Aortic Arch Stent Graft Hybrid Repair Method
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Solution Overview
Problem
Current methods for treating aortic arch diseases, such as aortic dissection, require prolonged circulatory arrest and cerebral perfusion times, increasing surgical risk and recovery time.
Innovation Solution
A method involving extracorporeal circulation with low body perfusion and normal-flow cerebral perfusion, where an incision is made on the ascending aorta, an intraoperative stent is delivered and expanded in the aortic arch, and the thoracic aorta is blocked between the incision and arch branch vessel to allow early recovery of low body perfusion, reducing circulatory arrest time.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a pure surgical method is used to treat aortic arch diseases, then the operation can be performed, but the surgical operation time and extracorporeal circulation time are long, and the bleeding amount is large
Solution Approach 1:
The patent combines surgical method with endovascular technique in a hybrid approach. The surgical team performs thoracotomy and establishes extracorporeal circulation, while the interventional team delivers and expands the stent graft endovascularly. This merging of two different technical approaches allows the operation to benefit from both surgical control and endovascular efficiency, significantly reducing operation time and bleeding while maintaining treatment effectiveness.
2Productivity
If a hybrid method is used to implant replacement stent, then the operation time and extracorporeal circulation time are shortened, but the circulatory arrest time and cerebral perfusion time remain long
Solution Approach 1:
The patent establishes extracorporeal circulation with selective cerebral perfusion before performing the aortic arch repair. The cerebral perfusion circuit is prepared and activated in advance, allowing the brain to receive protected blood flow during the circulatory arrest period. This preliminary preparation enables the surgical team to clamp the aorta and perform the stent graft implantation while the brain remains protected, effectively reducing the impact of circulatory arrest time.
3Loss of time
If the thoracic aorta is blocked between incision and arch branch vessel, then low body perfusion can be recovered early, but the cerebral perfusion flow must be reduced during incision formation
Solution Approach 1:
The patent uses an extracorporeal circulation system with a membrane oxygenator as an intermediary to maintain cerebral perfusion during periods when direct aortic flow is reduced or interrupted. When the thoracic aorta is blocked, the cerebral perfusion circuit continues to deliver oxygenated blood to the brain through the extracorporeal system, acting as a mediator that decouples the blockage from its harmful effects on cerebral blood flow.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This approach reduces circulatory arrest time, minimizes ischemia time for visceral organs and lower limbs, and enhances patient recovery by allowing earlier resumption of normal cerebral and body perfusion.
Implementation Method 1
radially expanding the distal section of the intraoperative stent
Data Source
AI summary
In a method for treating an aortic arch disease, after an intraoperative stent is expanded in an aorta and at least one arch branch vessel, and before the vessel is exactly anastomosed with an incision, by blocking a thoracic aorta between the incision and an arch branch vessel closest to the incision, the intraoperative stent in the thoracic aorta is also blocked, so that blood is prevented from flowing from the incision, and a proximal orifice of the intraoperative stent, and the low body perfusion may be recovered in advance, thereby reducing the circulatory arrest time of the low body perfusion and reducing the time of ischemia of visceral organs and lower limbs of a patient. Meanwhile, the flow of a cerebral perfusion through the right axillary artery may be recovered to a normal flow in advance, and the time of ischemia of the brain of the patient is reduced.