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WO2023033488A1 - Appareil pour supporter une paroi externe d'un vaisseau sanguin - Google Patents

Appareil pour supporter une paroi externe d'un vaisseau sanguin Download PDF

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Publication number
WO2023033488A1
WO2023033488A1 PCT/KR2022/012905 KR2022012905W WO2023033488A1 WO 2023033488 A1 WO2023033488 A1 WO 2023033488A1 KR 2022012905 W KR2022012905 W KR 2022012905W WO 2023033488 A1 WO2023033488 A1 WO 2023033488A1
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WIPO (PCT)
Prior art keywords
blood vessel
vein
support
wall
artificial blood
Prior art date
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Ceased
Application number
PCT/KR2022/012905
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English (en)
Korean (ko)
Inventor
하현수
강미란
이세원
박주영
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Tmd Lab Co Ltd
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Tmd Lab Co Ltd
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Filing date
Publication date
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Publication of WO2023033488A1 publication Critical patent/WO2023033488A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2/064—Blood vessels with special features to facilitate anastomotic coupling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
    • A61M1/3621—Extra-corporeal blood circuits
    • A61M1/3653—Interfaces between patient blood circulation and extra-corporal blood circuit
    • A61M1/3655—Arterio-venous shunts or fistulae
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
    • A61B2017/1107—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis for blood vessels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
    • A61B2017/111—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis with means for removing a constriction after performing anastomosis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
    • A61B2017/1135—End-to-side connections, e.g. T- or Y-connections
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2002/068—Modifying the blood flow model, e.g. by diffuser or deflector
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2206/00—Characteristics of a physical parameter; associated device therefor
    • A61M2206/10—Flow characteristics
    • A61M2206/11—Laminar flow

Definitions

  • the present invention relates to a device for supporting the outer wall of a blood vessel, and more particularly, to a device for supporting the outer wall of a blood vessel for supporting the outer wall of an artificial blood vessel anastomosed with a vein and the outer wall of a vein when arteriovenous transplantation is performed using the artificial blood vessel.
  • a complication that occurs frequently in patients undergoing dialysis by forming the dialysis line is blockage of the dialysis line due to blood vessel stenosis.
  • abnormal blood flow disurbed flow
  • vascular endothelial cell activation and functional abnormalities resulting in inflammatory response and neointimal formation ( Neo-intima formation process progresses, resulting in vascular stenosis and thrombosis.
  • Autologous arteries and artificial vessels have physical differences in their physical properties, and there is a clear difference between the flow of arterial blood that flows in when an autologous artery is directly connected to a vein and the flow of arterial blood that enters and joins through an artificial vessel. Therefore, in order to create ideal blood flow in the AVG that connects artificial blood vessels and autologous veins, what angle should blood flow be spliced and what anatomical structure should the outer wall support of blood vessels be induced to maintain artificial blood vessels and autologous veins after surgery? Technology development is required.
  • the outer wall support of a blood vessel also accepts pulsatile blood flow that repeats contraction and relaxation. Therefore, there is a demand for the development of a technology for minimizing deformation of blood vessels due to pulsatile blood flow in relation to the AVG blood vessel outer wall support.
  • Patent Document 1 US 10849627 B2
  • Patent Document 2 US 2015/0119908 A1
  • the present invention is to solve the problems of the prior art described above, and an object of the present invention is to support the outer wall of the artificial blood vessel and the autologous vein after arteriovenous graft (AVG) connecting the artificial blood vessel and the autologous vein to provide an ideal blood flow. It is to provide a device for supporting the outer wall of a blood vessel that induces.
  • AVG arteriovenous graft
  • Another object of the present invention is to provide a device for supporting the outer wall of a blood vessel that minimizes deformation of blood vessels due to pulsatile blood flow that repeats contraction and relaxation after arteriovenous graft (AVG) connecting artificial blood vessels and autologous veins.
