The invention relates to the technical field of medical devices, and particularly relates to a stent graft, in particular to a staged release aortic stent graft used for interventional treatment of aortic diseases.
Aortic aneurysm refers to the locally or diffusely abnormal expansion of the aortic wall, which compresses the surrounding organs and causes symptoms. According to structure, aortic aneurysms can be divided into true aortic aneurysms, false aortic aneurysms, and dissecting aortic aneurysms. Aortic aneurysms cause an increase in the medial pressure of the blood vessels, so they are progressively enlarged. If they develop for a long time, they eventually rupture, and the larger the tumor, the greater the possibility of rupture. According to statistics, without surgical treatment, 90% of those who have thoracic aortic aneurysms die within 5 years, and ¾ of those who have abdominal aortic aneurysms die within 5 years.
Thoracic aortic endovascular repair is currently used to treat aortic ectasia lesions such as aortic dissection, aortic penetrating ulcer, aortic intermural hematoma, thoracic aortic aneurysm, and pseudoaneurysm. And since the first case of abdominal aortic endovascular repair has been used in the treatment of abdominal aortic aneurysms in the 1990s, because of its advantages of low trauma, short operation and hospital stay, fast postoperative recovery, low perioperative mortality and complication rate, etc., it is rapidly developing in just 20 years.
Aortic lumen repair often uses an expandable stent graft as a treatment device. In order to maintain good adherence to the blood vessel to be repaired, the diameter of the stent graft after release is generally greater than about 10% of the diameter of the blood vessel and completely released stent graft is adhered to the blood vessel, so it cannot be readjusted even when the release position is imprecise, which requires the operator to have extensive experience and spends more time to accurately locate the angle of release of the stent graft before the stent graft is released, thus we need to develop a stent that can adjust its position when the stent is released in the blood vessel.
The technical problem to be solved by the present invention is to provide a staged release aortic stent graft which can be accurately positioned during release and has high stability during assembly in view of the defects of the prior art.
The technical solution adopted by the present invention to solve its technical problems is:
A staged release aortic stent graft, comprising a tubular covering and annular support frames, and the connectors for a release guide wire to pass through are arranged axially from the proximal end to the distal end on the covering, and at least two columns of the connectors are arranged axially with spacing.
Further, in the staged release aortic stent graft, preferably the connector is a closed-loop structure or an open-loop structure for the release guide wire to pass through or wind around; the closed-loop structure is a through hole on the connector for the release guide wire to pass through, or a through hole or a gap surrounded by the connector cooperated with the covering for the release guide wire to pass through, and the open-loop structure has a limit groove for the release guide wire to pass through.
Further, in the staged release aortic stent graft, preferably the connector is a flexible connection buckle arranged on the covering or a flexible connection buckle that can be attached and fixed on the covering.
Further, in the staged release aortic stent graft, preferably the connector is a coil fixed on the outer wall surface of the covering; or, the connector is a piece of wire fixed axially with spacing, and a gap for the release guide wire to pass through is formed between the fixed wire with spacing and the covering; or, the connector is a through hole formed in the covering; or, the connectors are at least two columns of flexible connection buckles with the limit groove, and the openings of the limit grooves in different columns are arranged in the opposite direction.
Further, in the staged release aortic stent graft, preferably a plurality of axially arranged support rods are fixed with spacing at least at the proximal end along the circumferential direction on the covering.
Further, in the staged release aortic stent graft, preferably the support rod is fixed on the outer wall or the inner lumen wall surface of the covering, and the connector is fixed on the outer wall surface of covering that corresponding to the support rod, or the connector is arranged on the support rod or the covering around the support rod.
Further, in the staged release aortic stent graft, preferably the support rod is fixed on the covering by sewing, heat sealing or bonding.
Further, in the staged release aortic stent graft, preferably at least one fixing point for fixed connection with the covering is arranged on the support rod, and the fixing point is a connection hole or an opening slot with an opening arranged on the support rod.
Further, in the staged release aortic stent graft, preferably the support rods are arranged parallel to the central axis of the stent graft; or the support rods are arranged with each other in a shape of a figure eight expressed in Simplified Chinese or a shape of an inverted figure eight expressed in Simplified Chinese.
Further, in the staged release aortic stent graft, preferably the stent graft is a tubular structure extending with an equal diameter or a non-equal diameter.
Further, in the staged release aortic stent graft, preferably a fenestration for arranging branch stents or branch blood vessels is arranged at the proximal end or middle of the stent graft.
Further, in the staged release aortic stent graft, preferably the connectors are arranged at both sides of the fenestration, for restraining a portion of the stent graft behind the fenestration.
Further, in the staged release aortic stent graft, preferably the stent graft is a tubular structure extending with a non-equal diameter, which comprises a main body section and an extension section, and the diameter of the main body section is greater than the diameter of the extension section, and a transition section is arranged between the main body section and the extension section; a fenestration for placing branch stents or branch blood vessels is arranged at the main body section or/and the transition section.
Further, in the staged release aortic stent graft, preferably the connectors are arranged at both sides of the fenestration of the main body section and the transition section, for restraining a portion of the stent graft behind the fenestration.
