CN107569300A - A kind of intracavitary repair implant for treating dissection of aorta vacation chamber - Google Patents

Abstract

The invention relates to the technical field of medical devices, in particular to an intracavitary repair graft for treating the false lumen of aortic dissection, which consists of a blocking member and a delivery device, wherein: the body of the blocking member is woven from wire mesh The body is formed into a cylindrical structure, and the main body is covered with a film, so that the blocking member forms a closed cavity. The invention can be stably fixed in the dissection false cavity, effectively seals the gap and blocks the blood flow of the false cavity. This occluder is different from the existing occluder repair device that is placed in the aortic vessel to precisely cover the breach, but a closed stent graft that fully covers multiple or even all breaches , at the same time, because both ends in the axial direction are covered with membranes, it is a closed cylinder itself, and its shape and mechanics are strictly suitable for the false cavity, which can basically or even completely fill the false cavity, increasing the difficulty of blood flow in and out, Block the blood flow in the false lumen and accelerate the formation of thrombus in the false lumen.

Description

An endoluminal repair graft for the treatment of false lumen in aortic dissection

technical field

The invention relates to the technical field of medical instruments, and relates to an endoluminal repair graft for treating aortic dissection false lumen.

Background technique

Aortic dissection (AD) refers to the rupture of the aortic intima due to various reasons. The long axis of the aorta expands proximally and distally, thus forming a pathological change in which the aorta has two true and false lumens. Its onset is sudden and harmful, and the torn false lumen vessel wall is weak, which may form an aneurysm or directly rupture and cause massive hemorrhage to death. Severe ischemic necrosis, causing serious complications such as myocardial infarction, cerebral infarction or even death.

At present, endovascular repair of aortic dissection has been carried out, that is, the minimally invasive method of percutaneous stent implantation is adopted, and a straight-type endoluminal graft is implanted in the true lumen of the blood vessel to seal the dissection breach and prop up the true lumen. Restore normal blood supply, so as to achieve the purpose of treatment.

The said vascular endoluminal isolation graft is composed of a tubular wire stent and an artificial blood vessel sutured or bonded inside the stent, and the tubular wire stent is formed of a straight tube surrounded by an elastic metal wire folded in a Z shape. The artificial blood vessel is made of artificial blood vessel membrane material, and the artificial blood vessel membrane material is usually polyester (polyethylene terephthalate, English name polyethyleneterephthalate, referred to as PET). When in use, the intravascular isolation graft is compressed and loaded into the delivery device. The delivery device sends it to the aortic aneurysm through the distant femoral artery or iliac artery and then releases it. Due to the elastic force of the wire stent, it automatically returns to a straight line Tubular and close to the inner wall of the aorta, the lesion is isolated from the blood flow, thus achieving the purpose of treatment. This method does not require open surgery, is simple and minimally invasive, has definite curative effects, and has successfully treated a large number of patients.

However, due to the many intimal tears in aortic dissection, a large part of the stent implanted from the true lumen is difficult to seal, and there are a large number of branch vessels in the false lumen, which may cause endoleaks, and the blood flow in the false lumen persists, affecting the healing of the false lumen . The current endoluminal repair grafts are only suitable for implantation from the true lumen to repair the gap. Therefore, it is necessary to develop a new intraluminal graft system to repair the gap from the inside of the false lumen, block the blood flow of the false lumen, and fundamentally achieve the purpose of eliminating the false lumen.

The utility model invention patent with the application number "201420199194.8", the authorized announcement number "CN 203852449 U" and the name "aortic dissection rip occluder" discloses an aortic dissection rip occluder, which includes a bare stent body , side branch outer sheath and the occluded side branch that is compressed in the side branch sheath; the described occluded side branch also includes spring coils and spring coil microvilli, or the described occluded side branch also includes steel wire and sponge One end of the spring coil is anchored on the outer surface of the bare stent body by a connecting ring, and the microvilli of the spring coil is attached to the spring coil; one end of the steel wire is anchored by a connecting ring on the outer surface of the bare stent main body; the spongy plugging is attached to the steel wire. The utility model is to carry a plugging side branch on the basis of a bare stent main body. The bare stent not only plays the role of carrier, but also plays the role of shaping the true cavity. The plugging side branch is fixed at the gap of the interlayer and Effectively seal the gap, prevent blood flow from entering the false lumen, and induce thrombus organization and absorption in the false lumen. The gap cannot be completely covered, and the false cavity dissection between the gaps will still be impacted by blood flow, and the blood flow in the false cavity cannot be blocked.

