The present invention relates to the technical field of medical devices, and particularly to a segmented covered stent and a preparation method therefor.
The middle layer of the artery wall of normal human blood vessels is rich in elastic fibers, and can dilate and contract with the heartbeat to deliver blood. If the middle layer of the artery wall is damaged, the elastic fiber breaks and fibrous scar tissue is formed instead. As a result, the artery wall loses its elasticity, and cannot withstand the impact of blood flow, which causes the bulging of blood vessel walls or tearing of intima, forming an aortic aneurysm or dissection. Aortic dissection is a life-threatening aortic disease with rapid progress and high mortality, wherein the incidence is about 0.3%, the early mortality without treatment increases by 1% per hour, and more than 50% of patients will die within one week.
With the development of medical technologies, more and more surgical methods such as open surgery, hybrid surgery or minimally invasive surgery are adopted for the active treatment of life-threatening aortic diseases. Endovascular aortic repair is such a technology that a covered stent is placed at the lesion site by a minimally invasive method to isolate the lesion, and effectively protect the aortic aneurysm wall from the compression of systemic arterial pressure, thus preventing the aortic aneurysm and dissection rupture.
By virtue of small trauma and definite treatment effect, endovascular aortic repair has become an important option in the treatment of type B aortic dissection and subrenal abdominal aortic aneurysm. However, for lesions that are adjacent to or involve the main branch vessels that need to be preserved, for example, type A dissection involving the ascending aorta and aortic arch, or abdominal aortic aneurysm involving the renal artery and important branches thereof, the conventional method at present is to replace the pathological artery with an artificial blood vessel by means of open surgery. During open surgery, the aortic blood flow needs to be completely blocked for a certain period of time and to a certain extent, which requires the close cooperation of surgery, anesthesia and extracorporeal circulation with the operating room. Currently, only a few hospitals have the ability to perform aortic surgery. In addition, due to the long-time extracorporeal circulation, myocardial blockage and body temperature fluctuations during aortic surgery, the postoperative mortality of aortic surgery and the incidence of other systemic complications are significantly higher than other cardiac surgeries, especially for the surgeries involving the aortic arch. Type A dissection account for 80% of the patients having dissection, and due to the difficult open surgery and the high incidence of postoperative complications, the open surgery is difficult to be deployed widely. New technologies have always been proposed and applied to extend the scope of use of minimally invasive endovascular aortic repair in recent years, for example, covered stents with branches, fenestration technology, chimney grafts, periscope grafts, and bypassing by hybrid surgery to preserve the blood supply of important branch vessels.
It is very difficult to guide the branches of an integrally formed stent with branches to in branch blood vessels and release them therein, and only single-branch stents are successfully used in minimally invasive surgery in clinic at present. The aortic arch has three important branches, and the distances therebetween and positions thereof are greatly different for different individuals. Multi-branch stents have been reported for clinical use in open surgery. However, it is very difficult to guide a stent with three branches into the corresponding branch vessels at the same time even in open surgery. The fenestration technology is to form a hole in a covering membrane of the covered stent at a position corresponding to an opening of a branch vessel, to maintain the blood supply in the branch vessel. When a fenestrated stent is positioned, it only requires to align the hole with the branch vessel as much as possible, and the operation is relatively simple. Therefore, the fenestration technology can be applied when the blood flow in multiple branches is preserved, however, it may readily cause type I endoleak. The chimney graft is similar to the periscope graft, and both of them have a small covered stent placed side by side outside the covered stent, for connecting a branch vessel to the aorta. This technology is currently mostly used to preserve a branch vessel. However, the covered branch stent is likely to be blocked by the compression of the aortic stent. In addition, because the covered stents are placed side by side, type I endoleak also tends to occur. Therefore, there is an urgent desire in clinic to develop a covered stent that is more suitable for branch vessels.
In view of this, the present invention provides a segmented covered stent suitable for a branch vessel. The following specific technical solution is adopted.
A segmented covered stent is provided, which includes a covering membrane and a support frame fixed to the covering membrane. The support frame includes an annular structure and a spiral structure, the annular structure is an annular structure formed by a plurality of first wave-shaped units connected end to end; and the spiral structure is a tubular structure formed by a plurality of second wave-shaped units connected end to end and arranged in a continuous spiral manner, and an overall extension direction of the spiral structure is parallel to the support frame.
Preferably, the annular structure includes a first annular structure and a second annular structure.
