Thoracoabdominal aortic covered stent and endovascular treatment system

Abstract

The present application relates to the technical field of medical devices, and discloses a thoracoabdominal aortic covered stent and a vascular endoluminal treatment system. The thoracoabdominal aortic covered stent comprises a main stent and a branch stent, and the main stent is covered with a flexible covering. Two window structures are arranged on the circumferential side wall of the main stent. The branch stent comprises two adaptive branches, and the two adaptive branches are oppositely arranged on the circumferential wall of the main stent. The adaptive branches are connected to the main stent at the window structures. The adaptive branches are in a cylindrical structure, and comprise an inner layer stent and an outer layer stent which are sleeved with each other. 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 two adaptive branches are suitable for reconstructing the left renal artery and the right renal artery, respectively. The present application can be applied to the reconstruction of the inner cavity of a dissection. The present application is simple in structure and is suitable for the differences of various visceral branches and the small true cavity of a dissection blood vessel.

Description

Technical Field

[0001] This invention relates to the field of medical device technology, specifically to aortic endovascular stent graft and endovascular treatment system. Background Technology

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

[0003] The thoracic and abdominal aortic segment comprises four branches: the celiac trunk, the superior mesenteric artery, the left renal artery, and the right renal artery. These four branches exhibit various differences among patients, including variations in the distances and angles between them, differences in the dimensions of each branch, and even variations in the diameter of the aorta itself.

[0004] The covered stents provided in the related technologies can solve the problem of intracavitary reconstruction of interthoracic and abdominal aneurysms.

[0005] However, it uses a structure in which branches and the main body run parallel to accommodate the differences in spacing and angle between different branches. But because the true cavity of the interlayer is small, it cannot accommodate the parallel arrangement of reconstruction branches and the main body. Therefore, it cannot be applied to the internal cavity reconstruction of the interlayer. At the same time, the structure in which branches and the main body run parallel makes the reconstruction branch support relatively tortuous, which makes reconstruction more difficult and easily leads to the closure of the reconstructed branches. Summary of the Invention

[0006] In view of this, the present invention provides a thoracoabdominal aortic endovascular stent graft and an endovascular treatment system to solve at least one of the following technical problems: the inability of thoracoabdominal aortic endovascular stent grafts to be used for endovascular reconstruction of dissections; and the problem that the reconstruction branch stents are relatively tortuous, making reconstruction difficult and prone to causing occlusion of the reconstructed branches.

[0007] In a first aspect, the present invention provides a thoracoabdominal aortic endovascular stent graft, comprising a main stent with a flexible endovascular membrane covering its surface and branch stents. The main stent has two fenestrated structures spaced apart on its circumferential sidewalls; the branch stents include two adaptive branches disposed opposite each other on the circumferential wall of the main stent, the adaptive branches connecting to the main stent at the fenestrated structures, the adaptive branches being cylindrical structures comprising an inner stent and an outer stent nested together, with a clearance structure between the inner and outer stents allowing the inner stent to move circumferentially; the two adaptive branches are respectively adapted to reconstruct the left renal artery and the right renal artery.

[0008] Beneficial Effects: The branched stent employs an adaptive branch. Because the adaptive branch is a double-layered cylindrical structure consisting of an inner stent and an outer stent, with a clearance structure between the inner and outer stents, the inner stent can move circumferentially through this clearance structure. Therefore, one model of adaptive branch can meet the matching needs of branch vessels within a certain range. This invention solves the problems of current thoracoabdominal aortic covered stents being unable to be applied to endovascular reconstruction of dissections; the large differences in spacing between the visceral branches of the thoracoabdominal aorta; the varying deflection angles between branches; the varying branch sizes; and the small true lumen of the dissected vessels. This makes endovascular repair of thoracoabdominal aortic lesions, especially dissections, simple and feasible.

[0009] In one alternative implementation, the clearance structure is an annular gap that surrounds the inner and outer supports and forms at the window structure.

[0010] In one optional embodiment, the starting end of the outer support is matched and connected to the window structure, and the end of the outer support is located inside the main support; the starting end of the inner support is connected to the end of the outer support, and the inner support extends from the inside of the main support to the outside of the main support; the outer diameter of the outlet end of the inner support is smaller than the inner diameter of the starting end of the outer support.

[0011] In one alternative implementation, the inner diameter of the outer support decreases, and the outer diameter of the inner support decreases from the starting end to the exit end.