Contents of the invention

The purpose of the present invention is to overcome the deficiencies of the prior art and provide a device that can be firmly anchored in the false lumen of aortic dissection, whose shape is completely adapted to the configuration of the false lumen, tightly seals the breach, and is compatible with the mechanical properties of the aortic false lumen. Vascular closure repair device.

In order to achieve the above object, the present invention provides an endoluminal repair graft for treating the false lumen of aortic dissection, which consists of a blocking member and a delivery device, wherein:

The body of the blocking member is a cylindrical structure woven by wire mesh, and the body is covered with a film so that the blocking member forms a closed cavity.

This occluder is different from the existing occluder repair device placed in the aortic vessel to precisely cover the breach, but a closed stent graft that fully covers multiple or even all breaches , at the same time, because both ends in the axial direction are covered with membranes, it is a closed cylinder itself, and its shape and mechanics are strictly suitable for the false cavity, which can basically or even completely fill the false cavity, increasing the difficulty of blood flow in and out, Blocking the blood flow in the false lumen and accelerating the formation of embolism in the false lumen is something that traditional stent grafts cannot do. The outer surface of the occluder is coated with a fully-enclosed film material, which can seal the gap and block the blood flow after the occluder is fully stretched, which is fundamentally different from other traditional stent-graft structures with axial through holes , can block the false lumen blood flow and seal the gap at one time. When in use, according to the location of the diseased aorta and the corresponding false lumen inner diameter, select a suitable specification model, compress the stent graft as usual, put it into the delivery device and deliver it to the false lumen and release it. Under the action, it will automatically restore to its original shape and stick to the inner wall of the false cavity, close multiple or even all the gaps, block the blood flow of the false cavity, and continue to promote the remodeling of the vessel wall. So as to achieve the purpose of rebuilding the normal blood flow channel. The delivery device is an existing delivery system for placing vascular stents, including an inner sheath and an outer sheath.

The body of the blocking member is a cylindrical structure woven by wire mesh, and the so-called cylindrical structure can be a cylindrical structure formed by laying wire mesh along the circumferential direction (that is, in the circumferential direction of the cylindrical structure The wire mesh is arranged in the direction), and it can also be a cylindrical structure formed by the wire mesh being arranged along the circumferential direction and the radial two ends (that is, the metal is jointly arranged on the circumferential direction and the radial two ends of the cylindrical structure), It is also possible to arrange the wire mesh along the circumferential direction and both ends of the radial direction simultaneously to form a cylindrical structure, and at the same time to arrange the wire mesh inside the cylindrical structure.

Preferably, a drug-carrying channel in the shape of a spiral depression is formed on the covering film outside the main body of the blocking member. A spiral concave drug-carrying channel can be formed on the outer surface of the occluder, and drugs for treatment are placed in the drug-carrying channel, for example, coagulant-promoting drugs such as thrombin and growth-promoting drugs such as fibroblast growth factor are loaded. After the occluder is sent into the false lumen for release and fixed, the drug in the drug-loaded pipeline starts to release the drug, achieving quantitative and targeted sustained release.

Preferably, the outer surface of the covering film is covered with a fluffy adsorption layer or a self-expanding sponge layer. The outer surface of the covering film may have a material layer with strong water absorption properties such as fluff and self-expanding sponge, so as to fully fill the gap between the body of the blocking member and the false cavity, and block the blood flow.

Preferably, the body is filled with self-expanding sponge. Filling the body with water-absorbing material layers such as self-expanding sponge can accelerate the absorption of blood flow into the false cavity, accelerate the accumulation of blood flow in the false cavity, block the blood flow of the false cavity, and induce rapid thrombosis of the false cavity.

Preferably, the wire mesh is in the shape of a coiled coil. The wire mesh is made of memory alloy wire, which can be made into the required spring shape at a specific temperature, and then released in the false lumen of the blood vessel after being compressed into the delivery device to restore the original shape; because the spring configuration has good The flexibility and scalability of the stent conform to the movement characteristics of the aorta, avoiding the adverse interaction force between the stent and the vessel wall, and the long-term storage in the body will not damage the vessel wall, avoiding long-term complications.

The outer surface of the blocking member is coated with a fully-closed coating material, which can close the gap and block the blood flow after the blocking member is fully stretched, which is essentially different from other traditional stent-graft structures with axial through holes. Different, it can block the false lumen blood flow and seal the gap at one time.

