Adaptive thoracoabdominal aortic covered stent and endovascular treatment system

Abstract

The present application relates to the technical field of medical devices, and discloses a self-adaptive thoracoabdominal aortic covered stent and a vascular endoluminal treatment system. The self-adaptive thoracoabdominal aortic covered stent comprises a main stent and a branch stent. The main stent is provided with two first windows and two second windows. The branch stent comprises at least one first self-adaptive branch and two second self-adaptive branches. The first self-adaptive branch is connected with the first window and is used for reconstructing the superior mesenteric artery or the celiac trunk. The two second self-adaptive branches are respectively connected with the second windows and are respectively used for reconstructing the left renal artery and the right renal artery. The branch stent comprises an inner layer stent and an outer layer stent. A displacement structure is arranged between the inner layer stent and the outer layer stent, and the displacement structure allows the inner layer stent to move along the circumferential direction. The present application can be applied to the case that the distance between the visceral branches of the thoracoabdominal aorta is large, the deflection angles between the branches are different, the sizes of the branches are different, and the true lumen of the dissected blood vessel is small. The structure is simple and convenient to operate.

Description

TECHNICAL FIELD

[0001] The present application relates to the technical field of medical devices, in particular to a self-adaptive thoracoabdominal aortic covered stent and a vascular endoluminal treatment system. BACKGROUND

[0002] With the increase of population aging and hypertension and arteriosclerosis, the number of patients with aortic diseases is increasing year by year.

[0003] The thoracoabdominal aortic segment includes four branch arteries of the celiac trunk, the superior mesenteric artery, the left renal artery and the right renal artery. There are many differences in the four branch arteries of different patients, including the distance difference between the four branch arteries, the angle difference, the size difference of the branch arteries, and the diameter difference of the aorta itself.

[0004] The covered stent provided in the related art can solve the problem of thoracoabdominal aneurysm endoluminal reconstruction.

[0005] However, it adopts a structure in which the branches are parallel to the main body to adapt to the distance and angle differences between different branches. However, because the true lumen of the dissection is relatively small, it cannot accommodate the parallel arrangement of the reconstruction branches and the main body, and therefore cannot be applied to the endoluminal reconstruction of the dissection. At the same time, the structure in which the branches are parallel to the main body makes the reconstruction branch stent relatively tortuous, making the reconstruction difficult and easily leading to occlusion of the reconstructed branch. SUMMARY

[0006] Therefore, the present application provides a self-adaptive thoracoabdominal aortic covered stent and a vascular endoluminal treatment system to solve at least one of the following technical problems: the current thoracoabdominal aortic covered stent cannot be applied to the endoluminal reconstruction of the dissection because the true lumen of the dissection is relatively thin; the reconstructed branch is relatively tortuous, making the reconstruction difficult and easily leading to occlusion of the reconstructed branch, and the branch blood vessel is difficult to expand.

[0007] In a first aspect, the present application provides a self-adaptive thoracoabdominal aortic covered stent, comprising a main body stent and a branch stent covered with a flexible membrane. The circumferential side wall of the main body stent is provided with two first windows and two second windows; the two first windows are arranged on the proximal end side of the main body stent, and the two second windows are arranged on the distal end side of the main body stent; the axis of any second window and the axis of any first window are non-coplanar; the branch stent is provided with at least three, including a first self-adaptive branch and two second self-adaptive branches, the first self-adaptive branch is connected with the first window and is used for reconstructing the superior mesenteric artery or the celiac trunk; the two second self-adaptive branches are respectively connected with the two second windows and are respectively used for reconstructing the left renal artery and the right renal artery; the branch stent is a cylindrical structure, comprising an inner layer stent and an outer layer stent which are sleeved with each other, the outer layer stent is connected with the first window or the second window, and a displacement structure is arranged between the inner layer stent and the outer layer stent, which allows the inner layer stent to move along the circumferential direction.

[0008] Beneficial effects: The present application adopts the self-adaptive branch technology, so that under the condition of setting a small number of stent specifications, it can be applied to the case that the distance of each visceral branch of thoracoabdominal aorta is large, the deflection angle between branches is different, the size of branches is different, and the true lumen of dissection blood vessel is small. The current thoracoabdominal aortic covered stent cannot be applied to the problem of lumen reconstruction of dissection, so that the treatment of thoracoabdominal aortic lesions, especially the lumen isolation of dissection, becomes simple and feasible.