  • AVG arteriovenous graft
  • an artificial blood vessel support having a curved shape and arranged to surround an outer wall of an artificial blood vessel anastomosed with a vein and disposed to surround an outer wall of the vein, distal to the artificial blood vessel support
  • An apparatus for supporting an outer wall of a blood vessel including a vein support unit connected to the artificial vessel support unit at an end thereof is provided.
  • the artificial blood vessel support has an arc shape
  • the vein support has a straight shape
  • the artificial blood vessel support may intersect the vein support at the distal end.
  • the artificial blood vessel support may come into contact with the vein support at an angle of 15 degrees or more and less than 60 degrees at an intersection with the vein support.
  • the artificial blood vessel support may have a length of 15 to 25 mm.
  • a length from a connection portion with the artificial blood vessel support to a proximal end of the vein support may be 20 to 40 mm.
  • At least one of the artificial blood vessel support part and the vein support part may include a plurality of annular segments spaced apart from each other in a longitudinal direction and disposed continuously in a wave shape along the circumferential direction, and a pair of adjacent annular segments. It may include a connecting member that is connected and disposed.
  • the connecting member may include a bridge connecting a pair of adjacent troughs or a pair of ridges along the longitudinal direction.
  • the connecting member connects the peaks located on both sides of the bridge in the circumferential direction and the valleys where the longitudinal ends of the bridge are in contact, or the valleys located on both sides of the bridge in the circumferential direction and the longitudinal ends of the bridge are in contact
  • An auxiliary bridge connecting the mountain part may be further included.
  • the artificial blood vessel support portion having a curved shape and surrounding the outer wall of the artificial blood vessel anastomosed with the vein is configured to be connected to the vein support portion at a predetermined angle.
  • a plurality of annular segments that are continuously disposed apart from each other in a longitudinal direction and disposed in a wavy shape along the circumferential direction, and a connection that is disposed by connecting a pair of adjacent annular segments.
  • FIG. 1 is a diagram showing the configuration of an apparatus for supporting the outer wall of a blood vessel according to an embodiment of the present invention.
  • FIG. 2 is a view showing an anatomical structure in which blood vessel stenosis occurs frequently due to abnormal blood flow in an anastomotic portion between an artificial blood vessel and a vein.
  • FIG. 3 is a view showing examples in which an artificial blood vessel having a straight shape is anastomosed with a vein.
  • FIG. 4 shows a result of analyzing abnormal blood flow regions in the examples of FIG. 3 .
  • FIG. 5 is a view showing examples in which an artificial blood vessel having an arc shape is anastomosed with a vein.
  • FIG. 6 shows a result of analyzing abnormal blood flow regions in the examples of FIG. 5 .
  • FIG. 7 is an upper perspective view of the device for supporting the outer wall of a blood vessel according to another embodiment of the present invention.
  • FIG. 8 is a lower perspective view of the device for supporting the outer wall of a blood vessel according to another embodiment of the present invention.
  • FIG. 9 is a rear view of the device for supporting the outer wall of a blood vessel according to another embodiment of the present invention.
  • FIG. 10 is a view showing an annular segment and a connecting member of the device for supporting the outer wall of a blood vessel according to another embodiment of the present invention.
  • FIG. 11 is a graph showing the hemodynamic effect provided by the device for supporting the outer wall of a blood vessel according to another embodiment of the present invention.
  • spatially relative terms such as “front”, “rear”, “upper” or “lower” may be used to describe the correlation with components shown in the drawings. These are relative terms based on what is shown in the drawings, and the positional relationship may be interpreted in the opposite way according to the orientation.
  • 'proximal' means a position relatively close to the heart
  • 'distal' means a position relatively far from the heart in the direction of blood flow. Therefore, it can be interpreted that arterial blood proceeds in a proximal to distal direction, and venous blood proceeds in a distal to proximal direction.
  • that a component is “connected” to another component includes cases where they are not only directly connected to each other but also indirectly connected to each other unless there are special circumstances.
  • FIG. 1 is a diagram showing the configuration of an apparatus for supporting the outer wall of a blood vessel according to an embodiment of the present invention.