When in use, according to the location of the diseased aorta and the corresponding false lumen inner diameter, select a suitable specification model, compress the stent graft as usual, put it into the delivery device and deliver it to the false lumen and release it. Under the action, it will automatically restore to its original shape and stick to the inner wall of the false cavity, close multiple or even all the gaps, block the blood flow of the false cavity, and continue to promote the remodeling of the vessel wall. So as to achieve the purpose of rebuilding blood flow.

It can be loaded with procoagulants such as thrombin, growth-promoting drugs such as fibroblast growth factor (3). The surface of the film can be provided with fluff, water-absorbable swellable sponge, etc., so as to fully fill the false cavity and block the blood flow. The inside of the bracket can also be filled with water-absorbable expandable sponge and the like.

Preferably, the diameter of the blocking member is 10-50mm, and the length is 100-300mm. According to the shape of the false lumen, choose and place an appropriate occluder.

Preferably, the blocking member is in the shape of a dumbbell with the middle retracted and both ends flared outward. The dumbbell-shaped occluder with adduction in the middle and expansion at both ends is suitable for placing in a false lumen with a narrow middle part and enlarged ends at both ends or pathological structure of an arteriovenous fistula.

Preferably, the blocking member is in the shape of a spindle filament. The spindle-shaped occluder is suitable for placing in the middle of the false lumen swollen into an aneurysm shape/or in the pathological structure of aortic pseudoaneurysm.

Preferably, several catch nets are provided inside the blocking member along its radial direction, and the ends of these catch nets are all connected to the metal support ring. The capture net serves the purpose of creating deposition points, capturing blood clots, inducing rapid thrombosis of the false lumen, accelerating the accumulation of blood flow in the false lumen, and blocking the blood flow of the false lumen.

Preferably, each of the metal support rings is evenly distributed with development marks. The role of the development mark is to facilitate the precise positioning operation.

The invention can be stably fixed in the dissection false cavity, effectively seals the gap and blocks the blood flow of the false cavity. This occluder is different from the existing occluder repair device placed in the aortic vessel to precisely cover the breach, but a closed stent graft that fully covers multiple or even all breaches , at the same time, because both ends in the axial direction are covered with membranes, it is a closed cylinder itself, and its shape and mechanics are strictly suitable for the false cavity, which can basically or even completely fill the false cavity, increasing the difficulty of blood flow in and out, Blocking the blood flow in the false lumen and speeding up the formation of embolism in the false lumen is something that traditional stent grafts cannot do. The outer surface of the occluder is coated with a fully-enclosed film material, which can seal the gap and block the blood flow after the occluder is fully stretched, which is fundamentally different from other traditional stent-graft structures with axial through holes , can block the false lumen blood flow and seal the gap at one time.

Description of drawings

Fig. 1 is a structural representation of the present invention;

Figure 2 is a top view of the present invention.

in:

1-Metal support ring 2-Film 3-Drug-carrying pipe

4- Capture Mesh A- Abdominal Aorta A1- True Lumen

A2-false lumen b1, b2, b3, b4-slit C-renal artery

D-iliac artery

detailed description

The present invention will be further described below in conjunction with the accompanying drawings and specific embodiments.

Example 1:

A kind of endovascular repair graft for the treatment of aortic dissection false lumen as shown in Fig. 1, 2 is characterized in that, is made up of blocking member and delivery device, wherein:

The body 1 of the blocking member is a cylindrical structure woven by wire mesh, and the surface of the cylindrical structure is covered with a film 2 so that the blocking member forms a closed cavity.

This occluder is different from the existing occluder repair device placed in the aortic vessel to precisely cover the breach, but a closed stent graft that fully covers multiple or even all breaches , at the same time, because both ends in the axial direction are covered with membranes, it is a closed cylinder itself, and its shape and mechanics are strictly suitable for the false cavity, which can basically or even completely fill the false cavity, increasing the difficulty of blood flow in and out, Blocking the blood flow in the false lumen and accelerating the formation of embolism in the false lumen is something that traditional stent grafts cannot do. The outer surface of the occluder is coated with a fully-enclosed film material, which can seal the gap and block the blood flow after the occluder is fully stretched, which is fundamentally different from other traditional stent-graft structures with axial through holes , can block the false lumen blood flow and seal the gap at one time. When in use, according to the location of the diseased aorta and the corresponding false lumen inner diameter, select a suitable specification model, compress the stent graft as usual, put it into the delivery device and deliver it to the false lumen and release it. Under the action, it will automatically restore to its original shape and stick to the inner wall of the false cavity, close multiple or even all the gaps, block the blood flow of the false cavity, and continue to promote the remodeling of the vessel wall. So as to achieve the purpose of rebuilding the normal blood flow channel. The delivery device is an existing delivery system for placing vascular stents, including an inner sheath and an outer sheath.