[0009] In an alternative embodiment, the yielding structure is an annular gap between the inner layer stent and the outer layer stent and at the first window or the second window.

[0010] In an alternative embodiment, the starting end of the outer layer stent matches and connects with the first window or the second window, and the end of the outer layer stent is arranged inside the main body stent; the starting end of the inner layer stent connects with the end of the outer layer stent, and the inner layer stent extends from the inside of the main body stent to the outlet end of the inner layer stent outside the main body stent; the outer diameter of the outlet end of the inner layer stent is smaller than the inner diameter of the starting end of the outer layer stent.

[0011] In an alternative embodiment, the inner diameter of the outer layer stent decreases from the starting end to the small end, and the outer diameter of the inner layer stent decreases from the starting end to the outlet end.

[0012] In an alternative embodiment, in the expanded state of the aortic covered stent, the axis of the branch stent is arranged perpendicularly to the axis of the main body stent.

[0013] In an alternative embodiment, the starting end of the outer layer stent, the outlet end of the inner layer stent, and the connecting end of the outer layer stent and the inner layer stent are all provided with a developing mark.

[0014] In an alternative embodiment, two first self-adaptive branches are provided, which are connected with the main body stent through the first window respectively, and the two first self-adaptive branches are respectively used for reconstructing the celiac trunk artery and the superior mesenteric artery.

[0015] In an alternative embodiment, the two first windows are arranged in front and spaced along the axial direction of the main body stent, the two second windows are arranged on the two sides of the main body stent along the radial direction of the main body stent, and the axis of the first window is arranged perpendicularly to the axis of the second window; the first self-adaptive branch is coaxially connected with the first window, and the second self-adaptive branch is coaxially connected with the second window.

[0016] In an alternative embodiment, the outlet end of the branch stent is connected to the corresponding blood vessel through a bridging stent; the proximal end of the bridging stent is located in the inner layer stent of the branch stent and is fixed in the inner layer stent through size interference, so as to realize the connection of the bridging stent and the branch stent and to prevent internal leakage at the connection; the distal end of the bridging stent is placed in the corresponding branch blood vessel, so as to realize the bridging of the self-adaptive thoracoabdominal aortic covered stent and the branch blood vessel.

[0017] In a second aspect, the present application further provides a vascular endoluminal treatment system, comprising the self-adaptive aortic covered stent in any of the above embodiments and a delivery device. The delivery device is used to deliver and release the aortic covered stent.

[0018] Beneficial effects: Because the vascular endoluminal treatment system comprises the self-adaptive thoracoabdominal aortic covered stent, it has the same effects as the self-adaptive thoracoabdominal aortic covered stent, which will not be described here. BRIEF DESCRIPTION OF DRAWINGS

[0019] In order to more clearly illustrate the technical solutions in the specific embodiments or prior art of the present application, the drawings needed in the specific embodiments or prior art description will be briefly introduced below. Obviously, the drawings in the following description are some embodiments of the present application, and those skilled in the art can also obtain other drawings according to these drawings without creative labor.

[0020] Figure 1 FIG. 1 is a structural schematic diagram of an aortic covered stent according to an embodiment of the present application;

[0021] Figure 2 FIG. 2 is a front view of the aortic covered stent shown in FIG. 1; Figure 1

[0022] Figure 3 Figure 1

[0023] Figure 4 Figure 1

[0024] Figure 5 Figure 1

[0025] Figure 6 Figure 1

[0026] Figure 7 Figure 2

[0027] Figure 8 ​​​​​​​​​​​For Figure 3 A local enlarged view of the middle B;

[0028] Figure 9 For Figure 8 A structural schematic view of the inner layer support at the middle B after moving upward;

[0029] Figure 10 For Figure 8 A structural schematic view of the inner layer support at the middle B after moving leftward;

[0030] Figure 11 For Figure 8 A structural schematic view of the inner layer support at the middle B after moving downward;

[0031] Figure 12 For Figure 8 A structural schematic view of the inner layer support at the middle B after moving rightward;

[0032] Figure 13 A front view of another aortic covered stent in the embodiment of the present application;

[0033] Figure 14 For Figure 13 A left view of the aortic covered stent shown;

[0034] Figure 15 For Figure 13 A right view of the aortic covered stent shown.