  • the device for supporting the outer wall of a blood vessel 100 is provided to surround and arrange an arteriovenous graft (AVG) artificial blood vessel and an autologous vein anastomosed with the artificial blood vessel.
  • AVG arteriovenous graft
  • the device for supporting the outer wall of blood vessels 100 minimizes the occurrence of abnormal blood flow in the arteriovenous graft and makes the blood flow smooth.
  • an apparatus for supporting an outer wall of a blood vessel 100 includes an artificial blood vessel support unit 110 and a vein support unit 130 .
  • the artificial blood vessel support 110 is disposed to surround the outer wall of the artificial blood vessel anastomosed with the vein.
  • the artificial blood vessel refers to an arteriovenous transplanted blood vessel that is artificially created and connects an autologous artery to an autologous vein.
  • the material of the artificial blood vessel may be polytetrafluoroethylene (ePTFE).
  • the artificial blood vessel support 110 has a curved shape. More specifically, the artificial blood vessel support 110 may have an arc shape.
  • the artificial blood vessel support 110 includes a tubular body 112 having a space inside the artificial blood vessel, an inlet 111 formed at a proximal end of the body 112, and a distal end of the body 112. It may be provided with an outlet 113 formed in.
  • Vein support 130 is provided to be disposed while surrounding the outer wall of the vein.
  • the vein refers to a vein joined to an artificial blood vessel at an arteriovenous transplant site.
  • the vein support 130 is connected to the artificial blood vessel support 110 at the distal end of the artificial blood vessel support 110 . That is, the vein support 130 may communicate with the artificial blood vessel support 110 through the outlet 113 of the artificial blood vessel support 110 .
  • Vein support 130 may have a straight shape.
  • the vein support 130 includes a distal portion 131 disposed distal with respect to a connection portion with the artificial blood vessel support 110, an anastomosis portion 132 intersecting the outlet 113 of the artificial blood vessel support 110, A proximal portion 133 disposed proximal to the connection portion with the artificial blood vessel support 110 may be included.
  • the artificial blood vessel support 110 has an arc shape
  • the vein support 130 has a straight shape
  • the artificial blood vessel support 110 intersects the vein support 130 at the distal end.
  • the artificial blood vessel support 110 may come into contact with the vein support 130 at an angle of 15 degrees or more and less than 60 degrees at an intersection with the vein support 130 .
  • the angle between the artificial blood vessel support 110 and the vein support 130 is the tangential line TL of the artificial blood vessel support 110 at the intersection of the artificial blood vessel support 110 and the vein support 103. ) and an angle ( ⁇ ).
  • the blood vessel support 110 has an arc shape and is connected to the vein support 130 at an angle of 15 degrees or more and less than 60 degrees
  • computational fluid dynamics factor analysis for verifying the effect of improving blood flow at the vascular anastomosis site explain the results.
  • FIG. 2 is a view showing an anatomical structure in which blood vessel stenosis occurs frequently due to abnormal blood flow in an anastomotic portion between an artificial blood vessel and a vein.
  • the diameter of the artificial blood vessels and veins may be assumed to be 3 mm.
  • the blood flow of arterial blood (A) flows into the inlet 111 at the highest speed in the range of 0.2 to 0.9 m/s, and is assumed to have a static pressure of 3700 to 5500 Pa at the outlet 113 , venous blood (V) can be assumed to have a constant velocity of 0.1 m/s.
  • ANSYS Fluent 20.0 was used as a software for computational fluid dynamics, and to change the partial differential equation (PDE) representing the flow into the differential equation (FDE), which is an algebraic equation, continuous
  • PDE partial differential equation
  • FVM finite volume method
  • FVM finite volume method
  • the K- ⁇ SST turbulence model was additionally applied to simulate the turbulent flow of the fluid.
  • the Carreau-Yasuda model was applied to the blood to apply the non-Newtonian model, and the density was set to 1060 kg/m 3 .