Example 2:

The rest is the same as that of Embodiment 1, and a spiral concave drug-carrying pipeline is formed on the film outside the body of the blocking member. A spiral concave drug-carrying channel can be formed on the outer surface of the occluder, and drugs for treatment are placed in the drug-carrying channel, for example, coagulant-promoting drugs such as thrombin and growth-promoting drugs such as fibroblast growth factor are loaded. After the occluder is sent into the false lumen for release and fixed, the drug in the drug-loaded pipeline starts to release the drug, achieving quantitative and targeted sustained release.

Example 3:

An endoluminal repair graft for treating the false lumen of aortic dissection, the rest are the same as those in Example 2, the models of the plugging parts are 10-50mm in diameter, with a difference of 5mm, and 100-300mm in length, with a difference of 50mm. Difference.

Example 4:

An endoluminal repair graft for treating the false lumen of aortic dissection, the rest of which is the same as that in Example 2, wherein the blocking member is in the shape of a dumbbell with the middle adducted and both ends expanded. The dumbbell-shaped occluder with adduction in the middle and expansion at both ends is suitable for placing in a false lumen with a narrow middle part and enlarged ends at both ends or pathological structure of an arteriovenous fistula.

Example 5:

An endoluminal repair graft for treating the false lumen of aortic dissection, the rest of which is the same as that of Example 2, wherein the blocking member is in the shape of a spindle filament. The spindle-shaped occluder is suitable for placing in the middle of the false lumen swollen into an aneurysm shape/or in the pathological structure of aortic pseudoaneurysm.

Embodiment 6:

An endoluminal repair graft for treating the false lumen of aortic dissection, the rest of which are the same as in Example 2, and several capture nets are arranged in the radial direction of the blocking member, and the ends of these capture nets are connected to the metal on the support ring. The capture net serves the purpose of creating deposition points, capturing blood clots, inducing rapid thrombosis of the false lumen, accelerating the accumulation of blood flow in the false lumen, and blocking the blood flow of the false lumen.

Preferably, each of the metal support rings is evenly distributed with development marks. The role of the development mark is to facilitate the precise positioning operation.

The preferred embodiments of the present invention have been described in detail above, but the present invention is not limited to the described embodiments, and those skilled in the art can also make various equivalents without violating the spirit of the present invention. These equivalent modifications or replacements are all included within the scope defined by the claims of the present application.

Claims (10)

1. a kind of intracavitary repair implant for treating dissection of aorta vacation chamber, it is characterised in that by closeouts and conveying device group Into, wherein：

The body (1) of the closeouts is the cylindrical structure formed by woven wire braiding, on the surface of the cylindrical structure Covered with overlay film (2), the closeouts are made to form airtight cavity.

2. the intracavitary repair implant for the treatment of dissection of aorta vacation chamber according to claim 1, it is characterised in that described to cover The outer surface of film (2) forms the load pencil road (3) of spiral shape recess.

3. the intracavitary repair implant for the treatment of dissection of aorta vacation chamber according to claim 1, it is characterised in that described The outer surface of overlay film (2) covers villiform adsorption layer or self-inflated spongy layer.

4. the intracavitary repair implant for the treatment of dissection of aorta vacation chamber according to claim 1, it is characterised in that described Filling self-inflated sponge in body (1).

5. the intracavitary repair implant for the treatment of dissection of aorta vacation chamber according to claim 1, it is characterised in that described Woven wire is in the spring round crimped.

6. the intracavitary repair implant for the treatment of dissection of aorta vacation chamber according to claim 1, it is characterised in that described A diameter of 10-50mm of closeouts, length 100-300mm.

7. the intracavitary repair implant for the treatment of dissection of aorta vacation chamber according to claim 1, it is characterised in that described The dumbbell shaped that closeouts extend out in middle interior receipts, both ends.

8. the intracavitary repair implant for the treatment of dissection of aorta vacation chamber according to claim 1, it is characterised in that described Closeouts are thread in spindle.

9. the intracavitary repair implant for the treatment of dissection of aorta vacation chamber according to claim 1, it is characterised in that described It is radially provided with some capture nets (4) to closeouts interior edge, and the end of these capture nets (4) is both connected to the metal supporting rings (1) on.

10. the intracavitary repair implant for the treatment of dissection of aorta vacation chamber according to claim 1, it is characterised in that described Each metal supporting rings (1) on be evenly equipped with development mark.