially outward protrusions of each annular adjustment part are arranged at intervals in the circumferential direction of the main pipe section.

4. The integrated stent-type artificial blood vessel according to claim 3, characterized in that: The regulating structure further comprises: There are multiple spacing adjustment lines, each of which passes through the through hole of the radially outward protruding part between at least two different annular adjustment parts. The axial length and / or bending angle of the main pipe section are adjusted by tightening or loosening the spacing adjustment line.

5. The integrated stent-type artificial blood vessel according to claim 4, characterized in that: The plurality of radially outwardly projecting parts of each annular adjusting portion are arranged on the same plane in the circumferential direction of the main pipe section. Furthermore, in the axial direction of the main pipe section, the plurality of radially outward protruding parts in all the annular adjustment portions are aligned into a plurality of rows to form a plurality of axial adjustment units.

6. The integrated stent-type artificial blood vessel according to claim 5, characterized in that: Each of the spacing adjustment lines adopts a U-shaped routing method to pass through at least two of the annular adjustment parts and pass through two axial adjustment units. The U-shaped bottom of the spacing adjustment line is arranged toward the distal end of the main pipe section, and the two free ends of the spacing adjustment line are arranged toward the proximal end of the main pipe section.

7. The integrated stent-type artificial blood vessel according to any one of claims 1 to 6, characterized in that: Also includes: an anti-reflux cap, arranged around the periphery of the connection between the main branch of the artificial blood vessel and the main pipe section, with the cap opening of the anti-reflux cap facing the flexible connecting pipe section; The brim of the anti-reflux cap is cylindrical, or, The brim of the anti-reflux cap is in a truncated cone shape, and the diameter of the bottom end of the brim of the anti-reflux cap close to the main pipe section is larger than the diameter of the top end of the brim of the anti-reflux cap close to the main pipe section.

8. The integrated stent-type artificial vascular according to any one of claims 1 to 6, characterized in that: The proximal diameter of the stent graft trunk is larger than the distal diameter of the main tube section; The ratio of the proximal diameter of the stent graft trunk to the distal diameter of the main tube section is in the range of 1.06 to 1.

9.

9. The integrated stent-type artificial blood vessel according to claim 8, characterized in that: The stent graft trunk is cone-shaped, and the distal diameter of the stent graft trunk is smaller than the proximal diameter of the stent graft trunk.

10. The integrated stent-type artificial blood vessel according to claim 9, characterized in that: The integrated stent-type artificial blood vessel further comprises: A reducing connection portion is arranged between the main tube section and the coated stent trunk, the proximal end of the reducing connection portion is connected to the distal end of the main tube section and the radial dimension of the first connection matches, the distal end of the reducing connection portion is connected to the proximal end of the coated stent trunk and the radial dimension of the second connection matches, and the radial dimension of the second connection is larger than the radial dimension of the first connection.

11. The integrated stent-type artificial blood vessel according to claim 10, characterized in that: In the main blood flow direction of the artificial blood vessel, at least one step is formed on the axial outer peripheral wall of the variable diameter connection part.

12. The integrated stent-type artificial blood vessel according to any one of claims 1 to 6, characterized in that: The side short tubular joint is provided in single piece; The artificial blood vessel portion further includes an artificial brachiocephalic trunk branch and a perfusion branch which are arranged beside the main branch of the artificial blood vessel and communicated with the main branch of the artificial blood vessel.

13. The integrated stent-type artificial blood vessel according to claim 12, characterized in that: In the main blood flow direction of the artificial blood vessel, the artificial brachiocephalic trunk branch and the perfusion branch are arranged on opposite sides of the main branch of the artificial blood vessel.

14. The integrated stent-type artificial blood vessel according to any one of claims 1 to 6, characterized in that: The side short tubular joint includes a first side short tubular joint and a second side short tubular joint, and the bendable connecting pipe section includes a coated short tubular stent correspondingly connected to either the first side short tubular joint or the second side short tubular joint.

15. The integrated stent-type artificial blood vessel according to claim 14, characterized in that: The artificial blood vessel part is also provided with a spare blood vessel branch, which is arranged on the main branch of the artificial blood vessel and is connected with the main branch of the artificial blood vessel. In the main blood flow direction of the artificial blood vessel, the spare blood vessel branch and the left subclavian artery branch are arranged on the same side of the main blood flow direction of the artificial blood vessel.

16. The integrated stent-type artificial blood vessel according to any one of claims 1 to 6, characterized in that: An anti-reflux ring is provided on the outer periphery of the proximal end where the short tubular joint is connected to the main pipe section.

17. The integrated stent-type artificial blood vessel according to claim 16, characterized in that: The anti-backflow ring is pre-arranged with multiple fixed lines along its circumference.

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