[0035] Explanation of reference signs:

[0036] 1, main support; 11, first window; 12, second window; 13, main proximal end marker; 14, main distal end marker; 15, direction indicator; 2, branch support; 21, first adaptive branch; 211, inner layer support; 2111, starting end of the inner layer support; 2112, outlet end of the inner layer support; 212, outer layer support; 2121, starting end of the outer layer support; 2122, end of the outer layer support; 213, accommodation structure; 214, outer layer starting marker; 215, inner layer outlet marker; 216, inner-outer connection marker; 22, second adaptive branch; 3, covering film. DETAILED DESCRIPTION

[0037] In order to make the purpose, technical scheme and advantages of the embodiments of the present application more clear, the technical scheme in the embodiments of the present application will be described clearly and completely below in combination with the drawings in the embodiments of the present application. Obviously, the described embodiments are some embodiments of the present application, rather than all the embodiments of the present application. Based on the embodiments in the present application, all other embodiments obtained by those skilled in the art without creative labor fall within the protection scope of the present application.

[0038] The present application can solve the problem that the distance between each visceral branch of thoracoabdominal aorta is large, the deflection angle between branches is different, the size of branches is different, the true lumen of dissection blood vessel is small, and the stent graft in the related art cannot adapt, so that the thoracoabdominal aortic disease, especially the dissection endovascular isolation treatment, becomes simple and feasible.

[0039] The related terms explained below:

[0040] Thoracoabdominal aorta: the aorta between thoracic aorta and abdominal aorta, which has four larger branch vessels from top to bottom, which are celiac trunk, superior mesenteric artery, left renal artery and right renal artery.

[0041] Thoracoabdominal aortic disease is a serious and life-threatening aortic disease, which is called aortic syndrome, mainly including aortic dissection, aortic aneurysm, aortic wall hematoma and aortic penetrating ulcer, etc.

[0042] Aortic syndrome can be treated by aortic endovascular repair.

[0043] Aortic endovascular repair: a minimally invasive endovascular treatment technology, which sends thoracoabdominal aortic stent graft to the lesion site of aorta through femoral artery incision, repairs aortic lesions from the artery lumen, thereby avoiding open surgery. Compared with traditional surgical operation, aortic endovascular repair greatly reduces surgical trauma, significantly shortens operation time, reduces surgical complications and mortality.

[0044] Thoracoabdominal aortic stent graft: a stent graft for endovascular isolation of thoracic aorta to abdominal aorta connection segment.

[0045] The embodiments of the present application will be described below in conjunction with Figures 1 to 15 .

[0046] According to an embodiment of the present invention, in one aspect, an adaptive thoracoabdominal aortic endovascular stent graft is provided, comprising a main stent 1 with a flexible membrane covering its surface and a branch stent 2. The main stent 1 has two first windows 11 and two second windows 12 spaced apart on its circumferential sidewalls; the two first windows 11 are located on the proximal side of the main stent 1, and the two second windows 12 are located on the distal side of the main stent 1; the axis of any second window 12 is eccentric to the axis of any first window 11; the branch stent 2 has at least three branches, including one first adaptive branch 21 and two second adaptive branches 22. The first adaptive branch 21 is connected to the first window 11 and is used to reconstruct the superior mesenteric artery or celiac trunk artery; the two second adaptive branches 22 are respectively connected to the two second windows 12 and are used to reconstruct the left renal artery and the right renal artery, respectively; the branch stent 2 is a cylindrical structure, including an inner stent 211 and an outer stent 212 nested together. The outer stent 212 is connected to the first window 11 or the second window 12. A clearance structure 213 is provided between the inner stent 211 and the outer stent 212, which allows the inner stent 211 to move circumferentially.

[0047] Specifically, the two first windows 11, one connects to the first adaptive branch 21, through which a bridging stent (such as a peripheral covered stent) can be connected for reconstruction of the superior mesenteric artery; the other can directly dock with the entrance of the abdominal enteric trunk artery, such as... Figures 13 to 15 As shown, this is used for endovascular isolation treatment in cases where there are no lesions in the celiac trunk branches and surrounding areas, and reconstruction of the celiac trunk is not required. When there are no lesions in the superior mesenteric artery and surrounding areas, reconstruction of the superior mesenteric artery is not necessary, and the first adaptive branch 21 can be used to reconstruct the abdominal-intestinal trunk artery. When there are lesions in the celiac trunk branches and surrounding areas, and endovascular isolation treatment is required for cases where reconstruction of the celiac trunk is necessary, two first adaptive branches 21 can be set, each connected to one of the two first windows 11, as shown. Figures 1 to 12 As shown.