[0012] In one alternative implementation, with the thoracic and abdominal aortic stent graft in an inflated state, the axis of the adaptive branch is arranged perpendicular to the axis of the main stent.

[0013] In one alternative embodiment, the starting end of the outer support, the exit end of the inner support, and the connection end between the outer and inner supports of the adaptive branch are all provided with imaging marks.

[0014] In one optional embodiment, the branch stent further includes two fixed branches, which are fixedly connected to the main stent and are located on the proximal side of the adaptive branch near the main stent. The two fixed branches are positioned close to each other on the main stent and are arranged in parallel along the axial direction of the main stent. The two fixed branches are respectively adapted to reconstruct the celiac trunk artery and the superior mesenteric artery.

[0015] In one optional embodiment, along the axial direction of the main support, the main support includes a main section and a branch section, the branch section is located in the middle of the main support, a fixed branch is connected to the branch section, and the sum of the outer diameter of the branch section and the outer diameter of the fixed branch is not greater than the outer diameter of the main section.

[0016] In one alternative implementation, the exit end of the adaptive branch is connected to the corresponding blood vessel via a bridging stent, the proximal end of the bridging stent is connected to the inner layer stent of the adaptive branch, and the distal end of the bridging stent is placed in the corresponding branch blood vessel, thereby achieving bridging between the thoracic and abdominal aortic stent graft and the branch blood vessel.

[0017] Secondly, the present invention also provides an endovascular treatment system, including a thoracoabdominal aortic endovascular stent graft according to any of the above technical solutions, and a delivery device, wherein the delivery device is detachably connected to the thoracoabdominal aortic endovascular stent graft.

[0018] Beneficial effects: The endovascular treatment system provided by the present invention includes the thoracic and abdominal aortic endovascular stent graft in the above embodiments, and has the same technical effects as the thoracic and abdominal aortic endovascular stent graft, which will not be described in detail here. Attached Figure Description

[0019] To more clearly illustrate the specific embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the specific embodiments or the prior art will be briefly introduced below. Obviously, the drawings described below are some embodiments of the present invention. For those skilled in the art, other drawings can be obtained from these drawings without creative effort.

[0020] Figure 1 This is a schematic diagram of the structure of a thoracoabdominal aortic endovascular stent according to an embodiment of the present invention;

[0021] Figure 2 for Figure 1 The front view of the thoracoabdominal aortic graft shown;

[0022] Figure 3 for Figure 1 Left view of the thoracoabdominal aortic endovascular stent shown;

[0023] Figure 4 for Figure 1 The right view of the thoracoabdominal aortic graft shown;

[0024] Figure 5 for Figure 1 A top view of the thoracoabdominal aortic endovascular stent shown;

[0025] Figure 6 for Figure 1 A top view of the thoracic and abdominal aortic endovascular stent graft shown;

[0026] Figure 7 for Figure 2 A magnified view of a section at point A in the middle;

[0027] Figure 8 for Figure 3A magnified view of a section at point B in the middle;

[0028] Figure 9 for Figure 8 A schematic diagram of the structure after the inner support layer is moved upwards;

[0029] Figure 10 for Figure 8 A schematic diagram of the structure after the inner support layer is moved to the left.

[0030] Figure 11 for Figure 8 A schematic diagram of the structure after the inner support layer is moved downwards;

[0031] Figure 12 for Figure 8 A schematic diagram of the structure after the inner support at the location is moved to the right;

[0032] Figure 13 This is a front view of another thoracic and abdominal aortic graft stent according to an embodiment of the present invention;

[0033] Figure 14 for Figure 13 Left view of the thoracoabdominal aortic endovascular stent shown;

[0034] Figure 15 for Figure 13 The right view of the thoracoabdominal aortic graft shown;

[0035] Figure 16 for Figure 13 A top view of the thoracoabdominal aortic endovascular stent shown;

[0036] Figure 17 for Figure 13 The image shows a top view of a thoracoabdominal aortic endovascular stent graft.