Further, in the staged release aortic stent graft, preferably a plurality of axially arranged support rods are fixed with spacing at least at the proximal end along the circumferential direction on the covering, and the support rod is fixed on the outer wall or the inner lumen wall surface of the covering, and the connectors are fixed on outer wall surface of covering that corresponding to the support rods, or the connectors are arranged on the support rods or the covering around the support rods.
The invention provides a stent graft, which is provided with a plurality of connectors on the covering, and the stent graft is folded between the two columns of connectors, that is two or more adjacent connectors are drawn closer, and a release guide wire of the delivery device passes through the connectors; after the restraint, the stent graft can maintain a semi-deployed state in the blood vessel to be repaired, and the diameter of the stent graft in semi-deployed state is smaller than the diameter of blood vessel, and can freely rotate and move longitudinally in the blood vessel, facilitating a precise position during the release process.
There are support rods inside or outside the covering, on the one hand, the support rods can facilitate the folding of the stent graft, on the other hand, the support rods can also be used as a stud during the assembly of the stent graft, which can not only ensure the stability of the stent graft during assembly, but also ensure a semi-deployed state with stable circumferential structure after the stent graft is partially released.
The present invention will be further described below with reference to the drawings and embodiments. In the drawings:
In order to have a clearer understanding of the technical features, purposes and effects of the present invention, the specific embodiments of the present invention will now be described in detail with reference to the drawings.
In the present invention, the “proximal end” refers to the portion of the stent graft or stent graft component that near the patient's heart along the direction of blood flow, and the “distal end” refers to the portion of the stent graft or stent graft component that away from the patient's heart.
Front and rear definition: tubular surface of the stent graft with the fenestration is the front wall, and the tubular surface of the stent graft opposite the fenestration is the rear wall, and the tubular surfaces on both sides of the stent graft between the front and rear walls are the side walls.
In Embodiment 1, as shown in
The shape of the tubular covering 120 may be a straight cylindrical shape with equal diameter, or a funnel shape, a dumbbell shape, of a non-isodiametric structure, or other suitable shapes. In this embodiment the tubular covering 120 has a straight cylindrical shape with an isodiametric structure. The covering 120 is made of a polymer material with good biocompatibility. In this embodiment, a PET film is preferred, and the film thickness is 0.07 mm to 0.1 mm. The covering 120 has good mechanical strength and anti-endoleak performance.
The annular support frame 110 plays a role of supporting the covering 120. A plurality of annular support frames 110 are sequentially sewn on the covering 120 in parallel along the axial direction of the covering 120 with uniform spacing. The annular support frame 110 on the proximal end and/or the distal end of the stent graft is a bare stent partially sewn on the covering 120. As shown in
The connectors 142 are used for the release guide wire 141 to pass through axially, and serves to assist the release guide wire 141 to restrain the stent graft in the radial direction to form a semi-deployed state, as shown in
The open-loop structure is arranged with a limit groove through which the release guide wire 141 passes, that is, the connectors 142 are at least two columns of flexible connection buckles with a limit groove, and the openings of the limit grooves in different columns are arranged in the opposite direction. The release guide wire 141 successively bypasses the limiting grooves of different columns of flexible connection buckles to restrain the stent graft.
In order to prevent the connector from damaging the blood vessel during the release of the stent graft, the connector 142 is a flexible connection buckle provided on the covering or can be attached and fixed on the covering, preferably made of a biocompatible polymer material, such as polyester, and it can also choose metal material, such as metal wire.
In this embodiment, the connector 142 is a coil with a through hole, and the release guide wire 141 with a wire diameter of 0.5 mm to 1.5 mm can pass through the through hole. In this embodiment, the material of the release guide wire 141 is preferably nickel-titanium alloy wire, and the wire diameter is 0.5 mm, and the number of connectors 142 is six, and they are uniformly fixed on the covering 120 in two columns, wherein each column has three connectors 142, and those three connectors 142 are arranged axially and spaced apart. As shown in
The Embodiment 2, as shown in
A staged release aortic stent graft comprises a tubular covering 120 and annular support frames 110 fixed on the covering 120. A plurality of axially arranged support rods 130 are fixed at least at the proximal end along the circumferential direction of covering 120 on the surface of the covering 120, preferably the inner lumen wall surface, and connectors 142 for fixing the release guide wire are arranged on outer side of the covering 120 corresponding to the support rod 130.
The first function of the support rod 130, that is, the most important function is to form a stent graft in a semi-deployed state, that is, two or more adjacent support rods 130 are drawn close to each other parallel and fixed by connectors 142, during the drawing process, the support rod 130 can always maintain the flatness of the covering and the stability of the overall structure of the stent graft. The covering 120 and the annular support frames 110 between the support rods 130 are folded to reduce the diameter of the stent graft, forming a semi-deployed state, and the diameter of stent graft of semi-deployed state is smaller than the diameter of the blood vessel, so that it can rotate freely and move longitudinally in the blood vessel to adjust the position, facilitating precise positioning of the stent graft during the release process.