[0048] Two second adaptive branches 22 are connected to two second windows 12 respectively. The bridging stent can be connected through the second adaptive branches 22 for reconstructing the left and right renal arteries respectively.

[0049] Since the axis of any first window 11 is skewed from the axis of any second window 12, the first window 11 and the second window 12 are not in the same plane. That is, the first adaptive branch 21 and the second adaptive branch 22 are not parallel to the main stent 1. The adaptive thoracic and abdominal aortic endovascular stent occupies little space along the axial direction and can be applied to the endovascular treatment of dissected vessels.

[0050] The branch stent 2 adopts a self-adaptive branch structure. Since the branch stent 2 is a cylindrical structure, the branch stent 2 comprises an inner layer stent 211 and an outer layer stent 212 which are sleeved with each other, and a displacement structure 213 is arranged between the inner layer stent 211 and the outer layer stent 212, and the displacement structure 213 can provide the inner layer stent 211 with activity along the circumferential direction. Therefore, one type of self-adaptive branch can meet the matching requirements of branch blood vessels within a certain range. Although there are differences in the interval and included angle between the multi-branch blood vessels, the positions of the branch blood vessels tend to be normally distributed according to clinical statistics. Therefore, when the self-adaptive branch can adapt to a larger area, under the condition of the same main body diameter, most of the requirements can be covered in several specifications.

[0051] The self-adaptive branch technology adopted by the present application can solve the problems that the thoracoabdominal aortic covered stent in the related art cannot be applied to the reconstruction of the inner cavity of a dissection under the condition that the interval of the branch blood vessels of the thoracoabdominal aorta is large, the deflection angles between the branch blood vessels are different, the sizes of the branch blood vessels are different, and the true cavity of the dissection blood vessel is small. The present application makes the treatment of thoracoabdominal aortic lesions, especially the endovascular exclusion of a dissection, simple and feasible.

[0052] The self-adaptive thoracoabdominal aortic covered stent is delivered by a delivery device, the delivery device releases the self-adaptive thoracoabdominal aortic covered stent step by step, when the self-adaptive thoracoabdominal aortic covered stent is first unfolded, the self-adaptive thoracoabdominal aortic covered stent on the side of the branch stent 2 is in an incomplete unfolded state, at this time, the self-adaptive thoracoabdominal aortic covered stent can still be adjusted in position more accurately, and the blood flow is not blocked, and when the self-adaptive thoracoabdominal aortic covered stent is further unfolded, there is no wind cannon effect, the self-adaptive thoracoabdominal aortic covered stent can be accurately positioned, and more importantly, it is convenient for a guide wire to enter the corresponding branch blood vessel through the self-adaptive branch, which can avoid that when the self-adaptive branch and the branch blood vessel opening are not at the same position after the self-adaptive thoracoabdominal aortic covered stent is completely unfolded, the branch blood vessel opening is closed by the cover 3 and the guide wire cannot enter the branch blood vessel. After all the guide wires enter the corresponding branch blood vessels, the self-adaptive thoracoabdominal aortic covered stent is completely unfolded, which can ensure that the branch opening position of the stent is adjusted by a bridging stent delivery device or other auxiliary instruments, so that the branch opening position of the stent is aligned with the branch blood vessel. The branch access after endovascular exclusion keeps the original blood flow inlet direction consistent with the original anatomical structure, so that the endovascular exclusion can retain a channel for later interventional treatment.