[0037] Explanation of reference numerals in the attached figures:

[0038] 1. Main support; 101. Window structure; 11. Main section; 12. Branch section; 13. Main near end mark; 14. Main far end mark; 15. Direction indicator; 2. Branch support; 21. Adaptive branch; 211. Inner support; 2111. Starting end of inner support; 2112. Exit end of inner support; 212. Outer support; 2121. Starting end of outer support; 2122. End of outer support; 213. Yielding structure; 214. Outer start mark; 215. Inner exit mark; 216. Inner and outer connection mark; 22. Fixed branch; 221. Starting end of fixed branch; 222. Exit end of fixed branch; 223. Starting mark of fixed branch; 224. Exit mark of fixed branch; 3. Covering. Detailed Implementation

[0039] To make the objectives, technical solutions, and advantages of the embodiments of the present invention clearer, the technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings. Obviously, the described embodiments are only some embodiments of the present invention, not all embodiments. Based on the embodiments of the present invention, all other embodiments obtained by those skilled in the art without creative effort are within the scope of protection of the present invention.

[0040] This invention can solve the problems that the spacing between the visceral branches of the thoracic and abdominal aorta varies greatly, the deflection angles between branches are different, the branch sizes are different, and the true lumen of the dissected vessel is small, which makes the covered stents in related technologies unsuitable. This invention makes endovascular isolation treatment of thoracic and abdominal aortic lesions, especially dissection, simple and feasible.

[0041] Explanation of related terms in the following text:

[0042] Thoracoabdominal aorta: The aorta between the thoracic aorta and the abdominal aorta. The thoracicabdominal aorta has four major branches from top to bottom: the celiac trunk, the superior mesenteric artery, the left renal artery, and the right renal artery.

[0043] Aortic lesions in the thoracic and abdominal aorta constitute a serious and life-threatening aortic disease known as aortic syndrome, which mainly includes aortic dissection, aortic aneurysm, aortic wall hematoma, and penetrating aortic ulcer.

[0044] Aortic syndrome can currently be treated with endovascular aortic repair.

[0045] Endovascular aortic repair is a minimally invasive endovascular treatment technique. A thoracoabdominal aortic stent graft is inserted through a femoral artery incision and delivered to the diseased site within the aorta, repairing the aortic lesion from within the arterial lumen, thus avoiding open surgery. Compared to traditional surgery, endovascular aortic repair significantly reduces surgical trauma, drastically shortens operation time, and reduces surgical complications and mortality.

[0046] Thoracoabdominal aortic endovascular stent graft: a endovascular stent graft used to isolate the segment connecting the thoracic aorta to the abdominal aorta.

[0047] The following is combined with Figures 1 to 17 The following describes embodiments of the present invention.

[0048] According to an embodiment of the present invention, in one aspect, a thoracoabdominal aortic endovascular stent graft is provided, comprising a main stent 1 covered with a flexible endovascular membrane 3 and a branch stent 2. The main stent 1 has two fenestration structures 101 spaced apart on its circumferential sidewalls; the branch stent 2 includes two adaptive branches 21, which are disposed opposite each other on the circumferential wall of the main stent 1. The adaptive branches 21 are connected to the main stent 1 at the fenestration structures 101. The adaptive branches 21 are cylindrical structures, including an inner stent 211 and an outer stent 212 nested together. A clearance structure 213 is provided between the inner stent 211 and the outer stent 212, allowing the inner stent 211 to move circumferentially. The two adaptive branches 21 are respectively adapted to reconstruct the left renal artery and the right renal artery.

[0049] The branch stent 2 employs an adaptive branch 21. Since the adaptive branch 21 is a double-layered cylindrical structure consisting of an inner stent 211 and an outer stent 212, and a clearance structure 213 is provided between the inner and outer stents, the inner stent 211 can move circumferentially through this clearance structure 213. Therefore, one model of adaptive branch 21 can meet the matching needs of branch vessels within a certain range. Although there are differences in spacing and angle between branches of multi-branch vessels, the positions of each branch vessel tend to follow a normal distribution according to clinical statistics. Therefore, when the branch can adapt to a large area, under the same main body diameter, it is possible to achieve coverage of most needs with several sizes.

[0050] This invention addresses the challenges of large differences in the spacing between the visceral branches of the thoracic and abdominal aorta, varying deflection angles between branches, different branch sizes, and small true lumens in dissected vessels. Current endovascular stent grafts for the thoracic and abdominal aorta cannot be used for endovascular reconstruction of dissections, making endovascular isolation treatment of thoracic and abdominal aortic lesions, especially dissections, simple and feasible.