The support rods 130 are arranged along the axis of the covering 120 in the circumferential direction of the covering 120. The plurality of support rods 130 are preferably arranged in an axial symmetry. There are two types of positional relationship between the support rods 130: one is the support rods 130 are arranged parallel to the central axis of the stent graft; the other is non-parallel to the central axis of the stent graft, that is, the support rods 130 are arranged in a shape of a figure eight expressed in Simplified Chinese or a shape of an inverted figure eight expressed in Simplified Chinese. As shown in
The support rod 130 is arranged at least at the proximal end of the covering 120, which means that the proximal end of the support rod 130 is arranged at the proximal end of the covering 120. The support rod 130 can extend toward the distal end of the stent graft, and its extension length can be selected as needed. It can be extended to the middle of the axial direction of the stent graft, and it also can be extended to the distal end of the axial direction of the stent graft.
As shown in
The material of the support rod 130 is metal or polymer material with a certain support strength, preferably metal material, such as nickel-titanium alloy wire, with wire diameter ranging from 0.3 mm to 0.6 mm. In this embodiment, the wire diameter is preferably 0.45 mm. The structure of the support rod 130 is shown in
As shown in
The rest of the structure is the same as that in Embodiment 1, and will not be repeated here.
The Embodiment 3, this embodiment is an improvement based on Embodiment 2. Difference between the two of them: the covering 120 of the present embodiment is a tubular structure with non-equal diameter extending.
As shown in
The stent graft has a funnel-shaped structure and comprises a main body section 100A and an extension section 100C. A transition section 100B is arranged between the main body section 100A and the extension section 100C, and the diameter of the extension section 100C is smaller than the diameter of the main body section 100A. Both the main body section 100A and the extension section 100C comprise a straight cylindrical covering 120 and annular support frames 110, respectively, and the transition section 100B includes a frustum-shaped covering 190 and a funnel-shaped annular support frame 140.
As shown in
The rest of the structure is the same as that in Embodiment 2, and will not be repeated here.
The Embodiment 4, this embodiment is an improvement based on Embodiment 2.
The difference between the two of them: the stent graft of this embodiment is arranged with a long branch section 102A and a short branch section 102B at the distal end of the stent graft of Embodiment 2. That is, as shown in
The distal end of the main body stent 101 is connected with two branch sections, which respectively are a long branch section 102A and a short branch section 102B.
The long branch section 102A and the short branch section 102B are respectively arranged with branch section covering 120A and branch section covering 120B in the circumferential direction, and branch section covering 120A and branch section covering 120B are sewn together with the covering 120 of the main body stent 101 to form as a whole structure, or an integral structure integrally formed with the covering 120. The branch section covering 120A has a straight cylindrical structure with a diameter ranging from 10 mm to 14 mm and a length of 70 mm; the branch section covering 120B also has a straight cylindrical structure with a diameter ranging from 10 mm to 14 mm and a length of 30 mm. A transition zone may also be arranged between the covering 120 and the branch section covering 120A and the branch section covering 120B, for connecting the main body stent 101 to the long branch section 102A and the short branch section 102B. The length of the transition zone ranges from 10 mm to 20 mm, preferably 15 mm. The materials of the covering 120, the branch section covering 120A and the branch section covering 120B can be selected from polyester, polyurethane, ePTFE, PET or other polymer materials. In this embodiment, the material is PET film, and the thickness of the PET film ranges from 0.07 mm to 0.12 mm, preferably 0.1 mm.
The outer wall or inner wall of the branch section covering 120A and the branch section covering 120B are respectively fixed by varying amounts of branch annular stent 121A and branch annular stent 121B, which are sequentially spaced apart and sewn separately. The stent material of the branch annular stent 121A and branch annular stent 121B is preferably a nickel-titanium alloy wire with good biocompatibility and super-elasticity.
The rest of the structure is the same as that in Embodiment 2, and will not be repeated here.
The Embodiment 5, this embodiment is an improvement based on Embodiment 2 or Embodiment 3. The difference is that a fenestration 300 for arranging a branch blood vessel is disposed on the covering 120.
The covering 120 has two kinds of structure, and there are also two situations for disposing the fenestration 300. As shown in
As shown in
As shown in
As shown in
The rest of the structure is the same as that in Embodiment 2 or 3, and will not be repeated here.
The above-mentioned embodiments only express several implementations of the present invention, and their descriptions are more specific and detailed, but they should not be construed as limiting the patent scope of the present invention. It should be noted that, for a person of ordinary skill in the art, without departing from the concept of the present invention, several modifications and improvements can also be made, which all fall within the protection scope of the present invention.
Number | Date | Country | Kind |
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201711483955.7 | Dec 2017 | CN | national |
The present application is a U.S. National Phase of International Application Number PCT/CN2018/124416, filed Dec. 27, 2018, which claims priority to Chinese Patent Application No. 201711483955.7, filed Dec. 29, 2017.
Filing Document | Filing Date | Country | Kind |
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PCT/CN2018/124416 | 12/27/2018 | WO | 00 |