[0053] The present application can avoid the branch stent 2 inlet forward or backward, and bring the problem of blocked branch blood vessel intervention channel caused by blood flow inlet forward or backward, and the branch bridging stent is blocked due to tortuosity. The inner layer stent 211 is movable relative to the main body stent 1 within a certain range, so that most patient requirements can be met under the condition of less stent specifications. Under the action of the bridging stent delivery device and the bridging stent, the respective adaptive branch position is automatically adjusted to the position of the corresponding branch blood vessel, so as to reserve the channel for the later endovascular interventional therapy; at the same time, in the thoracoabdominal aortic dissection, the opportunity for endovascular exclusion therapy is provided for the case that the true lumen of the dissection is compressed. The reconstructed branch anatomical structure is consistent with the original blood vessel branch, which avoids the risk of occlusion of the reconstructed branch caused by excessive tortuosity of the reconstructed branch, and also reduces the difficulty of branch reconstruction. The operation skill requirement of the operator can be greatly reduced, and the rapid promotion of the operation is facilitated.

[0054] In the bridging stent diagram, the bridging stent is known to those skilled in the art, and the bridging stent is also a metal stent with a surface covered with a film 3.

[0055] Specifically, the main body stent 1 and the branch stent 2 are metal stents, and the surface is provided with a flexible film 3. The starting end 2121 of the outer layer stent is inlaid with and fixedly connected to the main body stent 1. The fixed connection includes suture connection.

[0056] In some embodiments, the yielding structure 213 is an annular gap on the film surface of the main body stent 1, which surrounds the inner layer stent 211 and the outer layer stent 212 and is at the first window 11 or the second window 12.

[0057] Since the yielding structure 213 is an annular gap, the inner layer stent 211 can swing in any direction within the inner diameter range of the outer layer stent 212, for example, from the position shown in Figure 8 to the swing in four directions as shown in Figures 9 to 12 The axial distance and the included angle of the two adaptive branches are determined according to the distribution range of the two renal artery branch blood vessels, so that less stent specifications can meet the needs of most patients.

[0058] In some embodiments, the main body stent 1 is composed of a metal stent and a film 3, the metal stent is composed of a plurality of metal rings arranged at intervals along the axis, and the film 3 is arranged on the metal stent to connect the plurality of metal rings into a cylindrical structure to form the main body stent 1. In this embodiment, the metal ring is in a wave shape. The first window 11 and the second window 12 are both arranged on the film 3 and avoid the metal stent, so that the inner layer stent 211 can move within the inner diameter range of the outer layer stent 212, and the metal stent will not interfere with the bridging stent of the reconstructed renal artery branch blood vessel.

[0059] In some embodiments, the starting end 2121 of the outer layer stent matches and connects with the first window 11 or the second window 12, and the ending end 2122 of the outer layer stent is arranged at the inner side of the main body stent 1; the starting end 2111 of the inner layer stent connects with the ending end 2122 of the outer layer stent, and the inner layer stent 211 extends from the inner side of the main body stent 1 to the outlet end 2112 of the inner layer stent located at the outer side of the main body stent 1; the outer diameter of the outlet end 2112 of the inner layer stent is smaller than the inner diameter of the starting end 2121 of the outer layer stent.

[0060] Since the inner layer stent 211 extends from the inner side of the main body stent 1 to the outlet end 2112 of the inner layer stent located at the outer side of the main body stent 1, that is, the starting end 2111 of the inner layer stent is located in the inner cavity of the main body stent 1, and the outlet end 2112 of the inner layer stent is located outside the main body stent 1, the inner layer stent 211 maintains a certain length and can form a close anchor with the bridging stent used for reconstructing the branch blood vessel, effectively avoiding the risk of easy endoleak at the connection between the first window 11 or the second window 12 and the branch stent 2.

[0061] In some embodiments, the inner diameter of the outer layer stent 212 decreases from the starting end to the outlet end, and the outer diameter of the inner layer stent 211 decreases from the starting end to the outlet end.

[0062] The inner diameter of the outer layer stent 212 decreases from the starting end to the outlet end, that is, the outer layer stent 212 has a hollow circular truncated cone structure; the outer diameter of the inner layer stent 211 decreases from the starting end to the outlet end, and the inner layer stent 211 also has a hollow circular truncated cone structure. The outer layer stent 212 is fixedly connected with the first window 11 or the second window 12 of the main body stent 1 in a size-adapted manner, and the starting end 2111 of the inner layer stent and the ending end 2122 of the outer layer stent are connected, so that the first adaptive branch 21 or the second adaptive branch 22 as a whole presents a tapered stent extending a distance into the main body stent 1 and then extending towards the outside of the main body stent 1, and the adaptive branch has a double-layer V-shaped sleeve structure. An annular space is formed between the inner layer stent 211 and the outer layer stent 212, that is, the abovementioned accommodation structure 213. The adaptive branch also has a flexible covering film 3 arranged on the metal stent, so that it can deflect in any direction within the accommodation structure 213, thereby solving the problems of different branch spacings and deflection angles under the condition of setting a small number of stent specifications. At the same time, the branch blood vessel inlet form is not changed, thereby providing conditions for later interventional treatment.