[0051] The thoracoabdominal aortic stent graft is delivered using a delivery device that releases the stent graft in stages. During the initial deployment, the stent graft on the unbranched stent side (S2) is not fully deployed. At this stage, the stent graft can be positioned more precisely without obstructing blood flow. Further deployment avoids a blowout effect, allowing for accurate positioning. Crucially, this facilitates guidewire entry from the branch stent (S2) into the corresponding branch vessel, preventing situations where the exit end of the branch stent (S2) is not aligned with the branch vessel opening after full deployment, thus preventing the guidewire from being blocked by the stent graft (S3). Once all guidewires are in their corresponding branch vessels, the stent graft is fully deployed, ensuring that the opening position of the branch stent (S2) is aligned with the branch vessel through the delivery device or other auxiliary instruments. After endovascular isolation, the branch access maintains the original blood flow inlet direction consistent with the original anatomical structure, preserving a pathway for subsequent interventional treatments.

[0052] This invention avoids the problems of obstruction of the branch vessel intervention channel due to the forward or backward displacement of the branch stent 2 inlet, and blockage of the branch bridging stent due to tortuosity. The inner stent 211 of the branch stent 2 is movable relative to the main stent 1 within a certain range, which can solve the problem of different spacing between branch vessels. This allows it to meet the needs of most patients with fewer stent sizes. With the help of the bridging stent and delivery device, the position of the branch stent 2 will automatically adjust to the location of the corresponding branch vessel, preserving the channel for subsequent endovascular interventional treatment. At the same time, in thoracic and abdominal aortic dissection, it provides an opportunity for endovascular isolation treatment when the true lumen of the dissection is compressed. The reconstructed branch anatomy is consistent with the original vessel branch, avoiding the risk of reconstructed branch occlusion caused by excessive tortuosity, and also reducing the difficulty of branch reconstruction. It can significantly reduce the skill requirements of the operator, facilitating the rapid promotion of this procedure.

[0053] The bridging bracket is not shown in the figure. The bridging bracket is known to those skilled in the art and is also a metal bracket with a coating 3 on its surface.

[0054] Specifically, the main support 1 and the branch support 2 are metal supports with a flexible coating 3 on their surfaces. The starting end 2121 of the outer support of the adaptive support is matched and fixedly connected to the main support 1. The fixed connection includes a suture connection.

[0055] In some embodiments, the clearance structure 213 is an annular gap that surrounds the inner support 211 and the outer support 212 and is formed at the window structure (101).

[0056] Because the clearance structure 213 is an annular gap, the inner support 211 can swing in any direction within the inner diameter range of the outer support 212, for example, by... Figure 8 The position shown is as follows Figures 9 to 12 The four directions of oscillation are shown. The axial spacing and angle between the two adaptive branches 21 are based on the distribution range of the two renal artery branches, allowing a smaller stent size to meet the needs of the vast majority of patients.

[0057] In some embodiments, the main stent 1 is composed of a metal stent and a covering 3. The metal stent is composed of multiple metal rings arranged at intervals along the axial direction. The covering 3 is disposed on the metal stent, connecting the multiple metal rings into a cylindrical structure to form the main stent 1. In this embodiment, the metal rings are wavy. The fenestration structure 101 is disposed on the covering 3 and avoids the metal stent. This ensures that the inner stent 211 of the adaptive branch 21 can move within the inner diameter range of the outer stent 212, and the metal stent will not interfere with the bridging stent for reconstructing the renal artery branch vessels.

[0058] In some embodiments, the starting end 2121 of the outer support is matched and connected to the window structure 101, and the ending end 2122 of the outer support is located inside the main support 1; the starting end 2111 of the inner support is connected to the ending 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; 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.

[0059] Since the inner stent 211 extends from the inside of the main stent 1 to the outside of the main stent 1, that is, the starting end 2111 of the inner stent is located in the inner lumen of the main stent 1 and the exit end 2112 of the inner stent is located outside the main stent 1, the inner stent 211 of the adaptive branch 21 maintains a certain length, which can form a tight anchor with the bridging stent used to reconstruct the branch vessel, effectively avoiding the risk of internal leakage at the connection between the fenestrated structure 101 and the branch stent 2.

[0060] In some embodiments, the inner diameter of the outer support 212 decreases, and the outer diameter of the inner support 211 decreases from the starting end to the exit end.