The support frame includes a proximal annular support frame, a middle spiral support frame, and a distal annular support frame in sequence from a proximal end to a distal end, wherein the proximal annular support frame incudes a plurality of first annular structures parallel to each other, the middle spiral support frame has a spiral structure, and the distal annular support frame includes a plurality of second annular structures parallel to each other.
Preferably, each of the first wave-shaped units includes a first peak, a first bar, and a first valley, with the first bar connecting the first peak to the first valley, circumferentially adjacent first bars are connected at a position adjacent to a proximal end to form a first peak, and circumferentially adjacent first bars are connected at a position adjacent to a distal end to form a first valley; and wherein each of the second wave-shaped units includes a second peak, a second bar, and a second valley, with the second bar connecting the second peak to the second valley, circumferentially adjacent second bars are connected at a position adjacent to a proximal end to form the second peak, and circumferentially adjacent second bars are connected at a position adjacent to a distal end to form the second valley.
Preferably, the first peak and the first valley of axially adjacent two loops of first wave-shaped units are located on a same axial axis.
Preferably, the first annular structure includes a first start bar, a first end bar, and a plurality of first wave-shaped units connected between the first start bar and the first end bar, wherein the first start bar is the first one of the first bars in a loop of the first annular structure, and the first end bar is the last one of the first bars in the loop of the first annular structure; and wherein the first start bar and the first end bar are connected by winding, welding, or being fixed by a steel sleeve.
Preferably, the first end bar of the first annular structure includes a first end extension section, wherein the first end extension section extends to a start position of an adjacent first annular structure, and the first end extension section forms the first start bar of the adjacent first annular structure, to thereby connect the two adjacent first annular structures.
Preferably, the second annular structure includes a second start bar, a second end bar, and a plurality of first wave-shaped units connected between the second start bar and the second end bar, wherein the second start bar is the first one of the first bars in a loop of the second annular structure, and the second end bar is the last one of the first bars in the loop of the second annular structure; and wherein the second start bar and the second end bar are connected by winding, welding, or being fixed by a steel sleeve.
Preferably, the second end bar of the second annular structure includes a second end extension section, wherein the second end extension section extends to a start position of an adjacent second annular structure, and the second end extension section forms the second start bar of the adjacent second annular structure, to thereby connect the two adjacent second annular structures.
Preferably, the middle spiral support frame includes a spiral start bar, a spiral end bar, and a spiral portion connected between the spiral start bar and the spiral end bar, wherein the spiral start bar is the first one of the second bars of the middle spiral support frame, and the spiral end bar is the last one of the second bars of the middle spiral support frame in a spiral extension direction.
Preferably, a proximal end and/or a distal end of the middle spiral support frame is/are connected to the annular structure by winding, welding or being fixed by a steel sleeve.
Preferably, the spiral start bar includes a spiral start extension section, wherein the spiral start extension section is connected to one of the first bars of the first annular structure, to connect the proximal annular support frame to the middle spiral support frame.
Preferably, the expression that “the spiral start extension section is connected to one of the first bars of the first annular structure” includes the spiral start extension section being connected to one of the first bars of the first annular structure closest to the middle spiral support frame.
Preferably, the spiral end bar includes a spiral end extension section, wherein the spiral end extension section is connected to one of the first bars of the second annular structure, to connect the middle spiral support frame to the distal annular support frame.
Preferably, the expression that “the spiral end extension section is connected to one of the first bars of the second annular structure” includes the spiral end extension section being connected to one of the first bars of the second annular structure closest to the middle spiral support frame.
Preferably, the second peaks of axially adjacent two second wave-shaped units are located on a same axial axis.
Preferably, the middle spiral support frame extends from the proximal end to the distal end, the middle spiral support frame includes a spiral portion formed by a plurality of spiral units, and each spiral unit has a spiral angle of 1° to 75°.
Preferably, the support frame is formed by a woven continuous wire.
Preferably, the continuous wire is a single-strand metal wire or a composite wire composed of a plurality of metal wires.
Preferably, the proximal annular support frame has a strength greater than a strength of the middle spiral support frame.
Preferably, a wire diameter of the metal wire used in the proximal annular support frame is larger than wire diameters of the metal wires used in the middle spiral support frame and in the distal annular support frame.
Preferably, a rigidity of the metal wire material used in the proximal annular support frame is greater than a rigidity of the metal wire material used in the middle spiral support frame.