[0063] In some embodiments, the axis of the branch stent 2 is arranged perpendicularly to the axis of the main body stent 1 when the aortic covered stent is in an inflated state.

[0064] The present application is configured to make the bridging stent connected with the adaptive branch not parallel to the main stent 1, solve the problem that the true lumen of the arterial dissection is thin and the space is insufficient, and the parallel arrangement of the branch stent 2 and the main stent 1 needs to occupy a large space, which causes the problem that the endovascular treatment is not applicable to the dissection blood vessel, and can avoid the risk that the bridging stent is collapsed by the main stent 1 or the bridging stent is easily caused to occlude the branch due to the sharp turn.

[0065] Specifically, the "vertical arrangement" can be considered vertical within the assembly error range.

[0066] In order to facilitate the confirmation of the arrival position of the main stent 1 and the branch stent 2 during the delivery process of the thoracoabdominal aortic covered stent in the delivery device, the main stent 1 and the branch stent 2 are both provided with a developing mark.

[0067] In some embodiments, the starting end 2121 of the outer layer stent, the outlet end 2112 of the inner layer stent, and the connecting end of the outer layer stent 212 and the inner layer stent 211 are all provided with a developing mark.

[0068] Specifically, the starting end 2121 of the outer layer stent is provided with an outer layer starting mark 214, the outlet end 2112 of the inner layer stent is provided with an inner layer outlet mark 215, and the connecting end of the outer layer stent 212 and the inner layer stent 211 is provided with an inner-outer connecting mark 216.

[0069] Specifically, the edges of the cover 3 at both ends of the main stent 1 are provided with developing marks, including a main proximal end mark 13 provided at the proximal end of the main stent 1 and a main distal end mark 14 provided at the distal end of the main stent 1, so that the main stent 1 has clear developing under X-ray.

[0070] In some embodiments, the main stent 1 is also provided with a direction indicator 15 indicating the branch where the celiac trunk and the greater omentum are located, which is used for quick directional positioning during stent implantation.

[0071] In some embodiments, two first adaptive branches 21 are provided, which are connected to the main stent 1 through the first window 11 respectively, and the two first adaptive branches 21 are respectively used for reconstructing the celiac trunk artery and the superior mesenteric artery.

[0072] By providing two first adaptive branches 21, two adaptive branches are connected to two first windows 11 respectively, which can be respectively used for reconstructing the celiac trunk artery and the superior mesenteric artery. Thus, the two second adaptive branches 22 realize the reconstruction of the celiac trunk artery, the superior mesenteric artery, the left renal artery and the right renal artery.

[0073] In some embodiments, two first windows 11 are arranged in front of the main body support 1 and are arranged axially spaced apart, and two second windows 12 are arranged on two sides of the main body support 1 in a diametrically opposite manner, and the axis of the first window 11 is arranged perpendicularly to the axis of the second window 12; the first adaptive branch 21 is coaxially connected to the first window 11, and the second adaptive branch 22 is coaxially connected to the second window 12.

[0074] In this way, the two first adaptive branches 21 are arranged in front, and the two second adaptive branches 22 are arranged on both sides of the first adaptive branch 21, which has a high degree of adaptation to the orientation of the left and right renal arteries. In particular, the two second adaptive branches 22 for reconstructing the renal artery branches are symmetrically distributed relative to the main body support 1, and are designed in a non-parallel manner, thereby reducing the space of the adaptive thoracoabdominal aortic covered stent in the dissection blood vessel.

[0075] In one embodiment, the axis of the first adaptive branch 21 is arranged perpendicularly to the axis of the main body support 1, and the axis of the second adaptive branch 22 is arranged perpendicularly to the axis of the main body support 1. In this way, the bridging stent connected to the first adaptive branch 21 or the second adaptive branch 22 is not parallel to the main body support 1, and can be applicable to the case where the true lumen of the dissection blood vessel is relatively thin.