[0061] The inner diameter of the outer support 212 decreases progressively, meaning it has a hollow frustum-shaped structure. Similarly, the outer diameter of the inner support 211 decreases progressively from the starting end to the exit end, and it also has a hollow frustum-shaped structure. The outer support 212 is sized to fit and fixedly connected to the window structure 101 of the main support 1. The starting end 2111 of the inner support and the ending end 2122 of the outer support are connected, causing the adaptive branch 21 to extend a conical shape into the main support 1 before folding back and extending outwards. The adaptive branch 21 has a double-layer V-shaped sleeve structure. An annular space is formed between the inner support 211 and the outer support 212, constituting the aforementioned clearance structure 213. The adaptive branch 21 also uses a flexible membrane 3 on the metal support, allowing it to deflect in any direction within the clearance structure 213, thus solving the problem of varying branch spacing and deflection angles with a smaller number of support specifications. At the same time, it does not change the morphology of the branch vessel inlet, thus providing conditions for subsequent interventional treatment.

[0062] In some embodiments, when the thoracic and abdominal aortic stent graft is in an inflated state, the axis of the adaptive branch 21 is arranged perpendicular to the axis of the main stent 1.

[0063] For arterial dissections with narrow true lumens, where there is insufficient space to accommodate both the main stent and two or more parallel branch stents or bridging branch stents, this invention addresses the problem of insufficient space in arterial dissections requiring parallel branch stents to occupy a large area, making them unsuitable for endovascular treatment of dissected vessels. This design also avoids the risk of the bridging stent collapsing under the weight of the main stent or the risk of branch stent occlusion due to sharp turns.

[0064] Specifically, "vertical arrangement" can be considered vertical within the assembly error range.

[0065] In some embodiments, the starting end 2121 of the outer support of the adaptive branch 21, 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 imaging marks.

[0066] Specifically, the starting end 2121 of the outer support is provided with an outer starting mark 214, the exit end 2112 of the inner support is provided with an inner exit mark 215, and the connection end between the outer support 212 and the inner support 211 is provided with an inner and outer connection mark 216.

[0067] To facilitate confirmation of the arrival positions of the main stent 1 and each branch stent 2 during the delivery of the thoracoabdominal aortic endovascular stent graft in the delivery device, contrast markers are set on both the main stent 1 and the branch stent 2.

[0068] Specifically, the edges of the coating 3 at both ends of the main support 1 are provided with imaging marks, including a main body proximal mark 13 located at the proximal end of the main support 1 and a main body distal mark 14 located at the distal end of the main support 1, so that the main support 1 has clear imaging under X-ray.

[0069] In some embodiments, the main support 1 is further provided with a directional marker 15 indicating the branch where the celiac trunk and mesentery are located, for rapid directional positioning during stent implantation.

[0070] In some embodiments, the branch stent 2 further includes two fixed branches 22, which are fixedly connected to the main stent 1. The fixed branches 22 are located on the proximal side of the adaptive branch 21 near the main stent 1. The two fixed branches 22 are positioned close to each other on the main stent 1 and are arranged in parallel along the axial direction of the main stent 1. The two fixed branches 22 are respectively adapted to reconstruct the celiac trunk artery and the superior mesenteric artery.

[0071] The celiac trunk and superior mesenteric artery are transposed using an anterior branching technique, with the celiac trunk and superior mesenteric artery located on the same side of the aorta. The fixed branches 22 are positioned close together in parallel, minimizing their impact on aortic space. Furthermore, the anterior placement of the fixed branches 22, combined with the specifications and flexibility of bridging stents of varying lengths, effectively addresses the differences in distance and angle between the celiac trunk / superior mesenteric artery and the renal artery. Simultaneously, the overall downward flow direction of blood in the celiac trunk and superior mesenteric artery remains unchanged.

[0072] In some embodiments, the fixed branch 22 is embedded in the inner peripheral wall of the main support 1, or the fixed branch 22 is externally connected to the outer peripheral wall of the main support 1.

[0073] The fixed branch 22 can be embedded or external. Since the two fixed branches 22 are parallel to the main stent 1 along the axial direction, the connection between the starting end 221 of the fixed branch and the main stent 1 is elliptical, regardless of whether the embedded or external method is used. This ensures that when the stent is used to reconstruct the thoracic and abdominal aortic dissection, the aorta, celiac trunk, and superior mesenteric artery can effectively utilize the effective space of the true lumen of the dissection to maintain normal blood supply.

[0074] Specifically, for the fixed branch 22, both the starting end 221 and the exit end 222 of the fixed branch are provided with developing marks, including a fixed branch starting mark 223 and a fixed branch exit mark 224.