Preferably, the support frame has a straight tube structure with consistent diameter or a conical tube structure with inconsistent diameters.
Preferably, the distal annular support frame includes a transitional second annular structure, wherein the second annular structure is provided at a side of the transitional second annular structure away from the proximal annular support frame; the transitional second annular structure has a flared with a diameter thereof gradually increasing in a direction from the proximal end to the distal end.
Preferably, the covering membrane includes an inner covering membrane and an outer covering membrane, wherein the support frame is arranged between the inner covering membrane and the outer covering membrane, the inner covering membrane is located inside the support frame, and the outer covering membrane is located outside the support frame.
Preferably, the segmented covered stent further includes at least one marker member.
The present invention also provides a method for preparing a segmented covered stent, which includes:
wrapping an inner covering membrane around a covering membrane applying mold rod;
mounting a support frame around a periphery of the inner covering membrane, wherein the support frame is in close contact with the inner covering membrane; and
wrapping an outer covering membrane around the support frame.
The present invention has the advantages as follows. The annular structure in the segmented covered stent provided in the present invention provides a good radial support ability to reduce the compressive force subjected to, the spiral structure has good flexibility, to adapt to the shape change for various curved and arch-shaped branch vessels, and the annular structure and the spiral structure are combined to adapt to different requirements of different branch vessels regarding the flexibility of the covered stent.
Preferred embodiments of the present invention will be described below. It should be noted that those skilled in the art can make various modifications and variations to the embodiments without departing from the spirit and scope of the present invention, and these modifications and variations should fall into the scope claimed by the present invention.
Referring to
In a further embodiment, the annular structure 1200 includes a first annular structure 1210 and a second annular structure 1220. The support frame 110 includes, from a proximal end A to a distal end B, a proximal annular support frame 111, a middle spiral support frame 112 and a distal annular support frame 113 in sequence. The proximal annular support frame 111 includes a plurality of first annular structures 1210 parallel to each other. The middle spiral support frame 112 has a spiral structure 1300. The distal annular support frame 113 includes a plurality of second annular structures 1220 parallel to each other. In the embodiment, the middle spiral support frame adopts a spiral structure 1300, having very good flexibility to adapt to shape change for various curved and arch-shaped branch vessels; and the proximal annular support frame 111 and the distal annular support frame 113 has annular structures 1200, so that the entire support frame 110 provides a good radial support force at two ends, to stabilize the support frame 110.
Referring to
In a further embodiment, the length of the first bar 1111 in the first wave-shaped unit 1100 is 3-10 mm. The angle formed by the extension lines of two adjacent first bars 1111 is 30-150 degrees. The height of the first wave-shaped unit is 3-10 mm. In a further embodiment, within the proximal or distal annular structure, the first peak 1112 and first valley 1113 of axially adjacent two rings of first wave-shaped units 1100 are located on the same axial axis. For example, the peak 1112a and the valley 1113 in
Referring to
In a further embodiment, the length of the second bar 1411 in the second wave-shaped unit 1400 is 3-10 mm. The angle formed by the extension lines of two adjacent second bars 1411 is 30-150 degrees. The height of the second wave-shaped unit is 3-10 mm.
In a further embodiment, within the middle spiral structure, the second peaks 1412 of axially adjacent two second wave-shaped units 1400 are located on the same axial axis. For example, the second peak 1412 and the axially adjacent second peak 1412a in
Referring to
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In a further embodiment, the proximal end and/or the distal end of the middle spiral support frame 112 is/are connected to the annular structure 1200 by winding, welding or being fixed by a steel sleeve.
Referring to
It can be understood that referring to
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It can be understood that the spiral start extension section 1123 may be connected to the first bar in the first annular structure 1210 at any position in the proximal annular support frame 111. That is, the spiral start bar 1121 of the middle spiral support frame 112 may extend into the proximal annular support frame 111, thereby further improving the stability of the overall structure of the stent.
The spiral end bar 1122 includes a spiral end extension section 1126, which is connected to one of the first bars 1111b in the second annular structure 1220b, to connect the middle spiral support frame 112 to the distal annular support frame 113. The spiral end extension section 1126 is connected to one of the first bars 1111b in the second annular structure 1220b by winding, welding, or being fixed by a steel sleeve. In
It can be understood that the expression that “the spiral end extension section 1126 is connected to one of the first bars 1111b in the second annular structure 1220b” includes the case that the spiral end extension section 1126 is connected to the second end bar 1222b in the second annular structure 1220.