[0076] In some embodiments, the outlet end of the branch stent is connected to a bridging stent, and the bridging stent is adapted to bridge the outlet of the branch stent 2 and the corresponding blood vessel.

[0077] In some embodiments, according to the average diameter and blood supply demand of the corresponding branch blood vessel, the outlet end of the branch stent 2 is arranged to have the same caliber. By matching the proximal diameter of the bridging stent with the caliber of the outlet end of the branch stent 2, and by matching the length and diameter of different branch blood vessels through different lengths and outer diameters of the distal end of the bridging stent, the differences in branch anatomical structures of different people can be satisfied. At the same time, the inlet form of the branch blood vessel is not changed, thereby providing conditions for subsequent interventional treatment.

[0078] The adaptive thoracoabdominal aortic covered stent provided by the present application can reduce the difficulty of surgery, shorten the operation time, preserve the subsequent interventional access of the branch blood vessel, and is beneficial to the promotion of surgery and the improvement of postoperative effect.

[0079] According to the embodiments of the present application, on the other hand, a vascular endoluminal treatment system is also provided, which comprises the adaptive aortic covered stent of any one of the above embodiments, and a delivery device. The delivery device is used to deliver and release the aortic covered stent.

[0080] The delivery device controls the step-by-step deployment of the adaptive thoracoabdominal aortic covered stent, thereby ensuring that the guide wire can pass through the stent branch and enter the corresponding branch blood vessel.

[0081] For adaptive branch, the guide wire is sent into the inner layer stent 211 from the starting end 2111 of the inner layer stent in the main body stent 1 through the adjustable bending catheter, and then into the corresponding branch blood vessel (when the adaptive branch is not completely aligned with the branch blood vessel, the adaptive branch can also be adjusted to the desired direction by hooking through the adjustable bending catheter). The appropriate bridging stent is sent along the guide wire to bridge the inner layer stent 211 and the branch blood vessel. Under the action of the bridging stent delivery device and the self-straightening force of the bridging stent, the inner layer stent 211 will automatically adjust to the opening of the branch blood vessel.

[0082] The branch reconstruction of the present application does not change the anatomical configuration of the branch blood vessel, the reconstruction is relatively simple, there is no risk of occlusion of the branch due to severe tortuosity, and the operation is simpler. It does not affect the later intraluminal interventional treatment of internal organs; it can be used for intraluminal isolation treatment of thoraco-abdominal dissection; at the same time, because the access position of the branch blood vessel is not changed, the problem of being unable or difficult to perform interventional treatment later after thoraco-abdominal reconstruction is solved.

[0083] Specific delivery process:

[0084] The adaptive thoraco-abdominal aortic covered stent is delivered by a delivery device. After the delivery device delivers the adaptive thoraco-abdominal aortic covered stent to the target position, the adaptive thoraco-abdominal aortic covered stent is released to a semi-expanded state by operating the delivery device. After the adaptive branch is basically aligned with the corresponding branch blood vessel, the guide wire is sent in through the contralateral femoral artery, and then the guide wire is superselected into the corresponding branch blood vessel. After ensuring that the guide wire of each adaptive branch is in place, the adaptive thoraco-abdominal aortic covered stent is fully expanded. Under the guidance or traction of the balloon, guide catheter or bridging stent delivery device, the corresponding branch outlet moves relative to the position of the main body stent 1, so that the outlet of the adaptive branch is opposite to the opening of the branch blood vessel. Then, each adaptive branch is bridged with the corresponding branch blood vessel by the bridging stent.

[0085] After the branch blood vessel is reconstructed, the blood flow direction of the branch blood vessel (celiac trunk, superior mesenteric artery continues to flow from top to bottom relative to the aorta, and renal artery continues to be perpendicular to the aorta) is not changed, which reserves the condition for postoperative intraluminal interventional treatment. At the same time, it avoids the risk of occlusion of the reconstructed branch due to excessive tortuosity of the reconstruction path.

[0086] Although the embodiments of the present application are described in conjunction with the drawings, various modifications and variations can be made by those skilled in the art without departing from the spirit and scope of the present application, and such modifications and variations fall within the scope defined by the appended claims.