  • the maximum shear stress WSSmax (Wall Shear Stress Max), time-average wall shear stress TAWSS (Time-Average Wall Shear Stress) and alternating shear index OSI (Oscillatory Shear Index) were measured in Table 1 below. ], and areas with OSI ⁇ 0.1, TAWSS ⁇ 2 Pa, and WSSmax ⁇ 70 Pa were classified as vulnerable to atherosclerosis.
  • FIG. 3 is a view showing examples in which an artificial blood vessel having a straight shape is anastomosed with a vein.
  • the examples shown in FIG. 3 are those in which the artificial graft has a straight shape and is connected to the vein, and the artificial graft has an angle of 15 degrees and 30 degrees, respectively, to the vein. straight 30°), 45° (straight 45°), and 60° (straight 60°) angles.
  • FIG. 4 shows the result of analyzing the abnormal blood flow area in the examples of FIG. Specifically, FIG. 4 shows the area of the area of OSI ⁇ 0.1, the area of TAWSS ⁇ 2Pa, and the area of WSSmax ⁇ 70Pa in the toe area T.
  • the examples of FIG. 3 all have areas where errors occur in OSI, TAWSS, and WSSmax.
  • the artificial graft has a straight shape and forms a straight 15° with the vein, the region with OSI ⁇ 0.1 and the region with TAWSS ⁇ 2Pa are eliminated, showing relatively good blood flow, but still A region in which shear stress was high was observed with WSSmax ⁇ 70Pa.
  • FIG. 5 is a view showing examples in which an artificial blood vessel having an arc shape is anastomosed with a vein.
  • the examples shown in FIG. 5 are those in which the artificial graft has an arc shape and is connected to the vein. Round 30°), 45° (Round 45°) and 60° (Round 60°) are meeting.
  • FIG. 6 shows a result of analyzing abnormal blood flow regions in the examples of FIG. 5 . Specifically, FIG. 6 shows the area of the area of OSI ⁇ 0.1, the area of TAWSS ⁇ 2Pa, and the area of WSSmax ⁇ 70 Pa in the toe area (T).
  • the region with WSSmax ⁇ 70 Pa where a high shear force of 70 Pa or more is applied is lost regardless of the angle, and the region with OSI ⁇ 0.1 and TAWSS ⁇ 2 Pa is artificial blood vessel (Graft) vein. (Vein) has been confirmed to appear only when it forms an angle of 60 degrees. However, when the tangential angle exceeded 60 degrees, a tendency for abnormal blood flow to increase was observed.
  • Graft blood vessel
  • the artificial graft has an arc shape and is connected to the vein at an angle of 15 degrees or more and less than 60 degrees. Accordingly, the apparatus 100 for supporting the outer wall of the blood vessel according to an embodiment of the present invention needs to support the artificial blood vessel (graft) and the vein (vein) to maintain these shapes, and for this purpose, the artificial blood vessel support unit 110 In shape, the vein support 130 has a straight shape, but the artificial blood vessel support 110 is in contact with the vein support 130 at an angle of 15 degrees or more and less than 60 degrees at an intersection with the vein support 130. desirable.
  • the artificial blood vessel support 110 having an arc shape forms an angle of 30 degrees with the vein support 130, and the diameter d1 of the artificial blood vessel support 110 and the diameter of the vein support 130
  • (d2) is 3 mm
  • the radius of curvature R is 20 mm
  • the distance from the center of curvature O of the artificial blood vessel support 110 to the outermost radial side of the artificial blood vessel support 110 ( R+d1) becomes 23 mm.
  • the innermost length L1 of the artificial blood vessel support 110 in the radial direction is 25.8 mm
  • the outermost length L3 of the artificial blood vessel support 110 in the radial direction is 16.4 mm
  • the length of the artificial blood vessel support 110 is 16.4 mm. (L2) becomes 20 mm.
  • the crossing length L4 of the artificial blood vessel support 110 and the vein support 130 is 10.954 mm
  • the intersection area of the artificial blood vessel support 110 and the vein support 130 is 39.47 mm 2 .
  • the length L2 of the artificial blood vessel support 110 is preferably 15 to 25 mm for the anatomical structure of blood vessels and the convenience of the operator.