[0075] In some embodiments, along the axial direction of the main support 1, the main support 1 includes a main segment 11 and a branch segment 12. The branch segment 12 is located in the middle of the main support 1, and a fixed branch 22 is connected to the branch segment 12. The sum of the outer diameter of the branch segment 12 and the outer diameter of the fixed branch 22 is not greater than the outer diameter of the main segment 11.

[0076] With this configuration, the fixed branch 22 is connected to the branch segment 12, and the sum of the outer diameter of the branch segment 12 and the outer diameter of the fixed branch 22 is not greater than the outer diameter of the main body segment 11. This configuration does not occupy the axial space of the main body stent 1, thus solving the problem that the true lumen of arterial dissection is too narrow and the space is insufficient. The branch stent and the main stent need to occupy a large space to be parallel, which makes it unsuitable for endovascular treatment of dissected blood vessels.

[0077] In some embodiments, the outlet end of the adaptive branch 21 is connected to the corresponding blood vessel via a bridging stent (such as a peripheral covered stent), the proximal end of the bridging stent is connected to the inner layer stent 211 of the adaptive branch 21, and the distal end of the bridging stent is placed in the corresponding branch blood vessel, thereby achieving bridging between the thoracic and abdominal aortic covered stent and the branch blood vessel.

[0078] In some embodiments, the outlet end of the branch stent 2 is set to the same diameter according to the average diameter of the corresponding branch vessels and the blood supply requirements. By matching the proximal diameter of the bridging stent with the outlet diameter of the branch stent 2, and by matching the length and diameter of different branch vessels with different lengths and the distal outer diameter of the bridging stent, the differences in branch anatomy among different individuals can be accommodated.

[0079] According to an embodiment of the present invention, an endovascular treatment system is also provided, comprising a thoracic and abdominal aortic stent graft according to any of the above embodiments, and a delivery device, wherein the delivery device is detachably connected to the thoracic and abdominal aortic stent graft.

[0080] For the adaptive branch 21, a guidewire is inserted into the inner stent 211 from the starting end of the inner stent 211 within the main stent 1 using an adjustable catheter, and then inserted into the corresponding branch vessel (if the adaptive branch 21 is not aligned with the branch vessel at all, it can also be adjusted in the desired direction by hooking the adaptive branch 21 with the adjustable catheter). A suitable bridging stent is then inserted along the guidewire. Under the action of the delivery device and the self-straightening force of the bridging stent, the inner stent 211 of the adaptive branch 21 will automatically adjust to the opening of the corresponding branch vessel.

[0081] The endovascular treatment system provided by this invention reconstructs branches without altering the anatomical structure of the branch vessels, making reconstruction relatively simple. It eliminates the risk of occlusion due to severe branch tortuosity, making the operation even simpler. Furthermore, it does not affect subsequent endovascular interventional treatment of internal organs. It can be used for endovascular isolation treatment of interthoracic and abdominal dissections.

[0082] Specific delivery process:

[0083] After the delivery device delivers the thoracoabdominal aortic stent graft to the target location, it releases the stent graft to a semi-deployed state by operating the delivery device. After aligning the adaptive branch 21 with the corresponding renal artery branch, a grabber is inserted through the left subclavian or brachial artery. The grabber then retrieves the guidewire pre-positioned on the adaptive branch 21, prioritizing the guidewire of the branch requiring the largest adjustment range. Specifically, the guidewire pre-positioned on the adaptive branch 21 is pushed to the thoracic aortic segment, and the grabber grasps the tip of the guidewire, removing it from the body. A catheter is then inserted along the guidewire. Once the catheter passes through the adaptive branch 21 and reaches the outside of the main stent 1, the guidewire is withdrawn. A new guidewire is inserted from the catheter connector, superselectively entering the corresponding renal artery branch, and the stent graft is fully deployed. A suitable bridging stent is advanced along the guidewire inserted into the renal artery. Guided or pulled by the bridging stent delivery device, the renal artery branch outlet is moved relative to the main stent 1, so that the outlet of the bridging stent is aligned with the opening of the renal artery. The adaptive branch 21 is then bridged to the corresponding branch vessel using the bridging stent. The contralateral renal artery is bridged in the same manner.

[0084] Then, the superior mesenteric artery and celiac trunk artery were bridged using the same method.