Claims

1. An adaptive thoracoabdominal aortic endovascular stent graft, characterized in that, Including those with a flexible membrane covering the surface: The main support (1) has two first windows (11) and two second windows (12) spaced apart on its circumferential sidewalls; the two first windows (11) are located on the proximal side of the main support (1), and the two second windows (12) are located on the distal side of the main support (1); the axis of any second window (12) is skew to the axis of any first window (11); Branch stent (2), the branch stent (2) is provided with at least three, including a first adaptive branch (21) and two second adaptive branches (22), the first adaptive branch (21) is connected to the first window (11) for reconstructing the superior mesenteric artery or celiac trunk artery; the two second adaptive branches (22) are respectively connected to the two second windows (12) for reconstructing the left renal artery and the right renal artery; The branch support (2) is a cylindrical structure, including an inner support (211) and an outer support (212) nested together. The outer support (212) is connected to the first window (11) or the second window (12). A clearance structure (213) is provided between the inner support (211) and the outer support (212). The clearance structure (213) allows the inner support (211) to move along its circumference. The end (2122) of the outer support is located inside the main support (1), and the outer diameter of the outlet end (2112) of the inner support is smaller than the inner diameter of the starting end (2121) of the outer support.

2. The adaptive thoracic and abdominal aortic endovascular stent graft according to claim 1, characterized in that, The clearance structure (213) is an annular gap surrounding the inner support (211) and the outer support (212) at the first window (11) or the second window (12).

3. The adaptive thoracic and abdominal aortic endovascular stent graft according to claim 1 or 2, characterized in that, The starting end (2121) of the outer support is matched and connected to the first window (11) or the second window (12), the starting end (2111) of the inner support is connected to the end (2122) of the outer support, and the inner support (211) extends from the inside of the main support (1) to the outlet end (2112) of the inner support located outside the main support (1).

4. The adaptive thoracic and abdominal aortic endovascular stent graft according to claim 3, characterized in that, The inner diameter of the outer support (212) decreases from the starting end to the exit end, and the outer diameter of the inner support (211) decreases from the starting end to the exit end.

5. The adaptive thoracic and abdominal aortic endovascular stent graft according to claim 1 or 2, characterized in that, When the adaptive thoracic and abdominal aortic endovascular stent is in an inflated state, the axis of the branch stent (2) is arranged perpendicular to the axis of the main stent (1).

6. The adaptive thoracic and abdominal aortic endovascular stent graft according to claim 1 or 2, characterized in that, The starting end (2121) of the outer support, the exit end (2112) of the inner support, and the connection end between the outer support (212) and the inner support (211) are all provided with development marks.

7. The adaptive thoracic and abdominal aortic endovascular stent graft according to claim 1 or 2, characterized in that, The first adaptive branch (21) is provided in two parts, which are respectively connected to the main support (1) through the first window (11). The two first adaptive branches (21) are respectively used to reconstruct the celiac trunk artery and the superior mesenteric artery.

8. The adaptive thoracic and abdominal aortic endovascular stent graft according to claim 1 or 2, characterized in that, Two first windows (11) are positioned in front and spaced apart along the axial direction of the main support (1). Two second windows (12) are arranged opposite each other on both sides of the main support (1) along the radial direction of the main support (1). The axis of the first window (11) is perpendicular to the axis of the second window (12). The first adaptive branch (21) is coaxially connected to the first window (11), and the second adaptive branch (22) is coaxially connected to the second window (12).

9. The adaptive thoracic and abdominal aortic endovascular stent graft according to claim 1 or 2, characterized in that, The outlet end of the branch stent (2) is connected to the corresponding blood vessel through a bridging stent; the proximal end of the bridging stent is located inside the inner stent (211) of the branch stent (2) and is fixed to the inner stent (211) by dimensional interference, so as to realize the connection between the bridging stent and the branch stent (2) and isolate blood to prevent internal leakage at the connection point; the distal end of the bridging stent is placed in the corresponding branch blood vessel to realize the bridging between the adaptive thoracic and abdominal aortic endovascular stent graft and the branch blood vessel.

10. An endovascular treatment system, characterized in that, include: Adaptive thoracic and abdominal aortic endovascular stent according to any one of claims 1 to 9; A delivery device for delivering and releasing the adaptive thoracic and abdominal aortic endovascular stent graft.

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