  • the length L2 of the artificial blood vessel support 110 may be 20 mm.
  • the length from the connection portion with the artificial blood vessel support 110 of the vein support 130 to the proximal end in other words, the length L5 of the proximal portion 133 is 20 to 40 mm.
  • the arc-shaped artificial vessel support 110 forms an angle of 30 degrees with the vein support 130, and the diameter d1 of the artificial vessel support 110 and the diameter d2 of the vein support 130 When each of these is 3 mm, it has been confirmed that no turbulent flow occurs in the vein even when the proximal portion 133 has a length of 20 mm.
  • FIG. 7 is an upper perspective view of the device for supporting the outer wall of a blood vessel according to another embodiment of the present invention
  • FIG. 8 is a perspective view of the lower side of the device for supporting the outer wall of a blood vessel according to another embodiment of the present invention
  • FIG. It is a rear view of the device for supporting the outer wall of a blood vessel according to the embodiment.
  • FIG. 10 is a view showing an annular segment and a connecting member of the device for supporting the outer wall of a blood vessel according to another embodiment of the present invention.
  • an apparatus 200 for supporting an outer wall of a blood vessel includes an artificial blood vessel support 210 and a vein support 230 .
  • the shape of the artificial blood vessel support part 210 and the vein support part 230, the angle formed with each other, the length of the artificial blood vessel support part 210, and the artificial blood vessel support part 210 among the vein support parts 230 The length from the connection site to the proximal end (length of the proximal portion) is the same as described in relation to one embodiment of the present invention. Therefore, detailed descriptions of overlapping contents will be omitted, and only non-overlapping contents will be described.
  • the vein support 230 has a slot 230a formed along the longitudinal direction. During the operation of the outer wall support device 200 for the blood vessel, the patient's vein can be easily inserted into the vein support 230 through the slot 230a and placed therein.
  • the vein support 230 may be made of a material that memorizes its shape depending on temperature.
  • the vein support 230 has a shape in which the slot 230a is open during surgery, but has a shape in which the slot 230a is closed so as to entirely cover the vein at a predetermined temperature (eg, body temperature). can be transformed into
  • a predetermined temperature eg, body temperature
  • the slot 230a of the vein support 230 is opened to facilitate insertion of the vein, but after surgery, the slot 230a is closed inside the patient's body, and the vein support 230 is The outer wall can be supported as a whole. Meanwhile, once the slot 230a is deformed into a closed shape, the shape may be maintained regardless of temperature.
  • vein support 230 may be made of a material that does not remember its shape, and the slot 230a may be artificially closed by a surgeon after inserting the vein.
  • both the artificial blood vessel support 210 and the vein support 230 are spaced apart in the longitudinal direction and are continuously disposed. It includes a plurality of annular segments 300 arranged in a wavy shape along the circumferential direction, and a connecting member 400 connected to a pair of adjacent annular segments 300 and disposed.
  • deformation of a blood vessel due to repeated pulsatile blood flow in an arteriovenous transplant unit can be minimized through the plurality of annular segments 300 and the connection member 400 .
  • a plurality of annular segments 300 are spaced apart in the longitudinal direction and continuously arranged, and are arranged in a wavy shape along the circumferential direction, respectively.
  • the plurality of annular segments 300 may form the artificial blood vessel support 210 and the vein support 230 .
  • the plurality of annular segments 300 may integrally form the artificial blood vessel support 210 and the vein support 230 .
  • the connecting member 400 connects a pair of adjacent annular segments 300 and is disposed.
  • the connection member 400 may include a bridge 410 connecting a pair of valleys or a pair of peaks adjacent to each other along the longitudinal direction.
  • the connecting member 400 connects the peaks located on both sides of the bridge 410 in the circumferential direction and the valley where one end of the bridge 410 in the longitudinal direction is in contact, or connects the bridge in the circumferential direction (
  • An auxiliary bridge 420 may be further included to connect valleys located on both sides of 410 and hills where one end of the bridge 410 in the longitudinal direction is in contact.