[0085] After branch vessel reconstruction, the blood flow direction of the branch vessels will not be changed (the celiac trunk and superior mesenteric artery continue to flow downwards relative to the aorta, and the renal artery continues to be perpendicular to the aorta). This preserves the conditions for subsequent endovascular interventional treatment. At the same time, it avoids overly tortuous branch reconstruction paths that could easily lead to occlusion of the reconstructed branches.

[0086] This invention employs a renal artery adaptive branching technique (21), and uses anterior branching techniques for the celiac trunk and superior mesenteric artery to simplify and facilitate endovascular aortic resection. Because the adaptive branch (21) does not need to run parallel to the main body, it also addresses the issue of the inability to apply endovascular stent grafts to the dissected aorta due to the narrow true lumen of the dissected vessel. This invention reduces surgical difficulty and time, preserves access to subsequent interventional procedures via branch vessels, facilitates wider application, and improves postoperative outcomes. Furthermore, because it does not alter the branch vessel access location, it solves the problem of the inability or difficulty of subsequent interventional treatment after thoracoabdominal resection.

[0087] Although embodiments of the invention have been described in conjunction with the accompanying drawings, those skilled in the art can make various modifications and variations without departing from the spirit and scope of the invention, and such modifications and variations all fall within the scope defined by the appended claims.

Claims

1. A thoracoabdominal aortic endovascular stent graft, characterized in that, Including those with a flexible coating (3) on the surface: The main support (1) has two window structures (101) spaced apart on its circumferential sidewalls. Branch stent (2), the branch stent (2) includes two adaptive branches (21), the two adaptive branches (21) are disposed opposite to each other on the periphery of the main stent (1), the adaptive branches (21) are connected to the main stent (1) at the fenestration structure (101), the adaptive branches (21) are cylindrical structures, including an inner stent (211) and an outer stent (212) nested together, a clearance structure (213) is provided between the inner stent (211) and the outer stent (212), the clearance structure (213) allows the inner stent (211) to move along its circumference, the two adaptive branches (21) are respectively adapted to reconstruct the left renal artery and the right renal artery; 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; the branch support (2) also includes two fixed branches (22), and the fixed branches (22) are fixedly connected to the main support (1).

2. The thoracic and abdominal aortic endovascular stent graft according to claim 1, characterized in that, The clearance structure (213) is an annular gap that surrounds the inner support (211) and the outer support (212) and forms at the window structure (101).

3. The 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 window structure (101); 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 thoracic and abdominal aortic endovascular stent graft according to claim 3, characterized in that, The inner diameter of the outer support (212) decreases, and the outer diameter of the inner support (211) decreases from the starting end to the exit end.

5. The thoracic and abdominal aortic endovascular stent graft according to claim 1 or 2, characterized in that, When the thoracoabdominal aortic graft (3) stent is in an inflated state, the axis of the adaptive branch (21) is arranged perpendicular to the axis of the main stent (1).

6. The thoracoabdominal aortic endovascular stent graft according to claim 5, characterized in that, The starting end (2121) of the outer support of the adaptive branch (21), 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 thoracic and abdominal aortic endovascular stent graft according to claim 1 or 2, characterized in that, The fixed branch (22) is located on the proximal side of the adaptive branch (21) near the main support (1); the two fixed branches (22) are positioned close to each other on the main support (1) and are arranged in parallel along the axial direction of the main support (1); the two fixed branches (22) are respectively adapted to reconstruct the celiac trunk artery and the superior mesenteric artery.

8. The thoracoabdominal aortic endovascular stent graft according to claim 7, characterized in that, Along the axial direction of the main support (1), the main support (1) includes a main section (11) and a branch section (12). The branch section (12) is located in the middle of the main support (1). The fixed branch (22) is connected to the branch section (12). The sum of the outer diameter of the branch section (12) and the outer diameter of the fixed branch (22) is not greater than the outer diameter of the main section (11).

9. The thoracic and abdominal aortic endovascular stent graft according to claim 1 or 2, characterized in that, The outlet end of the adaptive branch (21) is connected to the corresponding blood vessel through a bridging stent. The proximal end of the bridging stent is connected to the inner layer stent (211) of the adaptive branch (21), and the distal end of the bridging stent is placed in the corresponding branch blood vessel, thereby realizing the bridging of the thoracic and abdominal aortic stent graft with the branch blood vessel.

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

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