In a further embodiment, the expression that “the spiral end extension section 1126 is connected to one of the first bars 1111b in the second annular structure 1220b” includes the case that the spiral end extension section 1126 is connected to one of the first bars 1111b in the second annular structure 1220b closest to the middle spiral support frame 112. The second annular structure 1220b closest to the middle spiral support frame 112 is the second annular structure 1220b as shown in
It can be understood that the spiral end extension section 1126 may be connected to the first bar in the second annular structure 1220 at any position in the distal annular support frame 113. That is, the spiral end bar 1122 of the middle spiral support frame 112 may extend into the distal annular support frame 113, thereby further improving the stability of the overall structure of the stent.
The proximal and distal ends of the middle spiral support frame 112 are respectively connected to the annular structures, such that the support frame 110 is connected together as a whole. With interaction between various segments, the support frame 110 has a higher stability in radial and axial directions.
Referring to
It can be understood that the transitional second annular structure 1220b has a smallest diameter at a position close to a proximal end A, and the smallest diameter is equal to that of the middle spiral support frame 112. The transitional second annular structure 1220b has a largest diameter at a position close to a distal end B, and the largest diameter is equal to that of the second annular structure 1220, so as to well connect the middle spiral support frame 112 to the second annular structure 1220 in the distal annular support frame 113.
In a further embodiment, the proximal annular support frame 111 has an axial length of 5-50 mm.
In a further embodiment, the middle spiral support frame 112 extends from the proximal end A to the distal end B. The middle spiral support frame 112 includes the spiral portion 1124 having a plurality of spiral units 1125. Each spiral unit 1125 has a spiral angle of 1-75°. Preferably, the spiral unit 1125 has a spiral angle of 5-45°. Within the above spiral angle range, the middle spiral support frame 112 has a very good flexibility, and can be bent freely, to adapt to various curved or arch-shaped blood vessels.
Referring to
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In a further embodiment, the support frame 110 is formed by a woven continuous wire. The continuous wire may be a single-strand wire, or a multi-strand wire. The material of the wire may be selected from metal materials or polymer materials, wherein the metal material can be selected from stainless steel, cobalt alloys, tantalum, nickel titanium alloys, or other biocompatible metals; and preferably shape memory alloys. The multi-strand wire can be formed by twisting or weaving multiple strands of wires, wherein the material of the multiple strands of wires may be the same or different.
In a further embodiment, the continuous wire is a single metal wire or a composite wire composed of a plurality of metal wires, for example, stainless steel cobalt alloys, tantalum, nickel titanium alloys, or other biocompatible metals, preferably shape memory alloys, and more preferably nickel titanium alloys. The woven support frame 110 formed by a continuous metal wire has an increased stability.
Referring to
In a further embodiment, the wire diameter of the metal wire used in the middle spiral support frame 112 is smaller than the wire diameter of the distal annular support frame 112, to ensure that the middle spiral support frame 112 has good flexibility. Preferably, the wire diameter of the metal wire used in the middle spiral support frame 112 is 0.25 mm.
Referring to
In a further embodiment, the inner covering membrane 121 and the outer covering membrane 122 are each formed as one piece.
In a further embodiment, the inner covering membrane 121 and the outer covering membrane 122 are together formed as one piece, to make the segmented covered stent firmer. It can be understood that the inner covering membrane 121 and the outer covering membrane 122 can be formed as one piece by thermal bonding.
In a further embodiment, the segmented covered stent 100 may further include at least one marker member 130, which may be arranged annularly or along a track of
Referring to
Step S100: wrapping an inner covering membrane 121 around a covering membrane applying mold rod 123.
Step S200: mounting a support frame 110 around a periphery of the inner covering membrane 121, wherein the support frame 121 is in close contact with the inner covering membrane 121; and the support frame 110 may be anyone of the support frames according to the above embodiments.
Step S300: wrapping an outer covering membrane around the support frame.
The above embodiments are only several implementations of the present application, which are described specifically and in detail, without limitation to the scope claimed by the present application. It should be noted that those skilled in the art can make various modifications and variations to the embodiments without departing from the spirit and scope of the present application, and these modifications and variations should fall into the scope claimed by the appended claims.
Filing Document | Filing Date | Country | Kind |
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PCT/CN2019/091935 | 6/19/2019 | WO |