  • the bridge 410 and the auxiliary bridge 420 of the connection member 400 minimize deformation of blood vessels due to repeated pulsatile blood flow in the arteriovenous transplant. More specifically, it improves the distribution of stress applied to the inside of the apparatus 200 for supporting the outer wall of blood vessels, thereby reducing maximum stress and alleviating stress concentration. Through this, it is possible to reduce fatigue and prevent breakage of the device for supporting the outer wall of the blood vessel 200 .
  • FIG. 11 is a graph showing the hemodynamic effect provided by the device for supporting the outer wall of a blood vessel according to another embodiment of the present invention. Specifically, FIG. 11 shows that the thickness of the annular segment 300 is 0.4 mm, the diameter (r) of the valley or peak is 0.3 mm, the amplitude (A) of the valley or peak is 1.27 mm, and the length (l) of the valley or peak is 0.3 mm. 0.65 mm, the distance (S) between a pair of adjacent valleys or ridges along the longitudinal direction is designed to be 2.4 mm, and the diameter of the blood vessel is assumed to be 3 mm. The results of the analysis of hemodynamic factors are shown.
  • the connecting member 400 includes only the bridge 410 and supports the outer wall of the blood vessel without the auxiliary bridge 420.
  • a vein (Model B) disposed inside the device 200 and a vein (Model B) disposed inside the vessel outer wall supporting device 200 having both the bridge 410 and the auxiliary bridge 420 in the connecting member 400 C) decreased hemodynamic stability, such as a decrease in the WSS area of the diastolic phase (see FIG. 11(a)), low TAWSS (see FIG. 11(b)), and a decrease in OSI (see FIG. 11(c)) you can check what you see.
  • the vein (Model C) in which the connection member 400 is disposed inside the vessel outer wall support device 200 having both the bridge 410 and the auxiliary bridge 420 shows the most stable hemodynamic factor. Therefore, hemodynamic stability can be maximized when the connection member 400 includes both the bridge 410 and the auxiliary bridge 420 .

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  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
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  • Engineering & Computer Science (AREA)
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  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Medical Informatics (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne un appareil pour supporter une paroi externe d'un vaisseau sanguin. Un appareil pour supporter une paroi externe d'un vaisseau sanguin selon un mode de réalisation de la présente invention comprend: une partie de support de vaisseau sanguin artificiel qui a une forme incurvée et est disposée de façon à entourer une paroi externe d'un vaisseau sanguin artificiel anastomosé avec une veine ; et une partie de support de veine qui est disposée de façon à entourer une paroi externe de la veine, et est reliée à la partie de support de vaisseau sanguin artificiel au niveau d'une extrémité distale de la partie de support de vaisseau sanguin artificiel.
PCT/KR2022/012905 2021-09-02 2022-08-30 Appareil pour supporter une paroi externe d'un vaisseau sanguin Ceased WO2023033488A1 (fr)

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US20060195175A1 (en) * 2005-02-25 2006-08-31 Abbott Laboratories Vascular Enterprises Limited Modular vascular prosthesis having axially variable properties and improved flexibility and methods of use
JP2009502226A (ja) * 2005-07-22 2009-01-29 アーク・セラピューティックス・リミテッド ステント
US8361092B1 (en) * 2007-06-18 2013-01-29 Wilson T. Asfora Vascular anastomosis device and method
JP2018126556A (ja) * 2011-08-01 2018-08-16 ラミネート・メディカル・テクノロジーズ・リミテッド 外部血管支持体

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US20060195175A1 (en) * 2005-02-25 2006-08-31 Abbott Laboratories Vascular Enterprises Limited Modular vascular prosthesis having axially variable properties and improved flexibility and methods of use
JP2009502226A (ja) * 2005-07-22 2009-01-29 アーク・セラピューティックス・リミテッド ステント
US8361092B1 (en) * 2007-06-18 2013-01-29 Wilson T. Asfora Vascular anastomosis device and method
JP2018126556A (ja) * 2011-08-01 2018-08-16 ラミネート・メディカル・テクノロジーズ・リミテッド 外部血管支持体

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